Lens of Passion was drawn to Dr. Katherine Attoh Berko by a posting she wrote on the LinkedIn platform. Her story is one that we hear frequently. A story about a woman passionate about making a difference in the world. A woman must balance all the responsibilities of her position in her culture and her gender in this world.
Women like Dr. Attoh are pioneers in their careers and countries. The first generations of professional women constantly battle the right – not to be seen as spectacular – but rather to be seen as typical, highly competent professionals. The expectations and pressures on women like Dr. Attoh are numerous. She does what she does not because it is hard but because it is the right thing to do. She happens to do this with a smile, a sense of humor, and a very contagious laugh.
LoP: Your post on LinkedIn featured your story about appearing at the bedside of a woman who was delivering. She looked at you as if she didn’t know you; she didn’t anticipate that you were her doctor. Can you tell us what happened in that circumstance?
Dr. Attoh: What happens in public hospitals is that when you need antenatal services, you are assigned to a midwife. We focus on antenatal care, and a particular midwife will see you throughout your pregnancy.
However, if you have any medical condition requiring that you see a doctor, you will be assigned to a doctor. That is where the doctor will have their first rapport with a patient. Subsequently, these patients are admitted to the ward for surgery. They get to meet the doctor who is going to do the surgery for the first time at the theater.
In some cases, the patient has been on the ward for a while, which was the case with the particular patient I wrote about.
She had been on the ward for a while and been managed by us daily.
I saw her every day, stopping by, saying, “Hi, Madame, how are you this morning? Do you have any problems?” she would say no. I’d ask specific questions. Do you have headaches? Anything impacting your baby moving? Are you bleeding? I asked all those questions. I wanted to examine her, and then I’d say, okay, so we are continuing with your management, changing your medication, etc. And I would discuss it all with her. She hears you, alright. But since you are female, she just automatically assumes you are not the doctor.
This incident is mostly where you have patients coming from less educated backgrounds, but surprisingly, sometimes, even when you have people who are fairly educated, they’ll still say, “Oh, since I’ve been here, I haven’t seen a doctor.” Some have said that to my face before. And I said, “I’ve been seeing you every day! This is me.” She’s like, “Oh! So, you are the doctor?” and I am like [smiles] “Un-hunh, yes.” [laughs]
So now I resist allowing anyone to call me by my first name at work. My colleagues, nurses, everybody – I don’t allow anybody to call me by my first name at work. Even if we are friends at work, you call me Dr. Attoh. Because what happens is that if I’m talking to my colleague at work, and she calls me Katherine, that’s what patients hear because it’s easier to pick up that, and they just assume anyway. But I’m thinking that if we keep calling each other “doctor,” eventually we will make a difference.
LoP: Are there many female doctors in Ghana compared to male doctors??
Dr. Attoh: I don’t have the exact statistics, but I don’t think there are more women doctors than male doctors.
LoP: When you went to medical school, were many other women in your class?
Dr. Attoh: Okay, so in my Medical School class, we were almost an equal number, and that was refreshing.
LoP: When you went to Medical School, did you choose your discipline right away, or did you enter Medical School knowing that you wanted to be an ObGyn?
Dr. Attoh: In Medical School, we were allowed to go through all four main rotations. You do surgery, pediatrics, and internal medicine. We also do all the other smaller disciplines. I use the word smaller because we spend much less time studying them, not that they’re less important. They were anesthesia, psychiatry, ophthalmology, and EMT, and we also went through those rotations.
I did not think I would become an ObGyn because I was prejudiced against it. My prejudice stemmed from my dad being an ObGyn; he was barely at home.
I clearly remember one Christmas, we were sitting at the table, and somebody comes to our house, the doorbell rings and there’s somebody outside the gates like can you please come with me to deliver for my wife?
It’s Christmas! It is Christmas Day! We were just having family time together. Times when you expect him to be at home, he might be at home; then they will call, and he will rush from our home to the hospital, which wasn’t too far off.
Surprisingly, this is the hospital I am working at now. [laughs]
I was going to be a physician specialist after medical school. I went through Internal Medicine, but I wasn’t too happy.
Then I went to pediatrics, and I loved being in NICU (neonatal intensive care unit); I love the little babies who are just being born, I just love them; however, I wasn’t too enthused about the older kids.
So, I knew pediatrics wouldn’t do it for me, and I went through all the surgical rotations. I was happiest in Neurosurgery. Neurosurgery used to just make me happy.
It would take me another four years to become a general surgeon. It would take me forever to become a neurosurgeon.
I went into my office and had a good evening session, and even though it gets really stressful, I will still be happy, so I just found myself.
LoP: What was your educational journey to become an OBGYN in Ghana?
Dr. Attoh: In secondary school, I took my exam. There are two systems for entry into Medical School. Either you go in directly from secondary school, or you do that as a first degree. So, immediately after secondary school, I was not able to get into Medical School because my grades were not so great. I went in and did my first degree. I have a first degree in biochemistry. After that, I applied and was accepted into Medical School.
I did five years of Medical School to become a doctor. It’s something I’ve always said I wanted to do. When I didn’t get in, I looked around me and saw all these businesspeople and all these ladies working in banks. I thought maybe I should get a corporate job, but I realized that it just wasn’t me. I realized that after university, I got the opportunity to pursue a Ph.D., which would have been fully funded, yet I found myself quite unhappy with that option. Once I got into Medical School, I was happy, so I knew I would be unhappy if I did something else.
LoP: Your first degree was in biochemistry. Were there a lot of girls in your class?
Dr. Attoh: No, we were not too many. All the disciplines that involve science and that involve math – you don’t find too many women venturing in there. Also, boys go into it because it’s been thought difficult. And, as a woman, at the end of the day, you end up having to take care of your children. People assume that, once you’re female, you should take what they consider to be the “softer” disciplines, ones they consider to be the easier disciplines. I think sometimes they think that they are helping.
When I wrote that article [on Instagram] and said that one of my bosses said maybe you should have chosen ophthalmology or psychiatry, he ended up saying because there are no emergencies in there. How many times will I be waking up in the course of the night to say, “Oh, you need to go to the theater now”? It rarely happens. Nobody will call a radiologist in the middle of the night and say you need to report on this film ASAP otherwise the person is dead. It usually doesn’t happen, so I think sometimes it comes from a place of concern, but it comes out sometimes as condescending.
I thought, “You have the same volume of brain matter in your head as I do, and sometimes if I were to compare IQs, the female you’re talking to might have a higher IQ than you do!” [laughs]
But just because I was born with XX chromosomes and you have XY doesn’t mean you get to choose a more difficult specialty, and I should automatically take what you consider to be softer. If the person is interested in it, you encourage them to do it, making the environment conducive for them.
As I was saying, in my year group of 10, two residents were female, and the other eight were all men. When I started, I already had a baby. The other lady got pregnant in the course of the program. I would expect that you would make it conducive for me to be able to, for example, express breast milk at work and run shifts that will not take me away from my family so much.
Because, traditionally, these are the same. People who, when they see a woman who’s achieved so much academically but doesn’t have a family, everybody goes like, “Ah, but she’s not married. Oh my! She has no kids!” It’s like we can never win. [Laughs] If you are too academic, it’s a problem. If you are too homely, it is a problem. Right?
We must be encouraged, whichever specialty you choose because we excel at those things.
Someone I went to secondary school with is the first female to become a cardiothoracic surgeon here in Ghana. She was in my classes in secondary school. Why has it taken a female so long to get there? Because the training is hard and in-between, you have kids, you have to manage your home, and you’d have to do other things.
The males in my class have families as well, but their wives are the ones bearing the brunt of having to juggle (everything) because, I mean, at the end of the day, they (the male residents and doctors) are not the ones breastfeeding the children – so they might support! They don’t have so much pulling them away from their work, right?
LoP: While in school, did you feel like you were treated differently because you were female?
Dr. Attoh: In school? No. In school, because it was a lot of academic work, you learn, you write your exams, you pass, you go for your general exam, even the ones that are clinical exams, there’s a scorecard.
I was in an academic environment, and the way to grade us was set on a grid. There wasn’t a way of seeing whether a person was male or female. When you get out, and you are a doctor, and we are in the work environment, you see the subtle differences in how you’re treated.
Even with nurses, for example, if my male colleague went to a nurse and said, “Can we set a tray for this patient and do A, B, C, and D?” and then I went to the nurse, I would be expected to be extra polite.
There is a perception and a need to be extra cautious; otherwise, you’re seen as being bossy.
LoP: The nurses you’re talking about are primarily female?
Dr. Attoh: Yeah.
LoP: This is a woman-to-woman thing.
Dr. Attoh: There’s that, and there are your male colleagues who usually relate to you as a ‘normal’ person. But when, for example, you have emergencies with your baby, they try to be nice and to cover for you, so you can do what you need to do, but there’s always this, ‘Oh, be soft on her- she’s a woman’ statements that come in, and we don’t get treated the same; it’s subtle. But it is there.
LoP: Some of those allowances are necessary because you are a mother. But the weird thing is that you are not just being a mother for yourself – you are doing it for your partner and family.
Dr. Attoh: Oh no! I get you. As I was saying earlier, if you don’t have that aspect of your Life (children and family), it is used against us. Like these career women are too bossy! That’s why they don’t have husbands or a family. The traditional thing is a woman is supposed to be submissive. If they feel like a woman is high and mighty in her work, then they cannot be a wife at home.
It’s just a prejudiced idea that people have. There is the work thing that there. There is also the dealing we have with patients and their relatives. When the patients and their relatives enter our work environment, they see a team. The first thing that’s assumed even if the person who passed by is the orderly, if the person is male, that person is thought to be the one in charge, as opposed to you, the female!
You are always assumed to be the nurse, and you have to make a conscious effort to say, ‘Hello, my name is Dr. Attoh. I’ll be the one taking care of you.’ If you have a younger colleague, what you call interns, after seeing a patient, they come to me to discuss the case so we can make a firm decision moving forward.
Sometimes they’ll say to the patient, “Please hold on, let me get my attending doctor so we can give you a concrete plan.” They don’t realize they are still waiting for the doctor because they were expecting to see a man!
Dr. Attoh: For my colleagues? It is even more of a disadvantage if you are female and you are small.
It is like, “The specialist will come and talk to you now.” Then you open the drawing-room curtain, and people look at your face like, “Oh, the doctor told us we were waiting to see the specialist.” ‘Yes! That is why we are here. I’m the one. I am the one you are waiting for.’ (laughs)
It will take a long time for people to come to the realization that the doctor can be female and a doctor and can be in a tough specialty such as an Ob-Gyn, Orthopedic surgeon, Neurosurgeon, or Cardiothoracic surgeon. We are the best they can find. It will take a while to get people to understand that.
LoP: I gave birth to three sons. I remember questioning God because as wonderful as it was to have sons, as a strong woman, I would never get to be that kind of an influence on a daughter. I came to peace with the idea because my sons will know that the first woman in their Life showed them that women are strong.
Your son, Dr. Attoh, will only know that women have always been surgeons and doctors because that is his world, and if your colleague, who is a cardiothoracic surgeon, has children, they will only know women can be that type of doctor, too. It will take a whole generation to normalize. Your son will always run up against people who say, “Well, women can’t do this.” And he will say, “You don’t know my mother!” At some point in time, this will all be a non-issue.
Dr. Attoh: Yes, hopefully.
LoP: The changes are there around us. Progress around equality and equity is happening.
Dr. Attoh: The only difference here is that we need to speak up if we want a woman to be treated equally.
People are given the same opportunity to get into Medical School. In other spheres of life, women should be given the same opportunities at every level, no matter how difficult people feel it is; every level should be open to women if they want it.
The different stages in a woman’s life are sometimes used against us, and people say things like, “Oh, she should go off and be having babies, or she’s hormonal.” [Editor’s note: Males are hormonal as well.]
Yes, she is hormonal! All these things are just a part of who we are. They are necessary for society to move on; if a woman refused to have children, that would be the end of society!
We should support women in every aspect of their life.
LoP: What about if your son decides that he wants to be a stay-at-home dad?
Dr. Attoh: Well, it will be weird in this part of our world for him to decide to be a stay-at-home dad. It is something that’s almost unheard of.
We still are very traditional in our minds when it comes to the role the man plays. The woman is primarily the caregiver. So, if he were this big-time doctor who decided to take the time to stop working and stay at home and take care of his kids, everybody would be talking. They would be shocked because they have never heard of such a thing. All his friends would laugh at him. It’s not a man thing to do here.
LoP: How did your dad feel about you following in his footsteps?
Dr. Attoh: Unfortunately, my dad passed away before I started Medical School; I’m sure he’s happy in heaven. My mom and my other siblings were like, “Yay, she took after her Daddy!” so everybody was happy…
LoP: How many siblings do you have?
Dr. Attoh: There are six of us; I am the last one.
LoP: You are the baby! Are all your siblings in the medical profession?
Dr. Attoh: No, the oldest is into IT, the second one is into construction, the third one is a pilot and a lawyer, the fourth one is into fashion, the fifth one is a journalist, and I’m the only one who is into medicine.
LoP: Of your siblings, how many are female and how many are male?
Dr. Attoh: There are three boys and three girls.
LoP: Tell us a little bit about your mom.
Dr. Attoh: My mom is 60. She was a housewife initially, and then she started doing some trading. She has a shop where she retails ladies’ bags, shoes, and stuff—basically, accessories. My dad was very busy, and he was very strict as well. So, my mom was the one that we would usually go to. I was 18 when my dad passed away. All of us just naturally gravitated toward her. She’s the one you would call if you needed anything, and she helps all of us take care of our children. It’s a great support system.
LoP: Was she your early influence then? Did you see her getting continued education and working?
Dr. Attoh: My mom didn’t get a formal education beyond, and so, then, that was from five. Now the educational system is different from what they had. Yea, so she did not go to the university, that’s what I mean. What she had would be equivalent to the AG SCA levels.
LoP: Can we compare that to a high school equivalent?
Dr. Attoh: It is like the UK system – so, high school before you go to university.
LoP: Did she go back for training so that she could open her business?
Dr. Attoh: It was just informal training; she didn’t go back to school.
LoP: You and your two sisters all are working professionals. What was your role model for that? What made you think that was a path that was open to you?
Dr. Attoh: My mom is very open-minded, and she is someone who just wants you to do what you want to do. She supports you all the way through. She has always said she wanted to be a nurse. But once she started to have kids, she decided to take care of her children. She is one person who always has believed in you achieving your things, whatever it takes. She would visit us in school, and bring us whatever we needed, just to make sure we achieved whatever we wanted to achieve! For her, it was just do what you want, and she supported you throughout.
LoP: I don’t know much about society in Ghana. I know for me growing up in the 60s and early 70s in the United States, there weren’t a lot of female role models, but there was a changing cultural revolution happening.
I’m the only child of my father, who instilled in me a sense that I could do whatever I wanted. The first thing I wanted to be in my life was an astronaut! [laughs]
What was the first thing you wanted to be?
Dr. Attoh: I’ve always wanted to be a doctor.
LoP: And when you were little, was that what you played?
Dr. Attoh: Yes. They buy you these like little sets to play with when you’re little. I always got the kitchen set and the doctor set! [laughs] It was something I always said I wanted to do.
LoP: You experience the birth process regularly as a delivering Obstetrician. This is something that is a life-altering event for everybody else. How did being an ObGyn effect you when you gave birth?
Dr. Attoh: I have a 2-year-old son. I had him after trying for a while. I had to be in hospital sometimes. So for me and being an Ob-Gyn patient, it’s had such a great impact on me.
We tell patients some things; you know, when patients are trying to have babies, and they are being too anxious. You tell them to try to relax.
Even though you’re managing them medically, you’re also telling them to relax. When it is you, you realize it’s not that easy to relax!
Being patient and, on the other side, was quite an eye opener. I think it’s made me a better doctor. I had to have a C-section to deliver my son. He was in the breech position. I remember feeling all jittery, even though I had the two best ObGyn doing the procedure for me!
Being a patient and being so vulnerable helps me to be a better doctor. When the patient says something, I’m a bit more empathetic. I appreciate my work more.
LoP: Do you believe that this strong maternal instinct just shows up when you’re pregnant that you didn’t think you were capable of before?
Dr. Attoh: I think once you realize you have this strength, you then have a sense of having to protect the little one. I think that is something you would never know if you hadn’t been through the process, especially if you had a pregnancy that was a bit tense and had a bit of complication. You have to tap into your inner strength and be strong for yourself and the little one you carry.
You learn to be extremely selfless because sometimes you have all these aches and pains, and you wish you could get it over and done with. But then you find the strength to move on because you’re thinking about this little one. Then all your senses just want to protect. So, I keep telling my male colleagues that sometimes they will never understand.
One time, a patient came and said she had pain in between her legs. In your vagina? She says no. That’s in your most pubis? She says no; I said what is it like? She says it’s deep down inside. I was thinking, and I examined to have a look. I press down. Does this hurt? She says no, and she is describing to me what, no matter how many times it is described to a male colleague, they would never understand.
When I went through it, it was like, okay! Sometimes you can’t find the words to describe it.
I think at the end of the day, the extra advantage for us females that we have over our male colleagues, and even over the females in ObGyn who haven’t been pregnant before or had their own babies, is we understand more of what is happening.
There is this extra care that we have deep within us for humanity, and I think our instincts are a bit sharper than our male counterparts. This sounds like an argument, but that’s how strongly I believe in these instincts. They are a bit on the higher side, and so we do better for our own kind, and we do better in ObGyn than our male colleagues.
LoP: I want to ask you more about breastfeeding. What are the current trends in Ghana around natural mothering?
Dr. Attoh: Globally, and here as well, it’s recommended that the mother does six months of exclusive breastfeeding, and then start with complimentary feeds, and continue breastfeeding up till the child is aged two.
Many mothers do not do that with work, careers, and everything. They try as much as possible to do the six months, but the big issue here in Ghana is that maternity leave is for three months which is 12 weeks. If they add up their annual leave, that gives them the maximum. The mother will be staying at home with a baby for four months, during which time she can exclusively breastfeed if she wants to. Subsequently, she would have to either express milk as an option or have somebody else do the feeding while she is away at work. Most work environments do not have a room for mothers who want to express their milk.
Most facilities don’t have daycare. Even large corporations, you would expect them to have a daycare! Intermittently, the worker could breastfeed the child and return to work. That concept is almost nonexistent here.
Only a few, very, very few offer this – you can count them on the one hand!
Usually, by the fourth month, most mothers will start introducing the complementary feed. Or, if they can manage it, breastfeed the baby for six months to one-year maximum.
When I began my residency, for example, my son was four months going on five months.
I live about one hour drive away from work.
So, I would usually be up by 4:30 am to breastfeed him for the last time even though I might have been breastfeeding him throughout the night.
Sometimes I would express breast milk, and the dad would feed him in the course of the night so that I could get some sleep.
By 4:30 in the morning, I’d do the last feeding, and then I’d have to express the other breast and put it in the fridge before I went to work.
When I would get to work, by 2 pm, I would have to stop whatever I was doing, take some 15 minutes off to pump the milk, put it in the freezer, and then go back to work. Because my mom was at home with our son, she gave him expressed milk, and he could be exclusively breastfed for six months.
When I started complementary feeding, I continued expressing the milk and adding it to his feed for up to a year. By then, I had to combine working on my master’s degree, my residency, being a mommy, being a wife, traffic, etc.
I did that for one year and one month, and that was it.
Many women can’t afford formula. They’ll buy it, so the father feeds the baby, or they add it to the porridge and smoothies they make for their babies, and then basically that’s it.
It is because the work environment and careers do not allow breastfeeding for that long.
LoP: One of the challenges in many countries is that, of course, as women, we want to have our careers and our work and our mission. Many of us also want our families, so we’re doing both of those jobs at the same time, but it has gotten to a place in the United States where it’s challenging.
Dr. Attoh: It is a major responsibility for the woman, and so, if she gets maternity leave, most workplaces don’t even have paternity leave. If they do, paternity leave lasts for just two weeks or a month max.
So, then the dad will do what he can when he gets back from work to support, but it is solely the responsibility of the mother. When the mother goes back to work, the child is usually cared for by the grandmother. With the grandmother, the child is in great hands.
But here’s the case. Let’s say in that era when my mother gave birth, her mother was a housewife or used to work trading, like buying and selling. She could sacrifice her time to come and look after your baby. Now people who are my mom’s age have their careers, and they also work in the universities and our offices. If that grandparent hasn’t retired, they must be at work. That brings in a lot of children being handled by nuns. In my case, I was lucky my mom does a business where she could let other people handle the work so she could come to take care of my son.
LoP: You were fortunate. Your whole nanny system of childcare, then, how are they trained?
Dr. Attoh: This is an everyday thing. Some agencies train nannies to care for babies, but traditionally, your mother usually lives in a smaller town or a village. They have somebody let’s say, a distant relative of yours, who might not be too well-to-do or might not have too many resources to take care of their children.
Sometimes it might be a girl between the ages of 18 and 25. They don’t have much money or many resources. She is then brought to you, and you train that person to look after the baby when you are not there.
You give the person a monthly stipend, or you agree on the amount of time that the person is going to spend with you, and then at the end of that time, you give them some money or some equipment to start a business themselves.
LoP: That still puts the baby at risk, though emotionally.
Dr. Attoh: Well, it is assumed that because it is a distant relative or someone close to you, they would have some connection with your baby, and they will take good care of the baby. But these agencies are springing up a lot nowadays. You see adverts for these agencies which take the nannies through formal training on how to take care of children, but as with everything, they are few.
Some people are not too good, and you hear of cases of nannies neglecting the children and watching TV instead of caring for your baby.
Some established schools have care systems and have also started admitting children as young as six months. Mothers can take their child to daycare.
LoP: Is your daycare subsidized by government?
Dr. Attoh: No, they are not. You pay for it, depending on the kind of daycare you want and the location.
LoP: One must look at one’s salary and then at how much they pay for childcare.
Dr. Attoh: Fortunately for some of us, considering our work, we can afford care. When I gave birth in March 2020, during the COVID pandemic, people were working from home.
You don’t have that luxury for a female doctor, especially in a surgical discipline. You can’t say, ‘Oh, let me take some time off and go, be a mommy for a while.
LoP: So, as a pregnant mom who had to interact with people during the beginning of the COVID19 pandemic and before the vaccine, what was that like for you?
Dr. Attoh: When the first few cases of COVID came into Ghana, I was still pregnant and doing a lot of outpatient consultations.
My doctor didn’t want me standing long hours in the theater, so my schedule was a lot of outpatient consultations. That meant I was in contact with many people – mostly pregnant women and those coming to the fertility clinic.
There’s no booking system. Many patients came in at once; it was scary initially.
I had to be extra cautious, so I took many precautions and observed all the protocols. Fortunately, the Ghana health service put in some regulations that allowed pregnant women to go off work. Those who were freshly breastfeeding got off work, and those with cardiac and respiratory issues were allowed to go off work. I was about 30 – 32 weeks pregnant when I stopped working.
LoP: This is really an incredible moment in history on all levels. Social scientists and researchers will collect data from this time for at least the next 50 years. There’s information about more miscarriages and late-term fatalities throughout this time. It appears that COVID not only affects the mother but then also affects the infant. Have you been noticing these kinds of things?
Dr. Attoh: The universities and those who do public health like doing all the research, as you said, to come up with the actual connections between these things.
However, even though we don’t have the numbers and the data to say for certainty, we noticed early on that those who contracted COVID were coming in with preterm labor. By mid-trimester, late trimester, they get COVID, and the person goes into labor. That’s what we observed. During the second wave, that was what was happening a lot. We have yet to put the data together and develop this solid connection between the two.
LoP: You were one of those pregnant moms during that time and were forced into your work arena because of your chosen occupation. Did they mandate the vaccine in Ghana?
Dr. Attoh: I think the issues with the vaccine here are the same as everywhere. Some were happy that the vaccine was here and quickly went in to get the vaccines done.
Then they are those who were, are, very skeptical about the vaccines because of all these conspiracy theories that are going on.
A lot of information went around, false information, that the vaccine is meant to make people sterile and that if you take those vaccines, you will be unable to have children.
Also, when the first batch of vaccines was started, they were not vaccinating pregnant women, so many people were, “uh hunh, if it were good enough, you would administer it to the pregnant women…”.
Some health workers were also not convinced.
Even though I was breastfeeding, I went in for the vaccine, and one of my colleagues asked if I was scared. I’m like, no, I’m not scared. Read the literature! I think I’m quite convinced. “Okay, so those of you who are taking the first batch of the vaccine, if you don’t die, then we’ll take it .”This was another colleague saying that to me!
Meanwhile, all doctors were supposed to be part of the first batch of people who got the vaccines, but some just refused to take the vaccines. Until now, there are places in Ghana where people do not believe COVID-19 happened and still believe there was no COVID thing.
LoP: I want to shift now to the treatment of pregnant women in Ghanaian society. Earlier, you mentioned the importance of relaxation during pregnancy. Ghana has many rural areas. What do you see in terms of trying to protect and preserve the environment of pregnant women, whether urban or rural?
Dr. Attoh: In general, pregnant women are treated special. People get up in the buses for them to sit down, people help them to cross the road, and people allow them to cross the queue.
When they come to the hospital clinic, it is run as a conducive environment as much as possible to protect them.
However, they will return to the environment they originally left. Not much can be done about the person’s home environment. Pregnant women are treated specially as a community both in Accra and even in rural areas. If anybody tries to do anything remotely bad to a pregnant woman, that man, that person, is in trouble. There are all these myths about how very special a woman carrying a baby is; it is like extra special, so they are very much protected here.
LoP: That’s great that they are so protected. When the baby is born, does that protection for mothers and young children carry on into the young child’s life, or is there a significant shift?
Dr. Attoh: When the babies are just freshly born, there’s extra care and attention. Everybody comes around to lend a helping hand and bring you gifts. They try to make you eat a lot if you are going to have breast milk to feed your baby. It goes on for a long while. Nationally, we have a special ministry that takes care of women and children.
All these special initiatives under the Ghana health service are specifically directed toward mothers and children under five. We have nutrition, and malaria prevention, programs for pregnant women, children under 5, etc.
LoP: Do they have adoption agencies? Are there children without parents?
Dr. Attoh: Yes, the social welfare system takes care of children who are put up for adoption, and the process is a bit long and a bit cumbersome. However, they work. The systems here have children’s and foster homes where children who’ve either lost their parents or been abandoned by their parents are taken care of by the government. Some churches and religious bodies also have a few of these homes.
LoP: Can you tell us a little bit about your husband?
Dr. Attoh: My husband, Emmanuel, is a banker. He works as a credit analyst in one of the biggest banks in Ghana, and when he met me, I was already a doctor.
I tell this story of the first day I met him. I was driving up the motorway when I realized that when I speed, he speeds; when I slow down – he slows. I’m like, why is this guy stalking me?
At the end of the motorway, I turned off the road to the hospital, and then he follows me to where I parked, and he is like, “Oh, hi. I saw you smiling at the tollbooth, and I thought your smile was beautiful!” I’m like, okay. Then he says, “What type of doctor are you?”
LoP: How did he know?
Dr. Attoh: EXACTLY! That’s the thing. Most people see a woman turning into a hospital, and they think they work in a hospital. They assume you are a nurse or a dietician or something.
So, the fact that he didn’t call me a nurse was the reason why I even spoke to him in the first place.
Almost two years after that meeting, we got married. He has been supportive of every step. When we met, I was an intern. We have a mid-level doctor here, which we call a medical officer. This position does not exist in the US because, in the US, you move from being an intern to going straight into residency. Here you have a three-year gap where you can be a medical officer and don’t have a specific specialty. You work as a GP does.
I was through the three years I was a medical officer and worked in ObGyn – those were long hours, long shifts, and night duties. He was ever so supportive and would wait for me to close and take me home, bring me breakfast, and if I needed to go somewhere, he would drive me there.
When it was time for my exams, he made printouts of my work while I studied. When the stress of the work gets too much, and I go off at everybody [smiles], he tries to, you know, be the emotional support.
I think for most women in medicine and other professions, you get busy, and you really need a man who is not shaken by the fact that his wife is climbing up the ladder or by the fact that his wife has all these odd emergency hours — a man who believes in your dream and does everything they can to help you to achieve them.
When I was doing my master’s residency, being a new mommy, it got to a point I almost decided that I would have to drop one of them.
Because it was just becoming too stressful, he would always ask what he could do to help, and you know, he did everything he could, so I didn’t quit.
I didn’t quit. I was still there, and my husband is still supporting me.
LoP: That’s wonderful! Your son sees that as well. Seeing his dad be a role model of all the things a man can be rather than just being limited to specific role expectations. This is why I asked about your son having the option one day to be a stay-at-home dad. As much as women struggle to break out of traditional roles, many men also want to break out of their traditional roles.
Dr. Attoh: Here, if the woman decides to be laid back, stay-at-home, that’s fine, but that cannot be said for the dad. The man has to be hustling.
LoP: Your husband has made certain sacrifices to pick up responsibilities with his son. Are there glass ceilings for you in your career?
Dr. Attoh: Once you get beyond becoming a specialist, to become a consultant in your field is like up there. There’s not much suppressing that anybody can do to you because you are up the ladder in your work.
However, to society, you are still a woman. Even though I might be a consultant at work, and now all the nurses and other colleagues acknowledge that I now have a fellowship in ObGyn and a subspecialty and will be a consultant, there is nothing they can say.
But in the eyes of society, if I walked into the room with my male colleague and they wanted a doctor to address, they would still look to my male colleague instead of addressing me.
LoP: Is this something you talk about with your male colleagues?
Dr. Attoh: It is something we say openly, yes.
LoP: What is your passion now? What is next aside from obviously loving and nurturing your son and your family?
Dr. Attoh: I mentioned my master’s degree. It is in public health.
Apart from the clinical work, I intend to have time and finish my fellowship. I want to go a bit into public health, which gives you more opportunity to be outside the clinic.
I can be involved in it for now in my little, small way, with my social media handles, my WhatsApp status, and everything I keep saying.
In public health, we can travel to other places and encourage more people. I want people not only to take good care of their health as women but to be able to come out and be who they want to be.
LoP: The public realm is a challenging arena sometimes, but that is where policy changes happen. Having delivered so many babies in your career, how do you feel now being at moments of birth, is it still miraculous?
Dr. Attoh: Ohhh, every single time. [Huge smiles]Every. Single. Time. I am like, oh boy, I can’t count the number I’ve been with.
I have been doing cesarian sections every day or other day since I have been out of the theater. Every time I pop a head out of a uterus, I … look! [swoons] Babies just make me happy!! It is just a joy, and it makes it all worth it.
Because of face masks, and even before face masks, many patients cannot recognize me. But sometimes you meet someone in town, and they are like, “Doc! Doc! Look at my baby!” One day, my husband sent me a picture of a child. He said they are here in the bank; the mother saw your picture on my desk and said you delivered this baby.
LoP: There must also be a certain amount of heartbreak in your job when things do not go well?
Dr. Attoh: Neonatal death is tough. Miscarriages are tough. Infertility is tough. And breaking bad news is really tough.
You know, they teach you to be empathetic. Don’t be sympathetic when the patient is crying, and don’t cry! There have been a few times where I’ve had to hold my lower lip to stop from shedding a tear when the situation has become quite sad.
Those days come. And when they arrive, you have to encourage yourself and tell yourself for this one loss, you had many successes.
For this one patient who couldn’t get the best outcome, I have brought a lot of happiness and positivity to others’ lives. I can encourage myself; it can all be good.
LoP: Are you a religious person?
Dr. Attoh: Yes, I’m Christian. I love God; I love my church.
LoP: And so, in those moments of good or bad, have you felt a connection, a presence?
Dr. Attoh: Yes, I do. Before I start my day, every day, I say a little prayer. When I am up in the morning, I say my prayers for myself and my family. I pray for all my patients and tell God to heal them from whatever they are going through. I’m just a vessel or tool through which they receive the healing.
When it’s bad, sometimes I want to argue with God, sometimes I want to ask him questions, but most of the time, I just say a prayer and give thanks anyway, and sometimes when the moments are really bad when I sit down to meditate, I put on some Christian music. It calms me down.
Ultimately, God laughs, and then he uses some of us as an instrument to bring healing to people.
LoP: What would you like your legacy to be?
Dr. Attoh: I want to be known as the female doctor who did her best for her patients and brought light wherever she went.
Especially for young girls, but all young people, in general, to be able to look at me and say, oh, because I came across Dr. Attoh, her Life inspired me to achieve what I achieved.
What do I want for my family? I just want to be someone who makes them happy. [smiles] My family, work, and religion are the most important things to me.
LoP: I see you as moving the loop of Life forward. I think of how unique you are today, and maybe someday, a woman doing what you are doing won’t be special because it will just be normal. You are pushing the loop forward on behalf of all of us women, and I want to thank you for that.
Dr. Attoh, it has been my pleasure to speak with you today. I so appreciate you and the excellent work that you do.
Dr. Attoh: Thank you so much!
Comments by Sopa de Piedra