Pregnant women in the rural villages of Ghana don’t have the same access to health care services and personnel as their urban countrywomen, leaving many of the babies’ deliveries in the hands of untrained midwives.
Because of poor prenatal and postnatal care, some of these rural areas struggle with high rates of HIV/AIDS and Malaria being passed on from mother to child.
Enter the Akpafu Traditional Birth Attendants Women’s Association (ATBAWA), an organization recruiting untrained midwives and teaching them to prevent complications in pregnancies. It’s an organization Photographer Without Borders, Amber Kissner, will cover from January 15 to 30.
“The biggest challenge they (pregnant women) face is poverty.” Pewudie Emmanuel, Programmes Manager at Akpafu Traditional Birth Attendants Women's Association said during a Skype interview from his office in Ghana. “Out of poverty some of the women cannot travel, they cannot afford or access the transportation costs to the nearest hospital.”
Though the Ghanaian government has made efforts to increase the number of midwives in the west African republic, few of them want assignments in villages where electricity, clean drinking water and good schools are scarce or non-existent.
That’s where the Traditional Birth Attendants (TBAs) come in. Funded partially by UNICEF, the TBAs work to better overall maternal health and prevent the spread of diseases.
“There is a report that says the women that are passing on HIV/AIDS to their children...the numbers are going down.” Emmanuel said. “About 150,000 now that have indicated they have congenital HIV. We want to train the TBAs every pregnant woman that comes to you must first face hospital clearance that the person is free of HIV/AIDS before you attend to them. Because there is a way that if the person is detected at the hospital that she has the virus, they can block the virus so the child will not be infected. She will be put on drugs.”
A great deal of the reason behind training TBAs is to recognize early complications. Not all births can have a healthy delivery from home, knowing the when the mother needs a hospital delivery can change lives according to Emmanuel.
“We have built a training centre specifically for training traditional birth attendants in Afpafu. That is our project centre. It accommodates about 100 traditional birth attendants at a time.” Emmanuel said. “The training is residential. After they have completed the necessary training they will be provided with equipment they will use to do their work. We do this project in partnership with Ghana Health Service. It’s Ghana Health Service personnel that comes to train them at our centre.”
The TBAs are trained in timely referrals, detecting early complications, hygienic practices, how to use gloves, disinfectants, how to tie the cord, how to examine the woman If the woman has absorbed the labia, has Malaria or diarrhoea.
“So far we have trained about 150 TBAs.” Emmanuel said. “Those 150 are scattered in various villages, they are living in hard to reach areas. They are scattered in one municipality and we cover about two districts for now.”
There are 216 districts in Ghana, including municipalities.
“Some travel 5 kilometres to another village that does not have a traditional birth attendant.” Emmanuel said. “I want you to understand, we have practicing, but untrained birth attendants (in Ghana). They have not been formally trained by either the government of Ghana or by our NGO. These are the ones we are looking for, these are our targets, we need to recruit them, train them.”
When photographer Amber Kissner goes to Akpafu in eastern Ghana, it will be her first time in Africa but not her her first time working directly with pregnant women and their care takers.
“Just because we have a lot of this advanced medical technology at our fingertips (in the western world) a bit of the human touch has gotten lost in that regard.” Kissner said. “Because we can just get in and out of the hospital and get all that prenatal care, to have that emotional support for women especially if they don’t know a lot about nutrition, I think midwifes offer support not just in the medical sense but in the emotional one too. That’s just something technology can’t do.”