After more than three decades of practicing as a public health nurse, Madam Rejoice Afua Ndewu has passed the legal retirement age and is set to hang her diaphanous but neat white dress.
However, Ms Ndewu’s dedication to the fight against Tuberculosis (TB) in the Volta Region has endeared the Ghana Health Service enough to re-engage her a few more years – for some more of her unparalleled service in the fight against potentially fatal disease killing hundreds of Ghana’s rural folks.
To appreciate Ms Ndewu’s effort as a Senior Staff Nurse and Institutional TB Coordinator at the Ketu South Municipal Hospital in Aflao in the Ketu South District of the Volta Region, you would have to first know about the unsettling statistics of TB infection in Ghana and the region in particular.
According to latest figures from the Ghana Health Service, about 122 people contract the dangerous infectious bacterial disease every day. Out of this figure, 27 people are most likely to die from complications, putting the figure averagely to one person dying every day from the disease in Ghana.
The 14, 632 cases diagnosed in 2015 makes Ghana a TB endemic country, but if you include news in March this year that 640 new cases of the dreaded Multi-drug Resistant TB (MDR-TB) disease are being recorded every year since 2012, then the need for improved measures to end the disease settles in.
The Volta Region currently ranks high in TB prevalence, with the Ketu South district, where Ms Ndewu is stationed, among the high-risk areas in the region.
Having written her case study on TB as a graduating Community Health Nurse sometime in 1983, the heavyset and energetic health professional took a decision to take up the fight against the disease most health professionals dread.
“Those days, people thought that once you are infected with TB you will only die. But I wanted to know whether you can really die with it or you can be cured. So when I was doing my General Nursing, I wrote on TB again. Midwifery too I wrote on TB in pregnancy to know much about TB,” she narrates.
This personal motivation to the cause of fighting TB will take her to some of the obscure places in Ghana, Togo and Benin – tracing contacts of infected TB patients at shrines, churches, prayer camps. Most rural folks misconceive the disease as influenced by spirits.
“When I came to the Volta Region hospital, I realised that there was nobody to care for TB patients because of the fear and stigma attached to the sickness. So I decided to work as TB nurse. I told them to open a unit so that I work there,” she recounts.
That suggestion from Ms Ndewu would give birth to the Chest Clinic at the Ketu South Municipal Hospital.
There is a famous story about how she went into a dreadful voodoo shrine in the Volta Region to trace and treat the disease despite importunities from her colleagues at the hospital.
“The inmates at the shrine were infected with HIV and TB. When I told a lady friend that I was going to that shrine, she told me if I go they will cut the skin on my back and use for rituals,” she said, but that did not deter her.
She said she understand very early on, in her fight against the disease that it will be difficult to barge on a household with information that they may all be infected with the disease and suggest testing for them, so she made a point to start her engagement as friendly and professional as possible. And that trick worked.
She said today, the inmates at the shrine (which she will not disclose) are all cured of the disease. Hence as news went round about her exploits in the unnamed shrine, other shrines dotted around the Volta Region opened their doors to her.
She will come to find that these obscure places have some of the highest cases of TB.
Barriers to treatment
Although the treatment itself is free, most of the patients she encounters are most often too poor to even pay for feeding and transportation to the clinic to keep up with treatment appointments. These two factors, she said, are critical to the effective treatment of TB.
“Sometimes I give them money from my own pocket. So anytime I take my salary, I divide it into four parts – one for that work,” she said.
Then there is the infamous issue of stigmatisation. She recounts how she was herself tagged as a sick person because of her constant engagement with TB patients at the hospital.
She wants the Ghana Health Service to compliment the deployment of the Genexpert test for the diagnoses of TB with the ultra-modern digital radiology X-Ray technology for the swift screening of suspected cases.
Rising to the top of her profession despite having been denied the chance to attend secondary school, Ms Ndewu says part of her motivation to fight the disease stems from her deep-seated hatred for failure.
“I entered nursing because, in the village where grew up, women died easily through childbirth. Death from snake bites was common and the nurses at my village too were not friendly, so I said I will also be a nurse so that I can care for people better,” she recounts.
Her joy has always been the happy and thankful faces that come back to her Chest Clinic to say ‘thank you’ after being cured of the disease.
Apart from the hundreds of treated TB patients under her watch at the clinic, her effort has also effectively cured four cases of the dangerous MDR-TB.
“I love my work. If I can get some NGOs I want us to set up and cure more TB cases. Because TB is prevalent in Aflao and Ketu South. So if we can get NGOs to help so that we develop the clinic to have a lab and a dispensary, all under one roof, I will like it. We also need a car to effectively trace contacts,” she pleads.
Ms Ndewu has been re-engaged by the Ghana Health Service to fight the disease for two more years, a move Dr Joseph Kwame Degley, Director of the Ketu South Municipal Hospital, says will prove most helpful.
“Currently as we speak, in the whole of Volta Region, Ketu South has more cases of Tuberculosis on hand and she is very instrumental in looking for the cases,” he said, confident that Ms Ndewu would remain invaluable resource to the fight against TB in many years to come.
“I think she is gifted,” he adds.
Recently, two development-focused groups in the Ketu South District held a short ceremony to honour the work of Ms Ndewu.
Ketu Youth in Development Network and Talent Hunt hopes to encourage the youth in the area to develop a spirit of selfless sacrifice in their chosen fields of work.
They believe this would bring the much-needed development to the entire region.
Elolo Kelie, who heads the Ketu Youth in Development Network, says Ms Ndewu’s story must be told to the entire nation to encourage others to emulate her good works.
“Madam Ndewu’s story is one that makes us proud. We need more of such people in Ghana. Ghana has many challenges in the public sector because not many people take their work seriously or work with passion,” he said.
Elolo Kelie and Ms Ndewu
Ms Ndewu has won many awards at the district, regional and national levels for her work.
In 2014, she won the prestigious Best National Health Worker Award.
She also won the National Special Award in 1997.
She offers this advice: “I will tell the whole world that girl-child education is very necessary and nursing is a calling. If you choose to be a nurse, don’t expect too much. You have to understand that taking care of sick people is a divine mandate”.