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Without better health policies governing healthcare access, the attainment of quality healthcare in rural areas will forever remain an illusion. The biggest challenge in policy-making remains the notion that rural areas are just like urban areas but with a different population distribution. Consequently, many policy makers simply transplant modified urban health services to rural communities without considering the unique village cultures and conditions. Cultural sensitivities, as well as income and literacy levels are some of the factors that need to be considered in shaping health policies for Ghanaians living in rural areas.” - Shadrack Frimpong (November, 2015)
This past summer, a team of students and a professor from the United States were in Tarkwa Breman in Ghana to conduct research on a model community clinic and school for girls. The project is the vision of recent University of Pennsylvania graduate, Shadrack Frimpong, an international student from Ghana, to bring accessible healthcare and education to his hometown, Tarkwa Breman, and 7 surrounding villages. This is where Shadrack grew up, in an underserved farming community where the nearest hospital is over 160 miles from the nearest major city in Ghana. Access to basic healthcare is non-existent. Here, educating girls is seen as a luxury and the female child is the first to be pulled out of school in the face of financial constraints for families. From that point onwards, it is downward spiral into early marriage, teenage pregnancy, HIV and other sexually transmitted diseases. It is a story too close to home for Shadrack whose friend and classmate, a brilliant girl who always topped his class, got pulled out of school by her family for financial reasons.
But through the Tarkwa Breman Community Alliance (TBCA), a non-profit organization founded and led by Shadrack, he hopes to change this. The Tarkwa Breman Model School for Girls and Community Clinic will offer educational opportunities for girls and healthcare for his community. The core group behind TBCA include Shadrack, Isaac Opoku (Swarthmore ’14), Jacob T. Mould (Penn ’15), Maxwell B Sencherey-Taylor(Penn ’15) and Julian Addo (Penn ’13). Together, they are working with students from Penn Design, led by Professor Richard Wesley with Professor Scott Aker, to shape this wonderful initiative.
Earlier this year, Shadrack was named one of the 5 winnners of Penn’s inaugural President’s Engagement Prize. His proposal, dubbed Healthcare and Education for Africa, won $100,000, which will go towards the construction of the school and clinic. Shadrack has been described by his mentor, Richard Wesley of Penn Design, as having visionary concreteness. His determination and clear vision can be seen in the underlying principles and design strategy for the Tarkwa Breman project, and in how it’s becoming a reality. Shadrack Frimpong is a young man whose success comes from the resilience born out his personal hardship, from dropping out of school at one point, selling on the streets to be able buy food, to becoming a graduate of one of the most prestigious institutions in the world. And now, he intends to give back to his hometown and other deprived communities across Africa, to give them the opportunity to create their own success stories through similar models tailored specifically for each community. We are honored to have interviewed Shadrack Frimpong and the team working with him to design and build the Tarkwa Breman model School for Girls and Community Clinic.
Proposed site location for the model school and clinic. Photography courtesy of Shadrack Frimpong.
Design233: Congratulations on winning the President’s Engagement Prize, Shadrack! A lot of exciting moments in your life in the last couple of months, from winning it to acquiring land for the Tarkwa Breman project to put into motion the Girls School and clinic for your hometown Tarkwa Bremen. What was it like growing up there?
Shadrack Frimpong: As a young boy, the harsh poverty climate made it to difficult to dream beyond teenage fatherhood and farming but I took inspiration from my parents. In spite of abject poverty in the village, they did everything within their might to educate and give us a fair shot at the opportunities they never had. Growing up, I saw how my Dad spent countless hours weeding and taking care of people’s farms while my mom trekked several miles to sell charcoal everyday, in their efforts to make sure we wouldn’t go to bed hungry. As a family, we wore tattered clothes mostly, but my parents strongly believed in a better future. My passions stems deep from my parents’ firm conviction that if we strive hard enough for ourselves and for others, we can improve our own circumstances and positively transform the lives of others as well.
In the face of harsh poverty, there were also some positive sides: a serene atmosphere, sense of community, and a simple life.
D233: Tell us about your family, any sisters?
S.F.: I come from a very resilient, supportive and God-fearing family. I have five siblings; a brother and four sisters.
D233: Your life story is extraordinary, very inspiring! You mentioned in your meeting with the Vice President of Ghana that you dropped out of school at one point. What created the opening for you to go on with your education and onto UPenn?
S.F.: The transition from life in the village to the city and the accompanying financial challenges resulted in that dropout situation. In addition to support from my parents, I also had assistance from many people who believed in me. In high school, my mentors and counselors also noticed my after-school life as a street kid, my poor financial situation, and consequently supported me to register, and sit for the SATs. By God’s grace, I did well enough and ended up getting a shot at American colleges.
D233: As a Ghanaian studying in one of the world’s top institutions, how did your background play into your experiences and choices at UPenn?
S.F.: Growing up in Tarkwa-Breman, one of the poorest and medically underserved villages in Ghana’s Western Region, I witnessed firsthand the devastating effects of infectious diseases. At age nine, my legs were nearly amputated after I had contracted a life-threatening water-borne infection. In high school, while working on the streets to take care of myself, I watched powerlessly as my fellow friends on the streets, who had no health insurance, endured painful symptoms of cholera and malaria. These experiences coupled with the death of my own relatives from infectious diseases spurred in me a strong desire to provide others with second chances in whatever small way I can, and defined my choices and experiences at Penn.
D233: What led you to major in Biology? Would you be proceeding onto medical school?
S.F.: My personal battle with an infection that nearly caused my legs to be amputated as well as the loss of lives of my relatives from preventable diseases aroused in me a passion for medicine and science as a child. I aspire to be involved in a career in both general surgery and health policy. Apart from my obsession with the study of human anatomy and physiology, I’m also drawn to this field of work due to the dire lack of medical specialists in this field in many developing countries. After my training, I envision working with underprivileged populations to provide free medical services to patients and perform surgeries where need be.
Shadrack and a member of the design team on the proposed site for the model school and clinic. Photography courtesy of Shadrack Frimpong.
In elementary school, the best student in my class was a girl. However, her parents didn’t support her so she dropped out, got pregnant and contracted an STD at a very young age. As a freshman in college, I began to think of what she could have become had she being supported to stay in school. I also thought a lot about the fact that; a similar situation could have happened to my younger sisters had they not been in school. I was motivated to not stay and just watch, but rather act. I wanted to be a voice and not an echo.- Shadrack Frimpong (November, 2015)
D233: You are the founder of Tarkwa Breman Community Alliance, Students for a Healthy Africa and cofounder of African Research Academy for Women (ARA-W). These organizations are benefitting many people, providing free health insurance for HIV/ AIDs orphans and giving career opportunities to women in science. At what point did you realize your interest in girl-child education and the drive to tackle this issue in Ghana?
S.F.: In elementary school, the best student in my class was a girl. However, her parents didn’t support her so she dropped out, got pregnant and contracted an STD at a very young age. As a freshman in college, I began to think of what she could have become had she being supported to stay in school. I also thought a lot about the fact that; a similar situation could have happened to my younger sisters had they not been in school. I was motivated to not stay and just watch, but rather act. I wanted to be a voice and not an echo.
D233: How are these organizations structured and how do potential beneficiaries access them?
S.F.: Students for A Healthy Africa and the African Research Academies for Women (ARA-W) are mainly student-led, and are run with a focus on membership and applications, respectively. Tarkwa Breman Community Alliance is more place-based and community-driven in focus and has paid staff that helps to run the girls’ school, community hospital and other facilities on-site. All these organizations have active board of advisers and board of directors who oversee their successful operations.
D233: Are ARA-W internships placements available to companies across the African continent or international?
S.F.: Internship placements through ARA-W are done mainly at research institutes across Africa. For instance, the research academy in Ghana operates by offering students internship placements at the Noguchi Medical Research Institute in Accra. On the international front, we are in the process of launching an exchange program that will allow some of our fellows to intern abroad at universities such as the University of Pennsylvania, Emory University and Georgia Tech.
D233: On your website you have the slogan, Transforming Ghana One village At A Time? Please share with us the origin of that motto and its significance to you and the project? Is the vision to make this project a model to transfer to other underserved communities in Ghana?
S.F.: National development is heavily dependent on rural development, yet many programs only seek to support urban areas. Ghana, for instance, has about 70% of our annual GDP coming from agriculture; the farming of cocoa, rubber and other cash crops in rural areas play critical roles in our country’s development. Therefore, the “ill health –> poor productivity –> poverty” cycle in rural areas needs to be broken if we want our rural areas to continue to thrive and support our economy. TBCA believes that when rural health and its social determinants such as education thrive, a nation works. We hope to learn from our first model in Tarkwa Breman and eventually, replicate the model in our rural communities and use it as a testament of what people in rural communities can do when supported. To transform Ghana, we’d have to tackle one village at a time.
D233: What is the main source of livelihood of Tarkwa Breman and its surrounding towns/ villages? Please describe it.
S.F.: Surrounded by several tributaries of the Dunkwa-On-Offinso River, water is easily accessible for farming and hence, about 90% of the local people are engaged in farming the cocoa and palm plantations.
D233: The synergy you have created between medicine and architecture through your collaboration with the Department of Architecture in UPenn is phenomenal. Tell us about your journey in getting the Department involved in this project and the project team you are working with.
S.F.: During the early phases of my project proposal, I reached out to Professor Richard Wesley, who is Penn’s Chair of Undergraduate School of Architecture. We met a couple of times, discussed my vision and how the architecture department could help us in design and implementation. He agreed. After winning the prize, I also approached my Ghanaian brothers, Maxwell Sencherey (Penn 2015), Jacob Tawiah Mould (Penn 2015), Julian Addo (Penn 2013) and Isaac Opoku (Swarthmore 2014). We were housemates and shared similar passions for development so we decided to put our hands on deck and return home full time to pursue the project.
D233: How is that relationship impacting your perceptions on the provision of healthcare where design and architecture are concerned?
The Design Team: The connection to the University of Pennsylvania is an important relationship that will keep this project rooted in intellectual innovation and academic interdisciplinary collaboration. A team of faculty and students in Penn’s undergraduate major in architecture in the College of Arts and Sciences are currently working with faculty in the School of Medicine to provide the best possible solution for a building that has women’s health as its top priority.
D233: You and the team are currently in Ghana. What activities and research are ongoing around the project?
S.F.: We’ve been talking with people in the communities we hope to serve and researching educational and health models. We have also been developing working partnerships with other organizations who share in our vision. Also, we have an upcoming fundraiser so perhaps, you could support us with some funds or point us to some donors?
This page - Existing school buildings. Below: Aerial view of Tarkwa Breman. Photography courtersy of Shadrack Frimpong.
D233: As an architect who writes about my country and continent, I discover things about Ghana I never knew of previously. Are you making discoveries about your hometown you never knew of before and how are they impacting you?
S.F.: Perhaps, one of the most disturbing discoveries I’ve made since returning home is the deplorable state of the village river, Ankobra. What used to be a place for me to enjoy my fishing and swimming hobbies as a child has now turned into a thrash site for “galamsey” (illegal gold mining). River Ankobra now looks dirt brown and many families in the village, including mine, can no longer depend on it for drinking water or aquatic protein.
D233: What influenced the choice of location for the clinic and school. Are they in close proximity?
The Design Team: The location of the clinic and school is a holistic decision to create a strong connection to the environment while forming a campus culture of education and healing for women. Penn’s architecture team is fine-tuning the exact arrangement of the buildings based on the topography, water drainage patterns, and best conditions to collect rainwater.
D233: What infrastructure is going to go into the clinic and school? What are the key design features going into the facilities and the general design concept?
The Design Team: In addition to electric power and fresh water infrastructure to the clinic and school, Penn’s architecture team is exploring other sustainable techniques to augment this substructure. Passive sustainable features include roofs that collect & filter rainwater, bathrooms that transforms human waste into crop fertilizer, polyface farming throughout the 50-acre property, and fresh water eco-ponds.
D233: What materials are going to be used in their construction?
The Design Team: It is our hope, where possible, to use all local material to construct the facilities. Penn’s architecture team is evaluating innovative ways to use concrete masonry block, rammed earth, and bamboo.
D233: Is the construction team going to be sourced locally?
The Design Team: Yes. The construction team will be a combination of experience contractors and local villagers from Tarkwa-Breman. Adding to this localized effort, we will have international support from faculty and students in Penn’s architecture team who will come to Ghana to participate in assembling special components for the project.
D233: What is the timeline of the project? Is it going to be done in phases?
S.F.: We hope to complete construction by December 2016. And yes, the entire project has been rolled out into three phases to allow organic growth of the delivery of our services.
D233: Is the school going to be private and how many students would it cater to?
S.F.: Yes, the school is going to be private. We envision enrolling between 100-200 students in the first phase.
D233: What programs will be taught in the school?
S.F.: While research on our educational model is still ongoing, we foresee that the programs will be a blend of the Ghanaian and international curricula. Most importantly, there will be great emphasis on cultural sensitivity and creativity as we keep in mind the unique needs of the communities that we’ll be serving.
D233: Would the clinic be providing basic health care or specializing in specific areas of medicine?
S.F.: There is an ever-pressing need for a “first point of access” clinic in the village to provide primary care, maternal and reproductive health services, as well as HIV care and treatment. This will be our focus in the initial phases of our healthcare delivery model. We hope to provide specialized medical services as we expand over time.
D233: Would there be housing for teachers and health care providers (doctors & nurses)?
S.F.: Yes.
D233: The Tarkwa Breman project is very-well thought out, a comprehensive plan which involves establishing a relationship with the Ghana government’s ministries of Health and Education to provide doctors, nurses and teacher for the clinic and school respectively, once they are done. What are the guiding principles behind it?
S.F.: We believe that governmental institutions, when actively engaged, can produce fruitful synergies with private entities to provide services for citizens. In this light, TBCA will work with the government to recruit trained personnel to staff our facilities. After recruitment, intensive on-site training will also be provided to ensure that new staff are abreast with TBCA’s unique healthcare and educational delivery models.
D233: Would the institutions, particularly the school, be public or private?
S.F.: The institutions will be a private partnership between the Tarkwa Breman community and our organization, Tarkwa Breman Community Alliance.
D233: They system of maintenance outlined for the school is incredible, where families of students of the school would farm 30 acres of the allotted 50 acres and proceeds from harvests would go towards running costs and maintenance works. Is this method to let the residents feel a sense of ownership towards the school? Are they typically farmers?
S.F.: Yes. We are working very hard to ensure that the entire project implementation is mainly community-driven, and that includes sustainability efforts. We have found that majority of the people wanted to have a sense of ownership and belonging to the institutions. This is crucial for sustainability purposes, as they will value and protect the facilities. Just like my parents, many people in Tarkwa Breman and its surrounding seven villages are farmers.
D233: Are there plans to teach sustainable farming methods to the farmers and what crops would be cultivated?
S.F.: Yes. We’re currently exploring what crops will give us the highest value propositions and sustainability yields. Cocoa, jatropha, Rubber and palm oil are some of the plants in our research fold.
D233: You’ve mentioned an interest in Health Policy. Health insurance systems and access to basic health care are some of the basic infrastructure lacking in many communities in Ghana. How can health policies be shaped to transform these conditions?
S.F.: Without better health policies governing healthcare access, the attainment of quality healthcare in rural areas will forever remain an illusion. The biggest challenge in policy-making remains the notion that rural areas are just like urban areas but with a different population distribution. Consequently, many policy makers simply transplant modified urban health services to rural communities without considering the unique village cultures and conditions. Cultural sensitivities as well as income and literacy levels are some of the factors that need to be considered in shaping health policies for Ghanaians living in rural areas.
Growing up in the village, I witnessed first-hand the failure of philanthropic initiatives in my community. I later realized that this was simply because many of these organizations, while they had good intentions, did not research and dive deep into the unique needs of my community. They assumed that we were just like any other under-resourced community in Ghana and Africa. What we must never forget is that oftentimes the people in the very communities we seek to help, know the solutions to their problems. They usually need a little support to get going. Discourse with the community and research are always crucial for any initiative to be self-sustaining and viable. - Shadrack Frimpong (November, 2015)
D233: Your professor at Penn, Prof Harvey Rubin describes you as electrifying, that you, to borrow his words on your site really think deeply about what you want to accomplish and you know how to implement them. What drives that persona, what inspires you to pursue these causes and I’m sure there are more cooking in your brain (Smile)?
S.F.: Growing up in the village, I witnessed first-hand the failure of philanthropic initiatives in my community. I later realized that this was simply because many of these organizations, while they had good intentions, did not research and dive deep into the unique needs of my community. They assumed that we were just like any other under-resourced community in Ghana and Africa. What we must never forget is that oftentimes the people in the very communities we seek to help, know the solutions to their problems. They usually need a little support to get going. Discourse with the community and research are always crucial for any initiative to be self-sustaining and viable.
D233: Where do you see yourself and the Tarkwa Breman project in the next 10 years?
S.F.: In the next 10 years, I see myself as a surgeon working with my colleagues in education and healthcare to continually push the frontiers of rural development. It is my hope that by then, the Tarkwa Breman project’s model would have been successful to be replicated in other rural communities in Ghana.
My hope is that Ghana and Africa is transformed into a place where access to quality healthcare is a basic human right, and not a privilege – with particular focus on rural medicine and social determinants of health such as gender equality in access to education. - Shadrack Frimpong (November, 2015)
D233: What is your hope for Ghana and Africa?
S.F.: My hope is that Ghana and Africa is transformed into a place where access to quality healthcare is a basic human right, and not a privilege – with particular focus on rural medicine and social determinants of health such as gender equality in access to education.
Design233 is most grateful to Shadrack and his team members Isaac Opoku (Swarthmore ’14), Jacob T. Mould (Penn ’15), Maxwell B Sencherey-Taylor(Penn ’15), Julian Addo (Penn ’13); Arc Emmanuel Nana Yaw Ofor i ,Prof. Scott Aker (Penn Design), Richard Wesley (Penn Design) and ARCH 490 Class (Penn Design) for the interview.
We look forward to featuring the completed project in Tarkwa Breman as well as future projects across the African continent.
Visit www.tarkwabreman.com for more information and updates on the Tarkwa Breman Community Alliance.
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