Out of My Comfort Zone: In the Labor Ward at Ridge Hospital
Written by Louisa Oates – August 2011
On May 16th, I was sitting contently in a folding chair on the Wake Forest quad, in my cap and gown, waiting to receive my college diploma in the presence of hundreds of cheering families and peers. Just a week later, I was sitting uncomfortably on a small box in the corner of a hot and humid room in the Ridge Hospital labor ward, in new scrubs, waiting to observe a dehydrated Ghanaian woman give birth in the presence of not only her midwife and myself but also five other women similarly moaning through their own labor pains. The sharp contrast between the two scenarios was surreal.
In the United States, women take for granted the hotel-like labor rooms, hospitable nurses and doctors, and most notably, low-risk childbirth. After working and volunteering with Kybele for the past year, I was familiar with the statistic that up to 500,000 women die globally per year in childbirth and the stories of difficult labor ward conditions. However, my knowledge did not prepare my heart for looking into the eyes of women and their families as they waited to see how their wives, daughters, and unborn children would fare.
Throughout the week in Accra, Ghana, I spent the majority of my days in the parking lot outside the women’s ward, sitting on the curb with husbands, sisters, and grandmothers awaiting the birth of their newest family member. At Ridge Hospital, the limited physical space in the labor ward prevents families from participating in the childbirth process. As a result, they must sit outside and wait for information about their laboring family member. Fathers are not generally present for the delivery of their child. Family members clearly wear their emotions in their tones of voice, postures, and facial expressions; emotion rising and falling with the day’s heat.
One of the most difficult parts of working in Ridge Hospital was differentiating between cultural expectations and preferred protocols. Everyone’s unique cultural lens at times limit the Kybele team’s ability to determine appropriate and necessary reforms to better meet the needs of the Ghanaian patient. Although challenging at times, the diverse professional and national backgrounds of the Kybele team actually proved to be one of Kybele’s greatest strengths. Each member offered varying perspectives about the hospital’s current and potential procedures providing accountability against our sometimes skewed cultural perceptions and therefore creating more constructive evaluations of the hospital system.
While watching the Kybele team and Ridge physicians collaborate, I quickly learned that national cultures do not merely shape perspectives and values of the individual. Culture, whether American, British or Ghanaian, and the resulting expectations of the patient and practitioner mold every hospital system. Along with obvious standards of medical practice, culture lays the foundational values of healthcare. It influences everything from communication to hierarchy of procedural importance to even the timeliness of staff. Although there is great potential to improve, I learned through the work of Kybele that imposing the American or British way is not necessarily the Ghanaian way to fix a high maternal mortality rate. A fusion is necessary. For me, the most inspiring aspect of this trip was observing the Kybele team work diligently to brainstorm and problem solve with Ridge Hospital midwives and practitioners, using each other’s resources to offer better hospital services.
After this trip, I could easily ramble on about the conditions of the labor ward at Ridge Hospital which are different from most US labor wards, but the mortality rate is improving. The Monday after we arrived in Accra, our team met with the Ghanaian Health Service Council to share encouraging statistics. Within the first three years that Kybele has worked with Ridge Hospital, the maternal mortality rate decreased by 34%, even as patient admittance into the labor ward increased by 36%. Ridge Hospital is on target to reach its goal of reducing maternal mortality by 50% within five years. These results offer incredible hope for the hospital system, Ghanaian Health Service as a whole, and future hospital sites. Going to Accra, Ghana with Kybele not only opened my eyes to the disparities within healthcare, but also helped me to realize sustainable change in the hospital system is possible through long term collaboration and hard work. Ultimately, every woman of every nation deserves to have a positive childbirth experience. I am honored to have had this opportunity to work with an organization faithfully making a difference to improve conditions long term and continually save lives. This trip and exposure to the needs internationally in healthcare truly inspired me to learn and to diligently pursue the goal of safe childbirth worldwide through continued work with Kybele.