Eleven years ago today Shiloh came into this world.

...sequel to yesterday's post...

I had gathered all my things the afternoon before, and made the two minute walk (or waddle in my case at the time), down the road to the back entrance of the hospital. All the kids from the compound were in tow, each carrying something, quite proud and happy to be part of the event and journey. At the hospital gate the guard tried to shoo them all away, but a few were allowed to follow me inside.

After the formalities of paying for everything, from bed space to intravenous bags, my Canadian friend and confidante, T and I were led to a fairly clean, private room.



We sat on the bed and chatted. We imagined what the baby would be like, what the birth would be like. My nerves ebbed and flowed.

In the evening my husband brought Kobi (Q) down the road to be with me. We all sat, we chatted. I hugged my boy. The nurse came and told me visiting hours were over. This was it. I was to be alone until the next day, after by baby was born.

I felt instantly terrified and sentimental. I wanted my family back. Aunty Maude! My mom. I’m sure I curled as much as I could into a ball and cried myself to sleep, hugging my belly and gathering the strength and bond the two of us needed for the next day.

In the morning I was wheeled down to the surgery ward, past the busy lobby, through the morning prayer being observed by all, made the obligatory stop and then proceeded to a smaller quieter lobby with a few people lying and sitting somberly on the hard benches.

The waiting ensued. I was supposed to be scheduled for 9am surgery, but on GMT (Ghana Maybe Time), I knew this was to be far later.

I was uncharacteristically calm. Serene. Baby thumped now and then to say hello and comfort me, in light of the dangerous events that we were about to submit ourselves to.

There was gathering momentum around the surgery as the time got closer, with nurses and other uniformed strangers moved in and out of the worn swinging doors. I was acutely aware of the dusty floors and hand marks on the walls and doors. Would they use sterile equipment? Would they handle any crisis that might arise with level headed expertise? Would they treat my baby with love and care while I lay there in a drug induced sleep?

The time came, the big white hospital wall clock showed five past ten, and a nurse came to collect my receipts. She pointed to a rickety wheelchair. “Get in”. I obeyed.

The room was blindingly bright. The light drowned out the dirt in the corners, and reassured me. It looked like a real surgery room.

I was heaved up onto a cold table while people shuffled around me. Soon I was connected to an IV and I remember asking semi-frantic questions about how long the procedure would take, where I’d wake up, did they promise to take care of my baby. I was largely ignored.

I looked around for my doctor, who appeared seconds before they injected the sleeping serum. His smile gave me an instant sense of calm. He was cool and collected and had an air of much needed authority. The curdled nervous mess of my insides became a smooth silky pudding. I slipped away while staring right into his eyes. All a mother’s trust thrown across the cold room in a glance that faded away with me.

I woke up dazed, with a heavy thudding pain in my middle. My eyes seemed crusty and my mouth was a harsh unforgiving desert. As I became aware of my surroundings I realized I was in a hospital room. There were three other people to my left. One groaned loudly. This sound was probably what brought me around from the groggy underworld. I wondered in a panic whether I’d been in an accident, what was wrong, why was I here?
Then as my mind caught up with my panic, I remembered everything and it all came rushing to me and up through my throat and formed into a frog-like yelp, “My baby!”
I’d apparently disturbed my bed-mates. One turned to me and talked loudly, as if I were deaf or a small child,

“You are in a hospital. You are fine. People are sick here, please do not shout.”

“Someone call the nurse that the obruni (white person) has woken up.”

Me: “But where is my baby? Where is my baby? I want to see my baby!” I was quite emotional, demanding, frantic. I feared the worst. What if I’d made it and the baby hadn’t? Why was I in a room with sick people? Why not the maternity ward?!

A nurse eventually appeared in the doorway, slouching against the doorframe, she looked at me with heavy lidded eyes. “Madam, you have to stop shouting! You will pull your stitches.” Her voice came across flat, monotone, slightly annoyed.

I was incredulous that no one would respond to my question. I started to cry. No one reacted. One of the other patients made a point of loudly turning over to face away from me. I was sure the baby was gone and that this was the dawning of the worst day of my life.

The nurse left the room and walked slowly down the hallway, her slothly footsteps becoming quieter and quieter, until they were gone. I was so alone, so afraid, so helpless. I considered getting up to go and ask someone in charge. I tried to move but was instantly overcome by shooting pains as my body attempted to twist. That was not going to be possible. There was nothing I could do but wait.

I called through my tears to each person who passed the room. No one was willing to help. Maybe they thought I was crazy. Maybe I was. I began to wonder. Where was my husband and my Kobi? Why wouldn’t they visit me? I checked the clock and it was after 1pm.

This was easily the most lonely I’ve felt ever, and it was the deepest, despairing emptiness that I shudder to recall it at all.

Then an angel appeared. A Canadian friend called G. I heard her sharp accent in the hallway and my anticipation of her arrival at the door was palpable. She appeared in the doorway, her face alive and bright, a huge basket with balloons and gifts and sweets in her arms. She looked so out of place in this dismal ward.

Her expression turned instantly dark once she saw my tear stained face and looked around the room. Still she came to me, dumped the basket and hugged me. Despite the pain, I grabbed onto her and the warmth of her embrace filled me to the brim. Definitely one of the best hugs I’ve ever had. I drank her in. Then she got to business and I was beyond grateful.

“Where is the baby?!” “why are you in here?”

All I could do was shake my head as more tears welled up and spilled, hot and frustrated down my puffy cheeks.

She squeezed my hand and assured me she’d go sort out everything and she ran down the hall.

I could hear her firm and then raised voice as she questioned the lethargic nurses down the hall. She was demanding, shouting now. And then silence. I bit my lip and waited some more.

An indescribably long time after that, she reappeared. Still alone but with a smile that gave me hope for the first time since I’d awoken.

“Well my dear, you are the proud mother of a healthy baby boy!”

I could have kissed her face off. My eyes lit up, by heart soared.

Me: “Where is he?”

G: “The nurses are just washing him and will have him up here in just a couple minutes, or I’ll go straight back down there and get him myself”.

She then went to work to gather up the shattered pieces of my sanity and cleaned me up, in anticipation for the arrival of my little king, Shiloh.

Three nurses came padding much faster than usual up the passage way and I heaved myself up into sitting position. I was gripped with both childlike wonder and a violent maternal desire to protect her young. Bring me that baby!!

And there he was! Wrapped all tight in a soft cotton blanket. His chubby tan face shining out the top. My baby! I devoured him. Grabbed the bundle of him and smothered him with a thousand kisses.

I felt in a bubble. I could hear nothing. The world was just me and my news.
I was at once amazed, frightened, ecstatic and numb. My baby boy had arrived!



They wheeled in a clear plastic bassinet for him to sleep beside me but I had no intention of letting him go again.

G had a mobile phone and we were able to call my mother. I barely said a word, and just managed to blurt out that the baby was a boy and that he was so sweet. I cried and smiled and blubbered. She did the same on the other end of the line…

I wanted to feed him right away but was informed by ‘nurse wretched’ that it wasn’t necessary as they’d given him a bottle of glucose syrup. I was furious. But at least he was with me.

Then G told me about her experience with the nurses downstairs. She had wandered around the surgeries and eventually found Shiloh, alone and unwashed, lying in a cold plastic bassinet. She was appalled and ran out calling wildly to the nurses. They were in a lunchroom, greedily pawing kenkey, fresh pepper and fish from a shared eating bowl. When she asked why the baby had not been cleaned and brought to his mother they casually explained it was lunchtime. I was beyond furious at the story, but at least he was with me.



I mentioned to G that I was sad and concerned my husband and Kobi had not come in yet to visit, she told me that they were refusing all visitors since it was not yet official visiting hours. I was furious, but at least Shi was with me.

Then G went to the nurses, now that she’d quickly developed a reputation as a no-nonsense obruni, and she demanded to know why I was placed in a room with sick patients. Apparently there was no room in the other ward. I couldn’t believe it! The man beside me had a rotting foot. My ailing roommates resented my eventual flow of visitors and Shiloh’s deep newborn cry. I was upset, but at least Shi was with me.

And when, in the night I had to call for the nurses help to use a bedpan, with the man beside me gawking, the nurse annoyed and unhelpful, my stitches pulling and stretching with excruciating pain, I was embarrassed and fuming inside, but at least I had my Shiloh with me.



Happy Birthday Shiloh. 11 years ago you arrived, causing me turmoil, crushing me with worry that I wouldn’t see you, and filling my life with more than a mother could ever ask, once you came. Beautiful, boisterous, ‘bad boy’. You charmed me from that first moment, and had me entranced every day thereafter. I only wish, more than a mother could imagine, that I had you here with me today.
>>>>>>>>>
Shiloh Devon Nii Kpakpo Mingle – January 9th, 1999 – June 22, 2005.
We miss you ‘like harmattan paw paw’. Every moment since you left us here without you.

Eleven years ago today my life changed forever.

Eleven years ago on this day I was huge. My ankles resembled over stuffed sausages, my cheeks hid my eyes.

I sat on a wooden bench in the Trust Hospital of Accra, sandwiched between many others in my bloated condition. The front door of the lobby was ajar, the power was out and air-conditioning was a far off dream. I wore chaley-wote (flip flops) and a multicoloured boubou, a tent dress that held me and my little one in, barely containing us as the sweat trickled down my back, my arms, my rotund tummy.

The sounds of the busy street permeated the hot waiting room, honking of cars, shouts of street hawkers and clouds of gritty dust made their way in amongst us.

After the lobby-wide morning prayer where we were all asked to stand (health status permitting), each of us was sent from reception to another cash kiosk where your appointment must be paid for in cash before joining the queue. Once paid, with our receipts in hand, the hours passed while we waited, some in silence, some clicking their teeth in exasperation, some chatting quietly, brought together by their shared predicament. So many women, so few doctors.

I was a volunteer and the only non-Ghanaian, non-African, non black lady in the building, apart from a Russian nurse that I’d heard about and had only seen once in my numerous pre-natal check-ups. I was not anonymous. But I was used to it.



Nine months before that, I had come home from a typical day at work. For me it meant moving around within the bustling craft market, sitting and chatting with the wood carvers, the painters, the trinket pushers about their needs and opportunities.

I took a tro tro into Osu, and walked up from the main road to the compound I shared with my husband’s family and various tenants. 54 of us in all.

The ladies sat out front of the compound gate, by the small shop that had been set up by a tenant, selling cokes and sweets and tiny plastic wrapped portions of peanuts and sugar and laundry soap powder.

They watched me approach and called to me. When I reached the group they were debating and jostling and laughing and it seemed I had provided the subject of their conversation.

“Kobi mami, (the name given to me affectionately in Ghana, as the mother of Kobi)

“Your face is looking tired”

“Yes look at her eyes!”

“And the walk. It is true.”

Me, clueless: “Good afternoon. What is it?”

In unison after a few giggles, “You are pregnant!”

They were all convinced also, in that African way, that it was a boy.

It seemed absurd. The consensus out of nowhere, the thought, the idea. Despite not having felt very well over the past few weeks, I shrugged it off. Later in the evening, we sat in our ‘chamber-and-hall’, the two rooms we had in the compound, connected by a doorway with a curtain, the overhead fan incessantly whirring above us. I turned to my husband:

Me: “Can you imagine, Aunty Maude and Josephine were outside with the other ladies when I came home today. They all said I was pregnant!”

Husband: “Well I’m not surprised. You are. I can sense it. It is good news, no?”

Me, with my cultural baggage fully in hand, wondering a.) how the hell does everyone know but me, and b.) how can this be my husband’s reaction, if it is indeed true?!
I headed to the pharmacy the next morning for a test. They explained that if you bought the test, they would do the test right there, and off they sent me to the grimy little bathroom in the back hallway. They took my urine to another room and came back with the positive symbol on the little stick. And there it was. They told me in a matter of fact way.

“Please the test is positive.”

“You mean I’m really pregnant?!”

“Yes please. Do you need a receipt for the purchase?”

So I walked back out into the baking heat of the street, dodging between the open gutters underfoot and the hive of life around me. I felt in a bubble. I could hear nothing. The world was just me and my news. The truth that it took a test to convince me, but that my African in-laws had known by intuition.

I was at once amazed, frightened, ecstatic and numb. My baby boy was on his way.



In the hospital on January 8th, 1999 I was very aware that my due date had passed and that there were dangers involved. My little kicking baby was in the breach position, and after giving my ribs a bashing for the past couple months, had not turned inside me.



My choice to stay in Ghana through the pregnancy haunted me on that hospital bench on that hot dusty day. What if I’ve compromised my baby’s chances? But he was a Ghanaian baby. His father wanted us to be here. His aunty, my angel Aunty Maude was a nurse and she wanted us there. She had always made me feel secure, calm. The hospital was a two minute walk from the compound, at the foot of our road, right on the main strip. It was a highly recommended hospital. But today there was a power outage. There were not enough doctors. The patients, like cattle, filled the hot pen. What was I doing?! Taking this whole African thing too far. I wanted to call my mom, so many worlds away. I had chosen a life that held no familiarity, no reference point for everyone I’d known back home.

So this was me, and I had shuffled up the benches over the hours, closer and closer to the door of the doctor’s office, until it was my turn.

I went in and was greeted with the doctor’s broad smile. He seemed tireless.

“Madam Holli”

“The boy is stubborn! I thought we’d have seen you in the delivery ward by now!”

He helped me up onto the rusty examination table and felt around with his warm hands.

“Ok, madam. He has not moved. The time is late. We will have to do Ceserean birth. You choose – tomorrow or the next day? I will make the booking.”

Oh my God. I had never envisaged a full operation in Ghana! The hospitals, the risks! The absurdity of choosing your child’s birthday?!

“Please, can my husband and aunty come in to the surgery? Will I be awake?”

“Sorry, no and no. This is a serious surgery and visitors cannot be permitted. They can visit you afterwards, during visiting hours.”

I knew right then this was not going to be like any of the C-section births I’d heard of in Canada. What happened to bringing your own music in, hubby with you, holding your hand, family in the waiting room to burst in a few minutes after the birth?!

My pulse pounded in my temples. There was no time, no other option in sight. I couldn’t run home to Canada. I’d have to trust this doctor and face this within the framework I found myself in. Baby nudged me back out of my paranoid frenzy, from within.

Me: “Tomorrow please. What time should I arrive?”

Doc: “You have to stay now, I will have them book you into the ward”.

I’d need to bring my own bed sheets, toilet paper, drinks, food, soap and towels, on top of all the normal things like newborn diapers and a carry home outfit for the baby….

My head was spinning. I told him my house was very close and I needed to go get my things.

So I walked back out into the baking heat of the street, dodging between the open gutters underfoot and the hive of life around me. I felt in a bubble. I could hear nothing. The world was just me and my news.

I was at once amazed, frightened, ecstatic and numb. My baby boy was on his way.



To be continued...

He Ain't Heavy, He's My Brother - the health care saga continues

The health care saga continues in Accra… So after his horrible ordeal in the North, our engineer flew down to Accra yesterday morning with multiple breaks in his arm, and was admitted to the 37 Military Hospital, which is close to the airport and was recently renovated with German government donations and expertise.

Our engineer is a professional with money and a company supporting/backing him. (Which is very important in seeking service at a hospital in Ghana). Yet it is not enough. He does not ‘know anyone’ who works at, or has clout with the hospital.

What does this mean? Even though he has money to pay for any treatment he would need – like immediate x-rays and a long overdue plaster cast, they have refused to serve him as of this morning, and he sits on the bed, with his mangled arm hoisted above his head in a ridiculous sling. No medicine, no cast. Meanwhile the bones are healing over, without having been reset and the long term implications will be evident. Imagine he had needed surgery, or that his injuries were more life threatening?

We are making arrangements to take him now to the main and largest government hospital. But I don’t hold out much hope for that. I’ve seen many people die there with my own eyes, all completely preventable. One vivid example comes to mind.

Years ago in the late 90's, during my wild and free days as a volunteer in Accra, when I was the ‘obruni with the blue motto (Vespa)’, a friend and I were mugged one evening and dragged along the road by thugs in a car who wanted my friend’s bag. Only the bag was slung across her body and it was difficult for them to pull it off, while driving alongside us in a car, the passenger’s torso hanging out of the car…

It must have been quite a scene actually – me concentrating quite hard on the handlebar/steering wheel as the car bumped and nudged my little motto from the side, with a huge open gutter on my other side, my friend holding onto my waist for dear life as her bag was being torn from her, until finally they yanked hard enough to pull her to one side, my balance thrown, we skidded into the gutter, the Vespa cracking as it slid out from under us, and the two of us grinding along the gravel as the car tore off ahead.

Once we’d semi-recovered from the shock and picked ourselves up, we hobbled towards a nearby restaurant to assess our wounds and make some calls to get us to the hospital. My hubby came immediately and we headed to the infamous Government hospital. Emergency ward. We were pretty bloody but luckily it was all surface wounds that just needed cleaning out.

On arrival at the place, (I was still a bit new and naïve in Ghana) and I have to admit I was just stunned. It was dark, a few fluorescent tube lights flickering here and there, the rest dead. Dirt and dried blood everywhere – on chairs, benches… thick grime on the windows and corners and dirty, grimy walls. You couldn’t tell what colour they once had been painted. It was night and there were only a few people around, but from the moment we walked in we heard screaming. Loud, high pitched screaming. After a nurse gave us some forms to fill we came around a corner into the hallway.

On a metal guerney there lay a woman in complete and utter agony. Blood was soaked through her wrap cloth and pouring literally down the metal legs of the guerney and had started pooling on the floor. She was the screamer. Being the 'nosey obrunis' that we were, we could not bear to watch her without knowing why no one was helping her, and what had happened etc., so we rounded the corner to ask the nurse. Conversation went about like this:

Us: Please, the woman in the hall, what happened? Why is she screaming? Can you please come and see if anything can be done for her?

Nurse: (Looking up very slowly with a look of extreme annoyance) Don’t mind her! She is shouting too much but doesn’t want to give out the coins in her cloth. We told her! Here, you buy the medicines. You don’t pay, we won’t mind you.

Us: But what is wrong with her? She is bleeding!

Nurse: She is an orange seller. They shot her driving by. In the leg. But she is stubborn! Since they brought her here, only screaming. We tried to collect money from her for the drip, but she only holds tightly her cloth, greedy with the coins. We ask her if she has family. Nothing. We are not paid to fight the people, oh! So we are not minding her. The family will come soon. Now come, here is your list for the pharmacy.

With that she sent us down another hallway to buy gauze and sterilizing solution etc.
After a very rough treatment of scraping all wounds and scrubbing the both of us through a few silent tears of our own, we were sent off.

By the time we came out to the main hallway the screaming had stopped. The lady on the guerney lay silent and lifeless, crumpled bright designed Ghanaian cloth around her, soaked dark with blood, her one leg limply hanging from the side… I just knew she was dead.

I came around the corner to look where the nurses could be, and there they were. Two of them, sitting at an old brown desk, eating something. They gave me the ‘what-do-you-want-now look’.

Me: The lady in the hallway? Who was screaming?

Nurse: The boys are not in yet. They will bring her to the morgue.

With that they turned away, back to their chat and their snack. And we hobbled out, bandaged, clean and devastated.

The road is long
With many a winding turn
That leads us to who knows where
Who knows when
But I'm strong
Strong enough to carry him
He ain't heavy, he's my brother.

So on we go
His welfare is of my concern
No burden is he to bear
We'll get there
For I know
He would not encumber me

If I'm laden at all
I'm laden with sadness
That everyone's heart
Isn't filled with the gladness
Of love for one another.

It's a long, long road
From which there is no return
While we're on the way to there
Why not share
And the load
Doesn't weigh me down at all
He ain't heavy, he's my brother.

He's my brother
He ain't heavy, he's my brother.

But say a prayer, pray for the other ones... Dismal health care in Northern Ghana

The only gift they'll get this year is life... (Bono and the Live Aid Band chiming in)... That's if they're lucky. The Northern Region of Ghana, which is about the size of that state of Louisiana or the entire country of Czech Republic HAS ONLY ONE AMBULANCE.

The population of Ghana’s Northern Region is roughly two million people. Honestly, this is insanity. We came face to face with the dismal reality of the non-existent health care system of Northern Ghana this weekend.

Despite years upon years of development projects catering to the North, and many specifically at building the capacity of the hospitals and clinics (one only has to Google Aid Northern Ghana to see), there is absolutely NOTHING there. On the ground, in the district towns and capitals, let alone the villages. Nothing. No skills, no supplies, no knowledge or any care at all for the value of human life.

On Sunday one of the drivers from our office managed to ‘kill’ a seemingly unbreakable and reliable Nissan Patrol, on route with some of the company engineers to do a customer installation at a site in the North. From Accra, with the bad roads, this drive can be 17 hours. They called from the side of the road with the bad news that they were now stranded in the middle of nowhere with a massive hunk of non-functioning metal and rubber. And all their equipment. The plan was to find a tow truck, which they miraculously did within an hour, and they set off again.

Within an hour we had a call that they had hitched up the company 4x4 to the tow, and then had ever so brightly gotten right back into our car, with no brakes etc. and embarked on the next few bumpy hours journey being towed along.

Except not. Disaster struck. The story, like many Ghana stories, seems unfathomable, yet the outcome pretty disastrous. Apparently a group of motorcycles (somehow I just can’t picture a gang of menacing Harley riders up on the roads of the North, lined by mud huts, shepards and families of emaciated cows and goats…)

The motorcyclists abruptly drove into the lane of our tow truck driver, who swerved violently in reaction. Somehow both the tow truck and our Patrol rolled three times and landed in the bush upside down. Interestingly car accidents are one of the main causes of death in Ghana and fatalities (from a 2006 survey) are double of that of South Africa which has double the population of Ghana, and over 4 times that of Canada which has a third higher population. (I’m guessing a big reason is the way the injured are dealt with after the crash).

When the dust settled our guys all climbed out of the vehicle and it was discovered that one had suffered some facial injuries, while another of our engineers had broken his arm in numerous places. Both needed medical attention immediately. But there was none.

They were taken presumably by a taxi to the closest ‘hospital’ (I use this term VERY loosely), in a town called Bole. On arrival they were told there were no doctors, no medicines, nothing to build a cast for a broken arm, and no equipment at all to test for anything at all. Just a dirty, dusty concrete building with some women sitting at a table. I can just imagine the treatment rooms, where the women and children lie on mats on the floor, no beds, no services… just a place to die.

Eventually – a few hours later – despite the extreme pain and suffering of our engineers, they were brought by taxi to Wa – the district capital, for treatment. It was 8pm on a Sunday night. No doctors. Without doctors, the nurses claim they cannot deliver first aid… So the guys waited it out until morning.

Only when morning came there were still no doctors, and once again they were told – nothing with which to cast a broken limb, no medicines, no supplies. They waited all day Monday, while down in Accra we called frantically around for a solution. They needed to get the 100kms to Tamale – the bigger town, where they could fly on a commercial airline back to Accra to be treated. By this time we had heard that the engineer with the broken arm could not sit (possibly due to internal injuries), and we needed to find an ambulance to bring him to Tamale. Apparently there was no ambulance available. This is when we discovered the hideous truth about the one ambulance for the whole region, which was ‘busy’ in Tamale. Knowing Ghana, it was being hired for a funeral… go figure. What we discovered was that there was not even a vehicle in the town of Wa that could take them…

So in our desperation, knowing the dangers of internal injuries, and the very real possibility of the bones in his arm healing in the wrong shape, we tried to find a way to fly them back to Accra. We called a local aviation company who said they could charter a flight for USD $12,000. Only they couldn’t get the plane organized until Saturday – 5 days away!!! We called on a foreign owned and run medical rescue company operating in Ghana that services International companies who are members. We are not members. They responded that they could send a fully medically equipped plane first thing in the morning. It would cost Euro14,000!!!!

Eventually they did manage to find a car and made the bumpy journey, all their injuries notwithstanding, back to Tamale and this morning they caught the commercial flight to Accra. They are now both admitted to a local hospital. Even these Accra clinics and hospitals pose serious questions about the quality of health care.
But the question is – what do the locals in Northern Ghana do in these cases? And the sad but true answer is that they suffer and they die.

Billions of dollars in Aid has poured in… Where has it gone? Why is there nothing?

Why doesn’t the government stop building palaces and start building real hospitals? Why did they spend over $60 million in largely unaccounted for sums on the 'Ghana @ 50' Independence Celebrations when the real needs are ignored completely? What exactly are we celebrating? What indeed.