We
are glad that you are interested in learning more about Volunteer/Donating and our work in Togo. We have
discovered that if we invest a sufficient amount of time and energy and
work hand-in-hand with the local people of Togo, we can
facilitate improvements in health, education and the local economy. |
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All
of our international coordination, fundraising, and marketing is done
through a staff of unpaid volunteers from the US and Europe. Our
on-the-ground operations are all run by local Togolese who are trained
in development, education, HIV/AIDS counseling and home-based care.
DONATETo donate please use either paypal or googlecheckout Paypal - Go to Paypal.com and send a donation to fredericoagent@googlemail.com
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Last Updated in 2010
Last Updated in 2010
| Welcome We are glad that you are interested in traveling or donating in Togo to participate in our Healthcare Program. Our goal is to enhance your medical knowledge, clinical skills and relations with patients by providing care in a cross-cultural environment in which resources are limited and challenges are plentiful. We hope that your experiences in Togo will lead to enhanced sensitivity to culture and diversity, as well as increased reliance on and improved physical diagnostic skills. |
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| Background Healthcare is neither easily accessible nor affordable for many Togolese living in the rural villages . Poverty creates a large barrier to the acquisition of healthcare in general, but in rural areas in particular. Although government-run hospitals do exist in Togo, most of the locals in the more rural village communities cannot afford consultation, treatment or pharmacy fees. Nor can they afford transport to these government clinics and hospitals, which are located in the larger towns and cities. Diarrhea, measles, tetanus, pertussis, pneumonia, and malnutrition are preventable and treatable and yet they kill thousands of people every year. Many people still die of endemic diseases like malaria, typhoid, and gastroenteritis, which are also manageable when proper treatment is available. Government-run clinics are ill equipped to handle the volume of people in need of care. Addressing the health care needs in rural villages is vital to improving the living conditions of these community members. During the summer of 2002, a group of our volunteer medical students from the United States set up a temporary health clinic in our public library on the farm. The students managed to start medical records for 487 people and distributed 24,000 vitamins. Throughout the summer of 2002, construction of a permanent medical clinic on our rural village location in Tsevie was started. |
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| On
August 12th, 2003, the Bill Selke Memorial Clinic opened its doors to
the Togolese community. The clinic consists of three examination rooms, a
nurses' station, a laboratory, a small pharmacy, a HIV/AIDS Education
Office with the potential for Pre/Post Test Counseling, a medical
records office, an administrative office and a waiting room. Doctors
and nurses are able to diagnose and treat endemic diseases and common
illnesses, stitch and dress wounds, give fluids, perform histories and
physical examinations, and other minor procedures. The clinic has not been as busy as we had initially planned due to our inconsistent supply of medications (e.g., we don’t have the funding to pay for a large stock and wide variety of medications) and the rural location of our clinic. In light of this, as we began to get a greater number of volunteer medical students and doctors, we realized that we could better utilize their knowledge and expertise by holding rotating mobile clinics in the rural villages of the Togo. In the summer of 2004, we began operating these mobile clinics in rural villages within a 1-2 hours drive of Tsevie. At the mobile clinics, acute problems are diagnosed and treated while chronic medical problems are diagnosed and then referred for follow-up. Since most Togolese live in very rural village communities where transportation is lacking or unaffordable, our mobile clinics have become the focus of our Healthcare Program. The Bill Selke Clinic is now the base of operations for our mobile clinics outreach services. The clinic still treats patients on a daily basis, but the bulk of our healthcare services are done through the mobile clinics since we can reach so many more people this way. For example, our clinic may only see 10-20 patients each day, but we see 100 patients per day on the average mobile clinic (due to the remote locations where we travel). We typically run three mobile clinics per week when we have volunteer medical students and/or doctors on the ground. During the busy summer months (June-August) when we have 4-6 Healthcare Program volunteers at any given time, we run the mobile clinics 4-5 days per week. |
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| Organization of Mobile Clinics Description of Process: The patient starts at the registration table. There they pay their consultation fee (currently 50KCFA, less than 1USD) and are given the medical record form. This form contains basic identification as well as a review of systems in Swahili to help focus the history and physical examination. The patient is then seen by the medical team (typically the volunteer in conjunction with the local healthcare worker) for further assessment and education. If the patient requires treatment, then they proceed to the pharmacy area for medications. If the patient requires referral, they are given a form describing their problem and suggested diagnostic studies that we are unable to provide. |
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| Role of Physician or Medical Student Volunteers: Each
doctor or medical student will work at a patient consultation station,
alongside a clinical officer, nurse or a translator. The volunteer
takes the lead in the patient interview, and fills out the patient
record form. The volunteer will take a history, perform a physical
examination. In collaboration with the local healthcare workers, you
will formulate a working diagnosis, prescribe medication if
appropriate, provide counseling and education, and write a referral
note if necessary. If you or the local healthcare workers are unsure
about diagnosis or management at any time, or concerned about a
patient, the patient will be referred to a local hospital. Role of Nursing Volunteers: Nurses will spend their time on the mobile clinics in a similar manner as they would back home—i.e. taking vital signs, helping to prioritize patients if there are matters that need attending to urgently, providing education, ensuring the patient understands their medical problems and empowering them to take an active role in their healthcare. Role of Liberta Togo Staff:
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| Typical Day on Mobile Clinic Volunteers report to the Bill Selke medical clinic around 8:30 AM. Mobile clinic staff will usually be there already. The nurse and pharmacist pack the medications and supplies. Everyone waits for the driver to arrive with the vehicle. The timing here can be unpredictable due to vehicle breakdowns and other ICODEI programs which also require transport. At some point in the morning the mobile clinic crew will depart for the mobile clinic venue. Transit time is anywhere from 30 minutes to 2 hours. Upon arrival at the mobile clinic site, it usually takes an hour to set up the mobile clinic. The pharmacist unpacks the medication and supplies, while other staff, locals, and volunteers set up tables and chairs for the different stations. Patient care begins when patients show up. This can be anywhere between 10:00am and 2:00pm. Patients will continue to arrive at the mobile clinic throughout the course of the day. After all the patients have been treated, the pharmacist and other staff will pack up the drugs and supplies and prepare to return home. The numbers of patients evaluated at the mobile clinics vary greatly depending on the location and the day. Upwards of 250 people have been evaluated and treated or referred on some clinics. Typically there will be between 30-100 patients per clinic. Arrival time back on the farm can vary as well, and can be as early as 2:00 PM or as late as 10:00 PM, though usually you return by 6-7pm. Potential volunteers for the healthcare program must be very patient individuals. Our clinics are not run with the efficiency and organization of a typical hospital in the developed world. It is critically important that volunteers are flexible and understanding. You will definitely not have the resources (equipment, medication, supplies) or atmosphere that you are used to having at your home country hospital. |
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| Common Medical Problems Some of the common medical problems you will see during your trip include: Malaria, Typhoid, Helminth infections (i.e. “worms”), Urinary Tract Infections, Respiratory Tract Infections (bronchitis, pneumonia, TB), skin lesions, malnutrition, diarrhea, Cellulitis, acute and chronic pain, HIV/AIDS, opportunistic infections, fungal infections, asthma, COPD (from cooking indoors), arthritis, Sciatic Pain, stomach ulcers/acid reflux, eye problems, STIs, dental problems, diabetes mellitus, hypertension, heart failure, altered mental status, Meningitis, and Sepsis. |
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| Tours of Nearby Hospitals and Clinics We can sometimes arrange for volunteers to tour other healthcare facilities in the larger towns nearby (Be, Lome, etc). Policies allow for visiting medical students and doctors to interact with patients and even enter operating theatres for the purpose of observing surgical procedures. Doctors and nurses at district hospitals are sometimes willing to answer questions and demonstrate procedures. Most often patients are willing to allow volunteers to be present during diagnosis, treatment and examination. Female volunteers have been able to observe both natural and caesarian births. Past volunteers have found this to be an interesting and educational experience. |
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| Please
keep in mind that we can’t guarantee you will be able to take any tours
due to the ever changing environment on the ground in Togo. We are in
the process of setting up some partnerships with local
clinics/hospitals so that our volunteer doctors and medical students
can work at these facilities on days when we are not running a mobile
clinic. Unfortunately, we cannot set up tours for pre-med and
undergraduate students at the local clinics and hospitals. Previously,
we were able to accommodate this. However, due to the high volume of
requests we get from undergrads for this each year, we have decided to
now only send medical students and doctors to tour and work at the
local clinics and hospitals. Paperwork for International Rotations If you are a medical student interested in coming to Togo for an international rotation, we are more than happy to assist you with any paperwork that your school may require. Please contact Dr. Edem Kodjo fredericoagent@googlemail.com if you need assistance with this. Health Education When the clinic opened in August of 2003, the intent was that it be both care-based AND education-based but to date, the focus has been on the care aspect. We are now beginning to implement facets of the educational aspect. We have produced several 1-2 hour seminars/lectures about locally relevant health concerns, which will be presented to locals. This is done either on a rotating schedule or on demands from various community groups. Topics include, but are not limited to: malaria intervention, hygiene, food/water safety, nutrition (general, maternal, child, PLWHA), sexually transmitted infections, and any other health topics deemed valuable. Volunteers involved in this program will perform research to develop the lectures and will help to produce literature on each topic. Our first health education lectures were produced in the summer of 2005. Directed towards Togolese women, they concern reproductive health issues. Since we typically only run mobile clinics three days a week, volunteers in the Healthcare Program are encouraged to give these healthcare educational seminars on off-days (unless they are scheduled to work at a nearby clinic or hospital). Potential Volunteer Qualifications and Requirements Volunteers in the Healthcare Program must have previous clinical experience. The healthcare volunteers must be doctors, nurses, or medical students. As part of your application, please include a short description of your medical education and clinical experience so that we can confirm your qualifications for the Healthcare Program. Volunteers working in this program will receive our Healthcare Program Orientation Manual before arriving in Togo. This will provide you with a lot of detailed information on our clinic and mobile clinics programs, as well as an introduction to many of the medical problems you will encounter while in Togo. The Healthcare Program is not open to undergraduate and pre-med students. However, students with an interest in healthcare can participate in our Health Education Training Programs, such as the HIV/AIDS Nutritional Training Program or the Women’s Reproductive Heath Training Program, or our AIDS Education Program. Volunteers participating in these programs must complete self-study on these topics and review our training manuals in detail before arriving in Togo. As is the case with all of our programs, volunteer are required to pay volunteer fees in order to participate in this program. These fees are what support all of our programs. Fees from volunteers in the healthcare program are used to keep our clinic running, pay salaries for our clinic staff of Togolese, buy medicine, buy medical equipment/supplies, pay for the gas and vehicle maintenance to make the 1-2 hour drives each day to set-up a mobile clinic, etc. Contact Us If you have any specific questions on this program, please contact the volunteer coordinator at fredericoagent@googlemail.com If you have general questions on volunteer placements or would like to get information on the application process, please contact our Volunteer Coordinator. | |||||||||
Last Updated in 2010
| How the School Began During 1999, Betty Lubanga, the wife of the Executive Director of Volunteer Togo, and her sister-in-law Grace noticed that many children in the community were not attending school. They decided to visit with each of the parents to find out why. It was, for the most part, a financial issue. Most parents still cannot afford the cost of uniforms, transport, books, supplies, or meals. Furthermore, older children cannot attend primary school without first attending preschool. Now, at the time that Betty and Grace were starting the preschool, there were the school fees as well as the other expenses of getting an education. This made it impossible for many families to send their children to school. |
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| So
Betty and Grace decided to start a free community preschool. Having no
separate building and no funds, they used the tiny church in the middle
of the family compound. This was a room smaller than our average
bedroom, with a rusty tin roof, crumbling mud walls, and a dusty mud
floor. Doors and windows are just open spaces left out of the walls.
Betty, Grace, and then Betty's cousin Irene worked |
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| Expanding to Include Primary Classes In July of 2001, we began constructing a new preschool near the current site. Construction was completed during August of 2001. The new preschool has two classrooms and an office, cement walls and floors, with lockable doors and windows, appropriately sized chairs and tables, a teacher's desk and cabinet for locking up supplies, chalkboards and posters on the walls. More teachers joined the school and the teachers began using the second room as a first grade (called Standard 1). As the number of students increased, it became impossible for Betty and Grace to continue to offer free schooling. They began asking parents to at least contribute what ever they could towards supplies and food for lunches. Many could not offer anything and Betty was forced to turn away children. It broke her heart every time. The enrolment kept increasing and in the summer of 2003, a third room was completed. The school, now called Epico Jahns Academy , has a pre-school class, and grades 1-6. As of 2006, there are over 300 students with more coming regularly. With the help of volunteers and donors, it is our hope that we can build a new classroom each year until we have a complete primary school. |
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| Volunteering at Epico Jahns Academy Volunteering at Epico Jahns is one of our most exciting and rewarding volunteering experiences. Our local staff of Togolese teachers is always very excited to have new volunteers join them in the classroom. Volunteers are able to teach alongside our trained staff of local teachers in their choice of Pre-school through Grade 6. If volunteers have a particular knowledge in a certain subject area (such math, geography, or science) they are encouraged to focus their experience on teaching those subject classes. Most of our volunteers at Epico Jahns have been college or graduate students who are Education majors and are looking for a once in a lifetime experience to teach at the grassroots level in rural Africa . |
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| We
have also had numerous volunteers with non-teaching backgrounds.
Volunteers have included homemakers, lawyers, retired professionals,
businessmen/women, etc. The main requirement is a love for children
and teaching, and a desire to be a part of a dynamic and interactive
classroom environment. We have also had adult volunteers who were or had been teachers in their home countries. We even had a family of four come to volunteer and the wife taught at Epico Jahns, the two young children attended class at Epico, and the husband worked on the various other Volunteer Togo programs. The students at Epico begin learning English in pre-school and by Grade 4 have very good English skills Therefore, knowledge of Swahili is not needed. Although only trained teachers and Education majors will be given the opportunity to teach unsupervised, the local teachers always welcome a helping hand and will assign tasks that are appealing to individual. Volunteers are able to contribute on whatever level they feel comfortable |
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| Sponsor a Child's Education In a separate project, before the introduction of first and second grades at Epico Jahns, Elke Jahns, a member of Outreach Togo Development Volunteers at Indiana University , set up a program with Betty to send fifteen of the pre-school children to primary school. This included the cost of uniforms, books, school supplies and other fees. Funds were collected to cover the first year. Betty made the necessary administrative arrangements, and sent Elke regular updates, as well as receipts and report cards. She was also kind enough to help the parents with the necessary errands and the children with their schoolwork. That was the beginning of our "Sponsor a Child's Education" program. Now that Epico Jahns is expanding, this program allows a student to attend the school and have all related costs covered. This includes uniforms, books, school supplies, a hot lunch, and transportation to/from school for those who live to far to walk alone. Hopefully, if this program becomes a success, Betty will never again have the daunting task of turning away a child whose only desire is to learn. The school fees we collect from the students are never enough to cover our costs of operating the school. The vast majority of our students cannot afford to pay the school fees that we are forced to charge in order to properly run the school. Therefore, we rely on the continued support of several past volunteers groups to help with our yearly running costs, as well as support from the Sponsor a Child’s Education program. Below is a summary of the Sponsor a Child fees for interested donors. |
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Contact Us For further information on volunteering at Epico Jahns or to sponsor a child’s education, please email the volunteer coordinator at fredericoagent@googlemail.com We are also happy to accept donations towards school equipment, supplies, or teacher's salaries. The school is always in need of notebooks, paper, folders, pens, pencils, teaching materials, etc. We are also hoping to build a computer lab at some point in the future. All school supply donations can be shipped directly to:
A Story from the Early Days Through the eyes of Elke, here is a glimpse of the early days at the school...... "Thank you, Teacher, Goodbye, Teacher, until we meet again..." Every day in the preschool ends with the children singing this refrain. It's been thrilling, crazy, frustrating, mind-boggling, wonderful, and nerve-racking teaching there. It's also been sweet and heart breaking. Let me tell you about Maurine. Maurine has coffee-colored skin, dark, almond-shaped eyes, and a sweet, shy smile. She is polite and quieter than most of her peers in the preschool. As the first-born of the family, she is expected to look after her brother and three sisters, walk to the mill to grind corn, collect firewood, wash clothes, clean the house, and fetch water from the river in a heavy ceramic pot she carries on her head. After two years of preschool, she knows her alphabet inside and out, can read and write several words, and do simple addition. She is ranked first in her class of forty. She and her parents hope she can attend primary school someday. At present, it doesn't seem likely. There are no free public schools in Togo . To help the poor children of the neighborhood, Betty started her own preschool in the tiny mud church in the family compound three years ago. Of her forty students, only five can pay these fees. Two others bring an occasional chicken or bag of beans. The rest rely on Betty's good heart. But that won't get them past preschool. The local primary schools cost three times as much and strictly turn away those who can't pay fees or buy uniforms. When Betty has no money to buy food for her own family, she reluctantly sends the kids home to collect late payments. Maurine knows her parents can barely afford food - school fees are out of the question. But like many others, Maurine will head down the dusty road and around the bend. Then she will squat by the roadside and wait ten minutes before returning. My dad is on his way, she says. Betty knows she won't get payment from Maurine. She will teach her anyway. But Maurine has mastered the preschool curriculum. Primary school seems impossible and time is running out. Maurine is already eleven years old. Maurine is one of fifteen neighborhood children that Betty would like to send to primary school: hard-working, enthusiastic kids who want to learn but can't pay the fees. Fourteen of these children have parents and guardians like Maurine's - people who dream of sending them to school and breaking the family cycle of poverty. Now let me tell you about Cylas. His skin is darker than Maurine's, although it is hard to tell because he is usually covered in dust from his runny nose and oversized faded blue sweater to his bare calloused feet. Even his friends will tell you that Cylas is a troublemaker. He is constantly being reprimanded for hitting, shouting, running, and throwing things. He was kicked out of his previous preschool for fighting and stealing. His father thinks school is a waste of time; his mother doesn't have much to say. Indeed, his parents don't bother much with him at all, as long as he tends the cattle, looks after his siblings, and fetches water. He's lucky if he gets one meal a day. When Betty invited him to attend her preschool, the neighbors shook their heads and warned her, "Keep a big stick handy and use it liberally. He's used to beatings at home; it's the only way to get his attention. Not that it's much use - he'll be in jail before long..." But let me tell you a little more about Cylas. He has never missed a day of school, even when he's sick. He's the first one there every morning. By the time Betty arrives, he has stacked the pews and swept out the little church with branches. He arranges the room neatly and has the other children clean up outside. When he catches sight of Betty, his whole face breaks into an enormous dimpled grin. He races to hold her hand and help carry her bags. When a visitor arrives at the preschool during break, he runs to get her. If the visitors are new parents, Betty will come to talk to them about the school, only to find that Cylas has already briefed them on the rules, uniform, fees, supplies, and 6 kg of maize each student it supposed to contribute. Because the school has no doors or windows, the chalkboard, straw mats, notebooks, and pencils are kept locked in a nearby hut where Betty's nephew Jackson lives. One morning Betty was out walking through the compound at sunrise and was surprised to find all of the supplies stacked outside Jackson 's door. When she asked her nephew about it, he explained sheepishly, "Every morning this little kid in a blue sweater comes banging on the door at an ungodly hour, asking for the preschool stuff. I just wanted to sleep in for a change." I don't know where Cylas gets his enthusiasm. Everything he does, he does with his whole heart. When he sweeps, the dust clouds fly up around him. When he fetches water to sprinkle on the mud floor, he runs back from the well so eagerly that the pitcher is half empty by the time he arrives. When the teacher asks a question, he raises his hand so high I fear he will dislocate his shoulder. When he sings in class, it is at the top of his lungs, and when he grins, he looks like he will burst with joy. He had to beg and plead with his parents to buy him a uniform, but he knows that's as much as he'll get out of them. For a while he tried Maurine's trick of waiting by the roadside when Betty sent him home for fees. Now he doesn't even bother - he just looks at her silently while tears trickle down his dusty cheeks. Despite the neighbors' advice, Betty never uses her big stick on Cylas. After months of patience and gentle explanations and corrections, Cylas fights much less and has stopped stealing entirely. He is learning slowly but steadily. Most school programs will only work with parental support - someone needs to pay fees, buy uniforms and books, check the report cards, and help with the homework. Betty knows that. But she is haunted by images of what Cylas might become. She wants him to go to school, even if it means taking over the parental role herself, even though she has to struggle to pay school fees for her own children. "Don't worry," she says as we cook dinner over the fire, "I will be a serious second mother to Cylas." I believe her. She has already started coaching Maurine on her own time after school, in hopes that she will be able to skip first grade and start in second next January. Betty has carefully selected the fifteen children (none are related to her) she would like to help sponsor, and has already begun meeting with headmasters to make the necessary administrative arrangements. She will open a separate bank account and send me updates, financial statements, and report cards, as well as monitor the children's progress, homework, and supplies. | ||||||||||
