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Time to Rest Another Day

Rural Ghana “Sister Joanna,” she called from the front seat. “It has rained. Our roads, they are very bad. Are you okay?”

“Yes, yes. I am fine,” I answered.

The truck had just hit another huge bump on the dirt road. The vehicle crept forward, bouncing me out of my seat every few minutes from the holes and dips on the path. We had been stopping every five minutes to assess the safest route through muddy puddles. I had been in Ghana long enough to know that a few bumps on the road were something to be expected during site visits.

“Sister Joanna,” she called again “Today we can do three more facility visits.”

“Okay, Auntie Sofia.” I didn’t bother asking about the details, such as how far we would be traveling or what time we would get back. I knew she would take care of me and that the work would all get done.

The sun was starting to set and we had been inching down dirt roads since early in the morning, trying to visit as many health facilities as possible. I was tired, but I knew better than to question the recommendation of my enthusiastic travel partner.

Sofia Sofia (pictured left, in white) works as the District Public Health Nurse for Upper Manya Krobo, one of the four districts in Ghana participating in the pilot project introducing distribution of misoprostol at prenatal care for the prevention of postpartum hemorrhage (PPH). She is one of the health workers who assisted with monitoring and supervision at the clinics and in the communities participating in the project.

We pulled up to a small building where a young nurse stood outside. I could tell she had been expecting us; she had already arranged all of her files neatly on the table and set up chairs for us. The clinic sat next to a large, wide-branching tree—the type I imagined must protect many waiting pregnant mothers from the intense mid-day sun.

Like all of the providers I had met in Ghana, the nurse was full of good things to say about misoprostol and the pilot project. Most providers had stories they told about postpartum hemorrhage - in fact, it seemed difficult to find anyone in the rural areas where we traveled who did not have a story about a relative, friend, or community member who had suffered from postpartum hemorrhage.

Rural clinic We sat around a table, listening to the nurse’s experience and reviewing the files she was keeping. The sun was setting, and the mosquitos were starting to bite. I tried not to distract from the conversation as I waved mosquitos away from my exposed ankles and discreetly scratched where I had already been bitten.

“It is getting late and the mosquitos are coming to bite you,” the nurse said. She had noticed.

“Oh, I am fine. Don’t worry,” I said, not really expecting her to believe me.

The nurse disappeared inside of the clinic and came out with a Ghanaian cloth. She walked over, and wrapped it around my waist. It fell perfectly to my feet, shielding my legs from the aggressive mosquitos. She stepped back to admire my new outfit, and she and Sofia both laughed. “Now you are a Ghanaian!” they smiled.

This is something I learned quickly when I arrived in Ghana: people take care of you. The nurse had taken care of me, just like she takes care of the women who come to her clinic every day. And she had done it with a joy that was apparent in so many of the providers that I met during my time in Ghana.

It was getting dark outside. We finished up our visit and said goodbye. We still had two more clinics to reach. I knew that even though it was late, the providers would be there waiting for us when we arrived. We got back in the truck to begin the next stretch of our journey.

I gazed out the window, taking in the remaining daylight. The landscape, scattered with banana plants and cacao trees, had begun to darken and I could no longer see the trees in the distance. Soon we would turn on the headlights, and the truck would have to move even more slowly to avoid the dips in the road.

I looked up to ask Sofia a question, something I had often wondered about many of the colleagues I met here. “Auntie Sofia,” I asked. “Do you ever get tired?”

She laughed and then paused for a moment to think. “The misoprostol, I see that it is saving lives,” she said to me. I could make out the expression of happiness on her face through the side view mirror. “It is a good thing. I want all of the women in my district to be protected from bleeding, so I am happy to do everything to help them. There will be time to rest another day.”

Joanna in Ghana

Joanna Ortega, a VSI intern and graduate student at UC Berkeley, traveled to Ghana from May to August 2011 to support VSI and Ghana Health Service’s (GHS) pilot project. On March 19^th, 2012, VSI and GHS will hold a national dissemination meeting in Accra, Ghana to share the results of this project with project participations and local stakeholders.

Time to Rest Another Day

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