our history
The Navrongo Health Research Centre: Its VAST Foundations:
By David Ross with Fred Binka, Betty Kirkwood, and Peter Smith -
April 2014
For more than two decades, the Navrongo Health Research Centre (NHRC) has been a leading institution conducting groundbreaking health research that has had a major influence on public health in Ghana and internationally.
NHRC begun it’s journey from the Ghana VAST Project, a pair of vitamin A trials conducted between 1988 and 1992.
It is produced on the occasion of the celebrations to commemorate 25 years of health research by the Centre in late April 2014.
The Ghana VAST Trials
Fred Binka and Survival Study Fieldworkers, 1989
The very first two Ghanaian members of staff were Heywood Benjamin (driver) and Everest Dery(administrator and accountant). They were soon joined by KwabenaBadu (laboratory) and then eight field staff who did their national service with us: Bright Abalori, Julius Adigao, AmisumAnyoka, Julius Ayuure, Elias Felikogo, Ricky Kasise, Cletus Katafisiga, and Godwin Minyila. In early 1989, the Survival Study team was boosted by Dr Fred Binkaand Seth Owusu-Agyeiwho joined the team from the Noguchi Memorial Institute for Health Research in Accra. The Ghana VAST Health Study team, led by Betty Kirkwood and Paul Arthur started to assemble in Navrongoin late 1989. At its peak in mid-1991, the total number of Ghana VAST staff based in Navrongohad risen to over 150, more than half of whom were field staff.
Betty Kirkwood and members of a Health Study family, 1990
”The years in Navrongoremainthe highlight of my career. Many people that I met through Ghana VAST have become lifelong colleagues and friends –and one became my wife!” David Ross
For ease of data entry, all Ghana VAST staff were assigned a two-letter staff code; a tradition that still holds within the NHRC. Given the large number of names that started with A or M, those combinations were soon exhausted and staff had to choose staff codes that were not based on their initials. Some largely abandoned their real names in favour of their staff code.
Everest Dery, Paul Arthur, Fred Binkain a staff meeting, 1989′
Staff party, 1989
A staff party was held every four months. Staff contributed to the costs of these parties, which became legendary events that were eagerly anticipated by all.
DBetween Oct 1988 and March 1992, a collaborative team from the London School of Hygiene & Tropical Medicine (LSHTM), the Kwame Nkrumah University of Science and Technology (KNUST), and the Ministry of Health of Ghana conducted two large, placebo-controlled, vitamin A supplementation trials in Kassena-Nankana District, Upper East Region, Ghana.
They were known as the Ghana Vitamin A Supplementation Trials (Ghana VAST), and included:
- The Survival Study in which the primary outcome was the impact on mortality over two years of 4-monthly large oral doses of vitamin A. 22,721 children aged 6-90 months were recruited into the trial and each child’s household was visited every 4 months.
- The Health Study in which the primary outcome was the impact on morbidity over one year of 4-monthly large oral doses of vitamin A. 1467 children aged 6-55 months were recruited into the trial and each child’s household was visited every week to record illnesses, and the mother was also asked to keep a daily symptom diary for the child.
Both trials were funded by the UK’s Overseas Development Administration (ODA) (now the UK Department for International Development).
The Survival Study showed that vitamin A supplementation significantly reduced young child mortality by 19%, and the Health Study showed that vitamin A supplementation significantly reduced indicators of severe illness (severe diarrhoea, severe respiratory tract infections, clinic attendances and hospital admissions), but did not reduce signs and symptoms of mild illness.
The combined results from the two trials confirmed apparently conflicting findings from previous trials that had found no impact of vitamin A supplementation on (mild) illnesses, while other trials had shown an important reduction in child mortality.
The two Ghana VAST trials were very influential and, in combination with other trials conducted around the same time, resulted in the adoption of vitamin A supplementation as a priority child survival intervention in low and middle-income countries -a public health priority that persists to this day.
INFRASTRUCTURE: BUILDINGS AND ROADS
To conduct the two trails, completely new research infrastructure was created in the grounds of the War Memorial Hospital in Navrongo. The project started with two pairs of semi-detached bungalows (later a third was added) that had just been constructed for hospital staff accommodation on the edge of the War Memorial Hospital’s grounds, and one staff house in the centre of town (later a second was added).
Unfortunately, when the team first arrived in Navrongo in October 1988, the houses on the hospital compound had not yet been handed over by the builders, and only one of the new houses in town (known as Chalet No.3) had been completed, so the ground floor of the Chalet became the project office with initial staff accommodation upstairs. After the project had constructed a road into the Ghana VAST compound, connected the buildings to the mains electricity, installed a back-up generator, and dug a lined well and installed an electric pump in it, the project offices moved to the War Memorial to the current site of the NHRC.
The Ghana VAST administration, led by Everest Dery, was housed in the bungalow closet to the main gate, with the kitchen converted into a small laboratory that was led by Kwabena Badu, while, the computer centre was established by Nicola Dollimore and Martin Adjuik in the bungalow next door. Most of the field staff were young men, and many of the computer centre staff were young women, so field staff sometimes found excuses to pay the computer centre an extra visit.
The other two pairs of bungalows, the two government houses in town and later a house on the Irrigation Company of Upper East Region’s (ICOUR) Tono compound, were used a senior staff accommodation. Other staff either lived at home or with friends or rented accommodation in Navrongo town. As massive quantities of paper-based data were accumulated, shipping containers were installed to store them.
The Main entrance, 1989
The administration, lab, and computer centre, 1989
SENIOR STAFF OF THE GHANA VAST PROJECT
Survival Study:
- Prof Peter Smith (LSHTM, Principal Investigator)
- Prof Hutton Addy(KNUST, Co-Principal Investigator)
- Dr David Ross (LSHTM, Director)
- Dr Fred Binka(Ghana Health Service, Epidemiologist and Health of Fieldwork)
- Ms Nicola Dollimore(LSHTM, Statistician)
- Mr Seth Owusu-Agyei(Ghana VAST, Assistant Head of Fieldwork)
- Mr Martin Adjuik(Ghana VAST, Data Manager)
- Ms Margaret Gyapong(Ghana VAST, Assistant Head of Fieldwork)Health Study:
- Dr Betty Kirkwood (LSHTM, Principal Investigator)
- Dr David Ross (LSHTM, Director)
- Dr Paul Arthur (Ghana Health Service, Epidemiologist and Head of Fieldwork)
- Mr Saul Morris (LSHTM, Statistician)
- Dr John Gyapong(Ghana Health Service, Clinician)
- Mr David Pendlebury(Ghana VAST/VSO, Assistant Head of Fieldwork)Laboratory:
- Mr KwabenaBadu (KNUST, Head of Laboratory Services)Administration:
- Mr Everest Dery(Ghana VAST, Administrator and Accountant)
- Ms Margaret Bugase(Ghana VAST, Secretary)
- Nina Saroi(LSHTM, Administrator in London)
Steve Tulloch, Jerry Weaver and Sharon Huttly, three statisticians from the LSHTM, also spent short periods working in Navrongo.