After 18 months of investigative reporting at a private health facility in Accra, The Fourth Estate has uncovered a frightening case of ‘Matron Gaga’, an unlicensed midwife whose 30-year track of malpractice has resulted in numerous medical accidents including the death of at least two newborn babies.
June 24, 2020: the case of Kate
Inside the labour ward of New Generation Medical Centre, a private clinic in the South Odorkor Estates at Sakaman in Accra, Kate Tetteh (not her real name), a heavily pregnant beautician was writhing and groaning in pain from her first labour pangs. As her contractions peaked, her screaming grew louder.
But the nurses on duty found that funny: they laughed out loud.
“They were even teasing me,” Kate, 28, recalls in disgust.
All she wanted at that point was professional assistance, as one would expect from a health facility. What she got at New Generation was derision. Her request for her fiancé and her mother to be allowed in to soothe her was summarily dismissed.
The ordeal became even heavier than she anticipated.
The beautician says she felt like she was between life and death, alone. She says the professionals who should have been her helpers became her tormentors.
“When my baby’s head was visible, the midwife who was the one delivering me wasn’t around.”
The ‘midwife’ in question is Francisca Quaye alias Matron Gaga. Matron Gaga had apparently taken some time off her busy cooking preoccupation to visit the nuisance of her patient who was admitted to the facility to deliver a baby. Kate says Matron Gaga walked into the labour ward to check on her holding a cooking utensil in one hand and vegetables in the other.
“When she returned, she was holding a knife and an onion or something; I don’t remember. I didn’t see her again for like five minutes.”
Kate’s ordeal and loss
Kate, who lives in Accra, says she first visited the New Generation Medical Centre on June 24, 2020. According to her antenatal records, she had a normal pregnancy, with her baby kicking from time to time as expected. According to her scan, she could deliver any day between June 19 and 30,2020.
And then a strange thing happened: even though Kate still had a week left within the expected delivery window, Matron Gaga, contrary to all established medical practice, decided to artificially induce labour by prescribing the oral medication Cytotec.
And then she asked the confused expectant mother to go back home.
Cytotec is used to induce labor in women. It works by softening the cervix to allow easier dilation and producing contractions. In most cases, Cytotec is a safe and reliable medication that can make labour easier for women in distress when administered correctly. The Reproductive Health Centre of the Korle-Bu Teaching Hospital however warned in 2011 that Cytotec abuse can cause infertility and even death.
Kate recalls the ordeal that ensued after the unnecessary artificial induction.
“I felt weak, [but Matron Gaga] asked me to go home, [and] roam until I felt pain, then I could come. I boarded a taxi and went home. But I couldn’t sleep. The pain was unbearable. I was feeling the pain and I called her and she said I should come when I felt more pain. I went through pain from 10 am to 6 pm”.
Kate says she cried until her neigbour convinced her to return to the clinic. Then her nightmares began.
“Initially, my baby was kicking. My baby was very strong. He used to kick me and I would even be crying. When [the midwives] started pressing my stomach, I didn’t feel him again. But it was my first time, so I thought it was normal,” she recalls.
Kate remembers Matron Gaga using “something sharp” to cut her “down there and “pulling” her baby boy out.
“When my baby came, I didn’t hear him cry. I expected the baby to cry because there were days I went to antenatal and would hear newborns cry. When I didn’t hear mine cry, I asked [Matron Gaga] why. She said the baby was tired and that he would eventually cry.”
Mother-child bonding is essential for normal infant development. New mothers will hold their babies next to their bodies, rock them gently, strive for eye contact, sing or talk to them and begin to nurse. Often within just hours of birth, mothers report feelings of overwhelming love and attachment for their new baby. As a convention, newborn babies are handed over to their mothers as their first opportunities for bonding. In Kate’s case, this did not happen.
“I forced [Matron Gaga] to put him on me. It didn’t even take a minute and they took him off me and placed him on a chair,” laments the horrified beautician.
The nightmare continued.
“I raised my head and saw one nurse cleaning my baby’s nose. There was blood from the nose. I asked the nurse what she was cleaning. They didn’t want me to know what was happening.”
Instead, Francisca Quaye and her team turned to congratulate her. They even poured powdered talc on her, a ritual to celebrate victory.
“Someone went to call the doctor. But I didn’t hear what they were saying because I was in pain. I saw his facial expression, and it wasn’t good. What I heard was [the doctor asking]: ‘Why didn’t you come and call me?’”
Matron Gaga then followed him outside. When they re-entered the labor ward, the doctor proceeded to “beat” the newborn baby.
“[He] was beating [my] baby. I didn’t know what was happening. I thought it was [normal] so I kept quiet for them to do their work,” Kate recalls.
Kate was then moved to a recovery ward where the horror continued.
Kate’s mother suddenly came in crying. When asked why she was crying, no answer came. The Fourth Estatecan confirm that the clinic’s poorly kept records show, however, that Kate had a stillbirth.
She became suspicious when she saw her baby wrapped tightly, but Matron Gaga falsely assured her that her baby was being referred to the Korle-Bu Teaching Hospital because “it wasn’t breathing well”.
That was Day One.
The next day, she was discharged.
“I was told I should go home for like three months before I could come for my baby,” Kate tells The Fourth Estate in disbelief.
When she insisted that she wanted to be with her “sick baby”, Matron Gaga assured her that she would be assisted to visit her child at Korle-Bu that night.
That night, the clueless mother held a vigil in pain and in anticipation. Needless to say, Matron Gaga’s call did not come. Instead, she lied to Kate that she tried to reach her during the night, but she was deep in sleep.
“She said she came and called, and I didn’t mind her, so she went with the doctor and my baby to Korle-Bu and [that] they put him in a machine.”
Soon, the reason for the baby’s referral changed from respiratory complications to the presence of a brain tumor. When she expressed confusion, Kate says Matron Gaga put her through to a “doctor” in Korle-Bu.
“She put the phone on loudspeaker and the person was talking. [The person asked]: ‘Are you Kate? Your baby has a brain tumor, and a lot of issues,” narrates Kate, who believes a New Generation Medical Centre staff member conspired with Matron Gaga for that call.
“They said my baby had a brain tumor so they would want to leave him in the machine so that he dies in the machine because if they brought my baby to me, it would become a burden on me,” Kate explains.
On day three, Kate’s worst fears were confirmed: her mother confessed to her that she lost her baby at birth.
Kate says almost two years after that fateful experience, New Generation Medical Centre is yet to officially communicate the death of her baby and its cause to her. Normally, each health centre in the district is required to submit monthly reports to its supervisory facility, the Ablekuma North Municipal Health Directorate. But these reports, The Fourth Estate has learned, are often “sanitised”, and do not reflect events at the private clinics.
The phony matron, Francisca Quaye, said she sometimes delegated the preparation of the report to her junior staff. The head of New Generation, Dr. Ralph Obeng Owusu, admitted to The Fourth Estate that he does not pay attention to such records.
According to Kate, “Even when I went for the dressing and asked [Matron Gaga] if my baby was dead, she asked me who told me my baby was dead, and that, I shouldn’t mind them.
“It was later that I WhatsApped her that I knew my baby was dead and that she should forget it.”
“My baby would have brought me a lot of joy because my baby daddy said he would marry me after [I give] birth. Now, he couldn’t marry me. I don’t think I can give birth again. Maybe I’ll adopt or something like that.”
Stitching gone bad
Going through the ordeal and losing her son at birth was not the end of Kate’s suffering at the hands of the fraudulent midwife Francisca Quaye. The bereaved mother discovered that her perineum was very badly infected. The perineum, which is the area between the vagina and anus, is liable to tear during childbirth. After delivery, the doctor or midwife usually closes the perineal tear with stitches. The stitches usually dissolve in a week or two, so they will not need to be removed. In Kate’s case, the suturing was done so badly that the entire region was septic.
“[Matron Gaga] told me to sit on hot water after 10 days. I did, but the thread tore, and it became sore and became big like a gutter. I took a picture and sent it to Dr Ralph Owusu. He got pissed and asked who did that to me. I told him it was Francisca [Quaye]. He told me to come so they could stitch it again.”
When Kate arrived at the clinic, she met an angry Matron Gaga who demanded to know why she sent the picture to her boss when it was, she who did the stitching.
“She got pissed… said I wanted to get her sacked. She said the doctor insulted her that she didn’t [close the perineal tear] well. They had to re-stitch it,” remembers Kate.
For the next three months, Kate couldn’t walk.
“Since then, I deleted all their numbers. I don’t [want to] have anything to do with them,” she told The Fourth Estate in July 2021.
That series of painful episodes at the New Generation Medical Centre has destroyed many things in Kate’s life — her baby, her relationship, and the idea of ever-carrying a baby. The trauma has left a scar in her life.
“My baby would have brought me a lot of joy because my baby daddy said he would marry me after [I give] birth. Now, he couldn’t marry me. I don’t think I can give birth again. Maybe I’ll adopt or something like that.”
“A midwife cannot do induction on her own”
Unconventional midwifery
When Kate’s induction ordeal was reported to the Midwives Association of Ghana, the President of the group, Mary Ofosu, described Francisca Quaye’s action as unconventional and inconsistent with midwifery practice.
“A midwife cannot do induction on her own,” she said of Matron Gaga’s Cytotec procedure. “There must be a medical officer or specialist around. You should also have a theatre around because induction can fail. So, when you induce and it fails, we need to take the client to the theatre. So, before you do induction, you need to get all those things around.”
She was not done yet.
“You can do induction of labour when the client is post-date. That’s when the doctor can prescribe induction of labour or when there is maybe some medical condition like pregnancy-induced hypertension,” the professional midwife with 16 years’ experience explained.
In addition, regarding the secrecy around Kate’s stillbirth, Mary Ofosu made it clear that a mother who loses her child at birth must be told before she leaves the health facility.
July 6, 2021: the case of Esther
On Tuesday, July 6, 2021, Esther Baker, 31, delivered her first baby. For a period of four hours, she suffered the most excruciating pain in her life. This was the longest four hours of her life.
She nearly bled to death. Medical practitioners call it post-partum haemorrhage, which research says accounts for 24% of all maternal deaths in Ghana. Experts say it happens within the first 24 hours after a baby is born. The most critical time for post-partum haemorrhage is the period from the birth of the infant until the placenta is delivered.
The night before she went into labour, Esther, a worker at a savings and loans company, said a part-time midwife who ran the night shift at the New Generation Medical Centre wondered why she had not been referred to a bigger hospital. She recalls:
“She said my age and [my] past record [with] miscarriage could cause some problems. She was like, immediately, they had to give me a transfer and that I shouldn’t deliver there.”
Given her history, Esther was very concerned, but she put her trust in prayer for divine intervention.
But that night, a midwife, whose name Esther remembers as Abigail, assured her that all was well. With that assurance, Esther prayed silently that Abigail would be the one to deliver her first bundle of joy, four years into her marriage.
Alas, this was not to be.
The night passed at the New Generation Medical Centre without any incident. The clinic is popular for affordable care. The icing on the cake for its poorer patients is that it accepts National Health Insurance. At the height of the COVID-19 pandemic, it was one of the vaccination centres.
And then morning came. At the point when Esther was fully dilated, her body became the grounds for a turf war between midwife Abigail and the clinic’s matron, Francisca Quaye. Matron Gaga, disagreed with her staff’s professional assessment of the situation and proposed a rather bizarre remedial action. The two argued: in the end, Abigail had her say, and Matron Quaye her way.
“Abigail is a professional midwife,” observes Esther. “It’s like a ‘by force’ something that [Matron Gaga] was doing. She doesn’t take her time attending to the person in pain. Hers is to just rush you and that you shouldn’t be that soft.”
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