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Exploratory trip to Ghana

Exploratory trip to Ghana in West Africa
February 13-25, 2008    
Catherine (Cate) Crowley, distinguished lecturer at Teachers College Columbia University in New York City coordinates the bilingual/bicultural program focus in the speech language pathology program. Dr. John Saxman is the program director and department chair. The two of them have established an annual, 4-week trip to Bolivia whereby select graduate students in the department participate in what has become a melding of work, study, and humanitarian outreach.  Miriam Baigorri is the clinical coordinator of the Bolivian program and a 2004 graduate of the master’s program in CSD at Teachers College. The Bolivia Project has enhanced the TC SLP graduate students’ experience of the essence of multiculturalism, created opportunities for them to develop their Spanish skills, and brought cutting edge techniques in diagnoses, intervention, and training to Bolivian children with disabilities, their families, and the professionals who work with them.

As with the student trips to Bolivia, Cate and John decide to explore Ghana as another possible place for the students to study and provide services. A country in West Africa, Ghana affords a different climate and culture for the students. Their  goals are to scout out all that will be beneficial to give the students a multi-dimensional experience of Ghana, of the best and the neediest of the clinics and schools and potential patients there, and, as always, a comprehension and a compassion for the culture, history and integrity of the people and countryside they will work with.
They invite Ewura-Abena Adomako Abdul-Mutakabbirto join them on the exploratory trip. Ewura-Abena also graduated in 2004 from the Teachers College master’s program in speech language pathology. She is a pure descendant of Ghana’s Ashanti tribe and moved to New York from Ghana twelve years ago.

Just in considering Ghana, Cate realizes there was so much potential for her students; so much to experience, witness, and absorb:  
  1. The polyglossic society in Ghana with English as the language of education and business with many tribal languages so that every Ghanaian speaks at least one of those languages.
  2. The lack of any speech language therapy program in Ghana.
  3. A presence of a number of special education teachers trained at the University of Education at Winneba.
  4. The equatorial climate; the wildlife; the traditional belief systems; the co-existence of traditional religions with the modern ones like Christianity and Islam; the proximity to jungle wild-life like elephants, warthogs, and baboons.
  5. The richness and diversity of Ghanaian cultures and linguistic groups.
  6. The positive effects of British colonialism, in terms of education.
  7. The emergence of Ghana as a model of a West African nation moving through various stages of self-determination, accountability, and stability.  
So much was planned, and yet, until schools were seen, roads were traveled, and villages were visited, nothing could be known.  The following notes, in as objective a manner as could be done, were scribed for future reference, for the formation of the Ghana Project for the program in speech language pathology at Teachers College Columbia University.  

Friday, February 15, 2008  

KORLE-BU HOSPITAL: Our first official trip is to Korle-Bu Hospital. Korle-Bu is the Teaching Hospital for the University of Ghana. Dr. Emmanuel Kitcher, Senior Lecturer, head of ENT, of the University of Ghana, meets with us. Dr. Kitcher returned to Ghana in 1990 for mission building.  Ear problems dominate here, especially middle ear infections. There was no hearing assessment clinic until 1990 when he started it.  He knows, from his ongoing study of 209 patients referred due to a speech and language delay, only 48% have hearing problems. The other 52% have speech and language delays alone, indicating the need for speech and language therapists in Ghana.   Dr Kitcher expresses concern that there is no one to do voice restorative work after he must remove a patient’s larynx. Cate’s idea, that SKYPE could be used to do long-distance training over the internet, seems a happy interim solution to Dr. Kitcher.   Dr. Kitcher and Cate speak about setting up a quasi-distance learning program to establish a master’s speech and language therapy degree from University of Ghana at Accra. Cate and he are very much of one mind, and excited and surprised at how well their plans might dovetail.    Dr. Kitcher, in poetically summing up his enthusiasm for the meeting with Cate and her colleagues from USA: “I have met a group of people who have brought to me my desire.”  And “I’ve been praying that I would meet more than one speech and language therapist – to share the joy and sorrow.”    
NEW HORIZON SCHOOL IN ACCRA: Mrs. Salome Francois is the director of the New Horizon School that she founded in 1972 for “special students.”  Mrs. Francois’s eldest daughter Helen was the inspiration/need for Mrs. Francois to begin to create this answer to the unanswered needs of special students in Ghana. Mrs. Francois won the prestigious Rose Fitzgerald Kennedy Mother’s Leadership Award in 2000.  Mrs. Francois continues to struggle with financial support, “We are in financial crisis because of the stigma attached to this kind of children; the parents do not wish to pay fees.”  “I’m serving my God this way.” Her email for the school is and the website is and; phone number 021-772878.  
 We travel by plane to Tamale the northern capital of Ghana.
Saturday/Sunday, February 16-17, 2008   
LARABANGA: One of the oldest mosques in Sub-Saharan Africa is located in Larabanga. First built about 600 years, it is made of mud and poles and a part of it can be seen in the distance in the photo at right. The gentleman at right is the mosque’s iman.
SAFARI, ELEPHANTS, BABOONS: The Mole Motel has a pool, and the pool opens itself up to local orphans.  The “chalets” into which we are booked are modest and clean, and we overlook the elephants’ watering holes, and baboons wander periodically around the grounds.  The walking tour is 2-hours long and we see an elephant feeding, some kobe (variety of antelope), hawks and birds, and glimpses of crocodile(s).  We return to the chalets atop the hill to be visited by various baboons and warthogs.  
THE VILLAGE OUTSIDE OF TAMALE: Frederick Addai ( takes over the trip, promising a surprise. He takes us to the village where he has been instrumental in providing the kids with a school and schooling.  His organization is, phone 00233-27-55303-66 in Tamale.  The village has two watering wells, and neither seems to provide sufficient water. The old mud-hut school is fascinating, useable.  The hard mud is produced by mixing cow dung with the mud which makes it dry like concrete.  The desks are jammed into each of the school-houses three rooms (each about 12 feet by 10 feet), with glass-less windows in each room and a rudimentary black-board of plywood painted dark.   On our inspection of the school, we are greeted by some of the enthusiastic loving children. They take our hands and usher us into a sample hut structure where we see the inner courtyard of a family.  There are about 4 circular huts (where a husband’s four wives stay) a mud-cow-dung floor and a square hut (for the husband).  We are then guided by Frederick to meet with the chief and the elders of the village; this is the surprise.  We sit on a grass-mat in a small hut with a staff in the middle which supports the circular thatched roof.  The chief sits on a raised platform atop an animal-skin and, greeting us with gratitude and honor, asks that we join him in his prayer that there will be water made available from God’s grace to the village. Then, outside, there is a dance, begun by the children, drummed by a magnificent drummer, and then the men teach us in a dance as we are encircled by cheering smiling children who clap in time to the staccato, feverish drumming.  We bid them formal farewells, wish them blessings, distribute some pens and pencils, leaving the rest of such with Frederick to distribute in school as he sees fit.   

KUMASI, Capital of the ASHANTI Region  
Monday, February 18, 2008
THE CHIEF LINGUIST AND THE KING OF THE ASHANTI TRIBES AT THE PALACE: We are invited to a meeting of the Ashanti Chiefs’ Council at the Manihya Palace by King’s chief linguist who is Ewura-Abena’s great uncle. The chiefs convene in this outdoor “palace” or meeting forum, and they are seated under grandly decorated umbrellas for the shade, in plastic chairs.  We sit at the side under a shady overhang, listening to the muffled, sometimes-miked deliberations.    We are struck by the concept of “protocol” here. Protocol is a word used to describe the complex system of customs, etiquette, propriety, and appropriate behaviors based on traditions primarily derived from the Ashanti, the British, and the various other tribal or European influences.  Much of protocol, for us,  has to do with honoring the hosts or family members who have helped us out along the way.  A bottle of schnapps is the customary method of paying tribute as it was back when the Europeans first brought it and used it for trade and tribute.  (Schnapps also figures strongly into the dowry a man must bring to his wife for marriage).  Liquor (along with tobacco, mirrors and perfume) was a primary means by which European slave-traders bartered with African slave-traders.  Schnapps retains an honored position in the culture even today.    

Tuesday February 19, 2008
GENERAL EDUCATION JUNIOR HIGH SCHOOL: The head-teacher at this Junior High, greets us with enormous graciousness, making sure to express his gratitude for us to have come.  Cate explains what she hopes to do with her graduate students, and asks if we could work with the students in one of the classes, and we push in on a class.  Each of the four of us takes about 15 of the students in a class, most choosing to go outside.  Miriam finds them eager to speak of the food they know how to prepare and eat.  George engages them in a debate about the value of education for girls, framing a speech-making for President forum in which a girl named Hannah and a boy named Adam-peter excel.  The schoolrooms are not that much more sophisticated than the mud-huts of the village, although the roofs are tin, the blackboards erase-able, and some of the structure is probably concrete rather than mud.  It is not horribly hot in the schools, though it is hot.   The classes we saw had over 50 students in each class.  
PRIMARY SCHOOL (GRADES 1-6): We then graciously exit and go on to the Primary School, grades 1 through 6.  We push in on a third grade.  (There are 62 children in the single classroom for the first grade; probably similar statistic for this third grade, though we did not count.)  We split up the children, again in four groups.    All the students are far and away more self-managing in terms of the kind of discipline expected in a schoolroom.  They pay attention, are so polite, no rudeness, no semi-violent horseplay even. All, in both schools, wear uniforms, boys and girls, and the classes are all co-ed.   Cate has glanced through some of the texts:  The science textbook has no text except a series of definitions of various science terms organized according to categories, like a dictionary.  The copy-books are just that; they copy from the boards and from their readers, even to the extent of creating exact replicas of the illustrations from those books (i.e., cartoon image of policeman with the word “policeman” underneath it.)  The English lesson-books are series of questions and answers and fill-in-the-blanks.  

ANGLICAN SCHOOL D-2: We spent a short time at yet one more school, not “pushing in” to the classrooms, simply meeting with the head-teacher. He mentioned that there is an autonomous kindergarten (“K-G”, he calls it) across the way, where kids go for two years before primary school.  “We have three primary schools,” he notes.  They learn Ashanti or “Twi” as a second language, but English is the language taught and spoken primarily in school.  

GARDEN CITY SPECIAL SCHOOL:   Peter and Deborah, two teachers, meet us as we await them at our car.  They bring us to meet the children who live here. There are approximately 150 students with special needs in the school with about 60 as residents and the rest as day students. Peter yearns for more accommodations. There are 500 on the waiting list. The kids are generally started in regular school, but, when the school determines them “special,” (in one case, because of failing the written tests in the regular schools), they are sent home, some waiting for admission.  The school grounds are broad, there is a playground, the children live in rooms with bunk-beds, they wear either red-and-white plaid uniforms or green-and-white plaid uniforms. The girls happily greet us; some are clearly in love with their means of helping the less competent, the non-speakers or the shy ones.  There are kids with down syndrome and kids with cerebral palsy.  Much hand-holding, some hugging, and we visit many, many of the rooms where they live.  The minimum age for admission is 8 years; they have to be able to feed themselves and to be toilet-trained to be admitted.  The many teachers employed graduated from the Winneba School for Special Students training program. We are treated to two beautiful spiritual songs sung by a group of about 10 of the children, conducted with feeling and precision by a young bright boy with Down syndrome who proudly accepts our compliments.   
February 20 Wednesday:

SUCCESS AT EFFIDUASE: We visit a “unit school” at Wesley Cathedral Methodist School in Effiduase. The Unit School system refers to there being a single (unit) classroom for “special students” on a school for general education of typically developing students. The concept of unit schools is the brainchild of Dr. Adrian Kniel a German who has spent the past six years in Ghana developing these unit schools and training the teachers at the university in Winneba.

Cate and the team are terrifically impressed with Belinda the teacher, the organization of the school, the suitability of the children’s needs.  Cate sees that they can work there using language enrichment as a byproduct. Ewura-Abena and the unit school teachers join with the children to sing in Fanti and Twi children’s songs.

KOMFO ANOKYE HOSPITAL (“G”), THE CLEFT PALATE CLINIC:    Later the team visits the room where assessments and apparently the cleft-palate operations themselves are performed. We remain there while 12 patients are seen with cranio-facial abnormalities; all but one has some kind of cleft of the lip and/or palate. The photo below is of just some of the hosptial’s cleft palate team. The TC visitors donate a See-Scape and SKYPE-ready camera to the clinic. It is hoped that the camera can be used for telepractice therapy from the TC speech and hearing clinic in New York with some of the cleft palate patients in Kumasi. Cate demonstrates the values of the See-Scape that she brought on 11 year-old Grace.  Grace had a successful operation closing her lip and palate, but she still has V.P.I. for all high-pressure sounds and comes for a follow-up evaluation.  Most babies/children lay on their mothers’ stomachs on the reclining dentist’s chair, and all were dressed immaculately in crinolines and the like, as if for their christenings.    Dr. Peter Donkor, maxillo-facial surgeon, acknowledges that we really don’t have any idea what causes cleft palates, that when people from the regions come with their superstitions that they may be caused by witchcraft, he doesn’t attempt to disabuse them of the notion.  It may very well come to be that witchcraft is someday proven to be causal, and then “we’ll have a department of Witchcraft Studies.”  


Thursday February 21:  
THE SLAVE FORT: We drive along the seacoast to St. George’s Fort in Elmina. We hear an exquisite, moving discourse about the building, maintenance, and shifting of possession (from Portuguese to Dutch to English) of this infamous slave holding-place.  The guide outdoes himself, and the moment of silence as we pray in the dungeon from which slaves were loaded into the slave-ships for their journey across the Atlantic Passage, is deeply moving.  It is a powerful, moving visit. 

Friday February 22:  
THE UNIVERSITY OF EDUCATION AT WINNEBA, WINNEBA CAMPUS:   The Winneba site is a prestigious education-directed school.  It includes a unit school for special students as well as the Winneba School for Special Students Training Program.  
The UNIT SCHOOL is amazing.  When we arrive, the children are creating a wild symphony of sound with drums, bells, singing and dancing.  We meet Florence Amenuvor. Her fellow teachers are all enthusiastic and exuberant. Mr. Alexander Oppong meets with us.    Mr. Alexander Oppong has an MSC (Masters in Science) from University of Pennsylvania near Scranton in Bloomsburg and is in charge of Education of the Deaf and Hard-of-Hearing.  Mr. Oppong is hearing and speaks Asante (Twi) as well as sign language. Mr. Oppong gives us a brief history of Deaf Education in Ghana.    The visit has been brimful with information and a great sense of confidence in the unit schools and the vision which birthed them (courtesy of Dr. Kneil).  We are given a number of texts and assessment-texts, and a book by Professor Grace Gadagbui. We learn that Dr. Kniel’s work to keep the unit school’s special education teachers apprised of current trends is a too-rare, valuable phenomenon.  

AND THE FETISH-PRIEST   We then visit the Castle at Cape Coast. Equally horrific; equally astonishing and moving that our civilization, like so many, is based upon such calculated exploitation and brutality.  In one of the deep dungeons for the male slaves, at an altar upon which are set the two stones sits a fetish-priest, a priest of the pre-European culture.  These two stones are the embodiment of the pre-European deity of the place, and the priest offers a libation and a blessing that all of us in his presence have every success and a safe return.  The ocean roars all around this castle, and, as with the last castle, there is a church (in this case an Anglican one) which rests right above one of the most mournful dungeons.    
Saturday February 23:  
We go early to Kakum National Forest, about an hour north of Cape Coast, and traverse the hanging canopy over the rain forest.  Thereafter, we stop at a Liberian Refugee Camp, and Cate questions some of the gentlemen who come up to talk to us. The men say there are at least 45,000 refugees, and that, though repatriation is being presently encouraged by the Ghanaian government, many consider it unsafe to return to Liberia (“Our lives are at risk; our homes are down.”), and the funds offered to those who would move back are meager.   
Sunday February 24:  
Today is spent in Accra revisiting Mrs. Salome Francois, Brian and Clare Shukan, and getting ready for the trip home. We have lunch with the wife of one of the three men running for president of Ghana in the December 2008 election and learn a great deal about the complexity of issues and some solutions for Ghana.
Monday February 25:
Return home.  

Possible Plans for 2009
(Based on Feburary 2008 trip)
1.     We will bring the students to the Ashanti region from around December 29, 2008 returning around January 16, 2009. We will not have placements or class on the weekends. Class will meet three times a week including one class for placement-specific discussions.

2.      We will all stay at the School of Education Guesthouse on the KUNST campus. Cost will be approximately $25 per student for a double room with breakfast included. The guest house is clean, with good air conditioning, cable TV, wireless internet and 3 available computers. An additional cost will be the taxis that will take the students and supervisors to their placement sites. It is likely that the taxi rides will cost each student about $5 per day. The only long distance is a 4 hour drive from Accra to Kumasi which we can probably do in a bus to keep down the costs.

3.      The clinical component will take place at three sites: the special school, the unit school, and the hospital in the cleft palate clinic. Before we leave students will know their placements so they can prepare materials beforehand.

4.      In the evenings we will have a seminar based upon the educational and health systems in Ghana, and cultural and linguistic issues relevant to our work in Ghana. Other evenings students will meet with their clinical supervisors.

5.      Students who wish to come will have to prepare AAC and classroom materials beforehand and learn the children’s songs that we will post on the website.

6.      Students will be required to have emergency evacuation medical insurance and submit copies of documents that certify this before the trip. In addition, visitors are required to have an up to date yellow fever vaccine to apply for and be issued a visa to enter Ghana. Students must contact their doctor about other recommended medications such as malaria pills.

7.      We will also encourage students to learn some Twi (the tribal language of the Ashanti region) before they leave.

8.      The people of Ghana dress up much more than we Americans. Women are expected to dress femininely and demurely. Bare arms are acceptable as the temperatures are regularly between 90 and 100 degrees. It is humid and dusty. Men should have one pair of dress pants and some nice cotton shirts. In the school placements, we can dress down somewhat, but jeans are not acceptable.

9.      Our main goal is for sustainability. We will think about what we can bring and do that can be continued and expanded once we leave.

Ghana Program