Tips to Reduce Risks During Pregnancy

MHC was approached by a freelance journalist, Angela Sarpong, to write an article pertaining to Maternal Health. Ms. Sarpong works for local and international blogs and websites writing on various issues. She came across our website and was moved to write an article for us. So here it is, some helpful and handy tips to help you reduce risks during your pregnancy:

Health during pregnancy is one of the world’s biggest issues at the time. Although thank the Lord most of pregnancies finish normally, there are still an important number of child and mother deaths in Ghana, and so part of the solution is to provide more information to the mothers. Here are some tips on how to keep you and your future baby healthy during pregnancy:

Medical care – It is extremely important you attend all your visits. Indeed, proper prenatal medical care is basic to avoid risks and it is something that should start as soon as you know you are pregnant. There are monthly visits from week 1 to week 28, fortnightly visits from the 28^th till the 36^th week and weekly visits until delivery, but if you feel something strange happening don’t hesitate to call your doctor right away.

Exercising – Exercising is also an important part of pregnancy, not only because it is good for the baby, but also because it is not healthy to gain a lot of weight during that time since it could lead to a miscarriage. You should try exercising at least 30 minutes a day but without exceeding yourself. Although some cities have pre-natal exercise activities, if this is not your case you can also do it at home. It doesn’t even require spending a lot of money; for example lift some light dumbbells you can even find second hand while sitting on the floor in order to improve your posture. This is important because when the baby starts growing you will start slouching because of the weight, so in order to prevent back-pain and sciatic problems exercise regularly. Other common activities include swimming, since you won’t feel the weight of the baby in the water.

Have a good diet – Eating right is one of the most important things during pregnancy. You should go over a proper diet with your doctor or your obstetrician, who will give you the kind of diet that suits you best. Indeed, not all pregnant women should eat the same way, it depends on their peculiarities. Of course there are certain types of foods you should always avoid, including seafood high in mercury like swordfish, shark, king mackerel or tilefish; other types of foods to avoid are raw or undercooked foods (meat, poultry, fish and eggs) and unpasteurized foods. There are other types of foods that you should eat in very small quantities, so remember to keep yourself informed. Also, drink plenty of water, which is very important for both you and your fetus.

Absolutely no smoking or alcohol drinking – This is absolutely vital if you want to have a risk-free pregnancy. Smoke is lethal for the fetus and can cause you very serious problems, so make sure to stay away from people who smoke and smoking rooms. Even just exposition can be very dangerous. As for alcohol, there are various syndromes associated to mothers who drink alcohol during pregnancy causing miscarriage or mental retardation in your baby, so not a single drop!

Sensible weight gain – Gain weight in a sensible and gradual way, otherwise your fetus can suffer from it, as well as you. Don’t starve yourself and don’t eat too much: find the right balance. The best thing is to gain weight eating breads and grains, fresh fruits, cooked vegetables and meats high on protein. Remember to boost your calcium intake because if not your body will absorb calcium from your bones in order to form the baby. A piece of healthy advice is to eat at least 6 small meals a day mixing and matching foods.

No toxins or chemicals – Whether it’s food or any other body product, stay away from anything that can contain toxic or chemical stuff, as this will alter your organism and the fetus too. Choose cleaning products made with natural components like lemon or vinegar instead chemicals and stay away from recently painted rooms.

“Radio broadcasting is a ministry and not just a job” – Bernard Avle

We came across this very interesting interview with Bernard Avle, host of Citi FM’s morning show as well as their news director, with enewsgh. He had some thought-provoking views, read them below:

I believe readers want to see your face and know you more.

So you are here to expose me.

Somehow

I like radio because it keeps you anonymous and if you keep your mouth shut, nobody knows you. So many times I walk into a shop and when I speak, they go like “oh I know that voice” then I know I’ve been caught. As broadcast journalists, our voice is our most prominent feature. I like it like that.  That is why I don’t do many interviews and come on front pages. Radio is my thing.

But you now have a following and a story that can inspire people.

Yeah, actually, you are right. When you do media for a while and people start trusting you, you have a responsibility to open up. You alluded to my story but I don’t think my story is too extraordinary. I was lucky. When I entered Legon, I got to Radio Universe. Not many people get that opportunity. It was a very good trainer, so for four years, I was doing like an internship where I was actually being trained on the job.  I got serious training from people like Alhaj Abubakar Sadique, Francis Ankrah, working with a very strong team of student mentors for four years.

By the time I finished my degree in 2004 and Citi FM was about to start, I was already ready. That’s way I said I was lucky. I hit the ground with some experience.

You hit the ground running

I did not hit the ground BAM! When I hit the ground I was running. Some hit the ground and stay there.

Your voice was so different from what they call “radio voice”.

Two reasons: I don’t have a very deep voice or the so-called radio voice. I remember some even wrote articles and said I can’t do morning show and that I should just remain with the news because my voice was not flexible enough.

Secondly, if you listen to Citi FM and compare us to other stations, you would realize we don’t boost up our sound. We prefer a cleaner sound especially because of the talk that we do. So my voice did not receive any extra boosting. The good thing about that was that it made me sound very different.

Again, aside the clear voice, we wanted to run the station in a way that it would be issues-based. So the issues being discussed would keep you glued to the station rather than focus on the voice.

For me the measure of success is when people tell me that Bernard, you made me late for work today because I could not stop listening to you.

How has the journey been so far?

It has been by grace. Because radio is a calling.

A calling? From who?

A calling from God.

 Like God calls people to do ministry work?

But you see, ministry is not restricted to pulpit ministry. Newspaper is a ministry; it is a service. Radio is a service. Every job you do is ministry. God is working through the gift He has given you to affect society positively. If you don’t approach your job with that mentality, you would feel people owe you something. God has given you a gift and a platform to express that gift and you are being paid for it so you must see it as a service where you can’t spend the three and a half hours discussing frivolity.

If you don’t see it as a ministry, you may think you are wiser than others or because politicians like you and they give you favours, then you begin to tow their line. But if you see it as a ministry, you would realize you have to account for the three and a half hours every morning. How many positive things did I discuss or what was my contribution to making society a better place.

If I was born in 1950, there is no way I would be doing this job because there would be no private radio. We were lucky when we were born in the early 80’s, by the time we were ready for radio, there were all these radio stations. Those of us in the media must be ready for the free dispensation and liberalization of the airwaves.

This is not a coincidence. God has a purpose for putting myself and all these young guys on morning radio at this time. Look at myself, look at Radio Gold and it is Suhuyini, Joy; Kojo Nkrumah before he left. We are all around same age. God has a special plan for that. This is a ministry not just a job.

Has it been fulfilling, rewarding, adventurous or regrettable?

It has been fulfilling, humbling, rewarding, and tricky. When we started this thing, a lot of people thought we were coming to copy Joy FM and just add to the numbers. It was not easy but in the nine years, I have learnt a lot about life, what it takes a business to succeed, I can tell a start-up company that it would be successful if it is consistent. I would never have learnt that if I had immediate success. It has been a very good life learning experience; a journey of new discoveries every day.

You are a born again Christian on morning radio.

I was in church last Sunday and after leading prayers, someone asked me if I am the one who plays all those songs on my morning show. When you have a calling God gives you the grace to do what others cannot do. Some believers think that because they are heaven-bound, they have no use on earth.

My philosophy is that if the only reason God saved me was to take me to heaven, He should have killed me the next day after He saved me because the temptations I am exposed to here would make it difficult for me. But God left me here to make an impact and bring the semblance of heaven on earth through the kingdom concept.

There are certain things you must know and learn to survive in this industry. You can’t say because I am a Christian then I would leave everything to chance. There are things you must plan and prepare properly for. Wisdom is the ability to discern the difference between what is from man and what is from God. I am able to survive as a born again in broadcast journalism because I know how to give unto Caesar what is Caesar’s and to God what is God’s without rubbing any other.

Does doing this balance require some special skills?

It takes grace.

What is this grace, grace, grace you keep talking about?

I don’t want t go into Theology. …Grace is the main thing. The most important feature of our religion…it is a diving enablement, divine favour and it helps you to achieve more than you could achieve on your own.

You had a private wedding. Why?

I invited a lot of media friends to my wedding. Let me explain something to you. When you are in the media, you are not a celebrity.  There are media personalities who are celebrities. Jessica possibly, Kwame Sefa Kayi possible, Jocelyn Dumas, some of them have transcended just been on radio and on television to having a following. Some of us think because we are on radio our weddings are for public events. At the time I did my wedding in 2011 and even as at now, I don’t even want the word celebrity to be attached to my name.

Because as media people we interact with a lot of celebrities, we sometimes get into the news.  This confuses us to think we are celebrities but in actual sense we are not. I don’t consider myself a celebrity and my wedding did not deserve any special attention.

Bernard you are saying this because you want to keep your privacy.

Well, because we interview politicians and government officials and sometimes we bring their private issues up, we can’t say we want to keep our issues private to ourselves. But there again, everybody deserves some semblance of privacy. I am not in public office. I am just in public space and there is a difference.

Have you started making babies?

That’s a very interesting question. It is God who gives babies. So when you say making babies, I am not a baby maker. We have been blessed with a son so far; a four and a half month boy.

 And how many more are you expecting?

Oh you can’t tell. I don’t know. I have one and I am looking after him well. If God blesses me with one or two more, fine. But I do not think I want to go beyond three.

Please take us through your school life.

I had a very boring life until I got to the University. I was born at the Legon Hospital, went to the University Primary School at Legon, from nursery one to JSS 3, went to the Presbyterian Boys Secondary School at Legon, then went to the University of Ghana, Legon, went to Legon Hall, started at Radio Universe on Legon campus and then I came to Citi FM for national service. I used to live at Madina then Adenta all near Legon. In 2008, I travelled to the UK for my Masters. I went to the University of Warwick for my MBA.  I studied Economics at the University of Ghana.

 What is your take on talks that a Journalism school is not what makes one a journalist?

I think people would judge you by your output and not by your qualification. Some of the journalists I respect most in this country do not even have a university education. But people who have gone to university cannot stand up to them in a five-minute debate.

Secondly, the world is changing so fast and this is changing the traditional definition of jobs. Mind you, there is a whole new group of people called citizen journalists and they are not even trained journalists but they are at home tweeting and blogging and they are communicating.

So the communication and journalism profession particularly needs to be responsive to the changes.  Because f you learnt journalism 20 years ago at GIJ, I can bet you there was no social media so the issues and approach and possibilities are different now.

Today, we have data journalists who do not even come on radio. I don’t think we should limit this to GIJ or AUCC. It is more about who occupies the communication space. I interviewed a medical doctor, Dr Buckle; a very articulate doctor. If you give him a medical programme to host, you can imagine the level and worth of knowledge he would be bringing on board.

People have become very knowledgeable and if we can’t respond to their needs appropriately, we would be wasting their time. The branding and strictures and definitions are not necessary.

What should Ghana expect from Bernard Avle in 2014?

Citi FM has tried to be very innovative and never afraid to try new things. Some have failed while some have worked. More such things are coming up. We would never stop innovating because people’s needs change so fast. So we would bring listeners new things. My life now is very tied to what Citi FM does because I am the director of news and I host the Citi Prime Time Breakfast Show, so asking what to expect from me is directly asking me what to expect from Citi because I am embedded in Citi.

It’s a rare thing that you have not been tagged with partisan politics after nine years on radio.

Time is the best judge of things and people. It is good you said nine years. If you had asked this question five years ago or three years into my career, I am sure people would have said different things. So let time be your vindicator. It is consistency that gives you the respect. I cannot attach myself to a political party because the problems we are discussing transcend partisan politics. It does not even make sense for me to even think of aligning to a political party.

If so, how come many journalists are openly aligning?

It is because we have overrated politics.  And the politicians themselves have overrated their importance. That’s the problem.  People recently did a demonstration at Prestea. It was neither NDC nor NPP and that’s where we are moving towards now.

Politics is important and it affects a lot of things but I believe the time is coming when people would stop the unnecessary political tags. The main issue is not politics. It is the incompetence of people who ought to work, be they politicians or not and regardless of which party is in power.

It is about what type of leadership we are experiencing at all levels. That’s why I don’t focus on the politicians. We do cover almost all the political events because it is part of our lives and drive everything but I am not interested in their politics.

Any final comments?

I think if Ghanaians read more, it would help us all. Trust me, if I take a DAILY GUIDE paper and I see the content – court cases, education, health, crime, social issues – I can run a million radio programmes just from the paper. If people want to understand their country, they should read more newspapers rather than allow newspaper reviewers to read the headlines and tell you what the stories are. That is unfair. Read it yourself because when a politician tells you what the news is, he may spin it.

MHC ORGANIZES TRAINING WORKSHOP FOR JOURNALISTS IN GHANA

In recent times, journalism in Ghana has been plagued by what Ms. Gifty Anti, presenter of the popular Stand Point TV Show and long standing journalist, described as the ‘touch-and-go’ approach to news and features. This is predominantly tabloid stories, focused around sensational, usually personal stories from either side of the partisan party political divide. There seems to be a lack of interest in credible, well-researched stories that highlight critical issues that concern majority of citizens. Ms. Anti was speaking at the opening plenary of the ‘Journalists For Maternal Health Training Workshop in Accra organized by Creative Storm Networks, producers of the Maternal Health Channel. The ‘touch and go approach’, is normally complemented by ‘cut and paste’ stories culled from press releases and on line information. This indicated a certain crisis in Ghanaian journalism, said Mr. Affail Monney, President of the Ghana Journalists Association. Throughout the day, journalists highlighted the critical importance of ‘Development Journalism’ which received great endorsement from Supreme Court Judge, Justice Dotse during the election petition hearing in August 2013. He recounted the tragic story of Perfect Daba, a young woman from Torgome in the Volta Region who died after giving birth and boldly proclaimed “These are issues we must address!”. It was a loud wake-up call to everyone.

The training workshop was attended by over 100 journalists from across Ghana working for newspapers, radio and television and social media. The workshop saw highlights from the Maternal Health Channel, including Torgome and Kayayei about the plight of homeless female street porters living and working in Accra. Lariba Ibrahim who was featured in the latter and  Samuel Ahemunya, husband of late Perfect Daba spoke to the journalists. In the plenary session Dr. Koma Jehu Appiah, Director of IPAS and Ms. Abigail, Burgesson from African Women’s Development Fund, both challenged the journalists to be more creative  and develop their skills, in order to report more effectively on maternal health.

After the opening plenary, the participants were then split into two breakout sessions; one for print media and radio, and another for television and social media. These focus groups were led by facilitators and presentations were given on how to strengthen reporting on maternal health issues within the different media structures. In the television and social media group, a presentation was given by Dr. Kwesi Owusu, Executive Producer of the Maternal Health Channel. He gave insights into the ‘The MHC Approach – ie finding new ways to tell old stories’, and humanizing the health statistics. Kobby Blay, an avid blogger, registered nurse, and founder of Ghana Health Nest, gave an interesting account of the various ways in which social media tools can be employed to enhance reporting on health issues as they happen. He demonstrated his live report on the internet as the session was in progress. The journalists also had a chance to discuss more deeply, the critical issues concerning the Kayayei. Lariba was at hand to share her personal experiences. The group saw MHC’s ‘The Road to Bomkpa’, which highlights the difficulty of reaching hospitals in remote communities. Seidu Issahaku and Innusah Ibrahim who played key roles in the filming of the programmes addressed some of the issues.This sparked keen interest and a lively discussion. In the Print and Radio Break Out Group, Bernard Avle and Betty Kankam-Boadu from CITI FM, one of Accra’s most popular FM stations spoke about the impact of their documentary on Maternal Health and some of the challenges. They played sound bytes from the documentary to highlight their points.

The last session was the closing plenary, in which rapporteurs from each of the breakout groups reported back. It was then left to Mr. Kofi Blankson, member of the Maternal Health Channel Advisory Board to try and summarise the key points of the day and suggest some ways forward. He encouraged the journalists to ensure that all the issues discussed are reported to the media consistently. The journalists agreed to join a  new network dedicated to maternal health issues.

HELP FOR THE HELPLESS AT LAST

(Feature by Francis Ameyibor, Development Communicator, GNA)

Accra, Oct 22.

The popular calypso song “Everybody Likes Saturday Night,” by Lord Kitchener which translated into an acceptable lifestyle for most Ghanaians years back has now become a nightmare for other classes of people.

Most Ghanaians lived under the vague thought that after a long spell of work, hustle and bustle during the week, it was important to restore the long-drawn-out energy of the body, on Saturday nights with amusement at night clubs, restaurants, theatres, beaches or hooked to other nocturnal activities.

Unfortunately for a large contingent of Ghanaians, every night is a nightmare as a recent nocturnal expedition I undertook at Tema Station, a portion of Accra New Town, Adabraka and Makola Market after watching the Maternal Health Channel (MHC) story of female porters “kayayei or kakayo” on the tough streets of Accra and other cities.

The nocturnal expedition exposed me to the horrible lifestyle of these special classes of Ghanaians not only on Saturday nights but on all the other days of the week as well. They carry heavy load during the day and sleep under unbearably conditions in the night. Is there any joy in life? What is the fruit of hard labour?

Most of this special group of people, in the night, transformed these market centres into night clubs, video theaters, and self-contained apartments. All that one needs is a mosquito net and then a stall is converted into a self-contained room whilst the tables used during the day for selling become beds.

The question is why would anyone leave their homes and families and travel to an unfamiliar, unfriendly city to sleep on the streets, suffer various abuses including rape and violent robberies, be forced to undertake grueling and sometimes demeaning work, and still persist in the same situation for years on end?

The recent exposure by the MHC of the story of female porters “kayayei or kakayo” on the tough streets of Accra and other cities, is a complex one. Their adversities are as varied as the reasons why they left their homes and continue to make out a livelihood under such dire circumstances.

The MHC broadcasted series of programmes on Kayayei in Accra, with a special focus on how (and if) they accessed maternal health care. Touched by their plight Dr. Ebenezer Appiah-Denkyira, Director General of the Ghana Health Service (GHS) picked up the issues and subsequently decided to team up with MHC to help chart positive ways forward.

Dr. Appiah – Denkyira promptly set up a city – wide health and welfare committee which would include representatives from the police, social welfare, health providers, and NGOs under the auspices of Ghana Health Service.

This unique partnership represents a great chance to provide lasting solutions to the challenges posed by this critical sector of public health care. The committee would meet every three months to evaluate progress made.

These steps are all very important in reducing the incidence of maternal deaths, and greatly improving the wellbeing of Kayayei in Accra. They certainly do not automatically erase what the Kayayei say are the prevailing conditions which occasion their existence on the streets in Accra; harsh economic conditions in their hometowns, pervasive traditions which they reject like forced marriages, etc.

Even as the debate on how to appropriately deal with the burgeoning marginalized population of Kayayei communities in our cities, Dr. Appiah – Denkyira’s initiative is a truly gratifying beginning. This should develop into providing a comprehensive solution to the multi-faceted difficulties faced by the hardworking queens of our markets and streets, the Kayayei.

Other interventions to support the general wellbeing of Kayayei includes posting a representative nurse to each Kayayei community whilst ensuring that all their community leaders have the phone number for their assigned nurse for easy and frequent communication. These nurses according to GHS would carry out outreach services in their localities, educating them on several public health issues, as well as attending to their medical conditions. They would also serve as a liaison between Kayayei communities and designated midwives.

All pregnant women and children are also going to be registered to facilitate service delivery of maternal health care. In cases of medical emergencies, these liaison nurses would ensure that all relevant procedures are efficiently executed including calling for an ambulance, giving prior notice to the receiving health facility, etc. All Kayayeis are going to be promptly registered on the National Health Insurance Service, and their children immunized.

Some of the Kayayei in an interview said they do not go to hospitals when they are sick because they are unnecessarily insulted by medical staff, and are sometimes even refused care because they are shabbily dressed. This blatant discrimination against Kayayei in some health institutions was personified in a story given by Ms Esther Worae, a midwife from Marie Stopes International who works with Kayayei communities. According to her a Kayayei woman and her family were denied access to her baby after delivery, even after repeated requests.

After a number of days and with firm insistence from Ms Worae they were eventually presented with a dead baby. There was hardly any adequate documentation to ascertain if that was really the Kayayei’s child or not. Ms Worae said they left the hospital deeply aggrieved, with no clue as to what had really happened to her child.

Ms Betty Blay Ackah, MHC Publicity, has noted that urgent need for adequate shelter, as their sleeping on the streets rendered them helpless to conditions like bad weather, mosquitoes, unsanitary spaces for food preparation, and rapists.

Now how do we sustain the help to these unfortunate brothers and sister called Kayayei? How do we as a nation uproot the problem? Reduce incidence of internal unproductive migration to seek for non-existing greener pastures only to end up on the streets?

MHC FAN STORY – A Woman Delivered Her Baby in my Car!

“I had a little shock yesterday when a woman delivered a cute baby boy in the front passenger seat of my private vehicle at exactly 6:35pm.I went to a village to buy cereals to be sent to my family in Accra and I was compelled to abandon my mission to lift a woman in labour from Vambelle (a deprived village of about 37km from Tumu, Upper West Region) around 5:35pm to Tumu Hospital because according to the Traditional Birth Attendant that accompanied her she’d been in some kind of complicated labour since morning and had no professional midwife and no means of transport to take her to the nearest District Hospital in Tumu (Capital of Sissala East District). The road was very deplorable, and there was at least a pothole in every square metre of the road I drove on; forcing me to drive at an average speed of less than 30km/hr and had to juggle two emergency situations, the survival of the yet-to-be-born baby & expectant mother & the comfort of this suffering woman amidst her wailing! She groaned with each pothole I hit. A few metres away from a village called Sakai also about 15km from Tumu, while still swerving these chronic potholes, she began delivering as I drove on with her left knee resting on my right shoulder and she gave birth to a beautiful boy. My people are really suffering in this part of the world, under development! I got to Tumu Hospital in an hour’s time and drove straight to the doors of the Maternity Ward where nurses attended to her in my car and completed the labour process before sending her to the ward. The mother and the baby have since survived. I also think, we as a nation ought to pay attention to these issues. It was real, no midwife, no vehicle & inaccessible road! I was impressed with the tact of this local TBA in my back seat so I had to reward the old lady with a hot Fifty Ghana Cedis (GHC.50) before leaving the Hospital. God is great! But in this 21st century, do we need to tolerate these situations in Ghana? I’m still shocked because it was a real experience!!!”

by Ken.

Study of the Quality of Oxytocin and Ergometrin used to treat Post Partum Hemorrhage in Ghana

While there has been significant improvement in maternal mortality in Ghana, the current maternal mortality rate of about 400 deaths per 100,000 live births will far short of meeting the Millennium Development Goal (MDG) of 185 deaths per 100,000 births by 2015. One of the main causes of maternal mortality is hemorrhage during child birth. This can be prevented by potent medicines such as oxytocin and ergometrin which can be administered during child birth to prevent severe hemorrhage. The quality of the medicines is vital in order to be effective.

The Ghana Food and Drug authority which is the government institution responsible for protecting public health by ensuring that medicines sold, manufactured and imported into Ghana are safe efficacious and of good quality. In August 2012, The FDA in collaboration with the Promoting the Quality of medicines Program (PQM) program which is funded by USAID and implemented by United States Pharmacopeia (USP) conducted a study of the quality of Oxytocin and Ergometrin in circulation on the Ghanaian market.

Of 303 samples collected from public facilities including government hospitals, central and regional medical stores, clinics as well as private facilities including private hospitals, mission hospitals, clinics, wholesalers and retail pharmacies, 97% failed to meet quality specification and 94% of Ergometrin failed quality specifications. Two Oxytocin samples collected from Kumasi and Koforidua were outright counterfeit with no active ingredient and three Ergometrin samples collected from Sonyali were counterfeit also with no active ingredient.

About 86% of the oxytocin samples were made in China and 90% of the Ergometrin samples were made in India. Almost all (over 90%) of the samples were not registered in the country and majority was not stored under the recommended refrigerated conditions of 2-8 degrees centigrade.

These results are disturbing and indicate systemic failures in the procurement and regulatory mechanism.  Credit should be given to the Ghana FDA for taking immediate regulatory action to recall the products from the Ghanaian market and notify the citizens in a several press releases. They also prosecuted those traders involved in the sale of the substandard drugs and engaged the Ministry of health to address gaps in the procurement system that allowed products to enter the country without FDA oversight and knowledge.

Study by: Dr. Patrick Lukulay, Director of PQM

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MP SUPPORTS COMPENSATION FOR FAMILY OF PERFECT DABA

Hon Samuel Ablakwa, MP for North Tongu has said that Volta River Authority (VRA) must consider a compensation package for the husband and children of Perfect Daba, the young mother from Torgome in the Volta Region who gave birth to a baby girl and bled to death after failing to reach the hospital. At the crucial moment, the only exit out of her village, a metal gate owned by Volta River Authority (VRA) was locked with no security guard in sight. Interviewed on Radio XYZ this morning, the MP also appealed to VRA to help the people of Torgome by renovating the health clinic in the village so that people won’t have to rush to Akuse hospital at odd hours. A number of callers to the programme appealed to the VRA and government to ensure that the justice was done as a tribute to Perfect Daba and to help improve maternal health conditions for women.  Read the full interview below:

Moro: Honorable Samuel Okudzeto Ablakwa good morning, thank you very much for joining us on the XYZ breakfast show.

Hon Ablakwa: Thank you very much for having me, good morning Moro Awudu.

Moro: Yes Sir. To what extent have you been following this Torgorme matter with some, you know  a 23 year old Perfect Daba who has died after bleeding so profusely because she couldn’t get to the Akuse hospital early enough, she waited at the gate, the VRA gate which was locked. She got there at 11:00pm and there was nobody there to open the gate and she lost her life. Even Justice Dotse in the last Supreme Court meeting mentioned it, telling… and of course reflecting the fact that a lot of people have taken keen interest in this matter. To what extent have you been following this and what has happened ever since you heard the story from your angle?

Hon Ablakwa: Thank you very much Moro, and let me use this opportunity to repeat my condolences to Perfect’s  family especially the three month old baby. I have also had the opportunity to commend you in the media, Radio XYZ for the extensive coverage you are giving this unfortunate development, and of course  the Maternal Channel also for the work they did to bring this matter to the fore. You know the North Tongu constituency is a constituency not too far away from Accra. But there are a lot of developmental ironies. The irony about this Torgorme community is that, they are so close to water, the Kpong  dam, and yet there is no water for the people to drink. They are so close to a VRA facility that generates electricity and yet there is no electricity for a large part of the community, and I have always said that it is these ironies and these contradictions, inherent contradictions in our development, which we need to address. And it was one of the factors that motivated me to run for Parliament for the area. On the specific matter of Perfect’s very unfortunate and tragic death, I think that the argument continues as to who really is responsible. But what is clear to me is that this situation could have been avoided if Torgorme had a decent health facility. Because if you look at the health facility that she was desperately trying to get to across the gate of the Kpong  dam, the Akuse health facility, it is no fantastic health facility, so extraordinary. We could have a similar health facility in Torgorme. So I have had meetings with the Chief Executive Mr. Awotwi. And I must say that he has been very cooperative and he’s been very passionate to help. The proposal  I have put before the VRA is that, as part of their community support services, they should help us to have a health facility in Torgorme. Because apart from Perfect’s situation, there have been several instances of even snake bites and people are being rushed and there are delays at the gate. I can understand that the Kpong  dam is a security installation and so if it’s not protected by security, that water could be poisoned or there could be some interference with the engineering fixtures  of the place, so we understand the security implications and the importance of that national asset. So we are saying that if the VRA can help us to have a health facility there, then this issue of people trying to rush to the Akuse health facility at odd times when the gate is closed will not even arise in the first place. So that has been our focus in terms of having the health facility and I think discussions are going very well so far. There are other immediate measures which have to be taken like, having an education plan for the child that has been left behind, and I am putting together a program for that and VRA has also indicated that they will support. And then also a compensation program for the remaining members of the family including Perfect’s husband. So these are some of the measures that have been taken since this incident happened. We have also held community meetings , and we have reviewed the VRA’s security at the gate. They have given out some phone numbers which we have given to the elders and opinion leaders in the community so that if there is an emergency, even before you get to the gate, you can call that number which will go to the control room so that they will make sure that there is somebody at the gate and the person is awake and ready to open the gate when you get there. But these are all the immediate measures which we are taking. But as I have indicated, our medium and most important measure is that we need a health facility which is up and running, which is decent which can save lives in Torgorme, and so we are working on that.

Moro: Fantastic, and I am happy that you have moved this thing forward and you are thinking of some kind of a package for this unfortunate child who by no fault of his is going to be put in this very difficult predicament. However, I have just two quick issues; one, the first one has got to do with this call facility where people can actually call ahead of time even before getting to the gate. I am told the network there,  Honorable, is terrible, before you can even get through to somebody it probably will take another 30 minutes, 40 minutes, and we were saying that 1 minute in the health journey of somebody is so critical. So I don’t know the extent of discussions that you had with Kweku Awotwi  with regards to what policy, whether the policy on the closure of the gate and people’s freedom of movement must change, which is that, is it possible to get people constantly at the gate? Because we are told there are people there but, even yesterday I am told, somebody just sent a txt from Torgorme telling me that even yesterday there were not people manning the gate so another Perfect Daba’s scenario could have occurred. I don’t know whether it is true or not, but if what this person who sent me the text from Torgorme is telling me is true, then it means that we still haven’t learnt from this experience. So I am saying that maybe you may have to, in your subsequent engagement with Kweku Awotwi,  look critically again about the policy of 10pm gate locked and 6am gate open, and the fact that people are not there to man it. So are you prepared, or are you… I don’t know whether you intend to have any engagement with him again, but I think that is one thing you need to take up very seriously. Because I am told the residents there are complaining bitterly about the fact that they feel caged. 10pm the gate is locked, when I have issues, when I have a problem it takes me forever  get somebody to open the gate. So I don’t know but I think you need to take this thing seriously.

Hon Ablakwa: Yes I agree with you Moro, and apart from having meetings with Mr. Awotwi, we have even scheduled to pay a joint visit to the installation and have a surprise arrangement that looks at how these gates are being manned. Because he was also concerned that they are paying people who are supposed to be at the gate, manning the gates from 10pm to 6am and yet this incident occurred. I think that internally they are looking at some disciplinary measures for those who were not available. My understanding is that the person who was on duty had a health challenge, and there was supposed to be a replacement and it is the replacement who let all of us down, especially Perfect. So my understanding is that some internal measures are going on within the VRA to address that and also to check what appears to be some indiscipline creeping in, in terms of people who are paid and employed to do a particular job but are not doing it. But you see, the point must also be made that, if you look at the entry and exit to Torgorme, that is not the only opportunity. You can go through the Fodzoku road all the way to Juapong,  and if that road had been fixed, if that road was in good condition, then people in Torgorme would not be feeling that caged. So that is another issue that I have raised with the Honorable Roads Minister, that if that road which is now in a very very horrible state could be fixed, then within 20, maximum 30 minutes, you can get to Juapong. And once you get to Juapong, Juapong  has a good health facility, it’s not too far away from Akosombo also which has another good health facility, and even other facilities which you may want to use. Because it’s not good for us to have only one entry and exit and focus on only that place, because of the obvious security implications of the Kpong  installation. So this is also an angle which I am looking at, and I’m hoping that at least the Torgorme Fodzoku Juapong  road will be, even if not fully tarred, at least the road could be levelled  to facilitate the easy movement of the people of Torgorme. So that at least it can vary the options that people have when they need to rush out of the community.

Moro: Ok, well it’s good you are professing alternatives in terms of we making sure that people do not just go through the main gate but can also use the other alternative roads that you are talking about. However, my information is that this alternative route you are talking about is far, you know it’s longer, so for emergency cases you don’t want to even consider that option. But I am happy that you are saying that the security arrangement at the gate, which is the shortest route, is being made to make sure that the indiscipline that occasionally occurs there is resolved. So that people, when it is important, it becomes critical that they use that gate, that happens. So I think we can allow this to rest and to say that congratulations so far, and I am already getting a lot of txt messages from people who are saying that, you know, are congratulating you for what you have done so far in terms of helping out this baby in its upbringing, because it’s still a baby so I can say in its upbringing. Thank you.

Hon Ablakwa: Thank you very much, thank you for the opportunity.

“Moving pain into the public domain”: Ghana’s Maternal Health Channel

BY AKU KWAMIE Research Fellow, Ghana Health Service/University of Ghana

A month ago, I wrote up some of my reflections from the Global Maternal Health Conference. In that piece, I called for a ‘moral revolution’ in maternal health care: the need for us to imbue the notion of honour into our maternal health efforts, and perhaps move past a focus on technologies and other resources in order to make the difference needed in improving maternal health for women and girls. In the meantime, some colleagues posted their own reflections on this issue. Recent developments here in Ghana enable me to respond further.

You may have seen coverage of a new Ghanaian initiative, the Maternal Health Channel (it was mentioned in last Friday’s IHP newsletter). I was at the launch, and it was so interesting, and not just for the expected reasons. An initiative of a Ghanaian social development communications company, and with support from the Netherlands and other development partners, the Maternal Health Channel will run as a weekly television programme: mashed-up docu-drama and panel sessions engaging civil society organisations, community representatives, the private sector, clinical experts, and policy-makers. This is to be combined with radio programming in local languages and social media. The event was rather high-level: approaching the National Theatre, I was struck by the colourful banners I could see from the street – and the military detail as we awaited the President.

In Ghana, maternal mortality was declared a ‘national emergency’ in 2008, a fact that is frequently mentioned. It is encouraging to see the new government administration continue to prioritise maternal health. In bleakest terms, our mortality and morbidity figures amount to 10 maternal deaths a day, and 270 maternity-related injuries and disabilities daily. We like to reassure ourselves that this is not as bad as in some countries. Yet, as we continue on our path of development, with markers like our new-found oil reserves, our near-‘middle-income’ status, and our maturing democracy, it is confusing and unacceptable that women continue to die or become disabled because of childbirth.

The Maternal Health Channel is endorsed by specialists, policy-makers, parliamentarians, queen mothers, students, front-line staff, pregnant women, international NGOs and donors alike. It is about education, information, discussion, and advocacy. We are supposed to watch and listen, and discuss what we think with our sisters, neighbours, nurses and husbands. I am not much of a television watcher. But my Thursday nights will be booked for the next little while.

The half-day launch was full of speeches which were interspersed with a trio singing odes to our mothers, and a sketch dramatizing one woman’s treacherous journey at the onset of labour. Notable was the representation of the President by the Minister of Foreign Affairs, Honourable Hannah Tetteh, an interesting choice, which served, I think, to heighten the cause ‘beyond health’. Mrs Tetteh spoke eloquently about growing up having known something about maternal health issues, being the daughter of an obstetrician-gynaecologist, and having lost an auntie to an ectopic pregnancy. All of this was stimulating, but these weren’t the highlights. Two particular episodes stood out. The first was Madam Lucy, who spoke of her anguish, losing her daughter during her daughter’s pregnancy. In the video clip presented, she said of the moment the doctor informed her of her daughter’s death: “my heart cut”. In the translated sub-title it read: “my heart jumped”. There were murmurs as the young nursing students around me chuckled and shook their heads at the rendering of this woman’s words. When Madam Lucy took to the stage to tell her story live, she re-iterated her own words in clear English: her heart had cut, to the overwhelming cheers of the crowd who supported her unedited voice.

The other highlight was the inclusion and acknowledgement of a large group of kayayi, the young porter girls who work in the markets, often migrants and homeless, who face huge challenges in accessing health services. Many of them brought their babies. I can’t say I have ever attended any kind of forum where ambassadors and MPs have sat alongside nursing and midwifery students, and kayayi and babies. It was very nice. The launch ended with singing and clapping in the aisles as the trio sang ‘Sweet Mother’ and the final sketch delivered us a baby – the journey had been successful!

To bring this all to the comments raised by my colleagues (see their feedback under my previous blog post), there are a few links. Elizabeth asked whether those in power and with the resources can actually hear our calls for change? I think the Maternal Health Channel is a sign that at least in some small way, power and resources are listening. Only time will tell whether or not the programme can contribute to reversing the trend of maternal death and disability in this country. But moving the dialogue of maternal health – not just slogans and platitudes – out of clinics, and into a broader public domain is certainly a start. There are changing perceptions of maternal death and disability as being purely health (service)-related issues. There is a recognition that the solutions are not only with doctors and politicians, and that sexual and reproductive health rights also need debating in Ghana. Rachel raised the issue of validating the outrage and loss experienced by families when a mother dies. The Maternal Health Channel does this perfectly as each week is based on the story of one family. We felt this during Madam Lucy’s testimony, and for the duration of the launch the atmosphere shifted from distress towards hope as we honoured the memory of Madam Lucy’s daughter. The messages of our global declarations do not always filter down to our communities, but we can see how a broad platform for families and communities to speak out – in their own voices – can bring messages of action and accountability upwards. Finally, Jean-Paul highlighted the fact that we need a new generation of researchers with flexible minds to bring about change. I agree, and I would add that in our flexibility we should remain open to inviting different kinds of partners to contribute to that change. The Maternal Health Channel was a welcome surprise to many of us.

The American civil-rights movement taught us that the revolution will not be televised. But through the Maternal Health Channel, we are hoping to raise awareness of maternal death and disability, provoke action, and perhaps transform our Ghanaian society in the process. Many of us are watching.

STRANGE DEATH ON THE VOLTA

Perfect Daba, a promising 23 years old woman from Torgome in the Volta Region bled to death in three extraordinary hours during which she failed to reach the hospital. She had delivered a bouncing baby girl in the middle of a salient night but complications set in, a familiar development with most of the other 4,000 Ghanaian women who die annually from pregnancy related complications. Bleeding is the major cause for maternal deaths in Ghana. What sets the death of Perfect apart however is the context and extraordinary circumstances.

There is only one exit out of the village of Torgome, a metal gate at the Kpong Power Plant managed by Volta River Authority (VRA). That morning at 3 am when Sammy, Perfect’s husband tried to rush her dying wife in a taxi to Akuse hospital, about 80 kilo meters away, the metal gate was shut. Unfortunately, the security man was nowhere to be found. Sammy recollects that it took nearly an hour to find and persuade him to open the gate. The gate is normally re – opened at 6am. The other exit possibility is the Volta Lake on the other side of the village but it is deep and unsafe for shallow canoes.

Apart from learning the right lessons in order to reduce the high incidence of maternal deaths across the country, Perfect’s story is significant because she paid the ultimate price for all of us. Torgome occupies a strategic place in Ghana’s development history. It is one of the resettlement villages created by the Volta River Hydro-electric project which transformed the physical environment of the area. It created largest man – made lake in the world. It also produced special passages for the power houses, security gates and restricted public movement.

Delays in reaching health facilities has been cited by the Ghana Health Service as one of the three key delays resulting in the high incidence of maternal deaths across the country. Normally this is associated with pregnant women failing to recognise or acknowledge the risk signs of pregnancy or labour, lack of transport to hospitals from far to reach villages, especially during the night, lack of ambulances and so on but never because a gate was locked.   That puts a strange twist to the phenomenom.

Perfect eventually arrived at Akuse Hospital. She was still conscious but in a critical condition. The staff responded promptly but more than three hours had passed since she went into labour. Sammy said when Perfect first complained about stomach pains, he took her to the village health post but it was closed that fateful Saturday.

At Akuse Hospital, there was no doctor on duty but the nurses did their best to resuscitate her. Such government hospitals have a perennial shortage of doctors and skilled medical personnel. As the nurses tried to bring Perfect back to life, Sammy and accompanying auntie were asked to leave the room.  The doctor eventually arrived but it was too late. He called Sammy back to the ward to tell him the bad news. The nurses said Perfect’s veins had collapsed making it impossible to inject a drip.  The newly born baby had also made the eventful journey to the hospital. She was well but must now be hospitalised for special care since she was born prematurely. That sad morning, Sammy went back home without his wife and baby.

Perfect’s funeral was one of the most emotionally charged funerals our cameras have ever recorded. It was proceeded by a wake and burial attended by family and people from all the surrounding villages. Perfect was a popular local girl known for her kindness and her helpful nature. Sammy is also the Village choice carpenter. More significantly however, people came in their numbers because they all knew that this tragedy could have happened to any of them.

There was sadness and there was also anger but it was all dignified and the pleas were almost cordial. The gate must be opened at all times everybody said. VRA can ensure that its security concerns are met by posting security guards around the clock.  Restricting their movement, especially when it was going to delay reaching the hospital and end in such a tragedy was a denial of their human rights. They also pleaded for a properly functioning local clinic that can ensure that women delivered safely at all times. In the TV programme to be broadcast, John Chobbah, VRA’s communication Officer expressed shock at Perfect tragic end and extended his sympathy to perfect’s family. He is however firm about this. VRA will not open the gate at night.

Dr. Kwesi Owusu, Executive Producer, Maternal Health Channel

“I am addicted to clay eating especially when I am pregnant, should I be worried?”

A women eating baked clay or ‘Ayilo’ as it is known locally in Ghana

This week’s blog post comes courtesy of budding blogger and psychiatric nurse Kobby Blay of Ghanahealthnest.com

Three months into her pregnancy Aboagyewaa has become the favorite customer of an ‘Ayilor’ seller who lives two blocks away from her. She had somehow graduated since she got pregnant from just a little “Ayilor” eating to much more.  Not even her husband was able to convince her to quit; she hadn’t even told the midwife at the ante-natal clinic she attends. She kept the issue to herself.

Three months after delivery Aboagyewa still takes ‘ayilor’ but not as much as she did whilst pregnant. The beautiful baby was actually smeared with some of the clay when he was a week old by Aboagyewa’s mother, who claimed it was meant to drive away evil spirits and make the baby’s skin look good.

Ayilor in Ghana is baked clay, mostly eaten by pregnant mothers. Many women who aren’t pregnant also consume it..making it a big business!

History

Aboagyewaa is, of course, not the first victim of this act of craving eand eating clay, also known as Pica (a derivative from the Latin for magpie, a reference to a bird notorious for eating almost anything).  This persistent attitude of eating non-nutritional substances such as the ‘ayilor’, is not limited only to pregnant mothers as there are others who have craving for chalk, starch and even paint!.

All these kinds of dirt-eating occur around the world. People on all the inhabited continents — more women and children than men, it seems, and more commonly during pregnancy — eat earth and other substances.  And this practice is not new; it dates back about two million years, according to one finding, and involves both medicinal and religious uses as well as the simple craving.

As with wine, the location of the clay is important. There have been times when some type of clay is known to be very medicinal (into the 20th century). Most of these famous clays contain kaolin. Kaolin is very useful in combating diarrhoea.

Interestingly (Amazonian) Parrots and Baboons also eat clay! Parrots will eat clay to effectively prevent them from absorbing quinidine sulfate, a toxic substance found in the plants. The Baboons even do so more when they are pregnant. The dirt they eat is high in clay, which protects the eater against toxic natural chemicals in food and also against bacteria and parasites, by lining the intestinal wall and grabbing on, chemically, to some of the toxins.

Other disorders — such as mental retardation, developmental disabilities, or obsessive-compulsive disorder and iron deficiency – may play a role as the cause of this odd eating behavior.

Overruling the cultural factor could prove difficult. Culture has been extensively used to promote the usage of clay and many mothers of pregnant women (in the Ghanaian community) encourage them to eat the clay.

Treatment

Treatment of this behavior does not come easy especially when the behavior might have begun from infancy or from a lack of education on this baked clay and its effects. All the same after confirming the presence of such an addiction, treatment is initiated involving a thorough physical and psychological examinations by a Doctor (usually a physician, psychologist/psychiatrist,nutritionist). The process could demand much effort both from the victim and the doctor giving the treatment. Complications may arise thereof if left unattended;

1. Eating non-food objects can interfere with eating healthy food, which can lead to nutritional deficiencies (and deny the fetus/baby same).
2. Eating objects that cannot be digested, such as stones, can cause constipation or blockages in the digestive tract, including the intestines and bowels. Also, hard or sharp objects (such as paperclips or metal scraps) can cause tears in the lining of the intestines.
3. Bacteria or parasites from dirt or other objects can cause serious infections. Some infections can damage the kidneys or liver.

Should you worry?

If you think you might be developing a craving for this baked clay or ayilo (it is normal especially during pregnancy), inform your doctor/midwife. Understand that the dangers you may experience when the pregnancy are not limited to you alone but your unborn baby as well.

Don’t hesitate either to assist anyone who finds herself in this, you may be the baby’s hero. Yea, you can be a hero of someone’s health!

Author:

Kobby Blay of Ghanahealthnest.com

References:

WebMD

AmericanPregnancy.org

Craving Earth,Understanding Pica Eating, Sera L. Young