Climate change and land degradation result in decreasing yields and crop failures in Northern Ghana and have caused further impoverishment of Ghana’s poorest region. Farmers have diversified their livelihoods to adapt to uncertain environmental conditions in various ways. While traditionally a diversification of the production and migration were the prime means of adaptation, many farmers have started to intensify their production by adopting shallow groundwater irrigation for vegetable gardening for Ghana’s urban markets. This has helped to cope with a changing environment, ameliorated poverty and reversed rural–urban migration, while the local hydrology curbed an over-exploitation of groundwater resources, commonly associated with an uncontrolled farmer-driven expansion of groundwater irrigation. This research confirms that farmer-driven small-scale irrigation can play an important role in the process of climate change adaptation. However, while farmers tried to integrate in the larger economy, they have become subject to market failures that in their essence are caused by unfair and unpredictable patterns of global trade. It is this double exposure to global environmental change and economic globalization that need to be taken into consideration when local adaptive capacities are discussed. Many convincing arguments call for the revision of some of the most unfair and devastating economic practices; however, the need to enhance adaptive capacity towards global climate change for poor parts of the population in the south should be added to the discussion.