The Health Facilities Regulatory Agency (HeFRA) has imposed a fine of GH₵105,000.00 on two healthcare facilities at South Odorkor in Accra, for employing the services of a quack midwife.
While the New Generation Medical Centre was slapped with the heaviest fine of GH₵ 80,000.00, the Adams Family Specialist Clinic has to cough out GH₵ 25,000.00 (both equivalent to $9,051.72).
HeFRA said the number of deaths, cases of injury, and other incidents, the use of an unqualified staff—Francisca Quaye— to provide service in a licensed facility for nearly 30 years informed the decision to impose the heaviest fine ever in the agency’s history on the two facilities.
In May this year, the regulatory agency launched investigationsinto the activities of the two healthcare facilities, following The Fourth Estate’s investigations into the work of Francisca Quaye, alias ‘Matron Gaga’, an unlicensed midwife. She worked at the two medical centres. The Fourth Estate’s 18-month investigations discovered that the quack midwife, who is currently on the run, had practiced for more than 30 years.
The Fourth Estate found evidence of multiple medical mishaps, including the disturbing death of at least two newborn babies at the New Generation Medical Centre within 11 months. The records of the facility were sanitised to hide these deaths.
Registrar of the Health Facilities Regulatory Authority (HeFRA), Dr Philip A. Bannor
HeFRA’sRegistrar, Dr Philip Bannor, told The Fourth Estate that “both of them [the two medical facilities] have paid the fine. The reason [they were fined] is that they should have checked her credentials before employing her.”
Dr Bannor said the fine imposed on the New Generation Medical Centre is the highest penalty ever slapped on a facility for flouting HeFRA’s regulations. He explained that management of the two facilities looked on while the quack midwife practiced, without any checks, with preventable deaths recorded at the New Generation Medical Centre.
Dr Ralph Obeng Owusu Snr, the Chief Executive Officer of the New Generation Medical Centre said he’ll partly take the blame for Francisca’s unethical behaviours
“I agree with you. It was probably a little bit of naivety on my part…But the thing with her was she was a little boisterous when it came to things of that nature. Anytime there was a problem, I used to talk to her. It was supervision, I didn’t know there would be so many problems,” Dr Obeng told The Fourth Estate in October 2021.
“…Partly, I’ll take the blame because she has been under my tutelage for quite a while,” he added.
HeFRA said as part of measures to ensure compliance with the sanctions, the two facilities have been informed that there would be unannounced special monitoring visits.
These visits are meant to ensure that the two facilities do not employ the services of an unqualified staff.
Dr Nana Esuman, Medical Director, Adams Family Specialist Clinic had told The Fourth Estate that the quack midwife did not deliver any baby at his facility but further investigations by HeFRA showed that Francisca Quaye delivered two babies during her two-month stint at the clinic
During the investigations, the Medical Director of the Adam Family Specialist Clinic, Dr Nana Oduro Essuman, told The Fourth Estate that the quack midwife was employed as a midwife assistant, a position the Nursing and Midwifery Council (N&MC) says does not exist. However, further investigations by HeFRA showed that Francisca Quaye delivered two babies during her two-month stint at the clinic.
Unannounced inspections by HeFRA
The fine is part of a wave of reforms The Fourth Estate investigations have triggered.
Until The Fourth Estate’s exposé, HeFRA was required to announce schedules for its visits to health facilities for inspections.
However, Agyeman Badu, HeFRA’s Director of Compliance and Enforcement told The Fourth Estate that the two healthcare facilities had lost that privilege as the agency’s inspectors would visit the facilities for six months until it was satisfied with their level of compliance.
Similarly, he said HeFRA had decided to do intermittent unannounced visits to all registered healthcare facilities nationwide, as part of measures to curtail the ingenious ways some facilities hid their unscrupulous activities.
He observed that the gaping loopholes in HeFRA’s monitoring system had been reviewed and that mechanisms for monitoring health facilities in the country had been enhanced.
“Relative to this particular story, [The Fourth Estate’s Quack Midwife Series], we have decided that it shouldn’t always be the case that we are prompted. So, we have stepped up our monitoring activities across the regions such that even facilities that have been licensed also fall in line, to make sure that the conditions for which they are licensed are not varied, which will affect patient safety.”
He said HeFRA now has 200 monitoring officers nationwide for the job.
Background
Quack midwife, Francisca Quaye, whose 30-year practise resulted in the death of babies at the New Generation Medical Centre
HeFRA announced investigations into the activities of the two health facilities following an investigative report by The Fourth Estate which showed the shocking trail of deaths and malpractices at the New Generation Medical Centre under Francisca Quaye’s watch.
Now on the run, she had practised without either training or license for more than 30 years. During this period, she was the instrument of numerous medical mishaps, with at least two children dying during delivery and another maimed at the New Generation Medical Centre within 11 months.
President of the Midwives Association of Ghana, Mary Ofosu, condemned Francisca Quaye’s unconventional and inconsistent actions
The President of the Midwives Association of Ghana, Mary Ofosu, condemned Francisca Quaye’s unconventional and inconsistent actions, including inducing pregnant women and asking them to go home, while she worked at the New Generation Medical Centre. She said the practice was 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.”
The Fourth Estate’s investigations revealed that Francisca Quaye had never been to any nursing or midwifery training school.
To be recognised as a midwife in Ghana, one has to complete an accredited nursing/midwifery training institution and pass a licensing exam conducted by the N&MC, renewable annually. Any exemption to this rule may only be granted by the board of the N&MC.
Francisca Quaye has neither a license nor an exemption. In fact, the closest she got to the ward was being a janitor at the now-defunct Susan Clinic, where she met Dr Obeng, who did little to stop her from the labour ward.
When Assin Central Member of Parliament, Ken Agyapong, announced his 2024 presidential bid, many dismissed it as one of his usual rhetorics.
To some analysts, the six-term legislator’s decision is to gain another level of relevance in a race that pollsters had predetermined to be between Vice-President Dr Mahamudu Bawumia and former Trade and Industry Minister, Alan Kwadwo Kyerematen, who has since left the New Patriotic Party (NPP).
There were several reasons for this scepticism. First, he had literally washed his hands off a presidential ambition multiple times since 2017. The last time was in February last year, when he insisted, he did not need to be president to change the lives of Ghanaians. He would later claim he didn’t want to distract President Nana Akufo-Addo with his aspirations.
Secondly, given his loud, quick-tempered and headline-grabbing feuds, political analysts were quick to write him off as a presidential material.
However, his second-place finish during the NPP’s August Super Delegates conference made his intention clear. He has been tapping into the growing discontent against the Akufo-Addo administration because of the country’s economic crisis while positioning himself as a major contender against Vice-President Dr Mahamudu Bawumia.
With Alan Kyerematen’s presidential odyssey in the NPP coming to an end, Mr Agyapong appears ready to fight for the ticket.
Source of wealth
Ken Agyapong, a graduate of Fordham University in the United States, is widely regarded as a wealthy businessman. However, his critics have questioned his source of wealth; with some labelling him as a drug lord, although no evidence has been produced to back this claim. While quick to laugh off the tag, in 2015, he set tongues wagging with the assertion that about 85 percent of indigenous businessmen are drug barons.
He takes credit for the financial engineering that got Chinese funding for the construction of the Bui Dam. His business portfolio also includes radio and television stations, cold stores, real estate, shopping centres, a commercial farm and an energy company.
Beyond the NPP internal politicking, Mr Agyapong has been talking a great game about how he canrevitalisethe ailing economy, putting emphasis on growing tourism, reducing interest rates, industrialisation, job creation, foreign direct investment and eliminating nepotism and favouritism from public office.
He has also given a hint of what would engage his attention in his first 100 days in office—reorient the mindset of Ghanaians through a collaboration with musicians.
As an MP, he does not have a significant legislative record. Although he chaired some committees, he is loudest outside the chamber. The applause, however, is resounding for his philanthropic work and lobbying for projects for his constituency.
But Ken Agyapong is a man of a thousand controversies.
Ghana’s version of Trump?
One to easily court controversy, many have likened Mr Agyapong to former American President Donald Trump, the anti-establishment politician and businessman, whose populist slogans and promises convinced Americans to elect him over former Secretary of State, Hillary Clinton.
He is, however, uncomfortable with being compared to the controversial former American president, who is currently on trial for nearly turning American democracy on its head. But he is interested in borrowing a Trump idea – build awall aroundthe Korle Lagoon to protect the water body from unending pollution.
On that score, their similarities are many.
A volcanic temper is a common trait of the two. They both command a lot of respect from the grassroots.
Both do not count on classroom education as their biggest strengths but are quick to point to street credo as the foundation of their success in businesses and highlight this as evidence of their ability to manage the economy and create jobs.
Similar to Trump, Mr Agyapong uses a lot of unfiltered language whether it’s on his employees, opponents, his party or the state institutions he is seeking to lead.
Just like the former American President, Mr Agyapong in his attempt to appeal to voters who are disillusioned with the government has positioned himself as an outsider who is not part of the political establishment.
But is Ken Agyapong truly an outsider? Mr Agyapong, who has been meeting delegates, has been touting his business credentials and painting himself as a Jubilee House outcast.
The records, however, say otherwise.
In Ghana, the award of contracts to party members is seen as the spoils of electoral war. Although Mr Agyapong has a record of railing against the elites and powerful in the Akufo-Addo administration, and past governments, the reality is that he is not an outsider. Having been anNPP financier for years, he shouts the loudest when perks of party financing, including contracts don’t go his way.
A generous financier of the NPP, Ken Agyapong feels entitled to contracts and does not hesitate to point that out
In March 2017, just three months after the NPP came to power, Mr Agyapong was involved in shadow boxing with the Executive Secretary of the National Identification Authority (NIA), Prof Ken Agyeman Attafuah, over a $293 million contract the authority had awarded a rival company, the Margins Group, for the printing of the Ghana card.
He claimed he bided for the printing of the Ghana card and could have done it for less. He accused Prof Attafuah ofinflating the contractsum to $1.2 billion which turned out to be false. He also alleged that the NIA Executive Secretary received bribe, including a parcel of land to award the contract to the Margins Group. Prof Attafuah vehemently denied that allegation.
A year after the verbal exchanges with the NIA Executive Secretary, it came to light that a company belonging to Mr Agyapong’s wife, Imperial World Ventures, was awarded a GH₵100 million contractfor the supply of 150Watts LED streetlights through restrictive tendering.
In July 2021, he was appointed as the board chairman of Ghana Gas, the company that operates the country’s natural gas resources. Such appointments have been criticised in the past because they contribute to weakening parliament. Experts say MPs who chair these boards are often caught in a conflict-of-interest situation and are often swift to lobby their peers in the House, rallying them to close their eyes to wrongdoing in the state-owned enterprises they oversee.
In February 2022, the MP claimed he had tobeg like a childto secure contracts from the government. However, he contradicted himself in September 2022 when he claimed that he had not been awarded any government contract since 2021.
While Ken Agyapong (left) wants the electorates to believe he is outside the inner circle of the Akufo-Addo (right, in blue) administration, the reality says otherwise.
Even in a loose sense, anti-establishment politicians do not frolic with the executive let alone benefit from political perks. Mr Agyapong belongs to the inner circle of President Nana Akufo-Addo and was even reported as saying that the president was shockedto hear that he (Agyapong) was not getting government contracts.
Further evidence of him being a close associate of the president also played out in his own admission in 2021. He claimed he had collected GH₵120,000 from the Chief of Staff, Frema Osei Opare, to deposit into Dome-Kwabenya MP, AdwoaSafo’s account. This transaction was meant to serve as an incentive to persuade Ms Safo to return home during a critical period in Parliament when the government was struggling to pass the e-levy, given its thin majority in the House. The Dome-Kwabenya MP, who was also the Gender Minister, had abandoned post to live in the US with the excuse of attending to her sick child. The two lawmakers have children together.
Lawless causes
Mr Agyapong has had his days in the courtroom from criminal to defamation cases.
In July 2013, a circuit court acquitted and discharged Mr Agyapongafter more than a year of trial. The vociferous legislator was dragged before court in April 2012 and initially charged with attempted treason, genocide and terrorism, but the state later substituted the charges and slapped him with provocation of riot and offensive conduct conducive to the breach of the peace.
Given everything that has happened in the past seven years, it’s not a surprise that Mr Agyapong during his recent campaign had denied having anything to do with the death of Ahmed Hussein Suale, the undercover investigative journalist who was shot weeks after the lawmaker blew his cover on television. On January 16, 2019, Suale was fatally shot by men on a motorbike as he drove his car in his neighbourhood at Madina in Accra. But more than five years later, the police have failed to identify the culprits.
Other journalists, including Joy News’ Erastus Asare Donkor, have been threatened by the lawmaker. The Speaker of Parliament in 2021 referred the threat against Mr Donkor to the Privileges Committee but the outcome is yet to be made public.
Although a lawmaker, Mr Agyapong has often supported causes that question his commitment to law and order. When members of the Delta Force, a vigilante group in the NPPattackedand forced out the Ashanti Regional National Security Coordinator, George Agyei, because he was not from the region, the legislator was quick to rally to their support. He was reported as saying that if he had been there, he would have clapped for them and urged them to slap Agyei.
“Anyone should dareand put any of the Delta Force guys on trial. I would personally lead demonstrations against the NPP and Kan Dapaah. Nana Addo didn’t win easily; we fought and these boys were at the war front when they were fighting,” he threatened.
In 2017, these members of Delta Force invaded the court trying some of their members for assaulting the Ashanti Regional National Security Coordinator
Probably taking inspiration from this statement, the Delta Force members invaded a courtroom to release 13 of their members who were on trial. In the end, they each paid GH₵1,800 for their rowdy behaviour. In the past, others have been jailed for words that were in contempt of court.
He is also on record to have defendedpersons caught in alleged corrupt practices including the former Public Procurement Authority Chief Executive Officer, A.B Adjei, who allegedly formed a company that won and sold contracts to the highest bidder and Kwesi Nyantakyi, a former President of the Ghana Football Association, who is currently being prosecuted for a raft of corruption allegations.
Work as an MP
When the sun sets on the tenure of the eighth Parliament, Mr Agyapong would have been a lawmaker for 24 years. But when counting Ghana’s most outstanding legislators of the Fourth Republic, the six-term MP might not make the list.
As a member of Parliament, Ken Agyapong’s record in the chamber is more of silence than action Credit: 3News.
Under his tenure as the Chairman of the Communications Committee, the National Communications Authority shut downmore than 100 radio stations from 2017-2019 for various offences including operating with invalid licenses. Some of these stations were said to be affiliated with the opposition National Democratic Congress (NDC). His own radio station, Oman FM, was reportedly on the list of the blemished, but was not shut down. He later claimed he pleadedwith the Ministry of Communications to have the decision reversed to no avail.
As Chairman of the Defence and Interior Committee in 2021, and one who claims hatred for injustice, one would have expected that he would champion an investigation into the murder of the eight peoplein the Techiman South Constituency during the 2020 elections. It did not happen.
Attack on institutions
Over the years, Mr Agyapong has used his radio and television stations to castigate all those who got on his wrong side. The judiciary, former presidents John Mahama and Prof J.E.A Mills (now late)and parliament have all received tongue lashes.
Ken Agyapong’s commentary on Net 2 TV is often fiery
So has he often been embroiled in seemingly trivial rows with various public figures, including musicians, actresses, journalists, pastors, trading unpleasant soundbites.
In September 2020, Mr Agyapong stunned the country when he descended on a judge handling a land case he was involved in, describing him with unprintable words. In response, the judge ordered him to appear before the court.
He did.
Before the judge, his volcanic outburst disappeared and was replaced by a much tamer demeanour. But before the judge could take a decision in the contempt case, Mr Agyapong ran to the Supreme Court, accusing the judge of being biased because the judge mentioned “severe punishment”. The apex court agreed with him and directed that the case be sent to another judge for the contempt trial. He later apologised to the judiciary and in 2021 became a member of the Judiciary Committee of Parliament.
That trial is yet to happen.
However, when he offended his peers in Parliament, allegedly calling the House ‘cheap and useless’, they did not spare him. The then Minority Chief Whip, Mohammed Muntaka Mubarak, dragged him before the Privileges Committee of the House where he was found guilty of contemptof Parliament.
Again, he got away with punishment because of the partisanship in the House.
While they were in office, former presidents J.E.A Mills and John Mahama tasted his venom. He described the now late Prof Mills as the country’s ‘chiefthief’ and Mr Mahama as greedy and incompetent.
In December 2020, he accused Mr Mahama of being a thief and the brain behind numerous burnt marketsand threatened to burn down the former president’s house, only to recently apologise that allegations he made against the former president were jokes.
The most denigrating of these insults was directed at Charlotte Osei, the then EC Chairperson, whom he accused of trading sexfor her position.
Economics and Political Risk Analyst, Dr Theo Acheampong, told The Fourth Estate that although Mr Agyapong had lofty ideas, it would be impossible to implement them.
“Nothing shows that he can. Isn’t he a part of the rot/mess of this country?”
On Mr Agyapong’s ability to fight corruption, Dr Acheampong observed that Mr Agyapong is far from being a redeemer.
“Everyone is neck deep. Me, I doubt if he or anyone else can fight it unless there is a fundamental resetting through major constitutional reforms,” he said.
Is Ken Agyapong suitable for the presidency?
Economist and Political Risk Analyst, Dr Theo Acheampong, while not optimistic about a better Ghana under a Ken Agyapong presidency noted that “the grassroots or ordinary people like him because he’s seen as a doer or no nonsense person.”
From the evidence in this analysis, Mr Agyapong’s conduct over the years in attacking presidents, the judiciary, and even parliament, where he is a legislator, openly supporting persons accused of corruption, threatening journalists and the use of inflammatory language against public officeholders raises serious concerns about his suitability for higher office.
Such actions demonstrate a lack of respect for democratic institutions and the rule of law, which are essential pillars of any functioning democracy. His divisive actions and rhetoric could further polarise the nation, thereby undermining social cohesion. Already, tribal politicking is showing in his campaign ahead of the NPP’s November 4, 2023, presidential primary.
Aspiring to be president requires statesmanship, integrity, and the ability to unite people. Mr Agyapong’s current conduct is at odds with his ability to fulfil these criteria.
If he cannot show decorum and continues to undermine institutions, can he preserve Ghana’s democratic values and uphold and defend the constitution?
A former bishop of the Lighthouse Chapel International (LCI), Larry Odonkor, on Friday walked out of an Accra Circuit court a free man after the court acquitted him of charges of stealing his social security contributions and income tax.
In siding with the accused, the court presided over by Ellen Ofei-Ayeh stated that the prosecution failed to prove the necessary ingredients of the alleged crime.
It is an end to 19 months of the case in which the LCI had alleged that Bishop Odonkor had pilfered funds that he should have used to pay his income tax and Social Security and National Insurance Trust (SSNIT) contributions after he had written cheques for those purposes.
He was charged with two counts of dishonestly appropriating GH₵3,257.00 belonging to the church. He pleaded not guilty to the charges.
The court agreed with him and ruled that the prosecution failed to prove the intent to steal and that the accused had a legitimate claim of right to the money contrary to the church’s complaint to the police.
The judge also ruled that the prosecution failed to prove the salary of the accused which would have determined the accompanying tax and social security contributions.
Bishop Larry Odonkor in a photo with Bishop Dag Heward Mills, Founder of the UD Group of Churches
The church struck back, counter-sued all six, and filed criminal complaints against Mr Odonkor in Ghana and then later in Madagascar.
In August last year, the same court in response to an application for a ” submission of no case to answer” filed by the accused, ruled that the accused had only one count to answer for, and dismissed the other charge against him.
The judge said having considered all the evidence in record, she did not “find any evidence has been led by the prosecution that the accused person in April 2020 appropriated funds [to] the sum of GHC 3,527.00 dishonestly, belonging to LCI, as charged under count two. It is for this reason he is accordingly acquitted on this charge as no case has been made on this count.”
Larry Odonkor and his lawyer, Kofi Bentil, had a fist bump in celebration after his acquittal at the Accra Circuit Court
Before his legal tussle with the church, Bishop Odonkor had headed branches of the church in South Africa and later, Madagascar. He spent at least a decade outside the country in the name of the LCI.
He returned to Ghana in January 2020 and was sent to Akim Oda in the Eastern Region to head the church’s branch there. He resigned four months later.
In December 2021, the LCI in Madagascar sued Bishop Odonkor, accusing him of selling the church’s Toyota Land Cruiser and pocketing the money. Lighthouse had asked the court to order Bishop Odonkor to cough up 80 million Ariary (GH¢157,200.00) in damages.
The court published its judgment in French, copies of which The Fourth Estate obtained and translated into English.
It said the court “hereby rules in favour of Larry Odonkor; declares all claims by Lighthouse Chapel International to be ill-founded and dismisses them all without prejudice…”
Background
Bishop Larry Odonkor holds a book during a sermon. Credit: Facebook/Larry Odonkor
The prosecution’s case against the former LCI bishop was that, from January 2020 to April 2020, Bishop Odonkor served as the head pastor of the Akim Oda branch of the church, and as such, he was responsible for the day-to-day administration of the branch.
As part of his responsibilities, he was to see to the payment of his SSNIT contributions and those of others working under him. In March, he allegedly wrote a cheque of GH₵8,527.00 dated March 10, 2020, comprising his February 2020 salary of GH₵5,000.00, together with his SSNIT contributions and income taxes of GH¢1,667.00 and GH¢1,850.00 respectively for the months of January 2020 and February 2020. The funds were deposited in his personal account. However, he failed to pay the SSNIT contributions and tax components of the amount drawn to the appropriate authorities.
Again, in April 2020, he wrote a cheque of GH¢8,527.00 comprising his salary of GH¢5,000.00 for the month of March 2020, together with SSNIT contributions and taxes of GH¢1,667.00 and GH¢1,850.00 respectively for the months of March 2020 and April 2020. However, he failed to remit the social security and tax portions to the relevant institutions.
The church, which is a complainant in the case, claimed that its attention was drawn to the issue in September 2020 and it was made to cough out the SSNIT contribution and the unpaid taxes with their penalties amounting to GH¢10,963.00. The prosecution also alleged that the accused admitted to signing the two cheques, the reason he was charged for the alleged crimes and dragged to court.
Court records show that Bishop Odonkor in his defence had said the amount in question was lower than his expected salary which was in arrears for over a month, but he was told to “hold on to this”, meaning he could expect more later.
He had also informed the human resource manager then that his previous salary was the equivalent of $1,000 in Madagascar and he had been upgraded to a level that he expected a salary of $1,200 or more, which was far in excess of what he was paid.
His lawyer also told the court that upon his resignation, Bishop Odonkor attempted to find out from an Archbishop of the church regarding any financial obligations he might have towards the church; however, he was told he had none.
Furthermore, the document showed that “there was no discussion or instruction given that Larry should pay a portion of the cheque to SSNIT or Ghana Revenue Authority (GRA), indeed it was never mentioned. Usually when SSNIT payments are added to the duty of the bishop, he is given detailed instructions as provided in evidence. The entries on the vouchers were not made by Larry and he was not alerted to them at any time till this case started.”
Employees not responsible for PAYE deduction and payment
The court documents also showed that in October 2021, the police wrote to the GRA to request information on the tax status of Bishop Odonkor.
The GRA in response said Bishop Odonkor had not paid any tax to the GRA ever since he registered for a tax identification number in 2020.
The GRA was also quick to point out that “the decision of the church, LCI to allow Mr Odonkor to collect the tax component with the pretense of paying same to GRA is not consistent with Section 114 of the Income Tax Act 2015 (Act 896) which requires [an] employer as a withholding agent, to deduct from income of employee PAYE and remit to GRA.”
SSNIT also responded to a police inquiry stating that no contribution was made in the name of Bishop Odonkor during the period in question. However, in September 2020, the church made payments to settle the arrears.
In the last two days, the name, Dampare, has been trending on both mainstream and social media. This follows public conversations about the content of a leaked audio recording that reveals a plot against the current Inspector General of Police (IGP) Dr. George Akuffo Dampare.
The recording features a voice that is said to be that of a Commissioner of police in a conversation with a senior member of the ruling New Patriotic Party (NPP). The leaked tape mainly features a discussion on why the current IGP must be sacked. In the conversation, the senior police officer accuses the IGP of many things and says the NPP cannot win the 2024 elections with Dampare as IGP.
It is not surprising to hear that a top police officer is against an IGP for one reason or another. The current exposé, however, reveals a rather bizarre and dirty plot against the IGP and also provides credence to ongoing speculations about some clandestine attempts to seek the removal of Dr. Dampare as IGP.
All the machinations and plots are meant to achieve one thing – convince the President to sack the IGP. Even though it is difficult to read the mind and intention of the President, for once, I am convinced that President Akufo-Addo will not fall for the dirty plots.
My convictions are based on the following firm predictions and reasons:
First of all, I can predict that President Nana Akufo-Addo will not want to go down in history as the President who presided over the annihilation of Ghana’s most priced asset, which is our peace and stability.
Secondly, I believe that President Nana Akufo-Addo will not want to go down in history as the President under whose tenure Ghana’s long march to democratic consolidation was curtailed.
Thirdly, I have some conviction that President Akufo-Addo will not want to go down in history as the President under whose reign civil war erupted in Ghana as a result of some desperate attempts to impose his political party on Ghanaians even if the people choose to reject his party in the 2024 elections.
Finally, I can confidently predict that President Akufo-Addo knows very well that if the NDC, under the very charismatic and brave Jerry John Rawlings, lost the 2000 elections and handed over power peacefully to the NPP’s John Agyekum Kufuor, then the will of the Ghanaian people will always reign supreme.
It is on the basis of these convictions that I have no doubts that President Akufo-Addo will not heed to any orchestrations and sinister plots to remove the man who has proven to be exactly the one he needs to protect and preserve Ghana’s most valued asset – peace and stability. Certainly, the President should want to hand over Ghana to whoever emerges as the winner of the 2024 elections in peace and not in pieces.
It is unwise for anyone to assume that President Akufo-Addo does not know that what he needs the most to govern the country is not political sycophancy but the internal security of the state, which Dr. Dampare is admirably helping him to have.
Also, anyone who assumes the President will be naive to remove Dr. Dampare must be someone who doesn’t follow the President’s pronouncement about his appreciation of the performance of the IGP or someone who simply disregards what the President says as useless commentary. This is because IGP Dampare has received praises and commendations from the President more than any other appointee.
The President appointed Dr. Dampare as acting IGP in July 2021. In September 2021, the President publicly praised him and stated that he (the IGP) had vindicated his decision to appoint him as IGP.
In early October 2021, the President confirmed Dr. Dampare as the substantive IGP and commended him for his great work during the few months he acted as IGP. Later that same month, during the swearing-in of the Police Council, the President again praised the IGP saying: “the IGP’s actions thus far, have received the strong backing of Ghanaians and many are now realizing that if you fall foul of the laws of the land you will not be spared.”
In the recent past, President Akufo-Addo has praised IGP Dampare for being on top of his job
In March 2022, during the presentation of the statement on the State of the Nation (SONA) in Parliament, President Akufo-Addo singled out the IGP for praise. Here is what the President said on that auspicious occasion: “Mr. Speaker, I believe we can all testify that our Police Service is undergoing a great improvement and a change of image before our very eyes. During times of anxiety, we need a responsive police service to boost the confidence of the population and it is good to see the police rise up to the challenge. The police service is gradually regaining the trust and confidence of the public, under the leadership of its new IGP.”
In February 2023, President Akufo-Addo continued with his praises for the IGP. Here is what he said about the leadership and performance of the IGP: “We see the discipline that has been restored to our roads, the enhanced police visibility and general discipline in society under the leadership of the IGP Dr. Akuffo Dampare. I want to assure him that he has my full support and the support of my government to continue his transformation of the police service.”
And just a few months later, in April 2023 the President said: “I want to commend the outstanding Inspector General of Police and his team for the deployment of officers across the country for the Easter festivities. Your officers could be seen everywhere in our streets smartly dressed on their motor bikes and on our roads, all in the bid to protect the people.”
So why would anyone think that the President can be praising the IGP all the time and suddenly turn around to remove him just to satisfy some sycophants under the false pretext that an IGP can help a party rig or win elections?
In fact, the conspirators against the IGP ought to have known that having contested for President for four consecutive times, President Akufo-Addo, knows very well that what is needed to win an election is super performance and quality message, and not a malleable, unprofessional, sycophantic and an overtly partisan IGP. Such an IGP can only bring about lawlessness, chaos, insecurity and instability.
The President knows very well that President John Agyekum Kufuor won the 2000 elections not because the then IGP, Mr. Peter Tenganabang Nanfuri, was an NPP member or appointed by candidate Kufuor. Peter Nanfuri was appointed by former President Jerry John Rawlings of the NDC. Yet, the NPP won the 2000 elections.
President Akufo-Addo knows very well that he lost the 2008 election not because IGP Patrick Kwarteng Acheampong, was an NDC member or appointee. He was appointed by President Kufuor, yet the NPP lost the 2008 elections.
IGPs don’t collate election results
The President is also fully aware that he won the 2016 elections by a landslide against the then incumbent, John Dramani Mahama, not because the then IGP, Mr. John Kudalor, was an NPP member or appointee. Mr. Kudalor was appointed as IGP by his competitor, President John Mahama on February 19 2016 (the year of the elections), yet he, Nana Akufo-Addo, won that election with over one million votes.
So certainly, the President knows that an IGP neither conducts elections nor collates results. The President knows that an IGP does not assign police officers as party agents or polling station officers. In the context of elections, the IGP’s job is to professionally lead the police to ensure peace, law and order as was exemplified by IGP Dampare in the recent Kumawu and Assin North by-elections.
From the foregoing, I also find the reaction of the opposition NDC to the ongoing brouhaha about IGP and elections, quite strange. This is because, I believe NDC officials will also know, or at least should know, that candidate Mills did not lose the 2000 elections to former President Kufuor because of an NPP-affiliated IGP.
It must also be clear to the NDC that President Mills did not win the 2008 elections because there was an NDC-affiliated IGP at the time. Of course, the NDC also knows that it did not lose the 2016 elections and the 2020 Presidential elections because of the conduct of an IGP.
So, it is, therefore, baseless for senior members of the NDC to be saying that they will resist any attempt to remove IGP Dampare in order for the NPP to rig the 2024 elections.
It may be worth reminding the NDC that, an IGP does not collate results. An IGP does not gather pink sheets for a party. An IGP does not appoint who represents the party at the strong room of the Electoral Commission (EC) during the collation of results at the national level. An IGP cannot also prevent a party agent at the EC’s strong room from focusing on having tea with the EC chairperson, instead of remaining vigilant in the results collation process.
I can understand the NDC’s defence of Dr. Dampare for his exceptional professionalism and leadership as IGP, but that should be done devoid of needless partisanship and false elections-rigging conspiracy theories.
It is not for nothing that for the first time, we are witnessing overwhelming public support for an IGP. The Ghanaian people know true leadership when they see and experience one. For once, let’s leave the partisanship and hatred and support Dr George Akuffo Dampare to continue with his exceptional effort and leadership to build the Ghana Police Service we want and deserve as a nation.
The author of this article, Sulemana Braimah, is the Executive Director of the Media Foundation for West Africa
Prisoners in Ghana normally lose certain rights to their personal freedom upon incarceration, including the right to have mobile phones.
However, an inmate at the Ankaful Maximum Security Prison in the Central Region has managed to, not only possess a contraband mobile phone in prison but also successfully mastermind a mobile money fraud scheme probably defrauding countless victims on the outside.
He seems to have built a network of accomplices who assist him in defrauding unsuspecting Ghanaians at home and abroad from his small cell at Ankaful Prison. Among his victims are a lawyer, a tiler, and a welder, who worked together to blow his cover.
The tiler, John Atsu, received GH₵3,000 from his employer, Canada-based Ghanaian lawyer, Francis Ontoyin, through mobile money. He was to send the money to a welder, who was working on the lawyer’s house.
John also received the welder’s phone number and promptly reached out to him. They both agreed to use a mobile money merchant for a secure transaction the following day. This arrangement was meant to help them avoid the telecom operator mobile money charges and the 1% e-levy on the GH₵3,000.
Early the following day, however, John received a call from an unknown number. The caller addressed him by his last name and asked if he had sent the money.
John, who by now thought he was talking to the welder, responded that he was waiting for the welder’s call before doing the transfer. The caller, however, changed the agreed mode of the transaction. He wanted the money sent to a mobile money wallet instead. Since the money was meant for the welder anyway, John said he didn’t challenge the new directive.
He transferred the money, only to realise that the earlier phone call was a scam when the real welder’s call came later. The GH₵3,000 landed in the wrong wallet.
John reached out to the call centre of his mobile operator, MTN, to report the transaction and seek a reversal. MTN informed him that the money had been withdrawn and nothing could be done about it.
The lawyer’s investigation
John’s Canada-based employer Francis Ontoyin, who is a lawyer, started his probe by unmasking the name behind the mobile number that stole from him. The mobile money wallet which received the GH₵3,000 was registered in the name of Samuel Adom. Having the phone number and a name connected to the scam, Ontoyin said, was a good start.
About a week after the incident, Ontoyin called the fraudster’s number with a Canadian phone number. Under the guise of acquiring land in Ghana, the lawyer asked Samuel for his help to buy land in Accra because someone had recommended Samuel to him as a real estate broker. Samuel, however, told the lawyer that he didn’t have land to sell but he had a friend who could help him acquire land. He identified this property seller as Nana Agyei.
Ontoyin contacted Nana Agyei, and he readily offered to sell him a parcel of land. The lawyer told Nana Agyei that he was a resident of Canada but would be coming to Ghana soon. The two began to exchange Whatsapp messages.
To see the face behind the WhatsApp texts and phone calls, the lawyer talked Nana Agyei into making video calls. It was also a strategy to win the purported land dealer’s trust.
Looking for love and business partnership
As the days turned into weeks, and the two discussed the land deal, Nana Agyei wanted more than a land transaction. He also spoke about entering into a business partnership with the lawyer. He expressed interest in importing cars from Canada. Ontoyin fed his newfound “business partner’s” hope by taking time to visit garages to show Nana Agyei cars on display for sale so he would make his choice.
Beyond business, Nana Agyei also wanted love and wanted the lawyer to play a matchmaker. In one of the recorded video calls made available to The Fourth Estate, Nana Agyei asked Ontoyin to match him with a white woman because life in Ghana was difficult. A match with a foreign white partner would mean a green card to a soft life outside Ghana, he envisaged.
As their virtual friendship bloomed, Francis also wanted to know if, indeed, the land existed. He made arrangements with his friend in Ghana to go and check it out. Nana Agyei and Samuel asked for money for transportation to Pokuase, where he claimed his land was located.
With the hope of unveiling more faces behind the alleged scam, Ontoyin didn’t mind losing some more money to them. He transferred GH₵200 to Nana Agyei for transportation.
Nana Agyei failed to uphold his end of the bargain despite receiving the money for transportation. After a few failed attempts, another appointment was made. This time around, he gave the lawyer’s friend the exact location, which turned out to be a parcel of overgrown land.
To ensure his trusted friend’s safety, Francis Ontoyin advised him not to go there with them. At this point, the lawyer was upset about Nana Agyei’s evasiveness, so he cut off communications with him for a while.
Airport pick-up and arrest
Before departing Canada, however, Ontoyin reconnected with Nana Agyei. He told him he was returning to Ghana and was still keen on buying the land when he arrived in a few months. Nana Agyei offered to pick him up at the airport.
The police arrested Shadrack when he was sent to pick up Francis Ontoyin at the Kotoka International Airport.
While on the flight, the lawyer received a WhatsApp message from an unknown person who claimed he had been instructed to pick him up when he arrived at the airport. The person claimed Nana Agyei had sent him. Nana Agyei confirmed to Ontoyin that he had, indeed, sent someone named Shadrack to pick him up.
To identify Shadrack, Ontoyin requested photos of the driver and a paging board with ‘Francis Ontoyin’ on it for easy identification at the arrival lounge of the airport. They also spoke via Whatsapp video call when Ontoyin landed at the Kotoka International Airport.
The lawyer gave his friend in Ghana all the photos of Shadrack. This friend liaised with the police at the Airport Police Station to monitor Shadrack’s movements before Ontoyin could reach the departure hall. The police then arrested Shadrack.
The revelation
Shadrack told the police that he had been sent by his brother who was away on a trip. He later changed his story and revealed that his “brother” was a prisoner named Nana Agyei.
The Fourth Estate can confirm from Shadrack’s cousin, who asked not to be named, that Nana Agyei is in the Ankaful Maximum Security Prison.
The source further revealed that the said Nana Agyei is actually known as Kofi Debrah. He also revealed that Shadrack and Kofi Debrah are half-brothers from the same mother. Kofi Debrah’s phone is registered in the name of Monica Donkoh and he appears to be using multiple phones.
Kofi Debrah on a WhatsApp video call with Ontoyin while in prison.
The Fourth Estate has confirmed from sources in the Ankaful Maximum Security Prisons that Kofi Debrah is indeed a prisoner at the Ankaful Security Prison. However, we have not been able to confirm the crime for which he is in prison and the number of years he is serving.
When The Fourth Estate contacted MTN to speak to the issue, it said its subsidiary, Mobile Money Limited (MML), “has not worked on any case involving fraudulent transactions from prison inmates,” an email response signed by the company’s Head of Corporate and Legal Affairs, Paapa Osei stated.
“Reported cases of fraud are investigated using internal processes and when required, we collaborate with our regulators and state agencies, including the police, EOCO [Economic and Organised Crime Office], Cyber Security Authority, and the relevant agencies,” it added.
The Fourth Estate found that the phone numbers involved in the fraud have been reported to MTN for fraud.
However, the company said since MML was subject to the Data Protection Law, it could not respond to whether the numbers had been reported to it for fraud.
“Details on the accounts listed can only be obtained after a court order has been presented to Mobile Money Limited. All cases reported for fraud through our official channels are dealt with in line with our internal procedures and as required by law,” it said.
Asked about the protocol for dealing with mobile money fraudsters, the company said, “Any mobile money account used for illegal purposes or involved in any suspicious activity on our platform is blocked pending investigations. The affected customers (complainant/victim) are required by law to initiate the complaint and file a report with the police to begin criminal investigations.”
The company said the procedure was in line with the Payment Systems and Services Act and the Anti Money Laundering Act. It declined to state the number of mobile money fraud cases it recorded in the last five years.
However, Bank of Ghana data suggests that mobile money fraud is a growing concern. According to the data, in 2021, fraudsters succeeded in stealing GH¢12.8 million, which represents a 90.14% success rate of attempted fraud using mobile money platforms.
How prisoners smuggle contraband phones
Although Ghana’s prisons do not allow prisoners to have access to mobile phones, the Ghana Prison Service told The Fourth Estate that some prisoners find cunning ways of smuggling phones into their cells.
Some of the phones are smuggled into the prisons hidden in bread. Photo credit: Ghana Prison Service
“People put the phone or SIM cards inside bread, soap, balls of banku, onion and so on just to outwit prison officers. It is part of the reason we are praying for detectors because currently, we do everything manually,” the Chief Public Relations Officer of the Prisons Service, Chief Superintendent Vitalis Aiyeh, said. “In some cases, the phones are dismantled and the parts smuggled into the prison in bits and assembled.”
A woman grabbed for attempting to smuggle SIM cards into one of the prisons Photo credit: Ghana Prison Service
He said in the past, the service had attempted to deploy signal jam equipment but had to suspend its usage because residents of communities in the immediate environs of the prisons were complaining about interference with their mobile network signal.
A consignment of contraband SIM cards the Prison Service seized in one of the prisons Credit: Ghana Prison ServiceSIM cards stashed into onions and smuggled into the prisons Photo credit: Ghana Prison Service
“We were threatened with court action, I think,” he said. “What we need is something that can centre in only the prisons. It is difficult blocking mobile phones from entering the prisons. They come in several forms. For officers, when you’re caught, you’re dismissed.
SIM Card registration vs. fighting MoMo fraud
One of the strongest cases the Ministry of Communication and the National Communication Authority (NCA) made for the re-registration of SIM cards was the fight against fraud.
However, the Chief Executive of the Ghana Chamber of Telecommunications, Dr Kenneth Ashigbey, indicated that many people in Ghana had not registered their SIM cards because they did not have the Ghana Card and had been granted a lifeline until May 31, 2023.
He observed that there was a possibility that some of the fraudsters may be among those yet to be disconnected.
“What surprises me is how they are able to get access to mobile phones when they are in prison,” he told The Fourth Estate.
The Health Facilities Regulatory Agency (HeFRA) has announced that it has launched an investigation into the practice of two healthcare facilities located in South Odorkor in Accra.
HeFRA’s action follows The Fourth Estate’s investigations which discovered that Francisca Quaye, alias ‘Matron Gaga’, an unlicensed midwife’s over 30 years of malpractice has resulted in numerous medical accidents, including the death of at least two babies under disturbing circumstances at the facilities within 11 months.
The Registrar of HeFRA, Dr. Philip Banor, says the agency on Tuesday dispatched a team to the New Generation Medical Centre where Ms. Quaye worked for almost three decades, and the Adam Family Specialist Clinic, where she found a new job after she was sacked from the former.
“This is pretty bad, and it is unfortunate that it went on without someone noticing and stopping it earlier than that. But once we’re involved, we’ll make the necessary referrals and we’ll discipline both the ownership and management of the facilities,” he told Joy FM on Tuesday.
Possible sanctions
Quack midwife, Francisca Quaye, and CEO of New Generation Medical Centre, Dr. Ralph Owusu Obeng Snr.
Dr. Banor says should investigations establish culpability, the management and owners of the institution will be sanctioned. The sanctions include the revocation of a facility’s license, and referral of the medical professionals involved to the professional bodies, including the Medical and Dental Council for sanctions.
Where the findings border on criminality, he says the agency would recommend that Attorney-General prosecute the offenders.
In the case of Francisca Quaye, who is not a midwife and is currently on the run, he says her case would be referred to the police.
It is an offence under Section 23 of the HeFRA Act (Act 829) to provide the regulatory institution with false information concerning the premises or to fail to submit the health data required to the Ministry of Health.
Section 15b of the law allows HeFRA to deny the renewal of a health facility’s license if it has “reasonable grounds to believe that the continued operation of the practice by the licensee will create a risk to public health, public safety or is indecent.”
Dr. Banor says the agency faces many constraints which prevent it from executing its mandate, including manpower.
Although the country has more than 15,000 healthcare facilities, the agency has only 125 personnel performing HeFRA’s monitoring functions.
Hiding the unqualified
With HeFRA required to announce schedules for its visits to health facilities before actually arriving for inspections, he says the agency is at a disadvantage when it comes to detecting fake healthcare personnel on the payroll of some of the facilities because the managements tend to devise ingenious ways of hiding them.
“The question is after you leave, who do they bring in? There are some people who don’t provide the list because they know there are issues and then the law says you must have a minimum number of [healthcare professionals]. There might be eight people working there, they give you six people as qualified. But then they go and hire other people.”
When The Fourth Estate wrote to HeFRA in 2022, it indicated that Francisca Quaye was not on the roll of workers the two institutions submitted to it.
“Unless you get a report like [The Fourth Estate’s] or someone reports them, then you make unannounced visits and enter the premises and so on [to investigate],” he explains.
Asked if HeFRA needs to announce its facility visits knowing that some of the facilities have been hiring unqualified persons, he says that can only happen after the agency receives a tip-off.
“The two institutions are registered but that woman was not registered. That is the funny thing they did. They know there might be an issue.”
Monitoring fees
Currently, the facilities are obligated to pay a monitoring fee to HeFRA before officials from the agency can visit and perform their functions intended to safeguard public health.
Dr. Banor acknowledges that the current arrangement poses challenges for HEFRA in fulfilling its role because when facilities fail to pay their monitoring fee, HEFRA is unable to conduct visits.
“Unfortunately, they have to pay for us to come. They have to pay monitoring fees and we use their fees to do the monitoring,” he says.
To authenticate the credibility of healthcare facilities, he advises patients to look out for the HeFRA license displayed at the facility.
Ironically, the New Generation Medical Centre and Adams Family Specialist Clinic had their licenses displayed but still employed Francisca, who is unqualified to practice midwifery in their facilities.
The Fourth Estate’s visit
Adams Family Specialist Clinic.
Meanwhile, When The Fourth Estate visited the two institutions on Tuesday, the New Generation Medical Centre was the busier of the two. At least two pregnant women at the facility were receiving healthcare.
There was, however, only one patient at the Adams Family Specialist Clinic.
After 18 months of investigations at a private health facility in Accra, The Fourth Estate has uncovered a frightening case of ‘Matron Gaga’, an unlicensed midwife whose over 30 years track of malpractice has resulted in numerous medical mishaps, including the death of at least two newborn babies within 11 months.
The story reveals how the New Generation Medical Centre provided the Greater Accra Regional Health Directorate with false statistics about its operations.
Here is the full investigative documentary The Quack Midwife – by Seth J. Bokpe and Evans Aziamor-Mensah of The Fourth Estate.
EDITOR’S NOTE: This story shall not be republished or broadcast, in part or in full, in any shape or form without the express permission of the Editor-in-Chief.
Health sector regulations are designed to curtail quacks like Francisca Quaye, who practised midwifery for more than three decades without any form of training. Should the laws work as expected, the system should have stopped her from entering the health sector or fished her out within a short time.
Had the licensing and inspection regimes of the Health Facilities Regulatory Authority (HeFRA) and the monitoring of the Nursing and Midwifery Council been effective, Francisca would probably have been an administrative staff or an orderly, at best.
For decades, she thrived as a midwife on the laxity of enforcement of laws and rose to become the matron of a private hospital that delivered at least 20 babies monthly.
The system did not just fail. It failed pregnant women who went through Francisca’s hands, hoping to receive competent care, from a licensed facility and practitioners.
Some lost their babies. Others had their babies maimed. Some suffered a postpartum haemorrhage while others had their reproductive organs stitched terribly—sutured—as the medical professional would put it.
There was no such thing as being trained on the job to qualify as a midwife in Ghana.
On top of that, they paid illegal fees, fees already covered by the National Health Insurance Scheme (NHIS), directly into Francisca’s pocket.
What the laws say
Although the law did not permit her to be a midwife, she told The Fourth Estate that she had 34 years of experience.
Per Section 58 (3) of the Health Professions Regulatory Bodies Act (Part 3):
“(1) A person does not qualify to practice as a nurse, midwife or nurse assistant unless that person (a) holds a certificate from an institution recognised by the Council, and (b) passes a licentiate or professional examination conducted by the Council.”
However, the board has the discretion to grant exemptions to persons deemed fit.
Quack midwife, Francisca Quaye, whose 30-year practise resulted in the death of babies at the New Generation Medical Centre.
Francisca Quaye didn’t attend any accredited training institution or passed any examinations. Neither has she been given the green light by the Board of the N&MC as she confessed to The Fourth Estate.
The Fourth Estate wrote to the N&MC on August 12, 2021, requesting the status of Francisca Quaye as a midwife.
In a verbal response, the nursing and midwifery regulatory body said it needed more information to be able to dig through its database.
But unofficial search in the N&MC database indicated that no such midwife existed.
Registrar of the Nursing and Midwifery Council, Felix Nyante says “If you don’t sit and pass the licence and exams, if you are not registered by the council, you cannot say I am a registered midwife.”
However, in an interview on February 22, 2022, the registrar of the N&MC, Felix Nyante, said there was no such thing as being trained on the job to qualify as a midwife in Ghana.
“You see, whatever we do, we are guided by this Act,” Mr. Nyante said, raising a booklet of the law that empowers the council.
“If somebody says, ‘I’m trained on the job’, you don’t pass through our regulatory mechanisms. You cannot put your hands on your chest to say, ‘I´m a midwife’. And when we don’t also pronounce on you that you are a midwife by virtue of the fact that, one, you meet the entry requirements…,” he said.
He continued, “So, you are put in a classroom to be trained. You are sent to the hospital to also gain some clinical skills. A nurse’s supervision, preceptorship, mentorship and all those things [are necessary]. If you don’t sit and pass the licence and exams, if you are not registered by the council, you cannot say, ‘I am a registered midwife.’”
‘There is nothing like learning on the job for the unqualified’
While Francisca did not have any training, she learned on the job, courtesy of Dr. Owusu of the New Generation Medical Centre, where Francisca was employed for 28 years, and Dr. Essuman of the Adam Family Specialist Clinic, where she got a new job two months after she was sacked by the former.
Dr. Nana Oduro Essuman employed Francisca Quaye as Midwife Assistant but the Nursing and Midwifery Council says there is no such designation in the nursing practise in Ghana.
Asked if the midwifery system in Ghana recognised any designation as ‘midwife assistant’ as Dr. Essuman suggested, Mr. Nyante said, “No.”
The President of the Midwives Association of Ghana, Mary Ofosu, agreed with Mr. Nyante but was quick to add that some private health facilities had such personnel.
Mr. Nyante pulled out a list of people who impersonated nurse assistants and nurses but were arrested in public health facilities across the country and added that the N&MC published the faces of such people in national newspapers.
The conversation delved into an inter-institutional collaboration between the N&MC and the Health Facilities Regulatory Authority (HeFRA), which is in charge of licensing health facilities.
“Do you work with HeFRA?” The Fourth Estate asked him.
“…Yes, sometimes when HeFRA has or encounters any challenge, they verify from us whether this practitioner is in good standing or not in good standing. Certain times,” he said.
“Apart from them getting in touch with you, do you work together? For instance, you’re licensing the practitioner and they are licensing the facility. They do a lot of inspections.
“We also do a lot of inspections.”
“You do inspections?”
“We don’t call it an inspection. We call it to support supervision and accreditation.”
He said the N&MC monitoring teams visit both public and private health facilities to observe best practices, according to its procedure manual.
This document can be likened to a nurses’ and midwives’ bible.
During these visits, the practitioners are also given the opportunity to clarify nagging issues concerning their work.
But the response didn’t sound like private facilities were part of the monitoring.
The Fourth Estate probed further: “Does this system track private hospitals as well?”
“The regulation is not only for public facilities. Yes, it tracks private.”
“And also tracks the qualifications of those practicing there?”
“Yes. You see, before you even set out to do anything, you would have written to the facility. Usually, it is only fair to inform the facility ahead of time. And then you even request the list of the staff in that facility and you give them a template, so they’re able to tell you the registration number, validity of the license of the person. And then you even compare it in your database here before you set out. So, you have some fair idea of the standings of the staff before you set out.”
“Using this system, is it possible for you to lose within the mill, someone who is a quack for instance, and has been in the system for 30 years. Is it possible?”
“I wouldn’t say no. It might be possible. It might be possible. But once our radar falls on you, we’ll bring you to book.”
Asked how it was possible that for [almost]30 years, a quack midwife avoided their net, he said it was possible because humans by nature didn’t like regulation.
“So, can we say with certainty that every single healthcare facility in Accra for instance, is checked by you, in search of qualified midwives, qualified nurses?”
“It´s not that easy. Per the law, we are supposed to. But it’s not that easy.”
“Why is it not easy?”
“You have just limited it to Accra. But essentially, it’s not only Accra, it is the whole country…
“So, we sample. Those we sampled last year, of course, this year we wouldn’t go there. But we have a robust database of all the institutions that come under our regulation. That’s why I said if any institution exists without our knowledge, then this institution is not under our regulation, and we cannot say that we are regulating that institution.”
Offences
Over the years, the spotlights have been on quacks caught in the act in health facilities but the owners of those hospitals and clinics go scot-free.
But Section 73 of the Health Professions Regulatory Bodies Act, 2013 (Part 3), makes it an offence to engage unqualified persons to practice.
For the quacks, it is an offence to practice in a licensed facility, or provide unauthorised service in a licensed facility.
“Although both facilities are licensed, Examination of the files of the two facilities did not indicate the inclusion of the mentioned Francisca Quaye in the staff nominal roles of either facility during the registration, inspection, post-inspection, and by extension, the entire licensing process.”
According to the law, a person found guilty of any of these offences “is liable on summary conviction to a fine of not less than 500 penalty units and not more than 5,000 penalty units or to a term of imprisonment of not more than ten years or to both.”
To be eligible for a license, HeFRA requires “copies of certificates of proposed practitioners in the practice and proof of their up-to-date registration with their professional bodies.” This is on HeFRA’s website.
As part of promoting a standard of care, HeFRA does annual inspections of both facilities and personnel.
Registrar of the Health Facilities Regulatory Authority (HeFRA), Dr.Philip A.Bannor says both the New Generation Medical Centre and Adams Specialist Clinic do not have Francisca Quaye’s name in their nominal role.
In a letter dated February 16, 2022, and addressed to the Registrar of HeFRA, The Fourth Estate enquired about the status of Francisca Quaye and her working relationship with the two facilities.
The Fourth Estate sought to know if Francica’s name ever came up during the assessment of the two facilities for licensing.
In a response dated February 17, 2022, and signed by its head, Dr. Philip A. Bannor, HeFRA said:
“Although both facilities are licensed, Examination of the files of the two facilities did not indicate the inclusion of the mentioned Francisca Quaye in the staff nominal roles of either facility during the registration, inspection, post-inspection, and by extension, the entire licensing process.”
Interestingly, Dr. Ralph Obeng Owusu told The Fourth Estate that his clinic’s license had been renewed. Dr. Nana Oduro Essuman of the Adams Family Clinic also said HeFRA had been on an inspection tour of the facility in January 2022.
The Nursing and Midwifery Council’s registrar, Felix Nyante, told The Fourth Estate that health facility managers who conceal the information on unlicensed practitioners would not be spared by the law.
EDITOR’S NOTE: This story shall not be republished or broadcast, in part or in full, in any shape or form without the express permission of the Editor-in-Chief.
In parts one and two of this story, we chronicled how The Fourth Estate uncovered an unlicensed midwife whose 30-year history of practice has resulted in the death of at least two babies within a year and the laissez-faire attitude of the owners of the facilities she worked. Today’s story reveals how the New Generation medical centre provided the Greater Accra Regional Health Directorate with false statistics about its operations.
In February 2022, The Fourth Estate wrote to the Ablekuma North Municipal Health Directorate requesting data on maternal and infant mortality at the New Generation Medical Centre, Sakaman, from 2019 to 2021.
The Municipal Health Directorate supervises all the health facilities under its jurisdiction.
This was to establish the number of mothers and children who had died at the facility within the period.
The response arrived nine months later— October 2022— although it was dated March 29, 2022.
“Per the Ghana Health Service (GHS) Code of Ethics and per the Standard Operating Procedures of Health Information for GHS external person seeking certain information pertaining to the service, kindly refer your letter to the Greater Accra Regional Health Directorate,” the letter signed by Dr. Yaa Dankwa said.
As it so happens, The Fourth Estate had already written to Greater Accra Regional Health Directorate in March 2022, asking for the clinic’s five-year child and maternal mortality statistics.
Their response came on April 11, 2022. Astonishingly, the New Generation Medical Centre says it did not record a single death, be it a child or mother, in the five years under review.
The Fourth Estate, however, established that within a span of 11 months, at least two babies died at the hospital.
A baby born to Kate Tetteh (not her real name) died on June 25, 2020. Another infant, Selasie’s baby, died on May 21, 2021.
Ideally, the New Generation Medical Centre is expected to submit monthly reports to its supervisory facility, the Ablekuma North Municipal Health Directorate.
Maternal and Infant Mortality Rate at the New Generation Medical Centre between 2016-2021.
Source: Greater Accra Regional Health Directorate.
Although the reports were submitted to the regional health directorate for the past five years, it appears the figures were ‘cooked up’ and did not capture the death of at least two babies in 2020 and 2021 as The Fourth Estate established.
The quack-midwife-turned-matron, Francisca Quaye, confessed that she sometimes delegated the writing and submission of these reports to her subordinates.
Her boss, Dr. Ralph Obeng Owusu Snr, the Chief Executive Officer of the New Generation Medical Centre, told The FourthEstate that he did not pay attention to such records.
Background
When Kate Tetteh’s (not her real name) baby died at the New Generation Medical Hospital in June 2020, the midwife in charge, Francisca Quaye, and the facility did not communicate the whereabouts of the baby to her until three days later.
Francisca convinced her that the baby was sent to the Korle-Bu Teaching Hospital because she wasn’t breathing well.
The story changed from the baby’s breathing difficulties to a brain tumour.
It took Kate’s mother to break the news to her. Kate said she was broken and vowed never to give childbirth another attempt.
Francisca corroborated Kate’s account, insisting that it was an attempt to help the first-time mother who had lost the child under her supervision.
The baby died a stillbirth, the clinic’s records show. This was not captured in the Ablekuma North Municipal Health Directorate’s records.
That was not the only death recorded in the New Generation Medical Center.
Selasie Awaworyie’s baby weighing 4 kg died on May 21, 2021, at 7.45 pm.
The baby got stuck in the birth canal for about 20-30 minutes.
The weight of the baby should have alarmed the clinic to refer her, Dr. Owusu would later admit to The Fourth Estate.
Repercussions
The facility’s failure to provide accurate data to the Greater Accra Regional Health Directorate undermines Ghana’s drive to meet the United Nation’s Sustainable Development Goal 3. This goal places priority on high-quality, evidence-based obstetric and neonatal care as a way to reduce maternal and infant mortalities.
This failure, according to the Health Institutions and Facilities Act,2011 (Act 829) is an offence punishable by law.
Section 23 of the Health Institutions and Facilities Act, 2011 says anyone who commits an offence by providing unauthorised services in a licensed facility and provides the Board with false information concerning the premises or practice “is liable on summary conviction to a fine of not more than five thousand penalty units or to not more than ten years term of imprisonment or both and in the case of a continuing offence, to a further fine of ten penalty units for each day.”
Part four of this story will be published on Friday, May 26, 2023.
In all these, what roles could regulatory bodies, including the Nurses and Midwifery Council (N&MC) and the Health Facilities Regulatory Authority (HeFRA) have played in keeping the likes of Francisca Quaye out of health facilities? How they respond to The Fourth Estate’s enquiries will be detailed in our report.
EDITOR’S NOTE: This story shall not be republished or broadcast, in part or in full, in any shape or form without the express permission of the Editor-in-Chief.
In part one of this story, we chronicled how The Fourth Estate uncovered a frightening case of ‘Matron Gaga’, an unlicensed midwife whose 30-year history of practice has resulted in the death of at least two babies within a year, and the maiming of another. Today’s focus is on the owners/supervisors of two places Francisca Quaye worked during the course of our investigations.
June 27, 2021: It was a Sunday. The clock read 2.15 pm.
Dr. Ralph Obeng Owusu, the Medical Director of the New Generation Medical Centre, paced the compound of the one-storey building housing his clinic and home. For years, the downstairs had been the clinic, and the top, his home.
The grey-haired bespectacled family health doctor appeared rattled and angry.
The Fourth Estate’s eyes and ears at the clinic reported that the veteran doctor had been moody all day.
It was unusual. Although reserved, he is hardly sulky around his staff.
For decades, Dr. Owusu had anticipated a quiet retirement—handing over his clinic to his two sons—both medical doctors. But now, all he felt was dread and a vague, formless panic.
After today, a lot in his well-ordered practice, at least, that was what he thought, would change. He is not the type who liked the strident, jagged edges of change. His preference is for his affairs to run smoothly, down the middle of the road.
But one person was about to alter it.
“Was matron at work on Friday?” He asked no one in particular, as he walked to the reception area of the clinic.
The nurses at the front desk responded “Yes” in a chorus.
“Why doesn’t she listen when I talk to her?”
The question was not one that demanded an answer.
So, they went mute.
“Who was with her during the last delivery?”
Again, silence.
He walked away. His pace was faster than usual. His arms across his chest, folded when he entered his office, which shares a wall with the reception-cum triage.
The last delivery in question was the near-death experience of Esther Baker. Esther nearly bled to death after she popped a 3.5-kg baby.
By matron, he was referring to his assistant of almost 30 years. A boisterous character who has no midwifery qualifications but had done all midwives do—attend to pregnant women, deliver babies, cut and stitch the cervix of women in labour when their babies were too big to come out of the opening.
For the first time, Dr. Owusu thought of terminating the appointment of the matron, Francisca Quaye.
There was no appointment letter when he hired her verbally almost 30 years ago.
She’ll lose her job without a dismissal letter.
When he entered his office, he took the most difficult decisions he had been contemplating for days. He had to end it.
He made a call.
When he said “hello” to the person on the other side of the line, the entire front desk went shush.
The call was to Francisca Quaye. With pleasantries out of the way, Dr Owusu, with a little hesitation told Francisca not to report to work until he called her.
But it appeared his sidekick for almost 30 years did not get the memo.
When Dr. Owusu graduated from medical school in 1980 and completed his housemanship a year later, he didn’t see himself surviving in an economy that imposed hardship on everyone, even doctors. Rawlings had just overthrown President Dr. Hilla Limann. The economy was in shambles.
Dr. Owusu fled with his stethoscope, joining the brain drain. There were no guns to his head. Hunger had a gun on his stomach.
It was a time Nigeria was fulfilling the dreams of the economically disadvantaged from Ghana and other parts of Africa. It was enough reason to look elsewhere. The lure of oil money won.
He laboured in Nigeria for seven years. Six of those at the Health Centre of the Obafemi Awolowo University in the ancient city of Ille-Ife in Nigeria’s Southwestern state of Osun. The last year of his stay in Africa’s biggest oil producer was in Lagos.
By 1988, Ghana’s economy was beginning to see some revival. So, the 27-year-old doctor who had left for greener pastures returned a 34-year-old man with a renewed sense of patriotism.
He worked briefly for Cocoa Clinic before joining the Susan Clinic as its head. For five years, he worked with Francisca Quaye at the Susan Clinic. He admired her work.
Dr Ralph Owusu Obeng Snr sacked quack midwife, Francisca Quaye, in September 2021 after 28 years.
By 1993, he decided to answer to himself, not another boss.
So, they (Dr. Owusu and Francisca) left to start the New Generation Medical Centre in one of the quietest neigbourhooods in Accra—the South Odorkor Estate.
That relationship carried them through 28 years until that phone call on June 27, 2021.
The day she was asked not to report for work, Francisca arrived before 9 am.
The 67-year-old doctor was flustered. He ordered the clinic’s cleaner to call his beleaguered matron to his office.
The conversation went from murmuring to a shouting match.
“You always cause problems. When we talk, you don’t listen, if it’s not a mother, it’s a baby. I said go home until I call you.”
“Is it a suspension or what?” she asked at the top of her voice.
“Three months, just go home, until I call you,” he replied.
She walked out angrily but kept in touch with some of the staff for a daily run down.
In October 2021, Francisca called to announce that she was reporting to work because her three-month suspension had ended. She indeed returned to work, but Dr Owusu sent her home again.
A day after she was asked to go home, she came to the hospital in the company of her brother and an unidentified man.
Their mission was to beg Dr. Owusu to accept her back.
If she was hoping the two men would make her case, they failed. The soft-spoken doctor didn’t budge. The Rubicon has been crossed.
He insisted he didn’t ask her to return in three months when he sent her home in June but rather when he needed her.
Determined to shoo her out, he handed her an envelope—compensation. That in addition to a three-month salary from June was meant to end it all.
Francisca threw it back at him, storming out of the office. She entered the nurses’ lounge, packed her belongings, threw them into a waiting taxi, and left.
It would be her last day in the clinic she saw the sunset, almost every day for almost 30 years.
But it wouldn’t be her last day watching women navigate the pangs of labour.
I’m sorry—Francisca Quaye
Two months!
That is how long it took for Francisca Quaye to get a new job.
Her experience in the labour ward counted. Due diligence into her past didn’t count, The Fourth Estate would later learn from her new boss.
The Adams Specialist Clinic employed Francisca Quaye as a midwife assistant two months after the New Generation Medical Centre sacked her.
On February 2, 2022, Francisca received two unexpected guests at her new workplace, Adam Specialists Clinic, where that day, health workers outnumbered patients.
Her guests—two members of The Fourth Estate team—had been at the facility at least six times. Two of those days were with an undercover agent, whose story of miscarriage Francisca had ears for and even offered to buy medication for her.
“I told her she took care of me at New Generation, and that I had a miscarriage with a recent pregnancy. She consoled me and advised me to take folic acid. She offered to buy me medication for conception which I would pay for when I return to see her.
“She asked that I come back when I menstruate,” the undercover agent reported her encounter with Francisca.
On the day she met The Fourth Estate team, she was on a bench outside a newly constructed building that towers over the clinic’s administrative block and consulting room. Her palms were cusped on her lap.
For a uniform, she wore a cream scrub dotted with maps, dogs, and flowers on the top and spotless pair of purple trousers. On her feet was a pair of black sandals. Her hair was neatly tied into a blend of ash and a sky-blue shower cap. For facial expression, she wore a smile. A face mask would have hidden the fast transition from cheerfulness to sad-puppy face when the team broached her work at the New Generation Medical Centre.
“Let’s talk in private,” a team member of The Fourth Estate suggested. It was an attempt to escape the glare and ears of an old man who shared the bench with her and a carpenter nailing a board very close.
But there is no privacy in the narrow compound, where even whispers could be heard.
She opened the glass doors into a narrow corridor that led into wards. A patient was lying in one of the rooms.
With the formalities out of the way, she nodded to the idea that it wouldn’t have been fair to go to town without her side of the story.
“Are you a qualified midwife?” we asked her.
“No,” she responded without hesitation.
“But how long have you been practicing?”
“For 34 years.”
She then went on to give a history of how she became a midwife.
“My grandmother was a midwife at the Dora Quaye Maternity Home. When I was schooling, I had an interest [in it]. When I graduated from Form Four, I worked there as a receptionist. While working, I got more interested. When they’re working, I’d be in the room.”
When the team asked her permission to allow filming.
She ducked behind ill health.
“I have gone through hell. Because of this, I have been through a lot. I see myself like your daughter, that is why I want to talk to you,” she said.
“Do you remember Kate—?”
“The names are a lot. This issue is making me sleepless. My blood pressure is up,” she said in an attempt to kill the conversation.
It made no impact.
A nurse carrying a syringe and medications walked in. Francisca went hush.
She pleaded the conversation should continue outside.
That outside is a dingy space behind the new building. Debris and mortar from the construction work were splashed everywhere. Refuse bins lined up neatly. The clinic’s cranky water pump occasionally burst to life, disturbing the tranquility of the backyard.
The questioning continued.
“Why did you continue to work as a trained midwife even though you know you are not a trained midwife?”
“Mostly I direct them (other midwives) to work on the cases.”
“Why do you supervise trained midwives even though you are not trained?”
She stared at the floor and said nothing.
Turning to Kate’s case, she admitted that Kate’s baby died.
But she couldn’t tell her because Kate’s parents and fiancé’ advised that it could take a mental toll on the 27-year-old.
“The father, the mother, and the husband all said we should not tell her. They all said that she can go off if she’s told immediately.”
She said that informed the cooked story about the baby being sent to the Neonatal Intensive Care Unit (NICU) at the Korle Bu Teaching Hospital.
But there were contradictions in her story.
While she claimed it was Dr. Owusu who delivered the baby, both Kate and Dr. Owusu said the doctor wasn’t present until the baby was born.
When the conversation turned to Zekiya’s baby, whose shoulder joint got dislocated and her elbow twisted backward, Francisca became elusive with her answers.
She claimed two of those cases happened in the hospital. And on both occasions, she was not involved. The closest she came to Zekiya’s was when she returned to work and the baby’s mother brought her for postnatal care.
“I came to work on Monday. The doctor said if the baby did not recover, then we could refer her to the Korle Bu Teaching Hospital. But when the mother came back, I realised that she had applied herbal medicine and a bandage on the arm and I said. ‘Oh Maa, the doctor said if it’s up to 40 days and we haven’t seen any change, then we refer her to Korle-Bu, but what you have done now, even if we refer you to Korle-Bu, they may not be able to find where exactly the fault is.’”
However, both Zekiya and Dr. Owusu confirmed that Francisca only called in Dr. Owusu when she was struggling to deliver the 3.7-kg baby
In the case of Esther, who nearly bled to death, she absolved herself of any blame. But admitted inducing her with a birth inducement pill, Cytotec.
Medical professionals at the Ridge Hospital questioned certain medications Esther was given after delivery, but Francisca disagreed with them saying, “I didn’t give her any other drug which shouldn’t have been given.”
For Bernice, who had a pad left in her vagina and had to return for its removal and re-stitching, Francisca had an excuse— it was not deliberate.
“Sometimes when the patient continues to bleed even after suture[restitching], we have had to leave the pad in there and we make sure that we inform them of it. We do that and remind them to remove it when they visit the restroom. I am sure she did not hear us speak about it probably because of the pain she might have been going through when we told her,” she explained.
Some midwives who worked with her insisted she interfered and dictated what should be done, although some of her practices were alien to best midwifery practices.
Away from dead babies and maimed patients, she couldn’t justify what went into the extra fees, except to say she sold nightgowns and other items and some of the women came to the hospital without those items.
Under Ghana’s free maternal care policy, pregnant women are entitled to free registration with the National Health Insurance Scheme (NHIS), free of cost health services and drugs up to the time of childbirth and 90 days after birth.
But this is often abused by some healthcare providers (both public and private) who demand out-of-pocket- payments from pregnant women during their most critical moments.
A study published in the Health Economics Review in 2017 revealed that 69.4 % of the sampled women in rural Northern Ghana who gave birth perceived that the NHIS did not cover all the expenses incurred during childbirth. According to the report, the women indicated that they had made out-of-pocket payments for drugs and other supplies during childbirth even though the costs were covered by the NHIS.
The women The Fourth Estate spoke to said they paid the hospitals GH₵100 prior to going into labour only to be confronted with extra bills between GH₵ 300 to GH₵ 700, for which receipts were not issued. These payments were allegedly engineered by Francisca Quaye despite the fact that they were covered under the NHIS.
The findings from the study and Francisca’s out-of-pocket-payment demands on women due for delivery undermines Ghana’s drive to meet the United Nation’s Sustainable Development Goal 3. This goal places priority on high-quality, evidence-based obstetric and neonatal care as a way to reduce maternal and infant mortalities.
For each woman that paid extra fees, she developed selective amnesia.
“It’s been long so, I can’t remember,” she said when The Fourth Estate put the allegations of illegal fees and the detention of newly-delivered mothers who couldn’t afford to pay until their relatives came to bail them.
“I can only apologise to them. To all of them, I am sorry. They should forgive me. I am really sorry for whatever happened. They should forgive me.”
When we pressed further, she could only beg.
“Daddy[referring to one of The Fourth Estate reporters], please, I am pleading with you. What’s going on with me can even cause me to take some poison,” she said.
“Uncle[referring to one of The Fourth Estate reporters], please, forgive me. I am taking care of an abandoned child who was left by the roadside by her mother. Anytime I remember what I am going through, then I feel like committing suicide. Daddy, Uncle, please, take me as your mother and forgive me. Please,” she pleaded grabbing the arm of a member of the team when she saw a letter addressed to the Medical Director of the Adam Specialists Clinic.
When The Fourth Estate put the issues of medical errors to her, she apologised.
“I can only apologise to them. To all of them, I am sorry. They should forgive me. I am really sorry for whatever happened. They should forgive me,” she said in what could be her first apology to any of the victims of her unlicensed practice.
Although the head of the New Generation Medicial Centre said he had fired her, Francisca Quaye told The Fourth Estate she left of her own volition, especially because of the many allegations
“I lost interest in the job when these issues started coming in. This got me thinking for some days. I went on hunger strike for two days just to understand the issues I was alleged to have been involved in.”
I was naïve –Dr Owusu
The Fourth Estate team’s first meeting with Dr. Owusu was on October 27, 2021.
He was brutally honest about his work with Francisca, with whom he started the New Generation Medical Centre.
“Who is your matron?”
“At the moment, we don’t have a matron, we have three midwives who help in the deliveries.”
“Have you ever had a matron before?”
“Yes, we did, but she is no longer here. There were a few issues and I realised that probably she wasn’t qualified for the work she was doing so we asked her to stop coming.”
“But you employed her, knowing her qualifications?”
“This is a difficult thing for me. I have known her for quite a while. She was under my tutelage. But I realised that there were a few issues with the management of some of the patients. We’ve had some supervisorial sort of enquiries about some of the problems. After that, I realised that it will be in the best interest of everybody for her to do proper licensing. It will not be professionally good for her to be doing what she was doing.”
“She was the one supervising the delivery of babies?”
“There were midwives here. I always have midwives here. She was doing general administration because she was helping me with running the place and then of course she was also supervising the midwives. I was supervising it.”
“How does someone who has not trained as a midwife supervise midwives?”
“I have tried very much to be directly involved with whatever happens here. Most times when there are problems or complications, they call me and I try to see what I can do. If it is beyond what I can do, then we refer to a higher authority. I have been responsible for manning the place and making sure things go well.”
He denied ever promising to deliver Kate’s baby saying, “I don’t do the babies directly. Maybe it’s her interpretation of how things are done that when the time comes, I’ll deliver her.”
“I think I’m in trouble. Am I not in trouble? …And that is my life. That is my life, and if this thing gets out of hand, I’m gone. I’m gone. And if it happens, who knows, I may put a knife on my throat.”
But The Fourth Estate would return for the answers to the questions of what happened on another day.
On Bernice, who had her vagina allegedly restitched terribly and a pad left in her without her knowledge, Dr. Owusu expressed shock that Bernice had not been told that she needed to remove the pad.
“In a case like that, she is [supposed to be] told that we packed it just to prevent bleeding and once she is here, we supervise it. If she goes home, we tell her there is a pad there when you get home remove it.”
Bernice was never told. She had to live with a skunk-like scent and pains for a week.
“Was it not dangerous to keep her [Francisca Quaye] here to even deliver babies?” The Fourth Estate asked Dr. Owusu.
“I agree with you. It was probably a little bit of naivety on my part. That is the truth. We were not doing too badly. There was always a midwife with her. But the thing with her is she was a little boisterous when it comes things of that nature. Anytime there is a problem, I used to talk to her. It was supervision, I didn’t know there would be so many problems.”
“What we’ve gathered here is that she didn’t even give the midwives the chance to operate”
Probably feeling overwhelmed, he paused.
“Hmmmm!” He let out an exasperation, before launching into an explanation “I don’t know, but I cannot explain that. Partly, I’ll take the blame because she has been under my tutelage for quite a while. I always try to impress upon the midwives that ‘I’m around. If there is any problem call me.’”
On the two occasions that Dr. Owusu spoke with The Fourth Estate, he insisted that forced labour was not done only on women who had gone beyond their expected date of delivery or had a weak contraction.
In an ideal situation, pregnancy should last for 40 weeks. So, The Fourth Estate sought to know why there were repeated cases of inducing pregnant women, some of whom were asked to go home and come back without any special care as best practice requires.
Dr. Owusu said, “If you have to induce labour to the extent that labour has not started at all, that has to happen when the patient has crossed 40 weeks. Pregnancy for a baby is 40 weeks. Maximum 42 weeks, their period in the womb is finished and the placenta’s ability to maintain the health of the baby goes down. So, the baby has to come out. The induction is done on post-term [pregnancy]”.
The conversation revealed that Francisca allegedly abused labour inducement drugs.
“At what point will you insert a medication in a pregnant woman and ask her to go home and come back?”
“No no no. That one, I don’t think is something that is …”
“Francisca Quaye’s processes involved that. It became a norm for medications to be inserted into women to enhance delivery, as she puts it. Did the hospital sanction that?”
At this point, he stammers.
“No! No! I didn’t sanction that.”
Asked about inducing pregnant women during their first stage of labour, especially when they had not passed their expected date of delivery, he said it was wrong, a wrong that Francisca allegedly perpetuated on many women.
When The Fourth Estate met Dr. Owusu for the second time on February 11, 2022, he wanted to cut the conversation short as he accepted that Francisca was not qualified for the job.
But he maintained that at all times, there were midwives around.
However, his attention was drawn to an earlier promise he made to clarify some claims including those his former employee made about him.
He admitted that Esther Baker was induced with Cytotec, a medication for inducing labour, but could not tell if she needed it at the time she was given.
He said it was possible for the nurses that accompanied her after the referral not to know the details of the event that got Esther referred to the Ridge Hospital because “some of the people who accompanied her may not even be midwives. They could be nursing assistants.”
Asked if the protocols permitted nursing assistants to accompany a postpartum bleeding patient, he said, “It’s not a perfect scenario.”
“I think I’m in trouble. Am I not in trouble? …And that is my life. That is my life, and if this thing gets out of hand, I’m gone. I’m gone. And if it happens, who knows, I may put a knife on my throat.”
Kate’s Stillbirth: allegations and Responses
Kate complained that when her baby’s head emerged, the midwife left her to her fate because she was cooking.
Dr. Owusu was of the view that while he didn’t encourage interference in the labour process, the time between when the head popped out and delivery was crucial.
“Once the cervix is fully dilated to the time the baby finally comes out of the womb, there is a time limit. You’re looking at that particular time limit. It should not go beyond that time limit. Once it goes beyond that time, then you’re looking at possible complications that are not making the baby come out,” he said.
Again, he said once the baby’s head emerged, the right thing to do was to encourage the mother to push because the contractions help with the baby coming out and at the same time gently rotate the head for the anterior shoulder to come with it.
“It is not a difficult thing, of course, [but] you have to be experienced and you have to be trained,” he said.
But he was also quick to add that it would also depend on the weight of the baby and the size of the mother’s cervix.
He pointed out that episiotomy—the cut in the cervix to allow the baby to come out— would be needed if the baby is bigger than the cervix.
When The Fourth Estate asked if Francisca was qualified to use the knife to expand the cervix, he said, “Francisca was not qualified to deliver a baby. The only thing is that we’ve been together for quite a while and she has learned on the job under my tutelage.”
“She was doing quite okay. Even with the deliveries, it was not too long ago that she started because I wasn’t allowing her. We’ve always had midwives here. She is a little domineering. The midwives she was working with; she was pushing them around,” he said.
On Kate’s delivery, Dr. Owusu admitted that he wasn’t around, but he was called and informed that she delivered a stillbirth.
“Did the hospital officially communicate to her that her baby had died?
“That one, I’m not sure.”
“What is the protocol around that?”
“The protocol is that you have to tell the mother that the baby did not survive. But sometimes because of emotional things, if she wasn’t told I won’t be surprised. Because of the initial emotional attachment, you want things to calm down a bit before you break the news to her. After a while, if she hasn’t seen the baby or heard the baby cry and all that, they’re in a better position to appreciate what has happened.”
“Is it a normal practice to tell the mother of a [dead baby] that you sent the baby to a NICU in another hospital?
“No! No! If the baby has died, I wouldn’t think that is the right thing to do.”
“That is what was done here.”
“I don’t know about that, honestly.”
“In the case of Kate, do you think you followed the procedure from birth to announcing to the parents that your child is dead?
“I’m not sure, probably we did it. I just left things for the midwives. They carry on with … so I’m not really sure,” he said.
“But I talked with her husband. We had a long chat with the husband. He brought out certain issues. There was something about Francisca cooking and all that,” he said.
Seeking to deflect the allegation, he said it was possible she had not fully dilated at the time she claimed Francisca was cooking.
Dr. Owusu also said it was impossible for Kate to see the baby’s head while lying down and that it was also impossible for the nurses to be laughing while Kate was in pain.
“I’m not perfect. This facility is far from perfect but look at the psychology of somebody who has lost a baby. I don’t think you can believe everything she says. She is bitter. She has lost a baby…Before they are fully dilated, they’re not even on the chair in the theatre, they’re in the bed. Hardly would you find anybody delivering on the bed,” he explained.
“There is a possibility that during the course of her contraction and pain, some of the nurses may be giggling and doing their own thing. We’re human. It doesn’t mean nobody cared for her. I will not agree with that one. It’s just the circumstances [under which] she lost the baby.”
He also confirmed that he was angry when he saw the outcome of the re-stitching of Kate’s vagina done by Francisca.
“There’s a way we do the stitching. If you don’t do it well, it can give in. When I saw it, I said no, no, this is not the right thing. It wasn’t properly done. I had to put her on some medication so that the wound will heal much faster without much complication.”
Dr. Owusu was honest about his failure to tame his employee. But he has fears about the consequence.
“I think I’m in trouble. Am I not in trouble? …And that is my life. That is my life, and if this thing gets out of hand, I’m gone. I’m gone. And if it happens, who knows, I may put a knife on my throat”
Francisca Quaye’s next stop
Dr. Nana Essuman, Medical Director, Adams Family Clinic, who initially told The Fourth Estate that Francisca Quaye was employed as a midwife assistant later refused an interview with The Fourth Estate.
On February 1, 2022, The Fourth Estate wrote to the Medical Director of the Adam Family Specialist Clinic, Dr. Nana Oduro Essuman, requesting an interview.
By February 3, 2022, The Fourth Estate met the Medical Director of the clinic, Dr Nana Oduro Essuman.
He admitted that the clinic employed Francisca Quaye as a midwife assistant. He described her as highly experienced but was quick to add that she wasn’t employed as a midwife because she lacked the qualifications.
Section 58(4) of the Health Profession Regulatory Bodies Act, 2013 (Part 3), requires that even nursing assistants must be trained by accredited institutions and licensed by the Nursing and Midwifery Council (N&MC). Where there is an exemption, it has to be granted by the board of the N&MC.
Francisca didn’t have that exemption.
However, halfway through the conversation on February 3, 2022, Dr. Essuman requested that he should be allowed to consult shareholders and lawyers of the clinic.
“After that you can even bring your cameras for a full interview.”
However, On February 11, 2022, he reached out to The Fourth Estate with a letter dated February 9, 2022.
The letter said, “We wish to state that there has not been in the employ of our facility any midwife named Francisca Quaye. To this end, we are not in a position to grant you an interview as requested.
It went on: “We are by this bringing to your attention that our facility has no association with any midwife by name Francisca and should not in any way be associated with any publication concerning and or/involving the said Francisca Quaye.” Dr. Essuman, the man who had told The Fourth Estate team that the woman worked there, signed the letter.
Further, the clinic threatened legal action should The Fourth Estate fail to adhere to the caveat.
Interestingly, Dr. Essuman said he would only grant The Fourth Estate an interview if the media house had a court order.
The Fourth Estate wrote to the Greater Accra Regional Health Directorate in March 2022, asking for the clinic’s five-year child and maternal mortality statistics.
Its revelation was astonishing and will be in part three of this story to be published on Thursday, May 25, 2023.
EDITOR’S NOTE: This story shall not be republished or broadcast, in part or in full, in any shape or form without the express permission of the Editor-in-Chief.
