CLINIC DAY!!

RE: TUESDAY JULY 18th

Today was clinic day! I have to admit to feeling a tad guilty going down though - normally we mix a 10-12 bag of cement pile. Today the team mixed an 18 bag pile. And Hope & I left when the task was less than half done.... The guilt was balanced out by some nervousness about not having a clue what “clinic” was, or how (if at all?) we could be of assistance. Which was all balanced out by excitement. We had been asked to arrive by 12 o’clock, so we left the worksite in time to get cleaned up and walk the 25 minutes to the clinic. It had been suggested that George our busdriver would give us a ride, so we had time to eat a pb&j here instead of while walking. But when we were ready to leave it turned out George had gone down to the village for something and we ended up walking anyway. Partway down the hill we met Daniel in his car so he gave us a ride. (Plans? Who needs plans?)

As we pulled up to the clinic we could see women with their babies streaming toward the front doors. There were women and babies in the yard, on the steps, on the benches inside, milling around... Women and babies everywhere! Many of the women were wearing beautiful white dresses. Hope commented on this to Daniel, who told us that in Ghanaian culture, white is symbolic of victory. Women who have survived childbirth wear white because of the victory that is. Knowing that, this sea of women in white was even more remarkable.

Once inside Hope & I were taken to meet the head midwife Sister Evelyne. Sister Evelyne was going to be doing “palpations” of women who were pregnant. We then met the doctor, Beatrice. She was there for consultations on anything beyond the scope of the midwives or community health nurses. At first she wanted to know what was wrong/what we needed, but once she realized we were there to assist in whatever way they needed us, a huge smile lit up her face.

At this clinic (which is a mini-hospital of sorts... Although I haven’t seen chickens or roosters roaming around the reception area in any North American hospital or clinic....) there is a doctor, a head midwife (who will be leaving soon), 2 secondary midwives, a primary community health nurse and 2 secondary community health nurses. The midwives work out of the clinic doing prenatal and postnatal care. If a woman is having a BIG problem during labour she may come to the clinic but most do not. They do not have even the most basic midwifery supplies (like CPR shields or ambubags) at the clinic, so the midwives ability to help is limited. The CHN’s do immunization clinics, well-baby care, counselling, and basic health care. Anything beyond their scope is referred to the doctor, or to the hospital in the city. They also do home visits.

So anyway - - - - Hope & I were told we’d be helping with imunizations, and came back out to the main room. I was introduced to Mildred a community health nurse, and was given a chair at a table where she and Lucy (another CHN) were recording data. My job was to transfer information from the Child Health Records into a log book, so that the clinic could track the nutritional status of the children. Once I had the hang of that, they also had me fill out which vaccines the children had received.

Hope was across the room - somewhere - doing something. The crowd was just too thick to see through! And the noise! An absolute cacophany of women talking, babies crying, orders being given, chickens clucking, wind blowing, ocean roaring, doors opening and closing..... It was wonderful. As the day progressed my job slowed down, which allowed me to talk at length with Mildred about her role as a CHN, about health care in Ghana, about breastfeeding, about being a doula, about vaccinations, about HIV/AIDS, about birth control.....

Two of the things I learned which really surprised me were:

(1) The majority of women in the village use 3 month injectable Depo-Provera (spelling?) birth control. It is the method of choice mostly because they don’t have to think about it. For instance, they don’t like the birth control pill, because they may be out fishing when it is time to take it. And while condom use is HIGHLY promoted, there is strong stigma attached to their use.

(2) Most women give birth at home, without any experienced person to assist them. Mildred said that much of the traditional knowledge around birth has been lost among the women, and they only come to the clinic for the assistance of a midwife if there is a SERIOUS problem during labour and birth. Mildred was very interested in what I do as a doula in Canada, and said emphatically that she wished women here were able to have that sort of support and encouragement, and wished that she as a CHN knew things that could help ease the labour process.

We wrapped up around 3pm, and headed back to the site full of stories to share. Turns out Hope was administering oral polio vaccines to the babies. We did manage to make eye contact once, but I didn’t know what she was doing until we had a chance to talk about the experience with each other at the end of the day. As we drove down the road, many women with babies smiled and waved as we passed by. We’re not just tourist obruni anymore....

I have been invited to go with the CHN’s on their home visits next week. EEK! Exciting and scary! I’ll keep you posted.

Blessings.

Sarah(thedoula)