Today, we got to have a conversation with Patrick about the social, cultural, and health benefits of traditional birth attendants. He started by clarifying that in the Akatsi District, there IS a difference between TBAs and professional midwives. Professional midwives are a type of health worker and work for the Ghana Health Service. TBAs are sometimes referred to as community midwives and serve a purpose far greater than simply delivering antenatal and postnatal care. TBAs are trusted and well respected in their communities. In fact, when CareNet trains TBAs they target already practicing but untrained TBAs in 20 communities within the Akatsi District. This way, people in the communities already feel comfortable seeking the care their community TBAs. Patrick told us that currently, TBAs are more important than ever because there is an extreme lack of professional midwives. In Akatsi alone, there are 13 professional midwives for a population of 200,000 people, all very spread out. We also found out that the one doctor in the Akatsi District recently quit and left the district! Scary thought!!
Beyond the roles of TBAs we also chatted about the reasoning behind hesitation to go to the hospital in Ghana. Compared to most African countries, Ghana’s government is extremely stable and there are many, many laws. However, when talking to one of CareNet’s staff, Sebastian, I learned that these many laws are rarely enforced, especially when it comes to health. Apparently, the attitudes of health workers in the hospitals of Ghana turns people away from seeking aid. Patrick described them as hostile, criminal, and having, “no patience for their patients.” Hospitals will often turn people away with severe ailments whom are close to death, because they do not want to be responsible for the death. Due to this fact, many pregnant women with severe complications, chose to stay home out of fear. Hospital deaths due to problems not associated with pregnancy are often preventable due to negligence. Patrick told us that pharmacists have a hard time reading the prescriptions and administer incorrect medication and injections. Once a death occurs at the hospital, no one questions how or why it occurred. Sadly, there is no system to check or enforce these issues.
Ultimately, TBAs hold a well-respected position in Ghana, whereas health workers do not. Yet, it remains a tough balance to walk because TBAs and health workers must work hand in hand in the case of extreme complications due to pregnancy.