I was once told a quote that I find extremely compelling, especially for experiences such as this.
“If I may offer you a simple maxim, ‘Be interested.’ Everyone wants to be interesting but the vitalizing thing is to be interested. Keep a sense of curiosity. Discover new things. Care. Risk failure. Reach out.” –John Gardiner
Over the past few days, Jenn, Austin, and I have traveled to eight different villages in the Akatsi district of Ghana. I have had the opportunity to ask questions to the women and TBAs regarding my research, but more importantly, I have had the opportunity to listen to unbelievable stories.
In terms of my research study, I am surveying and interviewing women in each community, TBAs, and CareNet Ghana staff regarding their views of CareNet Ghana’s TBA training and equipping program. Historically, the WHO advocated for, and recommended the use of, traditional birth attendants in developing areas of the world. They were seen as a productive and efficient way to deliver knowledge and safety when it came to births in rural and developing areas of the world. However, in the late 1990s the WHO altered their stance on TBAs from an emphasis on the training of TBAs in developing countries to promoting professionally skilled attendance at all births. Many smaller changes have occurred throughout the history of the WHO, but the recommendation for professionally skilled attendance was the most drastic, especially considering the shortage of professionally skilled medics in developing countries. My research will focus on whether or not those working at CareNet and those affected by CareNet are familiar with the change in recommendation, how they feel about this change, and whether or not they feel the need to move in the direction of professionally skilled attendance at all births.
In the eight villages we have been welcomed into, I have been able to observe the ‘Women’s Club’ meetings, listen to their minutes, play with the children, and talk to them about their experiences with TBAs. One story a woman so faithfully told me was about the newborn girl she was holding in her arms. When she went into labor, it had been days since she had eaten. The TBA assisting her brought her food and coerced her to eat even though she had no appetite. When it became apparent that there might be complications with the delivery, the TBA called for a car to transport the expectant mother to the hospital—a journey that the TBA endured with the woman. The TBA never left her side. She held her hand through labor, spoke encouraging words, and helped the mother and baby girl get home safely. Without the caring and devotion of the TBA in that village, it is unclear whether or not the mother and baby would both be happy and healthy today.
When I had the chance to talk to a TBA in another village, he told us how becoming a trained TBA has changed his life. Being trained has made him feel more proficient in his work as a TBA and thus helped him to deliver the best possible care to the women of his village. As a result of this, the other villagers have increased their trust and respect in him, which has made him a happier person.
Not only have I been interested in the stories, but I have had the opportunity to open my eyes to life in Akatsi. Several bucket showers later, I can say that my view on the world has definitely expanded. Whether it’s the kids running around in underwear, the women with babies wrapped in scarves on their backs, or the roosters waking us up in the wee hours of the morning, I would not trade Ghana life for anything (as much as I might miss air conditioning…). This past Wednesday, we got to experience both Market Day and Weighing Day. At the weighing, women from all over Akatsi gather to have their babies weighed and given injections under a single roof. The scene was hectic and hot. Women sitting on benches with their children, a few women selling goods in the back, and a single scale hanging from the roof. The mothers undressed their children and put them in what were called, ‘weighing pants,’ which were pretty much cloth diapers with a long strap. The baby was then hung on the scale hung from the ceiling to be weighed. The child was then examined, in front of everyone, and given an injections he or she may have needed. The whole process would never fly in the US. However, the women did not seem to be bothered by any aspect of it, including sitting for hours in the heat. They were happy to make sure their babies were healthy! Later on Wednesday, we explore the market—sprawling, open air, and strangely not busy. Everything you could need was sold at the market: vegetables, fish, meat, fruit, kasava, roots, beads, cloth, clothing, shoes, cutlery and household items. You name it, it was there. Yet, the most culturally shocking thing to me was not the weighing or the market, it is the idea of credit. Credit is what we know as minutes, but here, credit is purchased off the baskets on women’s heads or in huts on the roadside. Perhaps it is because we are so used to the idea of, ‘unlimited,’ that I’ve never considered where minutes, or ‘credit’ comes from. Regardless, I’m still struggling to wrap my head around it.