Konongo Hospital

my good friend Yaa, who also happens to be Sakola's sister, was showing the first signs of an impending labor. i had been visiting her daily since her due date of January 20th. each day passed and each day she grew bigger and bigger. i'd run up to her where ever she happened to be at and pat her belly saying "when?!?! when!?!?" while she leaned back and laughed.

Yaa has a wonderful sense of humor and oozes love. i don't think she speaks one word of English, but even through the language barrier, she generally seems concerned about my welfare and we enjoy each other's company greatly.

her house is the last one i pass on my walk to the clinic, so the daily visit was easy. the morning her labor began, she was outside waiting for me.

"akua kessywa!"

"madamfo opemfwo! (my friend the pregnant woman)"

she motioned for me to come, looking a bit worried.

she removed her house slippers and walked into her small one room living quarters. she held the screen door open for me so i followed her in.

"hwe (look)" she said. she pulled her dress up and showed me a pad full of blood.

i wasn't sure what to say but she was looking at me for an answer so i made one up. the safest one.

i told her to come to the clinic.

she wanted to know if she was okay, and i told her yes, although i really didn't know.

"me ba (i'm coming)" she said.

i walked back outside and greeted the two women sitting on a bench, and shook their babies arms all around. then i picked up a small infant that was lying on her back. she was a fat juicy thing and i had some time to spare. i bounced her around on my lap and felt her cotton soft hair. then she showed me her appreciation by leaving a nice warm puddle on my skirt. i didn't feel it until it had soaked through to my legs. i quickly put the little girl back where i found her and the 2 women and i began a group effort of washing my skirt while it was still on. they kept apologizing but i found it all very funny and wasn't too worried.

Sakola's sister was ready to go, so i wrung myself out and walked with her slowly the last stretch of the way to the ward.

Ma was in, behind her desk, and told my friend to sit.

we reviewed her patient card and Ma allowed her to check in to the first stage room. time passed slowly, and i tried hard to crack some jokes to move it along, but intentional humor in a not yet second language is quite a challenge. instead i napped. i was tired, auntie had woke the household up at 4:30 a.m. singing raspy gospel songs to herself for hours. i didn't go back to bed after that, so the sleep was well deserved.

it was friday and Ma had plans to travel. she was going to her youngest brothers wedding.

"i've never been to a Ghanaian wedding!" i told her. i wasn't saying it for an invitation, which was good because i didn't get one.

when i woke up it was close to 2 o'clock and another woman had just come in complaining of waist pains.

this was great, i thought. potentially two births in one day. i was a junkie and i was certain to get my fix.

"Errrghh, why?!" Ma was directing her distress at me. "I have to travel today at 3. I won't be staying here and these women come in? Go and bring me the fetascope."

our relationship has developed to the point where she feels comfortable ordering me around. i dreamed of this day.

i ran and got the fetalscope.

she checked the woman and told her to go back into town and come again later, the baby wouldn't be coming any time soon.

the woman said she was from a small village, Mangwase, miles away. i was glad to hear this because i had just visited her place that Tuesday with the health volunteers. i gave my talk about what to bring to the clinic and when to come. my advice was to come early to reduce the risk of delivering on the road, and to pack a small suitcase of essentials. now Ma was telling her she came too early, to take her bag and go walk around. she looked annoyed, but picked it up and walked out. i wondered if Ma had just said that so she could leave in an hour for her wedding.

"what are you writing?"

Ma was scribbling something on a white piece of paper.

"i am referring your friend to Konongo Hospital. She has a history of fibroid, she can't deliver here."

"why?" i assaulted Ma with my favorite question.

"she could bleed too much and die. she has to be seen at the hospital, that's why. i've sent for a taxi, she will leave now."

i went back and asked my friend if she wanted me to come to the hospital with her. she nodded through pain and fear.

"okay, i'll come."

the car pulled up and Efreeyeh and i loaded into the front seat, my friend, and the two ladies i had met earlier in the morning got in the back. our little beat up car left the village beeping every few seconds to warn livestock and people that we were in a hurry.

when we got onto the main highway i cursed the road for it's condition. each bump, every dip, sent my friend into a silent spiral of extreme discomfort. i looked over at our driver and admired his focus. he was off road driving in a 20 year old hodge podge sedan and little beads of sweat had accumulated all over his face. efreeyeh was looking out the window. i was trying to keep my knees away from the stick shift and not squash Efreeyeh too much. every now and then i'd lean back and rub my friends leg. i didn't want her to worry, but how could she not? we were rushing her to the hospital.

she started to cry, uncontrollable baby sobs escaped before both her sisters lovingly but firmly swatted her and told her to stop. they wiped her face and she then buried it in a cloth. i said a little prayer.

the drive took forever. uncertainty and fear can drag a moment into eternity.

we skidded down the dirt driveway and pulled up at the run down entrance way. we helped our friend into where the midwives were congregated.

"oh you again." one of them said looking at Efreeyeh. "did you bring a letter this time?"

Efreeyeh handed it over politely.

"what time did she go into labor?"

"at 12:00 today." Efreeyeh said.

there had to be a good reason to lie.

"come with us Sister." they told our friend.

i didn't want to leave her in her distress so i used my being a foreigner and pretended not to understand when Efreeyeh yelled at me and told me not to enter the maternity ward.

"trust me! i'll be right back."

"Akua, don't! you aren't allowed back there."

i gave her a quick wink and walked back. i entered the room where 2 midwives and a nurses assistant stared at me with disbelief.

"hello!" i said.

"what are you doing?" the short one said abruptly. she spoke English really well and it instantly intimidated me.

"i'm here to stay with my friend."

"why don't you go and sit outside?" the taller darker one phrased it as a question but meant it more as an order.

i suddenly became very foreign and very dumb. "outside? why? can't i just stay here? it's really nice inside here. these mint green walls are pretty." i looked around overly curious.

"you want to stay in here?"

"sure! why not?"

they powwowed their eyes and came to the conclusion i was odd but harmless.

"fine, fine." they all agreed to it rather than try to convince me to leave. then they leaned up against the beds, to relax and get to know me a bit. "where are you from?" the little one in the white dress said.

"america."

"can you help me to get there?"

"i don't think so."

"why not?"

"because it is a difficult process."

"but as for you, it was simple to come to ghana."

"yes, it was, in some ways."

"so how can that be?"

"i don't know, you should ask my president."

then they all laughed brash laughs.

she spoke in an accusatory manner, which made me want to flee her company, but instead i decided i'd ask questions instead of answer them.

"are you both midwives?"

"yes, of course." they stated.

"why are you the only one in a white dress then?" i said.

"because it's Friday, so i get to wear this, do you like it?"

it was a shirt about two sizes too small for her medium frame. it grabbed her sides and pinched her stomach. it looked bad.

"i love it!" i said.

the graphic redeemed the shirts hideous shade of yellow. there was a huge needle placed across her chest and in block letters it said "BEHIND EVERY GOOD DOCTOR IS A GREAT NURSE!".

Friday is "National dress day" where government workers are allowed to trade in uniforms to build national pride. They are allowed to wear Ghanaian dress.

"but aren't you supposed to wear something Ghanaian on Fridays? That shirt is western."

I got no verbal reply, but i did receive a sneer.

the third woman had on the same uniform Vera wears, an alarmingly bright pink dress. Vera wears fake hawaiian flowers in her hair. this woman did not. she was next to my friend setting up a drip.

the ladies shuffled out of the room and let me sit on the bed next to my sister.

"how are you?" i asked. she gave me a faint smile in return and moved her body to get comfortable.

the short midwife came back in and started yelling. my friend was in the middle of contractions and begged her to just wait.

the midwife said "your sister. i'm going to discharge her and send her to Agogo hospital. she is refusing me!"

"why what did she do?" the look on Yaa's face was a scared one. i felt sorry for her.

"she keeps moving. she has to stay still if the drip is to work."

my friend groaned "i beg you please". she just wanted to lay on her side.

"i said LIE ON YOUR BACK or you'll have to leave! last time!" then she turned and left the room.

Agogo hospital was far away. the thought of a referral was cruel enough.

Yaa yelled out for her to come back. despite the foul treatment she wanted the woman by her side to ease her worries.

the lady came back in with an incredulous laugh bubbling out of her, then she directed her speech at me, as it was in English and Yaa only speaks Twi. "your friend wants me to stay next to her, like she is a baby. this is a hospital. i see up to 50 woman a day give birth. does she think i will just stand here? NO! who does she think i am? there is a woman in the other room who needs help. come let's go, leave your friend."

i told Yaa i'd be right back. i wanted to see what was happening in the other room, but before i reached there i heard high pitched yelping that didn't sound very good. i peered around the corner and saw a thin woman with her legs open bleeding profusely.

the midwife in the yellow shirt yelled over her shoulder to me that this was "an incomplete abortion and extractions were to follow."

i didn't enter that room. instead i stayed next to Yaa and tried to drown out the horrible noises we were about to hear. the louder the screams came the more veins popped out of Yaa's forehead. the panic was spreading and so was Yaa's drip with Pitocin. her contractions were coming more steady and more strong. she was gripping the bars of the bed and quietly dealing with it all.

i needed a little fresh air so i walked outside. her sisters were sitting on a bench and stood up when they saw me.

"not yet" i said. and they sat down.

Efreeyeh had taken a cab back to the village, she was needed at the clinic.

i walked around the hospital and observed. mostly i was interested in the posters hanging from the walls. some talked of buruli ulcer, others of the benefits of breastfeeding, one showed pictures of before and after cleft palate surgeries, then one i hadn't ever seen before. i stepped up to it closely. it read:

AVIAN BIRD FLU

then it went on to list what to do with a dead bird.

1. Alert! If you find a dead bird, DO NOT TOUCH IT!!!

i thought of Sakola and our resident bird which had since grown thin, close to baring it's bones. then i reflected on the many dead birds i had been finding around our house recently, small ones that could fit in the palm of my hand.

"Sakola why so many?" i had asked.

he motioned that they fly into the house at night, then drop dead from the impact. i had a hard time believing that.

there were two yellow-breasted birds lying dead at the foot of the well. they were so close to each other they looked like they were spooning. birds don't fall dead in that position.

2. If you should touch a dead bird, WEAR PROTECTIVE GEAR!

"Sakola this is gross." i had said. i knew he was killing them with his slingshot. "could you move these?"

he picked them up and threw them into the brush.

the further i read the poster the more ridiculous it seemed. i could barely imagine Sakola running to the health clinic to buy gloves to move our dead birds.

i heard a loud scream from a baby down the hallway. SHIT, i thought, i missed the birth! i ran down into the room Yaa had been in. there was a tiny boy being circumcised and Yaa was not there. the screams were coming from him and i quickly left the room.

i walked by the room the woman who had suffered the abortion had been in. she wasn't there, but Yaa was, sitting upright with her knees pulled in close to her chest. she was giving birth. i ran in next to her side.

"PPPPPPPPUSSSSSSSH! PUSSSSSSSSSSHHH!" the midwives were instructing. nothing about Yaa's body made it seem like it was the right time to push. she looked exhausted.

"PPPPPPPPPPUSSSSSSSSSHHHHHHHHH" they screamed.

the energy wasn't fluid. Yaa's body was being told one thing by the staff, but it was apparent she was feeling something entirely different. the midwives would have none of it, the little one slapped her hard across her face, harder than i would have liked to witness.

"PUUUUUUUUUUUSSHHHHH!" they started to speak quickly in Twi, but i caught a lot of it. they told her her baby would die if she didn't start pushing and she needed to try harder. i wiped the sweat from her face and propped her knees up closer to her shoulders. she bore down so hard and long it made me tired. then she came back for a breath but the midwives didn't believe in breathing it seemed because they both slapped her across her face numerous times, each weighty and hard, and screamed at her even louder.

i wanted to run.

i wanted to get as far away from this scene as i could.

i hated it.

i tried to tell myself it was just a cultural difference but by the look on Yaa's face this was not something she was accustomed too. i couldn't leave but i didn't want to watch.

i held my friends hand and looked into her eyes. i silently tried my hardest to give her what little strength i had.

the white dressed midwife pulled up a stool, next to the side of Yaa. She stood on top and looked down at us.

"in ghana here" she was sweating "we call this FUNDAL PRESSURE." she clasped her hands together and pressed down at the top of Yaa's stomach. Yaa gritted her teeth and turned her head away. She winced and then yelled. The midwife began pumping her hands up and down and screaming at Yaa to push. "FUNDAL PRESSURE" she said again, looking at me.

I must have had my mouth hanging open out of complete disbelief because the lady asked me "why, you don't do this in America?"

i didn't say anything.

she kept pumping Yaa's stomach until she was too tired and had to stop to catch HER breath. "i'm tired!" she said. then she resumed.

the baby's head poked in and out, the way a difficult tube of toothpaste reluctantly lets the last bit free. they had been successful in objectifying Yaa into the state of a tube of toothpaste too.

her baby came following the trauma with a half convincing cry and skin as white as snow.

"OOOHHHHH!" everybody laughed "it is a white baby! baby white boy!"

someone mentioned i had turned a black baby white just by being in the delivery room. "good job, you made him white!"

it added a little humor to the situation, but i couldn't think too hard about being congratulated on an inherently racist joke. now was not the time to try and ask WHY she thought white was more beautiful. the baby was alive and healthy, and that i was thankful for.

the short aggressive midwife dangled the baby from his feet and whacked his butt and thighs with all her might over and over. this was not how Ma whacked. it was not a loving act. i gasped.

"you probably don't beat your babies in america either, do you? DO YOU?"

i looked at Yaa and she had covered her eyes.

they plopped him down on a table while they attended to the delivery of the placenta. he sat there, body stiff as a corn of cob with attached wirey wriggly limbs.

were they going to wash him? bundle him? make him warm? time passed.

i wasn't going to wait any longer.

"can i please wash the baby?"

they were crowded around Yaa, tending to 3rd stage needs. "do you know how to wash a baby?" they asked.

"yes! i do."

"you can go ahead then"

i picked him up and brought him over to the wash basin. i poured the water over his head and scrubbed his slimy body. i overcompensated their roughness with gentleness. i pondered if he was albino and wanted to ask. i wasn't interested in any further conversation with the hospital staff so i took a closer look at the baby and saw his eyebrows and eyelashes carried pigment. kofi oburoni. friday born white boy. he isn't albino, just very white.

i dried him, weighed him, bundled him, and went into the room i had spent time in before. the circumcised baby was gone but the woman who had the abortion was resting a few feet away. i felt conflicted, holding a beautiful alive creation, next to someone who had just lost theirs. she looked over at us and grinned. i said "kofi oburoni" and she let out a faint faraway sigh that seemed to come from a place of appreciation.

the midwife came in and asked "why are you sitting here? bring the child to the other room. your friend will meet you there."

i held him close as i strolled through the hospitals corridors. i joked to one person that the baby i was holding was mine. i had just given birth! didn't i look great? when she believed me i decided to stop with that joke, i deserved no fake credit, this child took a lot of work.

i walked into a room filled with beds lined up in a row, like the 7 dwarfs, except each had their own mosquito net. i walked down to a bed that felt right and sat down. Yaa came in, wrapped in a beautiful orange and purple cloth, hair in disarray. she came and plopped herself down with a defeated look on her face.

"you worked hard" i said, handing over her child. the sisters swept in carrying food and thanksgiving. they inspected the child and adored his mother with praise.

i left them to be and went outside. the road just outside the hospital was busy and loud. i was thirsty and could feel the processing of what just happened beginning to make it's way through my mind.

i looked up and saw a billboard that had comforted me in many uncomfortable times. it was a huge picture of Senam. he was smiling, wearing a colorful african robe, with his arms stretched out, modeling for a local telephone company. Areeba, the phone company, had come to the college campus in Accra looking for a good-looking man to represent their product. they had chosen Senam, and his picture was plastered all over Ghana. i sat and stared at it for awhile. the image brought me some peace, he always appeared at just the right time. a woman walked by with a cooler of bagged water balancing on her head.

i bought one and hung out with the picture of my friend for a while. then i went back into the hospital.

Yaa was going to sleep there that night, so i bid her farewell and jumped into a tro tro with her sister. the other one stayed behind to wash the cloths used during the birth. she would be coming shortly.

we didn't speak once on the way back to the village. it was the type of silence that comes from having experienced something so intense words are no longer needed. she heard the midwives yelling at Yaa, she knew what had gone on. my shirt was stained, matching the pee stain on my skirt from earlier in the day, my face was greasy and i was ready for bed. it had been a long day. this woman, Yaa's sister, had the face of a full moon, and friendly cheeks. i found comfort in that. she leaned her head against the window and stared blankly into the distance. when we reached my house i alighted, gave a little wave, and walked inside.

sakola was sitting at the table, waiting for me with a bowl of tomato fish soup. he wanted to know where i had been.

"i went to Konongo, to the hospital."

"why?"

"your sister" i said "she had her baby."

"you lie." he gave me a little smile.

"it's true. a little boy. kofi."

"ei! serious? ohhhhhhhhh" he shook around a bit "thank you Jesus."

"and" i noted "he is verrrry white."

"like you?"

"even more."

"you lie!"

"tomorrow, we'll go and see."

i was glad i could have been some help to Yaa, but i wondered truly how much help had i offered?

i was present which is sometimes all the help somebody needs, and i did all i could, so instead of worrying i decided to eat soup.