And a little child shall lead them. Children and young people are a vital part of the partnership between Hill United Presbyterian Church and the E.P. Church Bubiashie District. Youth are the ones who have responded to the call to write to one another across the miles. And our children are the ones who have led the way at Hill Church in collecting funds to help their friends in Ghana. In fall of 2006 and spring of 2007 the kids attending Kids Club and Sunday School at Hill collected funds to purchase mosquito nets. And in this fall the Kids Club kids were at it again collecting funds to purchase exercise books for Bethel E.P. Preparatory and Junior High School.

With the help of the Headmaster of the school we were also able to find a local print shop that was willing to print special exercise books for the school. The covers feature the school’s crest and a note that they were donated by the Children’s Ministry of Hill United Presbyterian Church. On Tuesday of this week, Kirkland and I were able to visit the students at Bethel to deliver the first of the exercise books.

These plain lined notebooks are very important to the student’s education as there are few textbooks and most of the material is given orally in class. The notes the students take are the main resource that they have to study at home. These books also serve to organize and keep homework assignments. The cost of these excercise books in some cases can be a factor in a parents decission to pull their child out of school.

After a warm welcome the students cheered for their friends in the U.S. They were thankful that someone had cared enough to collect their coins in order to help them. Then they shared a little secret with Kirk and I. They are preparing something to send back with us to show their appreciation. When it comes to partnership the kids are quick to catch on!

In the mainline church in the U.S. it is at best delicate to preach about money from the pulpit. Most often pastors find it deadly. We talk about giving of time and talents. We teach about tithing. And in many churches we do this at only one specified time of the year in order to avoid giving the impression that the church is primarily interested in their finances rather than their discipleship.

On the other hand here in Ghana over the last six months I have learned that money is far from a forbidden topic. In fact it is a regular and prominent part of the church's life. Tithing is expected, additional offerings are encouraged, and when there is a particular need there are levies instituted to raise the funds. Regular Harvests or fundraising events are held as a part of worship to meet the churches financial goals.

That there are two different cultures of stewardship operating in these two settings is not surprising. What is surprising is that the primary struggle both churches have with stewardship seems to be the same. In both settings the great obstacle to more stable financial support for ministry seems to be communicating about the purpose and value of the ministry that is funded by the giving of members.

In my experience with both churches I have found that it is always a challenge to get a large community of people to agree about the specific value of different forms ministry. In one setting it is tempting to focus on generalizations and platitudes about the joy of giving. By appealing to the emotions that can lead to a desire to give we avoid the need to talk about the specific characteristics of our programs that actually impact peoples lives. In the other setting there is a tenacious commitment to a traditional program of church development and growth that in some ways is outdated and unresponsive to the rapidly changing culture of a developing nation. Here it is not a strategic decision to avoid talking about the specific impact of programs and projects. Rather it is a strong dependence on a culture of duty and commitment to tradition that prevents us from inviting the members to become empowered participants in the support and direction of the church’s ministry.

I believe that we need to raise the standard for our stewardship in both settings. In the U.S. we need to talk more frequently and with greater detail about the impact of specific programs and projects. And yes, we need to talk about the cost as well as the value of these programs. In Ghana we need to talk more openly about the use of the church’s funds sharing details about what the funds are used to accomplish. And yes we need to speak specifically about the impact that programs and projects have on individual people whether the project is local, national, or global. In both places it will require a willingness among leaders to accept a greater burden of accountability and the members to place an increased amount of trust in both ordained and lay leaders to make decisions about day to day ministry. I believe that clear and direct communication will enable communities of faith will grow in their ability to respond faithfully to Christ’s call to ministry and to support that ministry financially.

After a busy morning I spent time with the Tetegu Shalom E.P. Church sharing information about Malaria, the Mosquitoes that carry it, and how people with limited resources can protect themselves. I traveled from Bubiashie to Tsokome, and Tetegu to administer communion at all three stations. Ending the tour at Tetegu with a fresh batch of ITN’s from NetMark was part of the plan. They have been anxiously waiting for us to acquire more nets since we distributed some at Tsokome in early September.

When worship had ended Catechist Martin Agbovi announced that we would take a short break before beginning the net distribution. He also explained again that the nets were designated for children five and under and women who are pregnant. After getting out of my hot black clerical robe and brining in the bundle of nets we gathered in the sanctuary. Using information on Malaria provided by the CDC and other NGO websites I taught a brief lesson on Malaria, how it is spread, and what prevention measures even the poorest families should take to avoid infection.

The primary point of the information which I shared about Malaria was that small children are at greater risk from Malaria. One of the greatest problems is the children’s inability to communicate clearly about symptoms. Parents cannot take a baby or toddler to the clinic every time that they are crying or upset. Thermometers which are taken for granted in the U.S. are not widely used in these homes. Monitoring fever, one of the primary symptoms, is difficult at best. Adults are more likely to be diagnosed effectively and in a timely fashion. This contributes to the higher death rate among children five and under. Malaria can also be transferred from a pregnant mother to an unborn child. Once the reason for the targeted distribution of the nets was explained in this way, most of the people were supportive of the effort to serve this most vulnerable population.

Since insect repellent is not readily available most of those gathered were encouraged to stay in after dusk. We also talked about the conditions that mosquitoes require to breed. Standing water is a difficult thing to eliminate in areas like this that have little ground cover, are often wet, and do not drain well. The condition of the dirt roads and the volume of traffic make this an even more difficult problem. Open barrels of water are a common source of water for homes. Learning the importance of keeping these covered may help reduce the family’s exposure to mosquitoes. Those that live in houses that can be screened were encouraged to put this at the top of their priority list. Some who have the resources for these more elaborate measures simply do not realize the value of such protection.

Basic knowledge about the link between the mosquitoes and malaria is common. Most know that sleeping under an ITN can prevent malaria. But the understanding of the risk is not very deep and so the commitment and effort required to implement simple prevention measures is lacking. That is why we are now moving towards an Education/Distribution model for our Net project. Following the presentation several members help me register the names of children receiving the nets. We are keeping record of the adult collecting the net, the child for whom the net is collected, and the child’s age. All fifty nets were given out and another 13 names were taken for more nets when we can bring them. Six members of the Shalom congregation volunteered for training as Malaria Prevention educators. After my departure from Ghana several teams of trained members will travel to other congregations and village organizations to present this material and distribute nets. We pray that through our sharing all those who have contributed can appreciate the work God is doing in the lives of Ghanaian children through their generosity.

We closed our first Breast Cancer Screening at Bubiashie E.P. Church at about 3:00 in the afternoon. Two Hundred and Eighteen women had been screened. Many had arrived as early as 7:00 in the morning while the E.P. Student Union group was still setting up the screening areas. Well before the program began there were over 30 women gathering under the new chapel construction to register their names for screening. The day began with a short educational presentation by Mr. Frank Ghartey who is the founder of Mammocare. Mammocare is providing the professional expertise to make this project possible. Mr. Ghartey came with two staff persons to conduct intake interviews, and two nurses to staff the screening rooms. He also came with some cutting edge technology which is being developed and tested right here in West Africa. The infrared device can identify dense masses of blood vessels deep in the breast which can indicate an abnormal growth. The device is hand held and only requires a darken room to be used. With a little innovation the storage room off of the chapel was set up with blankets to darken the window.

On the advice of some health care professionals here in Accra we asked each woman to contribute 5,000 old cedi which is 50 Gp (pesewa) in the new currency for the screening. This is the equivalent of 54 cents US. This token amount assures the clients that they are not receiving free treatment which is often looked upon with suspicion. It is also empowering to give the women the opportunity to be active consumers in charge of their health as opposed to passive recipients of whatever care is offered. No one was turned away for the lack of funds and there were no complaints about the fee. After some discussion Mr. Ghartey offered to provide a report letting us know how many women were referred to Mammocare’s office for mammography or other treatment. We will be making announcements encouraging women to follow up on their appointments, and communicating with Mammocare about any particular cases in which finances are an obstacle to treatment.

Two other Catechists from the District visited the screening. One brought several family members for screening. We are now in discussions with Mr. Ghartey about scheduling the second screening. To make the best use of the resources the next screening will be held in the Darkuman and Official Town area where we can serve a slightly different population. Praise God for the wonderful way he is using the gifts of so many people to preserve the lives of women in Ghana!