Ako is not far from the border with Nigeria in the northern part of the North-west Province and in the past there have been violent border disputes in the area. The Franciscan Sisters have been working there since 1983, but conditions are difficult, as the following extracts from a letter show:

The Health Centre looks after a population of 13,715 and has 7 staff looking after 35 beds in 8 wards.

"We are really in a remote area. It is a 22-hour walk to the town with a Post Office [Nkambe, nearly 50 km away]. We get very little money from the Health Centre and we use it for maintaining and paying the workers. We Sisters work farms to earn our own living and also teach the people that we can work before we can eat, because many suffer from hunger. We have many malnourished children with kwashiakor, so we have a malnutrition centre attached to the Health Centre where we care for these poor children."

The Sisters also pay monthly visits to 8 out-reach clinics. The Doctor only visits once a month.