Ghana Health Partners

On Tuesday, the mission and vision of our Ghana Health Partners organization, which had previously been words on a piece of paper, came to life.

Our mission is to foster collaborative consulting, teaching, and service partnerships with NEA’s Leyaata Hospital. Our vision is for the Leyaata Hospital to be a fully equipped and sustainable centre of excellence in Northern Ghana. Now let me tell you what happened.

Tuesday morning, the midwives and I sat down to complete one final module in the Helping Babies Survive course called “Essential Care for Every Small Baby.” This course trains health professionals in low-resource settings to care for preterm babies. According to the WHO, preterm birth complications are the leading cause of death among children under five years of age, responsible for 1 million deaths in 2015. Three-quarters of these deaths can be prevented with current, cost-effective interventions.

No sooner had we opened our books when Dr. Ben announced an emergency, and you probably guess where I’m going with this. A woman with severe, life-threatening preeclampsia needed an emergency caesarean section. She was not due to deliver for 6-8 weeks. He asked our team to immediately prepare for twin premature babies. Instead of sitting in a classroom learning the course with a premature mannequin, Leyaata midwives had hands-on training with two real-life preterm babies needing help. Every bit of training they received last week with Dr. Anne and me was put to the test to save these babies. The equipment that we were trained on by Daniel and Charles (our Biomed team) was all set to use — incubators to keep the babies warm and CPAP machines to help the babies breathe. Daniel and Charles made multiple trips to the NICU (neonatal intensive care unit) to support the medical team and ensure every piece of equipment (being used for the first time) was working perfectly for these delicate babies. Our pharmacy partners were on site, too, helping calculate doses of life-saving medications. Dr. Anne, back home in the UK, was on my speed dial and through WhatsApp video, she was able to coach us during some critical moments.

At about 9:00 pm, I sat with our exhausted team — Dr. Ben, Dr. Mercy, Abraham, and Ernestina to review the current situation. Leyaata midwives are doing their job — resuscitating babies and recognizing danger signs in the first hours of life. The Leyaata NICU is well-equipped thanks to Tim Beacons’ team at Medical Aid International in the UK. Leyaata midwives and medical staff are so smart and so motivated that they are quickly learning how to use this life-saving equipment to support dying babies. Leyaata is already becoming a centre of excellence here in Northern Ghana, and they have barely opened their doors.

Those who read my book will recall my professional nightmare ten years ago when working in a large hospital in Ghana (Chapter 18: Who Am I?) It involved a baby just like the babies we cared for today. It involved a hospital ill-equipped and ill-trained to deal with a critically ill baby. It involved a horrific ambulance transfer with a dying baby to a regional hospital that was no better prepared to help. Dr. Ben and I were working together that fateful day — a decade ago — and today, we are standing shoulder to shoulder with one monumental difference. We are now standing in the Leyaata NICU with a partnership team that is growing by the day.

My breath feels stuck in my chest when I realize the magnitude of what is happening here. The vision is crystal clear to all of us. I am so grateful to my GHP team, who are stepping way outside their comfort zone every day in the lab, the pharmacy, the biomed, and the nursing wards to support and learn from our incredible colleagues here. The commitment of this international group of healthcare professionals inspires me, gives me courage, and helps me continue to find answers to the question, “Who Am I?” Even today, Dr. Charlie (who returned home to work on Monday) presented Grand Rounds over Google Teams for our Ghanaian colleagues. He had barely landed in Canada and is back with us virtually to transfer knowledge and skills.

I have one more story from today, but I cannot bear to tell it yet. I pray that circumstances will soon allow me to conclude this 2023 GHP mission by sharing this tale with you.

“I cry because of the young midwife I am becoming,” said Doris as she dried her tears and began her speech during the Saturday morning graduation ceremony for the seven Leyaata midwives. Our entire team, Dr. David Mensah, the senior management team and the medical staff were all in attendance. After the presentation of two certificates for each midwife, Doris stood to begin. Her tears started to fall as she described how these training programs had given her and her team the confidence and the skills they so desperately wanted. Dr. Anne and I watched on like very proud (and emotional) mothers watching their kids graduate. In a loud and confident voice, Doris concluded her speech by saying, “We are ready, and I hope you are too!” The crowd stood with applause.

After the ceremony, while work continued in all departments, our Ghana Health Partners leadership met with the Leyaata leadership for a discussion and some systems planning. We are honoured to be invited to the Leyaata table as they strive to become a model hospital. We are humbled by their trust in us and the depth of this partnership. After dinner, we were invited to the Mensah home, where we enjoyed a fun evening of fellowship and food. David had some fascinating stories to tell to his captive audience! As a gift, he gave each of us a little bag of “kuli kuli” to take home. These are long, thin, pretzel-like snacks made from ground peanuts that are baked, rolled into these thin strips, and then fried. The oil is removed during the process, so they are hard and crunchy. I seriously doubt any of these delicious morsels will make it home to Canada!

Sadly, we had to say goodbye to our UK partners and Charlie this morning as they are all due back to work on Monday. As I write, we are thankful they had a safe and uneventful trip to Accra and are boarding their planes home. We miss them already. The rest of us went to the Carpenter church, which was full of colour, singing, dancing, and inspiration. David gave a thought-provoking sermon which prompted an interesting follow-up discussion under our gazebo. The afternoon was spent sleeping, relaxing, and playing games. Erin and Tracey made beautiful necklaces that we will give to some of the women who have looked after us so well.

This evening, we invited Peter, the artisan, to join us for Sunday dinner. Peter owns a shop in Tamale, and on every mission, he brings wares (baskets, jewellery, carvings, etc.) to sell to us, eager shoppers. I’m so happy that we could purchase almost all of his stock. Over dinner, he explained that the income he gains from our team will help him complete the floor and windows in the two-room home he is building for his wife and three children.

It has been a wonderful weekend of work and rest, and we are feeling primed and focused on making the most of our final four days at the Leyaata Hospital.

We, too, are ready!

On Thursday morning, the Leyaata and NEA staff filled the NEA gazebo for joint devotions. Six members of our team are departing on Sunday, and so the staff wanted to thank them. It was a moving time as we heard testimonies about the mentorship impact that Charlie, Dr. Anne, Dr. Jo, Dr. Karen, Jody, and Nicki had in one very intense week. Our team shared the impact that the Leyaata staff had on their lives, and Jodi said, “See you in November!” Sounds to me like the next GHP mission might just have been announced! The depth of friendship and mutual respect that continues to develop amongst our partners brought tears to my eyes.

David stepped up in front of the large group and shared one simple sentence from the Bible found in Colossians 4:17: “Tell Archippus: “See to it that you complete the ministry you have received from the Lord.” He spoke of how, when the pressure builds, and the load of leadership gets heavy, it is so easy for us to want to retreat. “Don’t check out!” he repeated over and over. In the way only David can do, he inspired every soul under that thatched roof to push on and complete the task that they have been called to.

We hustled off to the hospital with an extra spring in our step, and it was a good thing as the most critical situation was waiting for us. A pregnant woman, not due to deliver for seven weeks, was experiencing serious complications that required an emergency caesarian section. The surgical and anaesthesia team had spent the week preparing the maternity theatre and its processes and equipment, and the midwives had spent the week preparing to resuscitate babies at birth, but now it was time to put all that training into action. And so, for the first time, the Maternity Theatre opened its doors, and a Ghanaian team with their international partners walked through the doors to do everything possible to save the lives of a mom and a baby. 

Dr. Ben, fellowship trained in Obstetrics and Gynaecology, performed a masterful surgery under a highly-skilled anesthesiologist supported by his theatre and maternity teams. Dr. Anne, Dr. Karen, Nicky, Jodi, Ernestina and I cheered them along every step of the way. By God’s grace, this young woman survived and the first baby boy was born in the Leyaata Maternity Theatre — a designated theatre that is always available so that no mom will ever die waiting for an operating room to open up.

When the first cry of this premature baby filled the room, echoing off the glistening white walls, all 16 of us let out a massive cheer as our heart rates settled back down to normal. Our midwives were beside themselves with joy — confident and equipped to resuscitate a baby in trouble. As they counselled the family on how to care for a premature baby, Dr. Anne and I felt like proud parents and couldn’t hold back our tears watching this young, equipped team shine. The future is so bright.

Leyaata’s blood bank program is now up and running, and many of our teammates have made a decision to donate to the cause before going home. Dr. Anne was the first donor, and no sooner had the needle come out of her arm when a young woman with a critically ill hemoglobin level needed blood…and they were a match! Anne’s blood never made it into the blood bank fridge — it went straight into the arm of the young woman. 

It has been a great, full, and challenging day at Leyaata. The task before the Leyaata team is massive. The task before us — their international partners — is becoming more clear to me with each day we spend here. I pray we can continue to rally the people and the resources to complete our part in this task so that the Leyaata Hospital can become a model hospital — not just here in Ghana — but in all of West Africa.

“We are thankful to be counted among the living,” is often the opening statement when the hospital staff and our Ghana Health Partners gather under the hospital gazebo each morning. It strikes me each time I hear it — how often do I stumble into my day without taking the time to thank God that I am alive?

As Dr. Charlie gave the morning devotional about how God turns darkness into light, I couldn’t help but reflect on the darkness of unnecessary death and suffering we have witnessed here over the years and the light of health care provision at Leyaata. Even today, patients succumbed to illnesses that were too advanced to cure and that would have been preventable if diagnosed and treated early. One of the reasons Dr. Jo and I are in Ghana is that we are working with our partners on developing a breast and cervical cancer prevention and treatment program. Sadly, we were reminded today, that these programs are desperately needed right now.

Our day was productive and full, and we are getting in a lot of steps as the hospital is so massive! My iPhone is noting 8000 – 10,0000 steps per day even though Anne and I are spending most of the day in the classroom. Our midwifery students have been so keen to learn (even after being on night shifts) that we were able to move on to teach them some advanced skills for their NICU, such as using a baby CPAP breathing machine. Our partners in UK, Medical Aid International, supplied four of these simple, robust devices designed for low-resource settings. All you need is power and the machine mixes and warms air and concentrated oxygen (made from air). This can be life-saving for many babies after birth — especially premature babies. 

One of the things that causes a great deal of laughter around here relates to our communication and translation mishaps. During Charlie’s devotion, he shared a story that happened to him while operating on a patient. Although the hospital staff all speak excellent English, Isaac (lead accountant) stood to translate the medical parts to ensure no details were lost in translation. While he was translating, Amanda (lead pharmacy) stood up saying, “I think I better help you!” During her translation, she would turn to Dr. Ben and Ernestina for help with certain words. These moments add so much levity to our day. I asked two of my British partners to give me a Coles Notes version of a report and they had no idea what I was talking about. My favourite language blooper today took place when Anne was teaching and in her lovely North Hampton accent, kept using the word “nought” (which sounds like “noat”) instead of the word “zero.” It took me more than a few moments to figure this out and realizing the midwives were as confused as I was, I said, “Do you know nought means zero?” They understood immediately and burst into enlightened giggles, but Anne heard me say, “Do you know not means zero?” which made absolutely no sense to her British ears. I suspect the hilarity of this might be lost on paper — but it is still making me crack up as I write so worth a try!

We are using technology to the max here. Leyaata uses an electronic medical record and is working hard to be paperless. Diagnostic imaging is transmitted digitally to radiologists for interpretation. Our pharmacy department is waiting for their electronic labelling system to arrive, so in the meantime, Sherri and Linda were able to upload and implement the labelling program that our Ghana Health Team used for many years as a temporary solution. Our Ghana Health Team experience and processes continue to inform the support we are able to provide here. Nicky and Jodi reminded me so much of our dear friend Joan Maguire when they decided to join Andy (Ernestina’s son who is in charge of Leyaata Stores) to transform a massive room of donated equipment, instruments, and supplies into an organizational dream.

My favourite moment of the day took place when I made rounds on a three-year-old girl who has cerebral malaria. Thankfully she is improving, but the illness has caused her to lose much of her muscle strength, so she is having trouble sitting up and walking. I wasn’t sure if the Leyaata physiotherapist would have expertise in dealing with young children, so I requested a consult. At the end of the day, I swung by the physio department for the first time only to find Ahmed finishing a session with her in the expansive, well-equipped department. After some exercises and transcutaneous electrical nerve stimulation (TENS) therapy, he was compassionately massaging the child’s muscles as she was drifting off to sleep. “She will be fine,” he told me — and I believed him. They live many hours away but will stay in Carpenter village for a few weeks so the toddler can continue physiotherapy three times a week.

So, as the Leyaata team says, they are taking “small-small” (which really translates to big-big) steps every day to bring this hospital to life so that many more men, women and kids can be counted among the living and have their darkness turned into light. 

I’m finding it difficult to put into words how deeply meaningful today was — our first day of work at the Leyaata Hospital.

The morning began with devotions under the gazebo with the Leyaata Hospital and NEA staff. David reflected on the moment he saw our feet stepping off the bus one by one. It reminded him of a passage in the Bible from Isaiah 52:7 that speaks about those whose feet bring good news — news of peace and good tidings to the sick.

After breakfast in the bright hospital cafeteria, we were each presented with crisp, white hospital lab coats adorned with the blue and red Leyaata Hospital logo. Our partners wanted us to look and feel like part of their team. We wore those coats with great pride and great sweat.

And then, off we went to our various departments, partnering with our colleagues in a day in the life of caring for patients at the Leyaata Hospital. It was amazing for me to watch my colleagues so wholeheartedly come alongside the staff to encourage them, support them, and cheer them on in this monumental task of opening a hospital. As I watched everyone working today, I couldn’t help but reflect on the many years we spent together providing short-term medical and surgical care in this region. Together, we dreamed of the day when sustainable health care would arrive — and that vision is now becoming a reality.

Dr. Anne, Ernestina, and I conducted the Helping Babies Breathe training course for the first cohort of hospital midwives, who impressed us with their knowledge, skill, and enthusiasm. They recognize that this program will save lives and they fully embraced it. They seemed to really enjoy the KitKat chocolate bars that I brought as afternoon treats for them. Unfortunately, they were liquid because of the heat – not sure what I was thinking there!

At dinner, we pushed the cafeteria tables together so we could share our delicious meal along with stories of the day with our teammates and with Abraham (the Leyaata Hospital Administrator), Dr. Ben (the Medical Director), and Isaac (Leyaata Hospital’s “Minister of Finance”). We spoke of the highlights of our day as well as some of the challenges that we were co-solving with our colleagues. The biggest theme was by far, the exceptional staff at this hospital. Compassionate, committed, hardworking, creative and determined to make Leyaata Hospital a centre of excellence – this is our strong impression of this Leyaata Hospital team after just one day.

And more good news — a massive and welcome rainstorm rolled in this evening, and for the first time today, there is no sweat on my brow.