Last night we arrived at our new house for the week! I was totally nackred from the travelling! We met Rita and Christie who are both nurses in the hospital that we are working at and rent the house we will be staying in! They seemed really nice but Christie was just off a night shift so was even more tired than me! Haha
The house was not really what we expected! It had both of the girls rooms and our room which was quite big with mattresses on the floor and a fan.. What more could you ask for! We were expecting to be slumming it! We went and had dinner which was a weird spicy fish thing with yam which was so so nice! (Barbara didn’t like it!) At least once a month I am so thankful that Conor’s mum made me eat fish!
The shower was amazing! Freezing but amazing! It was the best shower I’ve had since being in Ghana! And the fan is so good in the room! I was a bit worried that this experience wasn’t going to be as different as I had expected! It might even be more luxurious than the other house!
We got up at 7, and strait away I had to go to the toilet! I was like oh not please don’t be ill again! All weekend I was feeling crappy and I had slept so much! I had a bit of relief so had some breakfast which was omelette and a bowl of rice.. Like watery rice.. apparently it was rice pudding but I really don’t think it was!
It was absolutely pouring down! Torrential rain! It’s not rained the whole time I’ve been in Ghana but where we are staying is like right next to a rainforest! So Rita said oh it’s raining we will be late for work today! I was like why? And she said oh we can’t walk in the rain we will get wet! It was still raining outside but not as bad and she said we still must go to work, we can leave at 9! Haha
We were shown round the hospital and everyone seemed really nice! Until we got to the labour ward.. They just didn’t really seem happy to see me! but I’m used to that being a student and then having to prove myself here! I honestly felt totally drained emotionally and physically. Working this hard trying to get people to like you, trying to prove yourself, working in 35 degrees and feeling rubbish is really exhausting! I am also working in pretty bad conditions and in some really horrible situations that you rarely see in the UK. The thought of working for another week in a hospital in Ghana really made me feel like I had no enthusiasm left for it anymore! I just wanted to go home and sleep!.. But that’s not why I am here! I am here to make a difference and to gain invaluable experience so I put on a smile and tried to make people fall in love with me! The midwives took a while to talk to me but I did the old routine! Smile and ask loads of questions and jump in and help wherever I could without being annoying! The midwives just don’t ask for my help because they want me to know they can do their job without me I think! Like I’m just this little rich developed white girl who thinks she knows everything and is here to try and tell them how to do their job better! So I need to show them that I respect them for the work they are doing here with the resources they have! Which I so do! They are probably more knowledgeable and skilful than every midwife in Scotland, they just don’t always have the supplies to give the most effective care!
I changed all the c/s dressings and the doctor was lovely! It is a very small hospital so they only have a general doctor who does all the surgeries and rounds! So he doesn’t specialise in OBGYN he does everything! but his c/s scars were beautiful!
A woman came in who needed a vaginal examination in query early labour. The midwife couldn’t reach the cervix so I gave her the old trick of putting your hands in a fist under your bum which lifts the pelvis and the uterus and she was like woooow! That’s great! Haha anyone who is a midwife or has had a baby knows how to do this!
I was like YAAAS I’m in now! So after that life was easy! The midwives were asking all about Scotland and what my life was like!
A woman came in to the ward. It’s a joined antenatal labour and postnatal ward because the hospital is so small! I took her into the room and did her observations, her BP was really high, pulse was high temperature was high and she had lots of protein in her urine.. Because the notes are so so bad you just have to start from scratch and assess every woman from the beginning which is a pain but effective! So I asked her when her last period was and how many weeks she is now. She was 29 weeks pregnant. I got her up onto the bed and strait away I saw she was not 29 weeks pregnant. I checked the fundal height she was measuring 14 weeks and I couldn’t hear a fetal heart. I told the midwives I needed a scan and also some antihypertensives! Apparently she was being monitored for preeclampsia but she hasn’t been to the clinic for 10 weeks..
The sonographer came to give her a scan. Unfortunately the baby had died some time ago. The girl said she hadn’t felt fetal movement since about 20 weeks. The foetus was measuring 19week size. The way they told her seemed a bit harsh just said oh here is the baby arms legs and head but there is no fetal heart. The girl was really upset but there was nothing we could do.
We went back to the ward where we had to admit her for observation for preeclampsia and also for induction. She protested and said she did not want to be admitted if she went home she would be fine. The midwives said this is a very common problem in this district. They just think they will be fine if they just forget about things that are wrong with them! Eventually we persuaded her to stay after telling her all of the risks to her health. I was so relieved! Unfortunately they only have one large room for everyone so this poor woman had to stay in a room with women in labour and also women who have had their babies. It is definitely not ideal but they don’t have the facilities to do anything else! It was such a shame.
A huge problem in this district is termination of pregnancy performed outside of the hospital. Terminations are legal in Ghana but it is frowned upon in communities. They say that pregnancy is punishment for having sex when you do not want children. This is not the only problem with performing termination of pregnancies! Midwives and doctors do not want to perform them unless there is a medical reason for doing so. This is mostly due to the country being mostly ‘religious’ apparently this is not really true. Midwives and doctors who perform abortions can get a huge stigma against them. They can become known for performing such ungodly tasks and no one wants this to happen to them. Some people also think that midwives performing abortions is allowing teenagers to be promiscuous! So they will not provide the service.
In this hospitals books they have around 1 in every 13 patients coming in severely ill due to incomplete backstreet abortions. Which means they have gone to a woman in their village who claims to be able to use instruments or herbs to remove pregnancies. They use dirty equipment or dangerous medicine to do so and women turn up at the hospital in serious states. Some women have to have hysterectomies some get sepsis and die and some have to go to theatre to try and remove the retained products.
There is a new midwife in charge in this hospital who I met with today who told me that just last week she took this issue to the board. I really loved the way this midwife thinks because it is just like me! She said why should we not offer this service? Women should have reproductive rights and we should provide the care for women that they need so that we can keep them safe. One way or another women will get an abortion, it should be done safely and in a clean environment to protect their health. Because of this midwife the hospital started allowing midwives and doctors in this hospital to perform abortions last Monday!
So a girl came in today who had been in 3 months ago and had had a backstreet abortion and needed retained products removed. She arrived and said she was pregnant again and needed a scan. She was 8 weeks pregnant and wished to have a termination of pregnancy. The midwife discussed with me that she was really nervous and explained everything to me that I have just told you and said they don’t even have the drugs to perform a medical termination but she can get them tomorrow. She was supposed to be off tomorrow but will come in to perform the termination to ensure she does not go to any backstreet clinics and is safe. No other midwife in the hospital feels comfortable or wants to be the first to do it. The midwife also offered the girl counselling and contraception advice to make sure she doesn’t come back with the same situation! I thought this was totally inspirational! This midwife has made a huge change for the sexual and reproductive health for all the women in this district! So amazing!
In this hospital there seems to be a lot of use of herbs and like witchcraft instead of seeking medical help! It has only been in the last 50 years that western medicine has come to Ghana, it all used to be herbal and local medicines. So some communities still see hospitals as scary places for severely sick people and will go to a healer in the community instead.
For example one woman came to the clinic and 1 week ago she fell and scratched her arm really deep with a rusty nail and it had become infected. Instead of coming to the hospital she went to a healer and they put purple paint on it.. So it was even more infected! When she finally came to the hospital it was just for the antenatal clinic. When they saw her arm they told her she had to be admitted and she refused because the paint would fix it! It’s so frustrating it’s like they think we are trying to trap them! But really it’s trying to help! It’s just being in a small community, and the hospital just seems like a totally different world to them they are just not comfortable in a big hospital, which is fair enough! I completely understand why they don’t want to come into a strange environment and be given all of these weird medicines and have the control of their health completely taken out of their hands into some doctors they have never met before. When in their community women who had known them all their life would be ‘treating’ them in their own home!
This hospital is much more homely than the other one I was in! It’s more relaxed and more like what I am used to! They are really into prevention. They see a trend and actively try to stop this from happening! So for example they noticed many many babies were returning malnourished or had jaundice, so before the mums are discharged they observe a breastfeed and ensure positioning and attachment are good! It was so nice to see! In the other hospital it seemed like it was only in Scotland mothers had problems breastfeeding! Haha they all just wapped them on! The midwife said she had never seen a mum who didn’t breastfeed her baby so she had no idea what they would do if a mum didn’t want to or couldn’t! I found one flier that said that mums could strain boiled rice and give the water to the baby so it had starch in it.. So weird!
I left the ward at 2 because that was what time Rita finished work and we were walking home with her! She made a nice fish thing for lunch (which babs didn’t like again!) and then we set off around the village!
It was so great to walk around and see how everyone lives! I have learnt so much about the struggles people face just trying to live! It costs 300,000 ceedies to buy a house so pretty much noone in Ghana can afford to buy so they all rent! It is 50 ghc per month for a 2 bedroom house with bathroom and kitchen! And that is still a lot for the people here! That is about £10 and then they have to pay for electricity. The electricity also goes out allllll the time! Because of the rain! A tiny bit of rain and it’s all off! Apparently it rains here every morning! Its so mad! when 1 hour down the road I’ve not seen rain for 3 weeks! Rita said it costs her about 100 ceedies per week to eat and drink and do any other activities (like sowing and buying material).
Because it costs money to get married people have a family ceremony where both families meet and the male buys gifts for all the females family. They then have a small ceremony. They call this an engagement but basically this means they are married! In the eyes of their family they are married so they can move in together and have children. They just need to get married at a registry office or a church Incase one of them dies so it is legal! Haha some people have a white wedding like what we have but only if they have a lot of money!
We went through the village and all the kids were running after us singing ‘hello broonie! How are you!? I’m fine!’ Haha it was so funny! Most people in this village are fishermen or they are fishermans wives who prepare the fish by smoking them in huge, kind of BBQs! All the women and their families who smoke the fish are really prone to infections in their lungs, respiratory tract and it also damaged their eyes. The men fish all the time but on Tuesday’s it is prohibited! No one fishes to allow the sea a day of rest. Anyone who fishes on a Tuesday may have bad things happen to them and it is their own fault! There was a huge shark on the beach that they had caught! They said they will just chop it up into small pieces and say it is normal fish!
All the baby girls wear beads on their hips arms and legs and this is supposed to make them have good curves! Rita said I don’t think it really works! But I was like well you never know! We don’t do it and everyone here has much better figures than us! Haha
We saw all the fishing boats that I love! And went up to the metal cross fort! It is a fort where they used to trade in gold and spices. During the slave trade they also traded slaves and sold slaves, the British owned this fort. It was really beautiful. In Ghana there are 14 forts and 4 castles. It is called the metal cross fort because they had a metal cross that they would put in the fire and before selling the slaves they would brand them with this cross. They are now renovating the fort and have houses all around it where people can stay, it is just next to the sea so really beautiful!
I am so excited for this week! I think we just thought this was a really nice place because we are used to slumming it! Haha having the Ghanian food and learning about how they live, their culture and struggles really is an eye opening experience. Even without going to the hospital I am learning so much! It is pretty exhausting walking everywhere and working every day but it is so with it! I love it! Everything about living here is amazing it’s beautiful in its own way. It’s just Africa. There is no better way to describe how Ghana is.
midwifecaitlin 