The Nangodi Clinic: Teaching about "The Birds & The Bees"

Our group at Nangodi Health Clinic

We were welcomed into the Nangodi clinic with open arms and open hearts. This clinic is located about an hour outside of Bolgatanga (in the Upper-East region of Ghana), down a very dusty and bumpy road. The Nangodi clinic receives referred patients from the surrounding rural clinics that require a higher level of care such as complicated deliveries, laboratory diagnostics, and overnight monitoring. We were privileged to spend five days at this clinic and were able to be involved in an array of experiences including: assisting the midwives with births and antenatal care, teaching sexual education at one of the nearby junior high schools, and working alongside the physician assistant with patient consultations.

The role of the midwives is to provide family planning, prenatal care and ensure safe deliveries. Family planning in Ghana is very different in comparison to Canada. The midwives discussed with us that women who come to the clinic for family planning prefer to use a method of birth control that is more discrete (such as the Depo injection rather than the Nexplanon arm implantation).

Birth Control Implant

This is often because men believe that once women start using family planning, it will ruin the women’s chances for future pregnancies and it is also assumed that when their wives use birth control that they are being ‘bad’ (having other relations). The midwives discussed that, majority of the time, the husbands will be angry with the midwives for providing these services. We also had the opportunity to assist with a birth in the clinic. The mother in labour came in the night before around 9pm and spent the night on the two-bed unit so the midwife could monitor her. It wasn’t until the next day at 2:30pm, that the mother was finally ready to push. It was amazing to see these two midwives work together. They were both so knowledgeable and reassuring to the labouring mother. This was refreshing for us to witness as our other colleagues did not have such a positive experience at the hospital. The birth went flawlessly, and I couldn’t have been happier to have been there to witness it.

Labour & Delivery Room

Many families and schools do not teach children and young adults sexual health education. On our last day we had the opportunity to speak at the Kongo Senior Secondary School, to a divided group of boys and girls. Some of the key topics we enforced were of sexual consent, pregnancy, safe intercourse, and women empowerment. Some of the questions regarding partner consent trended towards the traditional acts that a woman is expected to engage in intercourse after receiving gifts, after marriage, and at the male’s desires. When speaking to the male students, we asked if any of them would be able to provide a baby with food, clothes, medicine and a home; all of them answered no. We educated the students around how to prevent contracting a STI (sexually transmitted infection), HIV and AIDs. We taught both groups cheers, the boy’s cheer was “NO MEANS NO!”, and the girls was “WE ARE WOMEN! WE ARE STRONG! MY BODY IS MY OWN! NO MEANS NO!!!” Both groups got a kick out of them and were singing them as we left the school. 

Sexual Health Education at a senior school

We had the opportunity to work alongside the clinic’s physician assistant, Alucious, in the consulting room. Alucious is the main care provider that diagnoses, prescribes, refers and educates approximately 50 patients a day seeking health care at the clinic. Throughout each patient consult we collectively collaborated together in ways to provide the best patient care possible with the limited resources available. Patients travel long distances to seek health care and traditionally will come to the clinic as a last resort as other cultural/spiritual practices have failed. Alucious brought to our attention some of the challenges they faced as health care providers. One was of language barriers, as there are multiple languages spoken in the surrounding areas. Another one was that patients typically would often not return for follow-up due to various reasons. There were multiple situations where patients would present with malarial symptoms but would test negative on the rapid malaria test. Unfortunately, this test only screens for one strain of malaria, therefore further testing would be required by the laboratory technician who usually is not available. When this scenario was presented to us, the question was to treat for malaria or to not treat, and hope the patient returns tomorrow when the laboratory technician could be available for testing. All in all, we treated for malaria as this is the standard practice in Ghana as they treat patient symptoms based on a flow chart.

Malaria test

Malaria algorithm

The experiences at the Nangodi clinic remind us how privileged we are to live in Canada, a place where medical resources and health care is available to all Canadians. We are thankful for the opportunities given at the Nangodi clinic and have gained a new perspective and appreciation for global health. These new insights will allow us to become stronger nurses in our future nursing careers and endeavors.

Wheelchair at the clinic

Blog post written by: Katelyn Cowley and Rachel Kinvig, 4^th year UBCO BSN students