In October Liz and I went to Tamale again to run the second part of the course with the group learning how to make standing frames for the children. This time CPA are sent two Physios, Diane Lyle (not related to Liz) and Diana Jackson. Diane and I reviewed six children (exhausting in 38°C heat and 89% humidity), four of which received frames made by the course participants, which will help them with developing control of their head and upper body. A high point was when Mandi and his Mum called in to the Physio Department to show us the fantastic progress he had made since receiving his chair in February. The course ran from Monday to Saturday, long days from 8am to 6pm, sometimes without power for the electric kettles needed for glue making, it was a long trek to the children’s ward in the main block which had a generator. Four children received custom made standing frames at the end of the course. Since the end of the first course three more children have had supportive chairs made for them by the group. Then it was time for the CPA Physios to head for Bolgatanga where they were going to catch up with the APT workshop at Sandema and visit Bongu on the Burkina Faso border. Liz and I went to stay at the King’s Village at Botanga about an hour’s journey from Tamale, where we had a busy three days. Monday was spent at the Medical Centre, a small hospital in the process of extending. I was called to the Emergency Ward to give Physiotherapy to an unconscious 3 year old being treated for cerebral malaria to try and reduce some of his spasticity. I spent time explaining to Mum, with a nurse interpreting, how to continue regular exercises. We later heard he was discharged home as his malaria had not responded to treatment. Many patients presented too late for treatment to be effective. Often local herbalists will have offered treatment first and patients and their families only seek medical treatment if they deteriorate and can access funds and transport to reach hospital. Tuesday brought a visit to Kapahli, a distant village, two hours bouncing in the pick up truck along rough tracks with the Nutrition Officer, Kristal, and John, King’s Village project workers, to allow me to see Musa, a tiny six year old boy with CP, club feet and malnutrition. He received one of the car seats sent out in the container that left Beverley in January. This had been tied into a wheelchair allowing his brothers to push him to school. I showed his father how to do exercises to move and strengthen his limbs. I then reviewed another child and a remarkable older lady with a cleft palate who had been disabled for many years, probably due to polio, who happily demonstrated to us how she could get in and out of her ancient hand propelled wheelchair. We measured it up for new cushions which John will have made up at King’s Village. Our next stop was a sit down in the recently opened Ghana Health Service primary healthcare clinic where the nurse, administrator/helper, patients and drugs were all cooking in the heat from the tin roof. We used some of the money given to us by the Soroptimists to arrange for John and Kristal to buy a freestanding electric fan to take there on their next visit. John then visited a mother who had refused further antibiotics and dressings for her infected finger and found that she had had a change of mind, the finger was healing and no longer in danger of needing amputation. Wednesday was a health education day for the children at King’s Village School. I gave talks about disability and inclusion to four groups from the smallest ones, who sang beautifully to us, up to the seniors aged 15. Liz repeated the disease prevention and public health messages as despite access to clean water, many of the health problems are linked to poor hygiene and not sleeping under mosquito nets. Some of the children had old untreated injuries and disabilities no longer seen in the UK. I saw two more patients before we left both of whom would have had fewer problems if prompt medical treatment and physiotherapy had been available. A farmer initially treated by a healer had nearly lost his arm to an infection, now after prolonged hospital treatment he was on the mend. I showed him some muscle strengthening exercises. Another man had made a good recovery from a stroke but had totally lost his speech. There are only seven Speech Therapists in Ghana, all in Accra. On Thursday it was time to fly back to Accra with the CPA Physiotherapists and renew links with Multikids Inclusive Academy, a very progressive private school for disabled children with Physiotherapists, Occupational Therapists and 3 Speech Therapists as well as Specialist Teachers, a whole different world away from Northern Ghana.  We also visited the Physiotherapy Department at Korle Bu Teaching Hospital and met with three of the ladies who run the APT workshop there located in two shipping containers. There is the possibility of starting a second APT group in Accra at Multikids in Spring 2018. We were able to attend Sandra’s funeral held in the Central Region, three hours journey from Accra. It was a traditional Ghanaian Pentecostal funeral attended by members of her family and a lot of her friends. Some of the ladies from Wa in the Upper West Region had travelled for fifteen hours in a minibus. Pastor Ben from King’s Village, who knew Sandra, assisted in the service and conducted the burial. Sandra’s life and many achievements in Ghana were celebrated with joy.