Wednesday, February 29, 2012

Photo of the week, February 29th

Creative damming of streams across the country provides much needed water for livestock and crop farmers. Here we can clearly see the regular cow-tracks to and from the waterhole thus created. At times such damming also increases human bathing and 'relief' activities, coupled with the opportunity for development of certain water snails, and, with it, an increased risk of Schistosomiasis (Bilharzia) transmission. A National Forum to discuss the thousands of kilometres of potentially infected lake are river banks in Ghana will be held on the 15th March 2012. Perhaps, as a result of this, we will see the end of Shistosomiasis in our lifetimes - if we all work together.... Photo courtesy of Integrated National Schistosomiasis Control Initiative (INSCI) team'

Monday, February 27, 2012

February 27th, 2012

Fresh Air Matters... with Capt. Yaw

The small airborne ‘machine’ micro-buzzed into position, carefully avoiding detection. Stealthy, apart from that tiny buzz, that could only be detected once it was too late. Sensing the target ahead, it swiftly and deftly landed and delivered its deadly load, at the same time stealing, perhaps even spilling, human blood. Then, with the speed of a viper the child’s hand knocked the flying killer to the ground, destroyed, but sadly too late – its parasitic passenger had already been delivered to the child’s bloodstream.

We are all too familiar with the deadly acts of the mosquitoes – natures killer squadrons of malaria-transmitting sub-gram flying ‘machines’ – each one discrete, annoying and devastating. Another of nature’s light-weight flying insect miracles is very different. The butterfly, resplendent in colours that inspire awe and bring jaw-dropping silence to the crowd when they majestically land on a flower, with greater precision than any surgeons hands. Then there is the honey-bee, capable of flying, navigating and sharing knowledge of a food source, pollinating flowers for prosperity and making honey, propolis and more for the benefit of themselves and the careful apiculturist. Of course, the bee also carries its own defence mechanisms too!

Natures flying machines, like the flying machines of mankind, have a host of applications – some seemingly purely negative (although the mosquito eating bats seem to rather like the delicacy of human-blood-filled-flying-snacks!).

All too often focus is made on fast aircraft, large aircraft, fighting aircraft – and, as with the insects of nature’s world, the lighter end gets overlooked, despite their numbers and amazing range of abilities and economic potential (consider the silk moth, bees, bio-control insects, etc.).

It is all too easy to get excited about the massive aircraft, without reflection on the high maintenance-hours to flight-hours ratio. The Globemaster has over twenty maintenance hours per flying hour! Perhaps the Airbus A380 is magnificent, but it is not something you want to feed or house! Millions, nay billions of dollars have been spent and are being spent on special parking bays, taxiways, etc. to host the new giant of the skies – not to mention the fuel bill!

Interestingly, the excitement of the masses tends to focus on the big and the powerful, whilst the small and determined are perhaps able to achieve something equally amazing. Look at your house – you have doors, screens, windows with bars, and still the ants find their way to their target inside your kitchen!

In a similar way, light aircraft are about to reach into the places in Ghana that are not readily accessible by road or, indeed, by larger aircraft, and they will be working for the benefit of the people – finding their way to the target population, those in need of encouragement, training, health education, and with it community health empowerment.
We all take so many things for granted – like the beauty of the butterfly, we see it, smile and walk on, not thinking about the amazing struggle that creature has had to get to its multi-splendorous appearance and associated performance. We take for granted our access to clean water, to power, our apparent ‘instinct’ for cleanliness. Washing of hands before eating – sounds simple, seems instinctive – but it needs taught. We accept that a good bath with clean water and soap is our ‘right’ – perhaps our ‘dutiful-right’, but we fail to remember that it is a privilege to have access to it and to enjoy it. When did you last consider that the water you are bathing in could damage your health? Did you wonder if there were cercaria in the water (the little critters that penetrate your skin and cause Schistosomiasis)? Of course you didn’t! You know that you can only get that if you bathe or swim in an infected lake or river… BUT do you wonder about how those who live with the only source of water for many tens of kilometres around them infected?

With our blessings of development we seem to not only wash clean our bodies, but our consciousness about, and our consciences regarding the many people who do not have the knowledge, and even if they do, may not have the awareness of how to find solutions to living with the dangers in a manner that prevents them from being infected.

Of course, if a danger affects those in the cities and ‘developed’ portions of the world, there is a massive campaign – such as we see for HIV/AIDS. Yet, that same knowledge simply does not reach those who are remote, living in the lifestyle that we all came from at some point in our ancestry.

I believe that we all have a duty to ensure that those who have not been given the opportunity to understand the basics of health education should be given that opportunity as soon as possible, and that is the mantra of practically every government in the world. However, when accessibility is a challenge, it is all too easy to ignore the existence of the problem – unless you are ant-like in your thinking!

With creative thinking, the ant got past the barriers you put to your kitchen – slipping past the windows, bars, nets, blocks, etc. and finally discovered the knowledge of the sugar in the highest, most inaccessible cupboard! We can use that same creative thinking to send health education messages to those who are remote through lack of roads and other infrastructure, and, as I see it, the only practical solution to that is by air.

Soon there will be a trial campaign to reach many such isolated communities around the Volta Basin, it will be at a lower cost than going by road, and won’t be hampered by the rainy seasons’ muddiness, nor by the great distances. This solution is one of Ghanaian innovation and implementation – and I believe it is one that will accelerate the effort for behavioural change for health in the areas it reaches.

The moment one mentions an aircraft, people get excited about cost – perceived high cost. But I will leave you with this thought. In order to reach just forty of the isolated communities in the areas concerned, using traditional methods such a a 4x4 or a motorcycle, would take at least one week, probably more. It would consume considerable person-hours, fuel and probably result in repairs or simple failure to reach a community due to natural barriers. By air, the same result can be achieved in less than three hours. Now you ask me ‘How does this method work?’, and ‘How can it really be something that will bring about change?’ Well, I will share that with you next week, and will also be inviting all Fresh Air Matters readers to participate in a competition that will give the winner a chance to see first-hand what is happening…

In the meantime, remember to think about cercaria in many peoples bathing water when you next take your bath!

Capt. Yaw is Chief Flying Instructor and Chief Engineer at WAASPS, and lead Pilot with Medicine on the Move, Humanitarian Aviation Logistics ( e-mail

Wednesday, February 22, 2012

Photo of the week, February 22nd

It is always encouraging when communities make an effort to control waste, and with it associated diseases.  It is disheartening when the (lack of) management of the effort creates a bigger health risk, nuisance and community challenge - as is all too often the case.  We need community cohesion, supported by District, Regional and National efforts to make so many simple diseases go away, improving quality and length of life.  Sadly, those simple diseases are damaging national productivity, slowing socio-economic sustainability and actually snatching lives.  We must value all lives and our environment if we want to enjoy sustainable progression.  Photo Courtesy of Medicine on the Move

Monday, February 20, 2012

February 20th, 2012

Fresh Air Matters... with Capt. Yaw

Finally the skies appear to rejecting the air-borne, visibility-reducing sand particles of the Harmattan and spitting them back to the Sahara, where they belong. The past weeks have been challenging to operate light aircraft in, and, since mid-December, we have had less than eight days of good VFR conditions at Kpong Field. Takoradi, Kumasi, Sunyani and Tamale have all had fights cancelled due to poor visibility. The funny thing is, when you are in the air during Harmattan, your vertical visibility can be perfectly acceptable. Look down, and you can make out the landmarks immediately below you without any fuss. The horizontal vis is what is really affected, due to the effect of the sunlight being scattered and re-scattered by the mini-mirror-like specs that congest the air. You are blinded by the ‘photonic disruption’ caused by the individually insignificant, air-borne detritus, which have combined to create a nightmare effect, preventing any safe progress, and the resultant grounding of many aircraft with prevention of even local training flights. It has been one of those times when the pilot tells you ‘it is better to be down here, wishing you were up there, than up there, wishing you were down here’.

Flying is not like driving, not at all. It is easier. Yes, I said it is easier! On the road, if you make an error of a metre you will probably hit something – and possibly kill somebody. In the air, pilots can be a kilometre or two off the centre line of their course and still be perfectly safe – that is why air-corridors are so wide! Imagine a road thirty kilometres wide, with little traffic and more rules! I have always said, and stick by the statement ‘I can teach anybody to fly a plane in one hour’. It really isn’t difficult to fly a plane around the sky. Now, if you want to be able to control where it goes with any accuracy, take-off and land, well, that takes a longer time – a lot longer!

Sadly, few people learn to fly, and the drop-out rate worldwide is incredibly high. One statistic I read recently indicates over eighty percent of people who start learning to fly drop out. Why? Well, there are many think-tanks asking the same questions! Cost is a big one, because it is not cheap, and it never will be. Frankly, if people took learning to drive a car as seriously as learning to fly, maintenance of vehicles as seriously as maintenance of aircraft, and the maintenance of roads as seriously as aerodrome maintenance, learning to drive would be much more expensive – and the accidents on the roads would probably be reduced to a mere trickle.

Therein lies a challenge – how can you make flying affordable without compromising safety? However, we should better ask ‘how can we make driving safer without it becoming no longer affordable?’ The answer is not something I hold in my fingers, but it is clear, that if we want to ensure safety in the skies, we need to maintain standards, and that costs money, and since we apparently don’t mind accidents on the roads (the statistics indicate this), we keep the cost of motoring down, especially in the developing nations.

A Metro bus proves the point for me. I was driving in Accra, something that I detest and consider a punishment, when this Metro bus pulled up alongside my car, leaving a bare fifteen millimetres between my wing-mirror and the bashed, scratched and otherwise variously scathed side of the mass transport solution of the city. We crawled along side-by-side, unable to improve on the separation distance, since a taxi was too close for comfort on the other side. The taxi had also seen better days.

I worked relentlessly to keep the precious barrier of air around my vehicle from further erosion. The Metro bus gained on the advance and I was soon eye-to-eye with the rear tyre.

The rear tyre, looking at me through my window, was as bald and smooth as any top-model’s legs! In fact, add a little oil and you would have sworn it had been machined to the highest standards for smoothness and low-drag resistance! I have never seen such a silky tyre – it was a work of art!

The policeman ahead of me was alternately sucking water from a bag and talking on his mobile phone whilst guiding the traffic jam slowly forwards. He, like many other policemen in the life of that tyre, would see it, admire it, and wave it on. Doing their part in keeping the costs of transport down in our country. The same for the taxi, who no longer has any working seatbelts, for the numerous lorries without working lights, for the Mama-Wagons filled to spilling with women and children packed like sardines to prevent movement in the event of another pothole in the road. Yes, these are all efforts being made to keep the cost of road transportation down.

The young men who come to me with a ‘driving licence’ and who still can’t tell me the basic road signs or what a continuous white line means are also those who have benefitted from the reduced costs of road transport growth. The poor road maintenance and acceptance of pot-hole infested and road marking erased black-top are also contributing to that low-financial-cost of transport.

In some countries the penalty for a bald tire or poor brakes is more than the cost of replacement or repair, which helps to improve safety, but increases the cost of transport. In some countries, only those who have excellent driving standards are allowed to drive, and if they don’t demonstrate good driving they lose the right to drive. But it pushes up the cost of road transport.

So, all these little bits of ‘low-cost-detritus’ blur our vision, losing us visibility of what we are really dealing with. Our very own ‘low-safety-standard-Harmattan-haze’. A haze that I hate to travel in, seeing the dangers, and with them the damage to, and cost in, human life. Based on the maimed and dead bodies we hear about, and unwillingly witness, on the roads, the reality of that cost is large quantities of blood of the citizens. Should that same blood be spilt in an air-accident much noise would be made, but it isn’t because of the safety rules and enforcements (thank you GCAA, FAA and ICAO).

So, a decision has to be made. Do we save money or do we save lives? I know what I want to save, and I know that I train my crews to high standards, both for flying and driving, because I value life more than anything else.

We need to change the safety standards, and not just on the roads. We need to ground some traffic, ground some construction sites, ground some machine shops, ground some chop-bars, and ensure that there is a clear vision of what safety is all about. We need to do that now, today, this very hour, before any more people are injured or lives are lost through lackadaisical attitudes and lack of courage to stand up for safety. Lives depend on it - including yours and mine and all those we know and love. Let’s change the system before many more of them are maimed or die unnecessarily.

Capt. Yaw is Chief Flying Instructor and Chief Engineer at WAASPS, and lead Pilot with Medicine on the Move, Humanitarian Aviation Logistics ( e-mail

Wednesday, February 15, 2012

Photo of the week, February 15th

When I tell visitors that there are thousands of communities in Ghana without any access roads or drive-able tracks, water or power, I often get amazed looks. I regularly fly below 3000 feet above ground level around the country and see the needs of those in rural communities in a different light to most. By using light aircraft I hope to bring health education using a novel solution, developed by a team in Ghana, to inaccessible-hard-working-people who need regular 'Encouragement Training for Community Health Empowerment' - and I volunteer my time and skills to help make that happen. Together we can change more lives - one flight at a time..." Patricia Mawuli Nyekodzi, volunteer Pilot/Engineer with Medicine on the Move

Monday, February 13, 2012

February 13th, 2012

Fresh Air Matters... with Capt. Yaw

Last week we considered how easily we can become blind to many obvious things by being overly focused on one. Not just in flying but in many aspects of our lives, homes, businesses and governance. I have been intrigued at the reactions from those who read about this, both on-line and on-paper. Many people visited the image on the Medicine on the Move website and were amazed at the reality of the Troxler effect – and it caught their imagination as they considered how many things they had become blind to.

One area of particular concern is the current blindness to people’s identities. It amazes me – it really does. I was asked to fill out some forms with my staff by the Ghana Revenue Agency; no worries, until you read the content and start to fill it in with them (many staff need us to read and write with them). Not only am I amazed that Ghana now apparently has postcodes (yes they ask for the postcode on the form!), but they also ask for a ‘proof of identity’.

There is a current belief, started, it seems, by the ‘compulsory registration of mobile telephones’ that every person in Ghana, regardless of age or occupation must have one of the following, in order to be considered a ‘Person who is able to own a telephone’; and now, it seems, to be formally employed!

Proof option one is ‘Passport’. Clearly, not everybody has such a document, nor is it a legal requirement to possess one. Some own several, perhaps creatively! For a ‘National Identity’, such evidence is probably not the most applicable.

Proof option two is ‘drivers licence’. Again, something that not even half of the population possesses, and an item that many appear to have obtained ‘by alternative methods’. What is more, many people are driving without one! Sadly, the deaths on the roads are witness to the challenge in this area, making it a poor choice for anything other than driving related evidence!

Proof option three is ‘voters ID’. Being this time of year and the election season warming up, we are reminded of the ‘fake ID’s’ out there. What is more, many people are not in possession of one. How many people voted in the last election? Did everybody who could vote get a voters ID? Of course not! It is not a legal requirement to vote, and for those below the voting age but of working age, or indeed telephone possession age, it seems a strange sort of identity to ask for. As an employer I would never ask for this as a proof, since it is one step away from a political question – something that has no place in the workplace.

Proof option four, the final one, is ‘National Identity Card’. Fantastic option…if they exitsted… Remember the song… “Our Nation calls for duty now; all for one and one for aaaall. The time is now or never friends, we are called to get involved. Register with the National Identification Authority. … If you are a Ghanaian, or you are legally resident in Ghana, if you are over fifteen years, get your national ID card. Our Nation calls for duty now, all for one and one for aaaall.” – well you remember it too, don’t you! It even asked for children to be registered from six years and above, if I remember the rhymes correctly!

What happened to the National Identity Card?. How many people in Ghana have one? Sadly, the current focus on these four unique identities is potentially disenfranchising many people – and making them feel ‘left out’ and isolated – marginalisation of the rural and poorer people in our society, not on purpose, but by ‘Troxler-ing them out’ through focusing on the one cross – making a whole sector of society meaningless to the brains of those with the power to give.

I believe that the ‘telephone registration programme’ will now allow somebody with a suitable ID to register for you. Doesn’t that defeat the concept? Why can’t a student or other form of ID be used to register the phone? What if, as is the case for many, many rural folks, they have no ‘suitable’ ID? Such people are the ones who need access to telephones, and unencumbered access to employment, and yet they are marginalised by the desire for a proof that is neither a legal requirement nor something that is made freely available to them.

I have felt the bitter taste of this concept first-hand… I live rurally, and do not have a street, nor a house number, I have no electricity bill, no water bill and thanks to pay-as-you-go telephony, no telephone bill. I do have a pilot’s licence, passport, drivers licence and a host of other proofs of identity are insufficient for me to hold a credit card – and with many banks, even a bank account!

Why do so many organisations quickly forget that the majority of the people with the potential for development and growth – the national reserve of potential – do not have the required pieces of paper to break over the barrier forced down upon them, keeping them from development and forcing them to consider creative ways to move past their fortunes of birth?

Talking of birth! I was told this week that all the old Birth Certificates are no longer valid. Everybody has to get a new one – a green one! Oh, and that will only cost you thirty Ghana Cedis, if you have an old one, or fifty five if you don’t have one already. Not to mention ‘No we don’t give receipts until you get it back – in one month.’

How many people in rural Ghana a) have a birth certificate and b) can afford the price of getting one? What happened to ‘all for one and one for aaaall’?

It really seems to me that the folks with the desks are focusing on the wall opposite them and failing to look out of the windows. Please, if you are a person able to change this, and you can give me a proof of your position and ability to bring about a change in these policies, I will do something special to help encourage you in the bringing about of that change.

The first government official, who is able and prepared to change this state of affairs and to allow people, without question, to exist and grow, because they are people and not because they own a piece of paper; and can prove it, will be given a free flight, by me, over some rural areas of Ghana. I will show them first-hand the state of the villages without any usable roads, the people living, no struggling to live, against the challenges of many diseases, without water, sanitation or power – and who are trying so hard to raise themselves from their position – without the ‘proof of identity’ needed to remove barriers to their progress.

I see it. I feel it. I am not focused on one point. I am not suffering from the legislative or policy Troxler effect. Are you? Together we can change the focus – if we want to and if we truly believe ‘all for one, and one for all’.

Capt. Yaw is Chief Flying Instructor and Chief Engineer at WAASPS, and lead Pilot with Medicine on the Move, Humanitarian Aviation Logistics ( e-mail

Wednesday, February 8, 2012

Photo of the week, February 8th

The telecoms explosion into rural Ghana has given access to many areas, and with it access to the internet - connectivity, business and information... As the telecoms age continues to seep across the country it will open up opportunities for those who are able to register a phone, modem or other telecoms device - connecting them in new ways and opening opportunities, bringing them closer to others.  Of course, they also need power and water as urgent needs; if only it were as simple as a new tower!  Photo Courtesy of Medicine on the Move  

Monday, February 6, 2012

February 6th, 2012

Fresh Air Matters... with Capt. Yaw

How much blindness do you suffer from? By keeping your gaze constant, even when there is a moving field of view, you are almost certainly blind to certain objects in front of you – I really mean it, you cannot see them – they disappear! Don’t believe me? Read on, and try an experiment later.

Pilots are taught to scan the horizon for other aircraft – never looking at the same spot for more than a second or two. Different patterns are favoured by different schools of thought. Personally I like a left to right and up and down scan, blinking occasionally if I am certain that I am looking in the right quadrant of the sky where an aircraft should be. I use a similar system when driving, especially when scanning for potholes on the rural roads, focusing near then far repeatedly! This helps to increase the information coming into our brains, but also to prevent the Troxler effect, sometimes called Troxler’s fading or ‘motion induced blindness’, meaning that motion and non-motion together can lead to ‘disappearance’ issues.

Imagine that you are flying and an aircraft is on a collision course with you. If you are staring at the same point out of the window (i.e. where you are going) that small approaching aircraft image is in the SAME position on your eye’s retina – and your mind will exclude it from the image you see – seriously! All you need to do is to keep your eye moving, scanning – and then your eye and your busy grey matter will keep you appraised of the danger. You can take five minutes in the office later to look at the Medicine on the Move website ( - under the INSCI tab) at a simple demo of how our minds cut out images if we do not keep on adjusting our gaze – or scan.

An amusing party trick or a life-saving piece of knowledge? I recently did a presentation where I showed in cockpit video footage of pilots flying small planes – and it is amazing how much their eyes and heads keep on moving. Scan the horizon, scan the instruments, scan the ground ahead (checking for emergency landing areas), scan the instruments, scan the horizon, scan the airframe… on and on and on – never ending. Keep on changing the focus points, keep on checking the available information and keep on ensuring that you are heading safely in the right direction, ready to respond should the need occur.

I look at the way so many people are fixedly focused on ‘middle-income-status’ or ‘low-inflation figures’ or some other policy related mantra, without adjusting their gaze and scanning the risks to that goal that are quickly ‘Troxler-ed’ out of view! Even within a particular practice we can become blind within a specialist area. Take health for instance. We are so focused on the sexy diseases, we are missing out the massive micro-collision courses that will simply prevent achievement of the goal, because we are not looking at the little bits of the image we have become accustomed to and are no longer even aware of.

So much focus, quite rightly, is made of Malaria and HIV, but at the same time much of Africa is affected by challenges that seem to be invisible. For example, did you know that Schistosomiasis (also called Bilharzia) is the second most socio-economic devastating parasitic infection in Ghana? With an estimated two hundred thousand deaths each year in sub-Saharan Africa alone, and yet the majority of the population has ‘motion induced blindness’ to it, its causes, cure and prevention...

Even those who focus on Schistosomiasis may have a tendency to fail to see the other challenges to the treatment and eradication of this hidden stumbling block to our regions development. Schistosomiasis is contracted from contact with infected water – and Ghana has over ten thousand kilometres of potentially infected Lake and river coastline at risk. One study estimated fifteen million cases in Ghana every year. Most of which are repeat infections. The way to cure the disease is a tablet. Simple, quick and efficient. But that does not stop you re-contracting the parasite again in a couple of weeks. The rules are simple, and easy to preach 1. Never drink from a lake or river, drink only clean water (filtered or boiled). 2. Never bathe in a lake or river, take the water out, filter it, and preferably leave it covered (to prevent mosquitoes) for 24 to 48 hours, the time for the parasite to die. 3. Do not urinate or defecate in the rivers or lakes or anywhere your ‘doings’ can wash into the water.

Simple. Simple. Simple. So simple that the majority of people are blind to reciting the mantra, or think that ‘one telling is enough’.

We all know that a woman who wants her man to tidy up his dirty socks has to ask him more than once – EVERY day of their marriage… Why then do we think that one poster, one advert campaign and one visit to a village to tell them to change their centuries old habits work like magic? Behavioural change need is easy to become blind to. Behavioural change need, once in your visual range, is a big headache – because it is incredibly hard to bring about. It requires a lot of time, energy and repetition.

Here is the most amazing part of the ‘behavioural change benefits’ covered in our three points above; it will reduce or even eradicate many other diseases and if you can couple ‘wash your hands with soap and clean water before your eat’, you can lift thousands out of poverty at a relatively low cost. But it is not sexy. It is not popular. It is not something people want to hear. AND there is another problem – a big one.

The vast majority of people living in Ghana who are at risk, are not easily accessible. Lack of roads and other infrastructure to the thousands of communities means that even getting a message to each of those communities is going to take man years, if conventional methods are used. Perhaps that is why it has been ‘allowed to enter our blind spots’. The good news is, such communities can easily be reached using innovative new aviation related techniques, developed and perfected in Ghana – making regular, repeatable contact and awareness campaigns a realistic possibility in the near term.

This will be a major topic of discussion at the First National Schistosomiasis Forum to be held in Akosombo in March of this year, and the organisers plan to shift some focus around and come out with the first Integrated National Schistosomiasis Control Initiative – a tough job, but one that can be done, if only we can move our heads around and see more than just a fixated look at the policy headlines.

Capt. Yaw is Chief Flying Instructor and Chief Engineer at WAASPS, and lead Pilot with Medicine on the Move, Humanitarian Aviation Logistics ( e-mail

Wednesday, February 1, 2012

Photo of the week, February 1

Schistosomiasis (Bilharzia) affects millions of people in Ghana (and much of Africa). Easily prevented, easily treated. Yet, it is the second most socio-economic devastating parasitic infection in Ghana, and it takes over 200,000 lives in Sub-Saharan Africa EVERY year. Using four simple rules, this disease (and others) can be reduced or even eradicated, 1) Wash you hands before eating 2) only drink filtered/boiled/clean water 3) do not bathe or play directly in the lakes and rivers 4) do not urinate or defecate at the waters edge or in the water - use a proper latrine instead. Sadly, many of our communities are hard to reach and often the understanding is not complete. Here we see a urinal at the edge of the Volta (at Kpong) which is NOT good - the run off directly to the water is simply increasing the spread of infections (and is right next to where food is sold). Find out more about the Integrated National Schistosomiasis Control Initiative... it could change millions of lives - perhaps one of your family's too! Photo courtesy of Medicine on the Move