Being a midwife in Ghana

Delphine Bedel, Press Officer for Oxfam France's Maternal Health Campaign, gives a first-hand look at maternal health care, from a recent visit to the maternity ward at a hospital in Ghana's capital city.

After nearly an hour of waiting in the humid heat, irritating dust and anarchic horns of a chaotic traffic jam I finally arrive at Achimota Hospital, a district hospital in the north of Accra.

The long, dark corridor from the main entrance of the hospital leads onto a vast indoor open area, where numerous patients wait for their consultations on scattered benches.

It is 10.30 am and it is already very hot at Achimota. In the right wing, an area a little apart, the benches are solely occupied by pregnant women: this is the maternity unit.

The mothers-to-be, some young and some not so young, wait patiently in large numbers in their colourful clothes. It’s Thursday, the day for prenatal consultations. I’ve barely crossed the threshold of the office when I’m quickly welcomed by Patricia Conduah, Director of Midwifery of the hospital.

Patricia is 55 years old and has worked at Achimota Hospital for many years. In 35 years on the job, she has seen numerous babies born, often in difficult conditions, she tells me as she invites me into the delivery room.

This cramped room consists of two obstetric beds, an old metal cupboard, a rusty table, a few medical objects and the pinkish colour of the beds bear witness to the dilapidated state of the place. Patricia explains that often, when both beds are already occupied, she puts a mattress on the floor and the mothers give birth there on the ground. “It’s not ideal, but we don’t have any choice. We make do,” she adds.

There’s a piece of paper on the wall. It lists the equipment that mothers-to-be need to bring in on the day of the birth: sanitary towels, old clothes, antiseptics, soap, basins, etc.

“We don’t have any equipment and the showers don’t work,” Patricia explains. This list is given to the young women at the first consultation. Most of them buy these supplies gradually, one by one. For some of the women, it can even take the full nine months of the pregnancy to get them together. In addition, if a mother is unlucky enough to be allergic to one of the hospital’s drugs, the insurance does not cover additional drugs and it is then up to the patient to pay for them.

In 2008, when the Ghanaian government developed a policy of free access to treatment for pregnant women and for children under five years of age, the number of consultations increased considerably. From 2008 to 2009, for example, there were 430,000 more consultations for pregnant women than in the previous year. This explains the current saturation of the Ghanaian hospitals, which are having trouble keeping up with this major increase in patient numbers, as is the case in the Achimota maternity unit, which can process up to 400 consultations per day. This figure is all the more impressive for a hospital where there is only one doctor, eight nurses and 20 midwives.

Patricia then invites me into the resting room. The muted noise of an old black-and-white television set falls on the room where eight mothers and their newborns are lying on little, worn beds. “It’s too small and always packed. We need at least 20 or so extra beds,” she explains. After giving birth, the mothers stay in this one room under observation for eight hours, before being sent home. “We don’t have enough space to keep them any longer,” she adds. Several years ago, the hospitals were not as crowded, but many more mothers and children died in childbirth.

Today, Achimota maternity unit had the pleasure of assisting nine births: seven girls and two boys.

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