Ghana’s new mums endure inadequate healthcare

By Eszter Farkas As her physical condition was rapidly deteriorating right after she gave birth to her third child, Elizabeth Adase talked to her newborn.“Wait for me, I’m going to come back to breastfeed you,” she said, waiting for blood transfusion at one of the hospitals in the Ghanaian capital, Accra.According to her account, she was bleeding profusely and yet had to wait at least six hours to receive blood, which in turn was delivered for her from another hospital, thanks to her connections.Not all Ghanaian women are as lucky as Elizabeth, who survived the complications of childbirth. Seven women die every day in the West African country — the world’s newest oil producer that in 2011 achieved middle-income status — and many of them due to the lack of blood.While Ghana has been praised for its stable democracy and boasts the title of the world’s third biggest cocoa producer and the continent’s second biggest gold producer after South Africa, it still struggles in the area of health facilities and healthcare.Women in rural areas will often have to travel hundreds of kilometres to reach a hospital. The situation is slightly better in the rapidly expanding capital.About 350 out of every 100,000 women in Ghana die due to childbirth-related causes, according to the UN. And while this is 50 times higher than the maternal mortality ratio in Germany for instance, it doesn’t look so bad when set against other West African countries.In Africa’s most populous nation, Nigeria, for instance, the maternal mortality ratio is 840 while in Guinea Bissau it stands at 1,000.Mobilised by the brand new pan-African campaign, MamaYe, about two hundred young people gathered in Accra’s Children’s Park to donate blood on International Women’s Day on March 8.“I came to donate blood today because I know the concerns about maternal health. Most women die due to postpartum haemorrhage, that is blood loss,” said a young health worker. “When we give blood today, we can save lives.”About one quarter of the maternal deaths, or 24%, are caused by haemorrhages, according to the 2009 Ghana Maternal Health Survey.Illiteracy and a lack of knowledge of the importance of prenatal care, negative cultural beliefs and a lack of transportation and bad roads contribute to this high rate, Dela Gle, Programme Development Manager at the Alliance for Reproductive Health Rights, told DPA in her Accra office.A pregnant woman living in rural Ghana who would have “to look for transport to go to the hospital ... needs permission from her husband,” she said. Such delays often result in complications and bleeding.The abundance of age-old beliefs and superstitions, especially in far-off villages, can also hinder women from attending a doctor early on in the pregnancy, Gle said.“There is a belief that once they know you are pregnant, they can bewitch the baby and you can miscarry,” thus many women hide the pregnancy until it becomes very visible.However, Ghana has seen progress in prenatal care: about 87% of women see a skilled healthcare provider at least four times before childbirth, according to official figures from 2011.While Ghana was among the first country on the continent to start a debate about family planning, only a a quarter of married women or those in a relationship use contraception today.About a decade after the “Gold Coast” became independent of its former colonial ruler, Britain, in 1957, Ghana carried out a mass publicity and education campaign on family planning. But it wasn’t until the 1990s when further efforts started to slowly show results.Sometimes it is not just a lack of awareness that causes problems. A lack of means to buy contraceptive devices or a shortage of them leads to the second biggest cause of maternal deaths: abortion.“Many of the 15-20 years old girls do it at quack doctors,” Mary Bour, a member of the Ghana Registered Midwives Association, told DPA. “They do it out of ignorance.”Although the Ghanaian abortion law is considered relatively liberal, many women seek to terminate their pregnancy illegally, fearing community stigma and family judgment or out of concern for the welfare of the children they already have or a desire to continue in work or education.Some of these young women are advised by their friends to take herbs or “put objects in their private parts,” said Bour. This can cause miscarriage but may also rupture the uterus, endangering the woman’s life.The MamaYe campaign, which launched at the end of February in Ghana, aims at boosting public awareness that maternal deaths can be avoided. It is starting up in other African countries too, including Nigeria, Sierra Leone, Malawi, Tanzania and Ethiopia.It aims at engaging local communities to help a pregnant woman in need — for example by turning a wheelbarrow into a makeshift ambulance if necessary, or encouraging taxi drivers to volunteer to ferry women in labour to hospitals.However, the fact remains that Ghana lacks skilled health practitioners, particularly in the isolated rural parts of the country. There are well over 10,000 patients for each doctor in this country of 24mn. In 2009, according to Ghana Ministry of Health figures, there were 2,033 practising doctors.Nearly half of these doctors practice in the main cities of Accra and Kumasi, the cultural capital of the Ashanti people. The poorest northern regions have only a meagre 4% of doctors. “The smaller hospitals might not even have a gynaecologist,” Bour said. — DPA