The Bimoba :The People of Yennu


Hans J. Meij,
David van Bodegom
Daniel Baya Laar


In their book on Human Molecular Genetics Strachan & Read state that “Genetic research is of help in anthropological research”[1]. The other way around is true as well. To fully understand the epidemiological, demographic and genetic data, collected for our medical research, we needed the sociological, economical and anthropological background of the study population, the Bimoba.
The Bimoba tribe is scattered throughout the Upper East Region of Ghana, the western part of Togo and the southeast area of Burkina Faso. It is arguable whether the Bimoba are a tribe or not. Some mention them as a group only. Until now little has been written about them. We found one anthropological publication of sixteen pages describing the Bimoba in general and one unpublished essay [2,3]. Therefore, we collected data about the Bimoba, their history, their beliefs and their present situation alongside our medical research fieldwork in the FarFar area. This is the southern half of the Garu-Tempane district; Upper East Region, Ghana).
The aim if this chapter is to provide a general description of the Bimoba as a whole and a more detailed description of the Bimoba clans living in the research area.

In 2003 we stayed for five months in the FarFar area of the Garu-Tempane District. We conducted multiple field visits to obtain information about the Bimoba. We continued this research in 2004 - 2006 during four additional periods of field research (February 2004, July-August 2004, 2005 and 2006).
For the data collection of this concise ethnography of the Bimoba people we used the Rapid Assessment Procedure as basic method [4]. In this procedure it is assumed that descriptive material on the local cultural systems is available. Since hardly any written material exists, we additionally investigated the economic system, kinship, religion, and social organization.

The information about history, traditions, and religion was collected during a series of structured and non-structured interviews with older men (some Jaba (sub seers) among them) and women, as well as some Bimoba chiefs of the region.
The information about housing, habits, work, and social structure was collected through participant observations in four randomly selected compounds and some additional interviews with the landlords of these compounds. Apart from this, group-interviews were held with Bimoba women from different villages to obtain information about daily life activities and habits.
The demographic information, demographic characteristics and survival curves are based on our (medical) demographic research database. In this database all inhabitants of the research area are registered (in total appr. 25000 individuals). A total update of this demographic database is carried out annually since 2001.
To measure the health and medical situation we performed an in depth health survey among 2.000 inhabitants of three villages in the research area: (Bakinakoan (usually called Benakpezir), Zariboko and Tambalo). Finally we interviewed several traditional healers about their work and practice.

We reviewed the available literature. As mentioned above, the total number of articles and publications is low and usually of poor scientific quality.
Although some books and articles acknowledge the existence of the Bimoba, no general description has been found yet. Unlike the neighbouring tribes like the Mamprusi [5], the Kokomba [6], and the Kusasi [7,8], the Bimoba are not known by way of sociological, anthropological, or historical study. On the rare occasions that the Bimoba are described, it is always short, or even just a footnote. [9,10]
In 1990 the CUSO development organisation of Ghana asked Max Assimeng of Legon University to give a brief description of the Bimoba. CUSO missed background information about the people they worked with and Assimeng drew a sixteen pages sketch of the Bimoba [2]. He mentioned the existence of a few short unpublished essays about the marriage of the Bimoba [11], about the Koant, an initiation rite, and about some fragments of Bimoba history [12,13]. However, we could not trace these articles in the Upper East, nor in Accra or Legon.. However, there are many anthropological publications about the neighbouring Moba tribe in Togo, which in its system and rituals has many things in common with the Bimoba. Especially the monography of Juergen Zwerneman “Studien zur Kultur der Moba (Nord Togo)” is comprehensive [14].

A brief introduction to Bimoba history
The origin of the Bimoba people is not clear. According to oral history the Bimoba originate from the east and the west of Africa. Assimeng states that the Bimoba came from Burkina Faso, but he also describes other possibilities[15]. All written sources are clear about the fact that the Bimoba tribe is a combination of different smaller groups, although the combination of clans is different in each and every source (Bims, Moba and Daggams [2] or Moba, Basaalis, Gurmas, and Kokombas [16]).
The Moba, closely related to the Bimoba, migrated from Sudan to the west of Africa and it is clear that some clans of the Bimoba (the Naniik, Kpikpira and Nabakib clans) were sub-groups of the Moba. There is no clear indication when the Moba or Bimoba actually came to the west, but oral history claims that they did so in the aftermath of fights at the end of the Shilluk reign, 1500 AD [17]. They all settled along the route from Sudan to Ghana. The Bimoba settled at the end of the line and claim that they have migrated from the Sudan separately. They seem to originate from nomad traders.
Some other clans (Tambiouk, Maab, Bakpang and Tont) came, according to oral history, from the area that is presently known as south Togo and the Southern regions of Ghana (Ashanti en Dagomba land).

Although the Moba have some form of tribe structure, there is no such structure in the Bimoba group. They belong to the acephalous tribes [18]. In contrast with the surrounding tribes (Mamprusi (south), Kusasi (west), and Moshi (north) and Chekosi (east)), there are no kings, chiefs or big men among the Bimoba. The clan and clan group (see table 1) are the focus point of the members of the tribe. History varies from clan to clan. The only common history they share is the history of their first chief, Turiŋme. Allthough Turiŋme is connected to only four clans, all clans accept the story of his migration as the first fact of Bimoba history.
When they settled in East Ghana and West Togo, they occupied the least fertile and most remote parts of this region, mainly in the area they still live in. This indicates that they were not able or did not want to rival the existing kingdoms at large. As a result of this the Bimoba are a group with limited power. Up till now only a few Bimoba men from the more developed area of Nakpanduri (Northern Region) have entered the government at a senior level.
On the whole, the Upper East Region has been neglected for al long time. Compared to the south of Ghana, the region is still poor and less developed. The Gross Domestic Product of the Upper East Region is 304 US dollar per capita per year, against 2150 for the whole of Ghana [19,20].

As in many cases, it is arguable whether the Bimoba tribe truly exists. Many times people form a group (with its own history and habits) out of political reasons. The same could be the case with the Bimoba. We regard the Bimoba as an ethnic group with significant tribe elements, because the group is a well known, although not well documented, group of people, genealogic analysis shows clear evidence for endogamic relations within the group, the structure of the clans form an important and leading element in the social organisation of the group, and the people regard themselves as Bimoba and refer to the Bimoba as their tribe.

There is no exact figure of the size of the Bimoba Tribe. Most of the written sources estimate the total population of the Bimoba around 300.000. The Bimoba clans are spread throughout the upper west of Togo, the Upper East Region and the north-eastern tip of the Northern Region of Ghana. Approximately 17000 Bimoba are living in our research area, which measures approximately 400 square kilometres. This area is inhabited by 25.000 individuals (Bimoba (66%), Kusasi (24%), Mamprusi (4%), Fulani (2%), Busanga (2%) and some smaller numbers of other groups).

Figure 1 shows the total age distribution of the Bimoba population, based on our own observations. Fifty percent of all Bimoba is 12 years or younger (Ghana national: 33%), 2.3 percent of the population is 70 years or older. The life expectancy at birth is 55 years (Ghana National: 57,5 male, 59,5 female). These figures are quite different from the national data, but are in line with the underdeveloped status of the area. The situation in the Upper East Region is more like the situation in Burkina Faso than in Ghana [21]. Only the life expectancy, which is much better than expected, is almost similar to the south of Ghana.

As stated before, the Bimoba do not have an integrated tribe structure. There is no paramount chief or Bimoba king. The total group consists of more than 20 different clans. Each clan has its own geographical focal point throughout the Bimoba region. Table 1 gives the total clan and clan group structure of the Bimoba.
Bimoba can only marry outside their clan. Marrying outside the tribe is permitted, but rarely seen. By marrying, the wife is accepted to the clan of the man. She than regards herself and her kin as member of her husbands clan. If the husband dies, the widow can re-marry, but by doing so she might loose all her rights of possession and custody. Only when she remarries within the clan or clan group of her late husband, she will remain in her right.
In 2004 we performed a detailed genealogical evaluation of two clans in a typical Bimoba village. Despite the paucity of male variation, but likely because of the social ban of marrying within clans, we found the inbreeding co-efficient to be low [22].

Like many groups in this region, the Bimoba people are living in family compounds. Although extended family and clan are the main basis for social setting, most of the Bimoba are living in a semi-nuclear family compound under guidance of an adult man (the landlord). On average a compound is inhabited by 15 persons, but the largest compound we found had 214 inhabitants, the smallest only one. Polygamy is wide spread (figure 2). Bimoba men can take up to four women, depending on their financial means. Bimoba nuclear families are still large. The average number of deliveries in post-menopausal women is eight [23].
Bimoba are patrifocal and therefore, children always remain under custody of the father. Many women do have their first delivery before their official marriage and many of them with another man than their future husband. Casual sex before marriage is common and the children born out of these contacts are not frowned upon. The children are usually raised by the mother although at any time the father can demand that his child returns to his custody.
The work on the compound and at the farm is divided between men and women equally. The women on the compound divide their work between each other. If some of the women are farming or gone to the market, the other women of the compound take care of the children, including (breast) feeding. All members of the family, including the children, are part of the compound labour force, especially during ploughing, seeding, and harvesting time.

Political situation and power
The Bimoba Tribe is one of the smallest ethnic groups in Ghana. Being only 0.6 % of the nations population and having no chief or kingdom, they lack any formal power.
In Ghana there are - basically three different power systems. First, there is a governmental system with a democratic structure throughout the country. Second, there is the rural chieftainship. Each region has a chief, appointed by the government and an informal tribal chief. These chiefs are assembled in the ‘district house of chiefs’. The chiefs are highly respected mediators between the people and the government, but lack official power. Third, many tribes still have their tribe-chief or king. The tribe-chiefs and kings can settle disputes and deal with tribe and family matters. The Bimoba have some tribal chiefs but the chief of the (Bimoba) FarFar district is a member of the Mamprusi tribe for twenty years now, although the Mamprusi tribe form less than 3 % of the population.
The regional chieftainship of the Northern Region caused recurring tribal wars in the last century. Several wars were fought between the Konkombas and the Bimoba. These wars have costed thousands of lives. The original sporadic fighting has become more frequent, more intense and wider in scope since the 1980s and the destruction of life and property more widespread. By official counts, the Konkomba-Bimoba wars of 1984, 1986, and 1989 left 60 people dead, with several hundreds displaced. This tribal fight was part of a larger series of tribal fights. Most of these wars were fought in the Northern Region (the Gonja-Nawuri War of 1992; the Konkomba and allies against the Gonjas in 1992; the Konkombas and Mossis in 1993. Finally, the 1994/95 Guinea Fowl war in which modern weapons were widely used, resulted in at least 2,000 people killed, 200,000 internally displaced and 441 villages completely destroyed [24]. These fights were mainly induced by the introduction of a district council and the changing political structure (the power of the traditional leaders weakened). Clashes are rare now but the Bimoba - Konkomba relationship is still a matter of concern.
The Bimoba of the Upper East region escaped most of these atrocities but seem to be more and more aware of their situation nowadays. Some are interested in the chieftainship, but did not reclaim it yet. At present the Bimoba are living in relative peace with the surrounding ethnic groups and do not pay a lot of attention to the relative powerless chiefs of the region.

Yennu is the God of all Bimoba. Yennu is a complex referring to all different elements of the power of God. The name Yennu is used to describe “god”, it means “sun”, as well as the various places in a compound dedicated to Yennu (or as one of our informants puts it ”everybody has his Yennu but there is only one God almighty”). Yennu is also the name for the pile of sand that sort of marks the “center” of any N-Yennu (the personal God, possessed by an individual). This pile of sand is also referred to as Yennu and should therefore be regarded as part of any Yennu, or as an informant puts it: “the pile alone should be enough.” Yennu is extremely important in daily Bimoba life and his might is everywhere. The influence of religion cannot easily be over estimated.

The Bimoba religion is purely individual. There are no churches or weekly gatherings. Nevertheless, Yennu and all elements of the religion are completely integrated in normal life. Besides the important and ever present Yennu, ancestors play a major role in daily life. The ancestors are – although deceased - still living on the compound and they guide the Bimoba through his life. They are in close contact with Yennu and every life spirit (Mier) and body (Gbanant) is not only of the living “owner”, but also theirs. To please the ancestors, rituals and sacrifices are made. These sacrifices are made on the Patir (plural: patra), a clay construction annex to the inside wall of the ritual hut (Nakouk). The patir is a place of worship for the whole compound, men and women, although women do not enter the Nakouk.
Besides the communal Patir, every man or woman can put up his or her own small altar, called “Mier”. The Mier of a woman is set up in her own hut, the Mier of a man is usually set up inside or next to the Nakouk.

Apart from the individual shrines/altars, the Tingban is the shrine of the whole farm or the whole village. Tingban is usually a pile of stones or a tree (Baobab mostly) on a place, selected by the Jaba, the religious sub seer. The village Tingban consists of four shrines (one main shrine, two sub-shrines, and one shrine for Tinnj Yennu (the earth God). Bimoba visit their Tingban in case of problems (sickness, too much wind, long drought, insects, etcetera).

To communicate with Yennu a Bimoba can pray to the ancestors or see his Jaba. The Jaba is a senior member of the Bimoba who possesses supernatural powers. He is a mediator between the people and Yennu. All the individual arrangements of N Yennu are the concern of the Jaba.

Traditions and rituals
Based on our interviews, we found only a few Tribe festivals and rites, most of them being rites of passage. The Festival of Danjuor, where the history of Turiŋme is told and the coming of Turiŋme to the region is celebrated. This used to be the biggest and most colourful festival of the Bimoba. It had not been held for some decades, but in January 2004 the festival was reintroduced. The Danjuor festival includes music, dance, and one-day coming together of all Bimoba. The Danjuor festival of 2004 was visited by over 2500 people.
In the Bimoba tribe four rites of passage are of great importance: the Koant, (a language course or name giving process), the Ba Wanu (a ritual to establish Jaba’s), the wedding, and the funeral.

In the Koant ritual a secret language is learned and a new name is given to a member of the tribe undergoing the ritual. Each member of the Bimoba has different names. Apart from the first and family name, many have a Christian or Muslim name, mostly used when going to school or going “Kumasi”(far away). Besides these names Bimoba can obtain a ritual Bimoba name. These names (Konjit, Konduuk, Dinwaak and Tanjon for women, Duut, Laar, Kombat, Lambon, Konlan and Bombom for man) are given to them during a lengthy initiation process. This ritual is regarded to be holy and secret. Unlike other tribes, any Bimoba, man or woman, can request a Koant. The ritual is not compulsory and nowadays hardly performed, but still many initiated (Koantjies) are living in the area. Before entering the Koant process, the Konatji (the one undergoing the Koant) requests permission of the most senior Koant-member. After consulting the parents of the Koantji, the date of entering is fixed. The whole Koant process takes three months for men and four months for women. It gives the Koantjie a highly regarded status and the possibility to speak with other Koantjies in their own, secret language.

Ba Wanu
The Ba Wanu initiation, which most Bimoba under go, establishes whether you are a Jaba (sub seer) or not. The initiation takes 12 hours or even more. The Ba Wanu initiation is requested by a person’s Miar (which literally means nose but actually means a man’s spirit). Usually this happens when uncommon things happen to life like death, drought, or heavy flooding. There is no fixed age for married males to undergo the Ba Wanu initiation and, although it is possible to do the Ba Wanu at any age if you are not married, the vast majority of the unmarried men do not undergo the Ba Wanu under the age of forty. Women do not undergo the initiation if they are not married and if married they only do the Ba Wanu at the age of forty-five. The actual initiation is usually done by a Jaba, selected by another Jaba. The complicating factor is, that if a wrong Jaba is chosen to perform the initiation, the person initiated can either die or go mad. The owner of the Miar is made to faint for some time. In this period of unconsciousness the man can see whether he is a Jaba or not. If he is a Jaba, he will see two dwarfs (a man and a woman) on the rooftop of the nakouk. The attendees of the ritual will listen to his recollections after he comes back to his senses. If the attendees are satisfied with the answer (in fact the right description of the dwarfs on top of the nakouk) they can decide that the man is a Jaba. This implies that every Jaba has undergone the Ba Wanu initiation, but not every person who has undergone the Ba Wanu initiation is a Jaba. The person known to be a Jaba is then trained by an older Jaba. This training includes the interpretation of the message from the dwarfs to the people who come to him for consultation.

Women do not undergo this fainting process but they can be a Jaba if their miar want them to be. There are only a few female Jabas in the bimoba community. Although female Jabas can not perform the ba wanu for another person, they can advise other people.

The Bimoba regard marriage to be an important ritual, but the actual wedding is of extremely low profile. The original ritual (Pochianu) has faded out almost completely. Nowadays the broom seeks the permission of the father of his wife to be. This permission is obtained by intermediaries. Up till now there is no fixed bride price, and only small gifts are send to the father after agreement (cola nuts, guinea fowl, some local gin). The wedding ritual itself is performed by a simple visit to the parents of the bride. After this visit the broom sends more cola nuts, tobacco, two bottles of gin, a jerry can of local beer, and two guinea fowls. Influenced by the Kusasi culture, an additional bride price of four cows is set in most of the cases. This part of the bride price can be delivered during the first years of the marriage. Although not original Bimoba, this additional pricing has become widespread.
Reciprocal wedding arrangements are known, but now fading out. There is no other ritual in the Bimoba culture in celebrating a wedding, but due to the introduction of world religions, some seek the blessing of the church. This is – due to the low percentage of Christians and Muslims - still very rare.

Funerals are the most important social activity among the Bimoba. Each funeral is visited by hundreds of people and the funerals are a social event instead of a sad gathering of mourners.
Most of the funerals consist of two consecutive parts, the Kumian (Fresh Funeral) and the Kukoan (final funeral rite). Kumian and Kukoan are only performed for natural deaths. In cases of Kubir (bad death) a different ritual is performed.
The funeral of a male Bimoba takes three days, for a female it takes four days. During the first day, the funeral is announced in the early morning by firing carbide grenades, three for a male, four for a female. As soon as possible the corps is placed in a round grave close to the compound, naked in a sitting (foetal) position. The grave is covered and the water bucket of the deceased is put on the grave, broken into pieces, to mark the end of his life. At sunset some clans perform specific funeral rituals. The following two or three days the family and close friends stay together to remember the deceased and are visited frequently by relatives and friends.
The Kukoan (final funeral rite) is performed some time later, during the (next) dry season. Again the social gathering of the clan and friends is the central part of the final rites. They are famous for the social side effects, i.e. sex, alcohol use, and dancing.

As in most groups, rituals play a role in balancing society (as well as religion does). In the Bimoba tribe two rituals are important in keeping that balance: The Koant (name giving) and the Bawa Nu (appointing of Jabas). Through the Koant, the adults have learned a new and secret language in which they can communicate among each other at any time and place they want. This gives the group an elevated position over the rest of the tribe who cannot understand the language.
During the ritual of the Ba Wanu, the new Jaba’s are selected. Although it is said that the Ba Wanu has to see the dwarfs during his absences, the attendees of the ritual decide whether the candidate saw the right dwarfs or right things. So in fact the clan (or at least those attending the Ba Wanu) decides who is a new Jaba and consequently one of the new informal leaders: if they do not want a certain candidate, they can easily say that he just did not see the right things. This balancing power is seen more often and is quite influential. It maintains the balance in the community without harassment of those who were rejected as being a new leader. In Africa this pattern is seen for instance in the Mwari Cult in Zimbabwe [25].


Leadership and organization
In contrast to most of the surrounding tribes, the Bimoba don’t have their own chief or general leader. As stated before, they belong to the acephalous tribes, tribes without rulers [18]. The clan is regarded to be the most important organizational structure. Apart from this clan leadership, Bimoba accept the ruling of non-Bimoba chiefs. In our research area, one of the regional chiefs (the chief of Zariboko) is a Mamprusi and he is in charge of the whole area, including the Bimoba living there. The Bawku naba (chief of the whole Bawku district) is a Kusasi.
Due to the strong clan structure and the close-knit clan network, the mutual assistance system is extremely strong. Due to this system, the Nnoboa, the Bimoba have a norm of assisting the clan with the building of huts, farming, and sharing wealth.

All the land in the FarFar area is owned by three clan-families. The boundaries are based on family history. The oldest man of the clan is the caretaker of the land and decides who can live or cultivate the different parts of the property.
Not all the land is cultivated yet, and not al the cultivated land is cultivated by the owner. Landowners share uncultivated land with clan members as part of the Nnoboa. This is done at no cost, but the land has to be returned to the owner when needed. Since the boundaries are only based on this oral agreement and only marked with small trees or crop, many conflicts occur.

Figure 3 shows a plan of a Bimoba compound. Bimoba housing is extremely simple. Each compound consists of a number of round huts placed in a circle. The compound is located in the middle of the property (farmland). All huts are made of clay and the roofs are made of reed and straw. The huts have no windows. Due to its vulnerable structure the average life span of a normal hut is up to four years. Over the past decade rectangular shaped huts with corrugated iron roofing were introduced. Many farmers combine one or two of these modern huts with a series of traditional huts.
There is one hut for every adult (starting at the age of thirteen). There are separate huts for the children who sleep together until they reach puberty. There is a hut for storing food and a patra (ritual hut). All huts are linked by a wall. The wall and huts seal off the compound from the outside world. In front of the compound, some huts are placed for the animals and birds. Kitchens are placed in the centre of the compound, one for each women living on the compound and some times a common kitchen for brewing bear. Some corners between the huts are separated by a small wall and used as a shower.
Three villages have access to electricity although the vast majority of the houses is not connected. If connected, the electricity is mainly used for illumination.

The Bimoba in the Upper East region are almost all subsistence agriculturists. Only a small percentage of the population is involved in petty commodity or informal trade activities. Every family farms predominantly for its own use and survival. The estimated average income is below the international standard of 1 dollar per day (poverty scale United Nations).
Investments in tools or machines are rare. The average farmland that is used by one family is about 10 acres, but the actual size of the possessed land varies considerably. Most of the families own land around the compound and acres further away. Many times the land is hired out to other Bimoba (as part of the Nnoboa).
There is one sowing season with two harvesting periods. During the sowing season, May - June, millet (early and normal millet), round beans, maize, corn, and groundnuts are sowed. Apart from these grain varieties, tomatoes, green pepper, and cotton are produced on a smaller scale. Harvesting of early millet is as early as July; the other products are harvested in late September and October.
The total farming is done by hand. In the whole Bimoba region, no tractor was found during our visits, but according to local informers, one tractor is available, owned by a Mamprusi big man. Some 40% of the farmers make use of bull oxes for the ploughing of the land. The others plough by hand. The ploughing with bull oxes is done by men, the hand ploughing is equally divided between men and women. Sowing is almost exclusively done by women.
Fertilizers are used, but not by all farmers. Many farmers lack the money to invest in fertilizers and insecticides. Bad harvests are common and famine occurs in some parts of our research area too. In years of famine, many farmers lack the money for clothing, schooling and healthcare. They are just surviving.
The actual situation does not differ a lot from the situation some fifty years ago. In her study "Tribes of the Northern Territories of the Gold Coast” Manoukian describes the farming north of the escarpment and closely mimics the present situation.[26]

Illiteracy is still very high among the Bimoba in the Upper-East. Based on a survey in three villages in our research area (n=960) we estimate that about 5 % of the population over 15 year old is able to read and/or write. Since we did not test their ability to write or read, the actual percentage may even be lower. About 25 percent of the present population of children between 4 and 15 years visit school. Since many children do not attend school regularly, this is an overestimation.
In the research area several primary schools (25 in total) and several junior secondary schools are available. Education at senior secondary level or higher is available in Tempane or Bawku. Garu, the nearest central market village, has some small schools for vocational training, but only a few Bimoba go there. Most schools are established and run by the government. There is no monthly school fee for primary schools, but the monthly fee for secondary school is 60000 cedi (appr. € 5).
Although all women mention the importance of good education, they admit that farming is more important and that most children prefer working on the land instead of going to school. Apart from this, the landlords often lack the money to pay for the school uniform and the school fee.

The Bimoba tribe has its own language: Moar. The classification of the language is: Niger-Congo, Atlantic–Congo, Volta–Congo, Central, Northern, Oti-Volta, Guma, Moba. The language is related to the Moba, Togo, but not inherently intelligible with it [27]. The language consists of 23 characters and is spoken by the Bimoba only. The Summer Language Institute’s catalogue of languages of the world (14th edition, 2004) estimates the number of Moar speakers at 76.000, but this is an under-estimation since all Bimoba in Ghana speak Moar. Most of the Bimoba speak different varieties of Moar.
The language has been described in the mid-sixties [28]. Some missionaries wrote a language course, but Moar is still mainly an oral language. Recently some schoolbooks have been written to teach the language. We found two books in Moar: one private publication by the Canadian missionary society containing some clan stories (not dated, but most likely around 1990) and The Bimoba Bible (new testament only) published in 1986.

Health care - traditional / non traditional
Table 2 shows the distribution of the Body Mass Index (BMI) of a small representative survey in three villages and of rural and urban Ghana [29,30]. Data are expressed on the scale of Chronic Energy Deficiency [31] and referred to standard WHO BMI-rates [32]. We observed that almost one third of the Bimoba living in this area suffer from Chronic Energy Deficiency. For comparison, the corresponding figure for rural Ghana is 19.1 % [30]. This high percentage of Chronic Energy Deficiency in the region shows that the region is still in a pre- or early-transitional stadium of development.

The vaccination rate is increasing (especially due to mass vaccination programs), but from an (inter)national point of view still low. We have estimated that only about 50% of the children under 10 years of age are fully vaccinated against common child diseases. Many families cannot afford the vaccination of all their children.

In the Farfar/ Zariboko area there are no hospitals. More recently some primary health posts/clinics have been set up. These posts provide for very basic mother and childcare. Only the clinic in Garu, approximately 25 kilometres from Farfar, provides some medical care, but a medical doctor is absent. Most of the Bimoba rely heavily on traditional healers. They can be found throughout the region and treat all possible diseases. The Bimoba also use traditional birth attendance. Traditional healthcare is more readily available and cheaper than modern healthcare.

The Ghana Health Service has reported on the following outbreaks of infectious diseases [29]
- Meningitis 1984, 1991, 1996, 2002
- Measles (but mass vaccination is carried out now and then)
- Yellow fever (1996/97)
- Cholera (1991, 1995 and 1998)
- Anthrax (yearly)
- Malaria (100.000 cases reported each year in the Bawku East district)
Apart from this, morbidity of other water/environment related diseases like schistosomiasis, soil-transmitted helminthes is high.
Although AIDS/HIV is not considered to be a big problem (estimated prevalence of infection is <1 %), the risk of introducing the infection to the region is high. The regional health care authorities also observed a high micronutrient deficiency among under fives (Vit A 65%, Iodine 85%) over the last five years.

Birth control, family planning
Bimoba women are proud on a large sibship. Young women with large numbers of children are highly regarded and respected. Most of the Bimoba women deliver their first child before turning 18, sometimes at a much younger age (13 or 14).
On average, Bimoba women deliver eight children during their life [23]. Although infant mortality is on the decrease, it is still high and all respondents during our interviews mention this as one of the main reasons for producing many children.
Birth control is virtually absent and although -mostly younger- women know the existence of oral contraceptives, ac-devices, and condoms, they are hardly used. They report that this is the result of the husband’s wish. Spacing technique during breastfeeding is used by few women, as many of the respondents complained about the ineffectiveness of the technique..

The Bimoba people are a relatively small tribe of West Africa. The Bimoba economy is based on subsistence agriculture. Bimoba live in nuclear family compounds. They are less developed and less organised than mainstream Ghana or mainstream Africa [33,34] and the surrounding tribes such as Mamprusi, Kusasi, or Dagomba’s. This marginalized position is caused by long lasting neglect of the region by the central government but also by the strong family and clan structure, the weak acephalous structure and there scattered existence throughout the Northern Region, Upper East Region of Ghana and the Western region of Togo. This combination of factors the Bimoba people were not able to acquire enough power to put themselves in an advanced position. On the other hand, the almost absence of a market economy in the region explains why the traditional mutual assistance (the nnoboa) is still functioning and because of this, the chances to survive periods of drought and famine are higher than expected based on their socio-economic status. We observed the strength of the system during a period of drought in 2003 – 2004, when the more market oriented Kusasi tribe suffered far more from the disaster. Due to the Nnoboa and the strong clan ties, most of the Bimoba escaped the famine by sharing the scarce food resources.
Since the focus on family and clan is still strong, the total socio-economic status is still low and since most of the Bimoba cannot read or write, rapid changes are not to be expected and are not likely to be successful when introduced centrally. All landlords act individual with the guidance of one or more Jaba’s. Therefore (health) education, development and improvement of the social status has to be introduced and organized at a grass root level. Once the cooperation of the landlords and local (informal) leaders has been achieved, projects for improvement of the local conditions can be implemented more successfully.

We wish to thank Stephan Holzer for his field research and Marleen van de Vorm, Diana Plug, Femke Veldman and Vanessa Valk for their data collection on the actual health situation in the region.

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Map 1. Bimoba area. (black square) and actual research area (white circle)


















Rural Ghana

Urban Ghana






n =140

n= 5788 30

n= 3427 30










mean (SD)




19.4 (2.0)












< 16
























































BMI-ranges “<16”, “16-16.9”, 17-18.4” are also referred to as Grade III, II, I of Chronic Energy Deficiency; BMI 25-30: overweight, BMI > 30 obesity 31,32

n.g. = not given


Figure 1


Figure 2. two Compound pedigrees of Benkapezir






Figure 3. Bimoba compound





2nd wife

Mother of landlord

1st wife
Ritual hut
3rd wife
eldest son