A Day in the Life of a Sexual Health Worker in Ghana

A good word to describe my day today is; heavy. I came to Ghana to work with an NGO in business development with female farmers in a rural part of the country. I had a moment today as I was sitting in a brothel in the slums of Accra when I thought, “what the hell am I doing here”. It passed quickly as I collected the strength to put on my game face to get through our work. Being confident around the sex workers and their pimps meant the difference between polite hello’s and being taken advantage of.  This is how I found myself there.

            A coordinator at the office came to me yesterday and told me I was coming into the field with her, I spent last week sitting in on a Peer Educator course for male sex workers and had learned about how they recruit current and former sex workers, train them in sexual health and send them out to teach their peers. All of this had been theory until this morning when I was told to show up at a place on the other side of town and to wear good shoes as it may be dirty, which was all the information I was given. In the morning I was contacted by one of the women I was meeting with very specific instructions on how to get to the site, she called four times as it seems they were very attentive to my wellbeing and whereabouts. When I reached the bus depot to transfer towards my destination someone shouted out “Obruni (white person) where are you going?” He laughed when I told him and asked why I would want to go there. Why indeed.

I got off the bus at the designated spot and as I looked around I knew I was close to the market, a busy part of town mostly devoid of foreigners, especially on their own. People shout at me from across the street and from cars and motorbikes going by “Obruni, where are you going? What are you doing here?” My colleague arrived in time to save me from awkwardly rejecting a man asking for my phone number so we could marry and I could bring him back home with me.  She led me through a maze of huts and converted shipping containers that made up the community they were working in, towards their satellite office. As I swatted away the flies I choked back the urge to cough at the pungent odors at every turn.  Frying fish, a dead dog, garbage everywhere, the smell will haunt me in my dreams tonight. We waited for the team to arrive, children running by me and gawking at the unfamiliar visitor, one even so bold as to poke me and run away. As most of the women I was working with had limited English the conversation hung around them giggling at the nickname they had given me the week before “Nana Afia” or Queen Friday, as this was the day I was born which is significant to them. Once everyone had arrived it was time to head out. When I asked them where we were heading and what we were doing they said “Were going to meet the women”, I was really in it now.

Our group of seven women accompanied by three male assistants walked calmly through the muddy pathways towards a more trafficked area. There someone pointed to a narrow doorway leading into a dark room, “we're going in there”. Pricilla, the one who had picked me up from the bus stop pulled me aside and told me “we are going in there, don’t worry they are mostly Nigerian and can speak English”. When I asked what I needed to do I was answered with a wave through into the darkness. As I entered I was greeted with the smell of marijuana and sweat that simmered in the air along with pulsing beats coming from a sound system on max. Women that were casually dressed sauntered about the room and peeked out of hallways, a few men passed through the room, drinking and smoking and not paying much attention other than to stare me down for being the odd looking Obruni in the room. My colleagues, familiar with some of the women seemed totally at ease, introducing me to some of their old favourites. I politely smiled, shook hands and said many hello’s, watching in awe as the women quietly and efficiently set up shop inside. A Peer Educator (PE) I came in with, a dainty, seemingly calm looking girl produced a wooden dildo from her purse and stuffed it between her legs. She then unwrapped a condom and demonstrated how to properly wear one, surprising many of her viewers who were unfamiliar. While that was going on another PE set up her work station “were going to do the testing”, right here, in this unlit room inside the brothel. I volunteered to hold her phone as a light throughout the procedures, offering what little assistance I could in this situation.

One by one the other PE’s would pull aside a sex worker and take down their information and then send them towards us for testing. Just a prick of the finger and 5 minutes was all it took to identify antibodies that would indicate HIV status. I was amazed as this women had clearly been well trained and masterfully processed each women through, giving each one a number on the wrapper from the antiseptic wipe that had sterilized their finger to correspond with the number on the test waiting to be finalized. We tested 35 women in just over an hour, at the end they called for “results, results” and they each came forward for a private whispered answer muffled by the blaring afro beats that filled the room. One tested positive. The one that had earlier asked if she could do anything for me with a wink and a riotous laugh at my quick rejection. As she was told the news her face remained unreactive, she had been complaining of sores on her arms and face and wondered if they were connected. I too remained blank to try to keep the privacy of the moment between us. We then indicated to a supervisor her positive results so they could follow up with her, I fought back tears, this was not the time nor the place for such emotions.

We left only when we had run out of test kits, needing to return because we hadn’t seen everyone. “They are all new inside, so we have many tests to do” the routineness of her statement stuck with me. I was led to the police station; it was good practice to keep the police informed of our activity in the area. As the golden ticket I was paraded through to a constable and a police chief “this is a volunteer come to see our work” “You are welcome” they would say. What was I doing here? It didn’t matter anymore. What mattered was that these women were putting themselves on the line everyday, these are the world’s superhero’s, women will save us all. I’m going out again tomorrow, even if it was just to shine a light on the work being done here.    


Wether your day was light or heavy like mine, I hope it meant something. 

XX Melanie