Education and Health Systems in Togo

I didn’t have internet today, but I staggered my blog posts.

Girls’ education in Togo is one of the goals of the Peace Corps, but there are many challenges to getting more girls in school. Girls are often needed in the home for cooking, cleaning, getting water, farming, and taking care of the animals. There is also the cost of school, which can be challenging for families that are subsistence farmers. In Togo primary school is free, but there are still books and supplies to be bought as well as uniforms. For Middle school there is a tuition fee usually about 3600 CFA a year for boys and 2800 CFA a year for girls. Families also have additional maintenance fees, books, and uniforms to buy. For high school boys pay 8000 CFA a year and girls pay 6500 CFA a year. For college it is 50,000 CFA a year, which is not possible for subsistence farmers. Many families have to decide in the spring if their children go to the fields with them to grow their food or go to school. Women traditionally pay for their children to go to school and doing projects in the community that benefit women economically inherently improve the opportunities for girls to get an education.

The health system in Togo is something I have been really excited to learn more about. There is public and private health care in Togo. Private health care is generally privately funded and the government funds public health care. Financial and structural challenges in health care often lead people to use traditional methods as alternatives, which are often ineffective. There are two major obstacles to good health in Togo:

  1. Infrastructural Challenges
  2. Lack of access: The nearest health center could be far away across mountains and rivers and without transportation can be difficult to walk to when 9 months pregnant or with a fever and vomiting.
  3. Some treatments are extremely expensive and inaccessible, such as cancer treatment or surgery. Some things like malaria treatment, IUD’s, and cesareans are free. However, health care is always perceived as expensive and is only used in emergencies. There are also barriers to the free treatments, as patients still have to pay for the consultation.
  4. Lack of trained personnel: Due to understaffing and lack of funding for salaries. Some clinics sit closed for years and when they reopen people are discouraged from going to the clinic as they may not know it is open and it feeds into the cycle of lack of access.
  5. Cultural Challenges
  6. Patients can feel condescension from hospital staff or stigma for certain diseases.
  7. Traditional medicine such as Charlatons and fetishists are more readily available, perceived as more affordable, and accept payment in goods, services, or credit. This is more accessible to those who cannot pay up front like what is required for treatment at the hospitals.
  8. Gender complications such as men traditionally pay for the doctor and can be a barrier for women and it can be seen as weak for men to be seen at a doctor.

Malaria prevention is a cross-sectorial project for PCV’s in Togo because malaria affects education, health, and food security. If kids have malaria they can’t go to school. If farmers have malaria they can’t go to the fields to grow food, making them less economically stable creating challenges in being able to go to the doctor when sick or sending their children to school. I would like to work on the malaria campaign in Togo as malaria is so prevalent and there are many misconceptions around malaria.

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