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The heavily-fortified Ivory Coast border
Some of my respondents are in Ivory Coast. They end up in our sample because they have visited health facilities in Ghana.

Why do Ivoirians come to Ghana for health care? Ghana has a very affordable national health insurance program. It’s not easy in rural areas to verify who lives where, so Ivorians in border areas occasionally sign up for health insurance, reporting that they live in a village on the Ghanaian side. Sometime they even give a typically-Ghanaian name, in place of their French-ier real one.

This is bad for Ghana’s government budget, but it’s bad for us too, because it means that we are trying to find respondents with fake names, and we don’t even know what village they come from. Our typical strategy is to go to the handful of villages near the border, ask for anyone who might have visited the Ghanaian health facility, and see if they are the person we are looking for.  You can imagine, when we walk in and essentially ask “So anyone around here defrauding Ghana Health Services?”, how many people yell “Me, me!” Surprisingly, though, we actually find people.

I spent one day serving as moto driver for one of my surveyors, Nana, in the border area. The road was rough—in many places impassable by car—and the surveyor had never been on a moto in his life.

When we first arrived at the health facility, still in Ghana, I asked the surveyor how far it was to the border, expecting it to be maybe a mile or two.  He pointed to a spot two meters to my left.

We crossed into Ivory Coast about three times that day.  Most of the borders weren’t even marked. There was one border crossing where a couple of Ivoirian border police were playing cards. They were happy to give us directions to the Ivorian village we wanted to visit.

Once across the border, not much changed, except that people in rural villages spoke French the same way they speak English in Ghana—that is to say, not much.  I was able to communicate more with my tiny bit of Twi than with my more extensive (if badly pronounced) French vocabulary.  Nana, fluent in Twi, was fine.

The day ended with several unfruitful hours looking for “Sabrina”. I felt pretty good though. On the drive home, I smugly told Nana that there were not too many PAs in IPA who would have driven these roads and asked for directions in French and Twi. He winced and rubbed his seat as we hit a bump, and I am pretty sure he wished he had been with one of those other PAs.


 


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