I recently had the privilege to join a TBA meeting at the MVP office. TBAs are Traditional Birth Attendants, who support the Community Midwives in the Bonsaaso village cluster. They are not midwives themselves but are trained in basic skills and can pretty much deliver a baby if the mother cannot make it to a clinic in time.
To put this in context, there are 30,000 people in the Bonsaaso cluster and for this number of people there are 7 midwives and about 60 TBAs. Due to improved education, the majority of births (70-80%) now take place in clinics but that still means 20-30% take place in people’s homes/in fields/by the side of the road – and these are the ladies who help when this happens (= about 180 births a year). Despite better awareness of the benefits of giving birth in a clinic and a subsequent improvement in the number of mothers surviving birth, there is the constant challenge of huge distances/little transport/terrible roads which continue to contribute to the high “out-of-clinic” birth rates here.
The TBAs meet about every 3 months to keep their skills up-to-date and to share experiences and knowledge. The meeting was facilitated by the lovely Lydia (nurse), Ruth (pharmacist) and Gordon (community development facilitator). The focus of this meeting was the recent use of MISOPROSTOL in the community. My understanding is that until recently, the majority (80%) of mothers who died post delivery at an out-of-clinic birth, did so due to excessive blood loss. Misoprostol , when used correctly, can counteract this and has now reduced this figure to nearly zero in the cluster. However, when used incorrectly, the drug can be used to cause an early stage abortion and was being used as such by teenagers who had unwanted pregnancies. Due to the abuse, the drug had been banned in Ghana, however, MVP and this group of TBAs had special license from the relevant authorities to use it and had been trialling a “tag” system whereby each dose had a number. Amazingly, they’ve had a 100% success rate with this new system and in the last 3 months, they’ve dispensed 406 doses and none have been lost or misused. This was a cause for much celebration and everyone was given a gift as a thank you as it had gone so well. Although I originally started taking the photos of the gift presentation, they then wanted me to give the gifts out instead – so I felt like a rather sweaty Father Christmas! – but was honored to be involved. FYI In each package that you can see is a roll of fabric for clothes/linens etc.
On a personal note, I was given another very warm welcome by this group and was lucky enough to have people occasionally translating from Twi so that I could follow what was happening. You’ll see from the photos that the room was a riot of colours – the ladies looked wonderful in their bright apparel. In contrast, I was dressed in toned down black/grey and felt like a blackbird sitting in the middle of a flock of birds of paradise!!
