Health & Sanitation Projects

Axim is desperately short of toilet facilities. As recently as July 2012 we were told that up to 3,000 people are using one 10-seater ventilated pit toilet. Our own visits to Axim verify the need. So, since 2013, between the Bellingham, WA based Engineers Without Borders and ourselves, we've constructed three urine diversification/dehydration (dry) (UDDT) toilets at three schools in Axim. These are now working toilets and prototypes for the community as they improve sanitation in the community.

UDDT at Community Development Vocational/Technical Institute

In 2016, we completed the renovation of the guy's dormitory at CDVTI, but there was a problem. The only toilet available was one very small flush-type used by the female teachers! So, we built another UDDT. Not quite completed in this picture, but you can get the idea.

Students in construction, welding/fabrication worked with the contractor and learned the principles of this type of toilet.

Urine Diversion Dry Toilets (UDDT

Urine Diversification Dry Toilet.

BUT, in 2013-2014, the Pacific Northwest Chapter of Engineers Without Borders, based in Bellingham, WA, built a new design "UDDT" toilet at a 250-student junior high school in Axim.

And in 2015, Ghana Together funded this second UDDT at the Methodist-Government School in Axim, serving about 750 children!


Not only will this help the school and nearby community, but the design is much improved over currently used toilet designs. EWB has shared its drawings and expertise openly. Low impact, no piped water needed, good compost, hand sanitation, acccommodation for menstrual needs...

KVIP Meeting

Ghana Together nurtured this project. When Maryanne Ward was in Axim in 2012, she met with local leaders, including James Kainyiah (WHH); Mrs. Yawson, Headmistress;  Fr. Paul Awuah; Mr. Emmanuel Appiah, contractor; and teacher and parent representatives. .

The Maryanne on behalf of EWB, and the Axim group signed the formal EWB proposal.

We can help groups like EWB facilitate their projects, ensuring ensuring they are are well-planned and expectations understood.


Boys at Well


In 2009 a team from this same EWB Chapter traveled to Axim to learn about the place and do a water assessment. They learned much about the municipality of Axim and its water supply. They conducted classes for the engineering students at the Takoradi Polytechnic, taught them how to map water systems professionally, and introduced water system evaluation techniques.

They pulled together representatives from the various agencies dealing with water, from the local to the national level, and other local Axim leaders. Using the WHH facility conference room, they facilitated an all-day water advocacy meeting. As a by-product, they modeled meeting facilitation techniques, using small groups, brainstorming, consensus building, etc.

From this experience, the EWB team decided their best contribution would be in toilets and sanitation, which inspired the KVIP project outlined above.

Shown here are boys getting water from a shallow well. On our 2012 visit to Axim, we met some Chinese contractors who were laying some new pipes for the Ghana Water Company in Axim. Hopefully that will increase the number of piped water spigots.

Hand Sanitation Program - Veronica Buckets

Veronica Bucket

Axim has 19 schools for primary and junior secondary students, and many of these schools have hundreds of children in attendance. The schools have very primitive bathrooms and usually have had no place to wash hands. In this region of Ghana, the leading cause of death is malaria, but the second and third causes of death are diarrheal and lower respiratory diseases. Simple hand washing has the potential to save lives.

Enter the Veronica Bucket! Invented by Veronica Bekoe, a biological scientist who worked at the Public Health and Reference Laboratory of the Ghana Health Service from 1972 to 2008, the VB consists of a wooden stand, a large bucket of water with a spigot near the bottom, and a wash basin placed below the spigot. This hand-sanitation setup is entirely fabricated and maintained in Axim by local craftsmen. In addition to the wooden stand and bucket, towels and soap are placed at the Veronica Bucket station. Each Veronica Bucket costs about $50.00.

Madame Bekoe was given an award by the Ghana Health Service for her innovation.

Mr. John Abugri, then an Nzema East Environmental Health Officer, requested these stations in 2008. Jeanie Birchall, a nurse from Bellingham, WA facilitated a connection with generous employees from the Whatcom County Health Department in Bellingham, WA. They  contributed funds. John himself arranged to purchase the parts, worked out the spigot which had to be procured in Accra, at least eight hours tro-tro ride away, found a local carpenter to build about 60 of them, and distributed the buckets.

But, here is where our inexperience has led to some disappointment. John himself left that position and became a teacher in a Nursing School some distance away. While he was still supportive, he also was elected to the District Assembly. This very busy man did not have time to monitor each school himself.

And, we didn't really coordinate carefully enough with the most important players—the school headmasters/mistresses and lead teachers. Accustomed to an economy of extreme scarcity, some schools tucked the VBs away in storage rooms, keeping them "safe", and using them only for special occasions. They were afraid the children would "spoil them," as they say. And indeed, the children were rough on them—some of the basins were used for throwing games and they were broken. The kids were fascinated by the spigots, and sometimes played a little too vigorously...

SO, built on a much better understanding, we are now re-visiting the veronica bucket project. visiting every school, discussing hand sanitation, and the role the buckets can play. A use and maintenance plan is worked out with the school leaders. Older children are trained to care for the buckets as part of the ongoing "proctor" program (it's a great honor for P6 students to be named a "proctor").  



One of our most satisfying projects was funding surgery and ongoing care for Kwao, an Axim boy born with two club feet. His successful surgery was in large part due to his Mom and Esi Biney, a senior "auntie" in Axim, who guided the family through months of medical attention. Kwao's family has moved to another city, but last we saw him in 2011, he showed us how he could run in his Dr. Brown shoes! A wonderful moment! Until then, his Mom had to carry him everywhere. He could not walk a step. Thank you to Esi who doggedly pursued this on our behalf, and who convinced the family that it would be OK to let the strange Dutch doctor do his work---and thanks to that anonymous Dr., too, wherever you are...




Emmanuella is one of the original Western Heritage Home scholars. She lived in the Heritage until it was closed. Diagnosed with early onset macular degeneration, she is blind. She is now a student at the Ghana National College Senior High School for the Blind.

Emmanuella is a wonderful singer. We were told she sang the national anthem at the 6 March Independence Day celebrations, before a large crowd! She told us it works because the blind sing and ue their arms to show the rhythm, and the deaf dance.

We support Emmanuella with her personal needs: school supplies, clothing, toiletries, menstrual supplies, etc.

She is show at right at her school, with the water tanks and dormitory in the background, with Maryanne Ward, of Ghana Together.