As an American taxpayer, I would rather that money went to maternal care provided by the United States Agency for International Development (USAID) than to a ballroom.
Would-be mothers in northern Ghana have to travel miles across river and road while heavily pregnant – to reach health centres without clean
Would-be mothers in northern Ghana have to travel miles across river and road while heavily pregnant – to reach health centres without clean water and all the means to help them. Rachel Hagan reports
Saturday 06 June 2026
In northern Ghana's Upper East Region, the road to giving birth can be treacherous. Women in labour have to cross rivers by canoe to give birth, or walk for hours along flooded clay paths, doubled over with contractions, clutching plastic bags filled with baby clothes and sanitary pads. Sometimes they ride bicycles because no motorbike can get through the mud and often they do not make it to the clinic at all.
Dorcas Azongo, 29, gave birth to her twins after crossing two rivers at night while in labour, riding part of the way on her husband's motorcycle. She says: "When we reached the [first] river, it was difficult to cross because during the rainy season it is always full... I was in too much pain to speak". She could not sit probably on the motorcycle for the same reason.
By the time she reached Bongo Hospital, exhausted and in agony, it was too late to get her inside. "I delivered in the yard – as the babies were already coming, the [midwives] could not carry me inside. They helped me deliver there, then took me inside, cleaned me up and dressed me and the babies."
It was not her first dangerous delivery, after her first child was born in the yard after her husband failed to find transport in time. For her second, relatives balanced her on the back of a bicycle and pushed her for nearly an hour to another clinic. "I feel bad and a bit down sometimes when I sit and think back on how difficult my deliveries were. Sometimes I feel like giving up and tell myself I never want to give birth again because of all that pain," Dorcas says.
"If they delay and reach the riverside and cannot cross, we sometimes have to deliver them there", Rejina Abane, a midwife working across remote communities in Bongo district explains. "Delivering on the ground is not good. There is risk of infection, and the place is not prepared. Cutting the cord and other procedures are not safe there, especially when it has rained and the ground is muddy."
In villages like Beo Tankoo and Atampiisi, close to Ghana's border with Burkina Faso, childbirth is shaped by water. In the dry season, streams disappear and boreholes fail. In the rains, rivers swell and cut entire communities off from hospitals and maternity wards, leaving pregnant women stranded on riverbanks in the middle of labour, waiting for canoe operators to return in the dark.
A fall in aid
Inside the health centres themselves, the conditions are scarcely safer. Women arrive carrying their own water from home because clinics have none, midwives fetch buckets from distant boreholes before they can begin work and patients needing urine tests squat behind buildings because there are no toilets.
In neighbouring Atampiisi, Sophia Atule, 31, is eight months pregnant with her fifth child, waking before dawn each morning to sweep, cook and queue for water at the community borehole, often spending close to two hours waiting. She knows the local clinic has no midwife and no water, and she knows the rivers well enough to have already planned the long route round to Bongo Hospital for when labour begins "If you are in labour as a pregnant woman, the rivers are too dangerous to cross during the rainy season. When it's rainy season and you have to go the long way, some of the women might end up delivering on their way to the facility," Sophia says.
The crisis comes as aid agencies warn that years of progress on maternal health across parts of Africa are becoming increasingly fragile as deep cuts begin to bite. In January 2025, Donald Trump functionally dismantled the United States Agency for International Development (USAID) with more than 80 per cent of its programmes stopped or terminated – that has been followed by cuts from the UK, Germany and other nations.
