Neither Healthful Nor Caring: My Experience At a Polyclinic Maternity Ward In Ghana

Lack of adequate healthcare is an issue that affects an undue number of Ghanaians, but as an Africa American woman, I never could have imagined that this issue would one day also affect me. It goes without saying that life can take you to places that you would have never imagined.

I was born and raised in Los Angeles, California, USA, and little did I know that one day I would find myself heavily pregnant and entering a run-down polyclinic in the middle of a traditional market in a West African country.

I’m still heartbroken whenever I think about Kasoa polyclinic, because my experience there personified the regrettable state of the country’s healthcare system. Even now, almost one year later, it’s difficult for me to write about what I witnessed and experienced.

However, I feel it’s time for me to tell the story, so that I can do my part in possibly helping this country that is both my adopted home and the land of my ancestors.

It was a late night in December, and I was eight months pregnant with my second child. My pregnancy had been a stressful one, and my head was aching terribly. The ache warranted a trip to the hospital.

However at that time, my job earnings were scant and I didn’t have very much to work with, nor any health insurance. So I took a travel bag full of my belongings and went to Kasoa polyclinic.

The polyclinic, as I later discovered, was the “last stop” for people to go for medical treatment when they had no other option.

It was a collection of buildings with worn paint and dusty grounds, and the only public toilet available was two outdoor latrines that a person had to squat down to use. It looks precisely like the type of place one would go to when they had no other options.

I arrived and waited to see the doctor for consultation. After the consultation, I was directed to the maternity ward.

It was a white-walled room with dim lights, and twelve beds lined up in two rows on either wall. There wasn’t much hospital equipment here, except for some IV stands beside a few of the beds. But the most prominent thing I remember about the maternity ward was the attending nurse, whose name I never did get.

When I arrived she was reclining on a stretcher near one of the walls, looking as if she were ready to fall asleep. She seemed like she would have liked to be anywhere else. I gave her the paper the doctor had given me after my consultation.

“Have you been here before?” she asked. “Yes, I have a folder here,” I answered. Without sitting up, she gave the paper an unbothered look. “There are some medications to get,” she said. “These we don’t have. You have to go outside.” “Where?” I asked?

“In the market,” she answered. I stared at her, as if perhaps she would add something else. But yes, she actually just told me that I had to go out of the clinic, into the busy market and find a pharmacy to find my own medicine. This was not what I had expected. “It’s for your treatment,” she added, as if this would convince me. But it was late, my head was aching, and I hadn’t come to the clinic to argue. And if this is how things were usually done, I thought, then I could go along with it.

I don’t know if you can imagine being seven months pregnant with a headache, attempting to navigating a busy, unfamiliar roundabout at night. The traffic, blaring car horns and bright lights were disorienting to me. I found myself wondering how people, especially pregnant women, were suppose to live if situations like this were of the norm. I never did find the pharmacy; I was having a hard time understanding the directions given and, unfortunately, I still have my American habit of locating things myself instead of “bothering” others by asking. So, annoyed and uncomfortable, I returned to the small maternity ward of the polyclinic.

Unfortunately, that was only the beginning of all that transpired that night. Not having the medications didn’t seem to be an issue for the nurse. She assigned me a bed and I took two paracetamol, since that was the only one of my drugs that was available at the polyclinic pharmacy. Minutes and hours passed.

The nurse eventually did fall asleep. The entire time I was laying there, thinking about whether or not I should leave. Not having the medicine the doctor requested for me, I was basically laying there in my pajamas, taking paracetamol and waiting. For what, I can’t say. I wondered if it would have been better if I had stayed home. Also, my house didn’t have this many mosquitoes.

There was one other woman in the maternity ward that night. At one point she was having some trouble and she needed the nurse’s attention. She called her once, twice, but no answer. The nurse was fast asleep on the stretcher.

I pied the woman, so eventually I got out of my bed and went to tap the nurse awake. The woman finally got her attention and I returned to my bed, still wondering if I should go home.

Two women who were in labor came in that night, both clad in hijabs and looking as if they were ready to burst. The first woman arrived with an older woman accompanying her. She was in a lot of agony, and I hoped that her delivery wouldn’t be difficult. The head nurse, finally compelled to leave her resting spot, went to see to the laboring woman along with two other nurses.

I couldn’t understand what was being said, but their words toward the moaning, tossing, expectant mother were sharp and hard.

Their facial expressions were something that looked like disgust or annoyance. The scene reminded me of a story Ihad once read, of a girl who had been sent away by her mother to give birth in the village.

During labour, the elderly women attending to the girl were spitting rebukes at her for becoming pregnant at a young age. The woman in labour didn’t look as young, but I was reminded of the story all the same.

I was somewhat resentful on her behalf, that healthcare workers could open their mouths to scold her in this, her most vulnerable state.

Finally the baby was coming, and the head nurse’s volume increased as the woman cried in pain. All the while, I had had my back to the scene, staring at the opposite wall and waiting for silence to return.

My heart was racing. She was pushing the woman too hard. This could not have been helping her.

More screams, more hard words, grunting, a watery gushing and a loud plopping sound. Soon after, the first gurgling cries of a baby who had just entered the world. I sighed. The mosquitoes were biting me still.

A second hijabi woman entered some time later. She too was crying in pain, ready to give birth. I imagined having to endure another round of wailing, screaming and berating and decided I had had enough for one night. I went to the bathroom to change my clothes and approached the nurse’s table. I told her that I felt better and wanted to go home.

My headache had subsided and there was no way I was going to sleep in that atmosphere. But the nurse wouldn’t hear it, and she cut me off before I could finish my statement. “Why are you out of your bed?” she said in her booming voice, still stuck on high volume from the recent baby delivery. “Lay down!”

I was livid. Where I come from, shouting at anyone this way is considered extremely disrespectful, especially when coming from the staff of a care facility. I pressed my lips together to avoid screaming.

“Madam, do not raise your voice at me,” I said, restraining my anger. “I’m not a child.” I heard the security guard behind me softly laugh.

I can only imagine what he was thinking. The nurse then stepped away and looked elsewhere, as if she suddenly didn’t see me. I figured we were done talking. I thanked her, though I’m not sure for what, and I left.

After that night, it was burned into my mind just how unjust government systems can be toward those who don’t have financial resources. I’ve recognized the importance of observing and honoring the established norms in my adoptive country, even if they are at times far outside of my own comfort zone.

However, my experience that evening left a devastating mark on me. Perhaps this was the norm for a government polyclinic in Ghana, but some things shouldn’t be accepted as a norm. It was painful to have been treated that way.

But even more so, I was heart-broken by the way I saw poor women being shouted at and degraded, even as they were giving birth. The harsh facial expressions, the raised voices, and even patients being outright ignored. Is there no compassion for pregnant women to be found in public polyclinics? My experience certainly discouraged me from thinking so.

However, in the broader scope, the country of Ghana is operating within established norms of the world at large. As professor and scholar Yuval Noah Harari notes, the modern world puts much emphasis on increasing one’s financial worth, but offers zero incentive for expanding one’s levels of human compassion.

Because of this, we all remain ignorant to the causes of human suffering, uncaring toward the suffering of our fellows, and we give little attention to the ways in which we could alleviate this suffering.

How has this affected Ghana? As my case demonstrates, public healthcare facilities are treated as an afterthought, as if they’re only there to keep the country out of trouble with the UN. They’re given little to no funding, and demoralized staff give little to no consideration to the people that they are to help.

If you’re a pregnant woman of limited means, imagine how daunting the prospect of going to a public care facility to give birth might be; to begin with, the costs for everything from lab work to medications will quickly add up to a sum that might leave you a prisoner of the hospital until you find the money to pay the bill. Secondly, high rates of maternal death in hospitals has been a hotly discussed issue in recent years. To spend a day tending to maternal emergencies in places like Kasoa polyclinic or Korle-Bu Teaching Hospital is not for the faint of heart.

Add to that the likelihood of being treated harshly during your stay, and going to a public care facility to give birth becomes a heavy psychological burden. It’s really no wonder why many poorer women avoid healthcare facilities if they can, opting instead to give birth at home or even go to prayer camps.

We must recognize that it’s not only the selfishness of government officials that causes these conditions to develop.

It is also the collective attitude of the people that drives the development of a country.

If one is willing to bend the truth as a way of life, and another routinely ignores the poor beggar asking for alms, how then will they lobby for their brothers and sisters to receive the healthcare they need?

How then will they see their plight as their own? And what reason does the person with more resources than you have to stand on your side when you are in need? These are questions that Ghanaians must ask themselves in earnest, especially since these questions affect every area of life. In this case, even the intimate relationship between a woman and OB/GYN staff. If we don’t include everyone in “ese ne tekrema” it has farther reaching implications than many realize.

I admit that there are many areas of Ghanaian life that could be improved upon, but there are obvious reasons to make healthcare a priority. And there is every reason to make sure that pregnant women are treated with care and compassion during this, a most vulnerable time of their life. I wish for Ghana to transform from a nation of people accustomed to classism and abuse of authority, into a a people that gives immense value to transparent leadership that leads with a true spirit of service.

And what better place to start than to make sure that the country’s mothers are taken care of, protected, and nurtured? I gave birth the following month at Korle Bu Teaching Hospital. I am grateful to the nurses and doctors at Korle Bu who made a difficult, unsure time for me more bearable.

I would like to see that same spirit reflected in all public hospitals and polyclinics in Ghana, whether in Greater Accra, Central Region, Northern Region or elsewhere. Ghana is the black star of Africa and both the people and the leadership have much to gain from once more leading the way into the future.

Also consider that the medical professionals of this country see and handle much more than most of us could see and handle ourselves without breaking down in tears. They deserve our support. Lastly, I recognize that Ghanaians have strong emphasis on respecting authority.

I recognize that this society exists in an hierarchy. But is it possible that an hierarchy can exist to help people up in life, rather than keep them in their place? Consider that all parts of a tree, including the roots, trunk, branches and leaves, exist and thrive because all of them benefit from the functions of each other.

The roots never refuse to send water to the trunk and the leaves never refuse to let the branches benefit from

the sunlight. What is demonstrated in nature is possible for us, but it can only exist when the people are aware of their power. Not a power that causes chaos and loss, but a power that restores dignity, a sense of worth, and operates for the collective good.

The women who attend government polyclinics to give birth are indeed worthwhile and precious in God’s sight. They don’t deserved to be yelled at and treated badly. Not in a facility where they come to be taken care of. They deserve dignity, and to have a sense that they are valued parts of the whole.

Mine was not an experience that I would wish anyone to have, but perhaps God placed me in that position so that I could witness for myself what my sisters were being subjected to. I firmly believe that we are all brothers and sisters, created in the image and likeness of the Creator. It is then no surprise that Jesus said “Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.”

He knew the truth that every life is precious and that no one deserves to be left behind. I urge Ghanaians to weed out this spirit of selfishness and discrimination from the society, and to replace it with a spirit of respect and service to all.

May this not be only a dream in our minds. May this become our reality, so that we can witness in our lifetimes how the country will thrive once each of us decides to help each other without condition or prejudice. Then we all can have a sense of our value as Ghanaians, because it is reflected in the faces and attitudes of our fellows. This is my dream for Ghana.

Author: Tiffany Howard