Emergency! She is in labor!
We spot her on a motorbike sandwiched between her husband and sister on the Salaga road, heading to Kpandai in the Northern region.
She is wincing in great pain as her husband looks confused by his inability to save her from further hurt. He is in a hurry but is forced to drive slowly due to the terrible state of the road. In addition, with his motorbike weighed down by three adults, it simply impossible to speed.
The pregnant woman, whom we later get to know as Idonkir, vibrates on the motorbike, slouching badly and resting on her sister who supports her firmly while carrying her delivery bag.
Idonkir sandwiched on a motorbike on her way to delivery
Her groans were so piercing to the heart that I could not bear watching so the crew abandoned our journalistic mission for a humanitarian one.
The back seat of our car became a makeshift bed for Idonkor and we crammed into the front seat and boot space to begin the journey to Kpandai polyclinic.
Typically it would take an hour to get there, but the four wheeled vehicle in the professional hands of Richard we made it in 45 minutes.
I find out Idonkir had labored throughout the night but the baby would not come out. She is experiencing what doctors’ term obstructed labour.
Even in the relative comfort of our vehicle, Idonkir still jerks about in pain as we travel on the road riddled with potholes. Her cries were frightening and her sister clutched her firmly to give her comfort, but the labour pains were excruciating.
Eventually we make it to the clinic.
The first sight that greets us in construction works obstructing the main entrance. An ominous sign of things to come.
Interestingly, we were also the first vehicle in a long while to bring in a patient, since most patients arrive there on a motorbike.
The labour room
We finally make it to the delivery ward and the medical team takes over.
It was a nail-biting experience waiting and hoping to hear good news, but after 30 minutes of tense silence, Idonkir’s baby is yet to come out. We find out the baby was in a breeched position, the baby’s leg had come first instead of the head.
The midwife conducts a scan, announces that the baby has a strong heart beat and recommends an emergency caesarian section since Idonkir is too weak to push. The medical team is trying to prevent fetal distress but sadly, their fears are confirmed. The only medical doctor at the Kpanda polyclinic has travelled to the Northern region capital, Tamale for training so the medical team prepare Idonkir for a referral to another facility.
Vehicles are rare and ambulances are a lot harder to come by, so our news vehicle once again, comes to rescue. Our car, which usually carries cameras and tripods makes way for different kind of equipment, as nurses transfuse Idonkir on the way to the Evangelical Church of Ghana hospital, a mission hospital now supported by government of Ghana.
At the Evangelical Church of Ghana hospital, the only doctor available had just started an emergency caesarian section so Idonkir had to wait her turn.
No Medical Supplies
We get the shock of our lives when the midwife of the hospital announced that there are no medical supplies for the surgery.
“We don’t have drugs. We don’t have infusions, rangers and other essential drugs so her husband would have to go and buy these drugs. The National Health Insurance Scheme have not paid us since last year”. She stated.
So we drive Idonkir’s husband Jagri to a nearby pharmacy to purchase essential medications for the surgery. Jagri pays about 60 cedis and we drive him back for the surgery.
Meanwhile, Idonkir’s situation had worsened. The only doctor at the hospital Dr. Sonlaar Joseph had just finished a successful caesarian section but he looks worried. He could not hear heartbeat of the baby and was frightened the baby may not be alive.
“For now I want to concentrate on saving the mother, I can’t hear anything”. He stammered.
Idonkir is wheeled into the theatre for the surgery that may save her life and the baby.
The theatre is poorly lit. The ceiling lights are not functional and so the anaesthetist improvises with a mobile phone torchlight to illuminate her back to administer anaesthesia into her spine. It takes a while for Idonkir to be sedated for the surgery.
We later find out that the hospital had no anaesthetic machine and so the anaesthetist had to do his job manually. 50,000 cedis can give Evangelical Church of Ghana hospital an anaesthetic machine.
The theatre is tense and Dr. Sonlaar Joseph bursts into prayer. “Father we thank you once again. We commit this patient into your hands. Let this surgery be successful and we will give you praise”.
Within 15 minutes of surgery, a loud cry! It is a boy and everyone in the theatre is happy.
Idonkir fortunately, does not end up as one of Ghana’s grim maternal mortality statistics.
According to the Ghana Health Service, in 2016, out of every 100,000 live births, 378 women died. This figure could be equated to 42 Trotro Urvan buses crashing and killing all passengers. In the Northern region alone, 136 maternal deaths were recorded in 2016.
The baby is handed over to his father. Jagri was so excited that he named his son immediately. The baby boy’s name is “Kwabena Joy”. Jagri explained that if it had not been for the timely intervention of the Joynews crew, the worst would have happened.
Dr. Sonlaar Joseph is excited too, but has many concerns. Firstly, the National Health Insurance Scheme has not reimbursed the hospital since July 2016. “NHIS owes my hospital 700,000 cedis. I have written many letters pleading for payment but no one is listening.”
JY Pharmacy and Tobinco pharmaceuticals have sued the hospital for delay in making payments and stopped supplying the hospital drugs. “SSNIT also dragged me to court for failing to pay social security contributions of my staff. I have not paid my staff for more than one year but they always come to work. How can I work at a hospital without drugs?”
Dr. Sonlaar Joseph explains that the practice of pregnant women sitting on motorbikes during labour is very dangerous. “If a woman starts bleeding and the bleeding is so severe, the woman can get into shock and the blood pressure will drop. This is where pregnant women have to lie down but unfortunately they sit down and so can die even before they come to the hospital”. He added.
The District Chief Executive of Kpandai Kofi Tatablata, says the Kpandai District has just one functional ambulance which is stationed far away from Township. “We have a lot of challenges. Our roads are horrible. Sometimes our women sit on motorbikes to hospital even when they are very sick. We are not generating enough money. Last year only 86,000 cedis was collected as internally generated fund”. He stated.
Idonkir’s story definitely brings closer home how development infrastructure such as good roads and hospitals can make a difference in the lives of citizens. It highlights the real life implications of governments’ failure to reimburse hospitals for the cost of care given to patients on the national health insurance scheme.
It also brings to the fore, the need for government to invest in emergency care such as provision of ambulance. Who knows how it would have happened in Idonkir’s case if she had to hop from one hospital to another on the back of a motorbike, had the news crew not showed up when it did?