Ghana is a low-income country with a high dependency population of 18.4 million people. Of these, approximately 45% are less than 15 years old and only around 20% of the workforce is in formal employment. In spite of this, up until very recently, health care in the country has operated under the so called 'cash and carry system'. Under this scheme fees were introduced for health care services in order to recover costs but this brought untold hardships for the poor and vulnerable and created many instances where urgent care was denied because of the inability to pay.

Add to that the fact that many people in rural areas have poor geographical access to even the most basic health care and that where this does exist it is inadequately funded and drugs and equipment are frequently in short supply, it is clear there are many serious hurdles still to overcome if the health of the average Ghanaian is to be improved.

The Government of Ghana is attempting to make these improvements in public health and a fledgling government health service was introduced in the last year. However this is still extremely poorly resourced in terms of drugs, equipment and medical staff.

The Friends of Ashanti are now into the second year of an ambitious hospital build project in the village of Kotwi near Kumasi. This is to be a 56 bed two storey general hospital named the G G Marvin Hospital, in memory of the head of the family of three of the charity's trustees. Initial estimates in May 2006 put the cost of construction at £200,000 and although we are able to provide regular funds of £300 a week, it is clear that more help with funding is needed to bring the build to completion within a reasonable timescale and prevent costs increasing over time.

The weekly contributions are used to buy all the construction materials such as steel reinforcement, sand and cement and to pay decent wages for the workforce. Each concrete block is individually hand pressed in a mould and although this is a painstaking task, the work has progressed well. With continued support we hope to have the fabric of the hospital completed by 2009/2010.

Once this is achieved one of our most important tasks will be to attract some of Ghana's finest Doctors, Nurses and health care staff. It is a sad but true fact that, despite Ghana offering excellent undergraduate training for its medical students, very few of those trained remain in Ghana and instead over 60% leave for the developed countries including the UK. Whilst some may return to Ghana with the benefit of their experience in the developed world, in theory very few choose to do so. The reasons for this brain drain are primarily down to the lack of decent facilities to work in and the comparatively poor financial rewards for their efforts back home.

With the 'G G Marvin' we hope to create a flagship hospital incorporating the very best of facilities and delivering the highest possible standards of medical care - in short a hospital in which 'home grown' Doctors would be proud to work and, more importantly, a hospital which primarily serves the health needs of the some of the poorest Ghanaian people.