I just returned from taking the nursing exam in Accra. Only a few questions covered the material I studied but still, it was not a difficult exam, and for once in my life I did not feel compelled to score well. I am quite sure I passed and that will be enough. It was however, a frustrating experience. I learned at the exam that if I want to be registered as a midwife in Ghana, after the results are out for this exam and after I complete three months of full-time unpaid “orientation” at a teaching hospital, I must submit another application, pay another fee take another exam and do another three months of orientation in order to be registered as a midwife. Since I will be in the US in June - working for money so we can eat - I won’t be able to take the midwifery exam until next December, which means I will not be registered as a midwife here until mid-2010!! This kind of ridiculous bureaucracy is what bring me to the point of wanting to pack my bags. It is not the struggles of daily life or even the tragic and stressful experiences in the hospital, but the nonsense roadblocks set up to prevent people from actually being useful in the areas where they are most needed.
We were 20 foreign-trained nurses taking the exams to become registered in Ghana. Most of those in the room were Ghanaians who had trained in the UK or US and were returning home for a period to work and help their country. During the break between the exams, nurses traded story after story of how the Nurses and Midwives Council made every step of the process difficult. Several nurses had started the application process two years previously. While in Accra I also heard stories from another nurse returning to the public sector after leaving the field years previously to raise a family. She was required to complete six months unpaid orientation in the public sector, in a town two-hours from where she lives (she rented house and paid for transportation without an income). Since completing that phase she has spent the last three months waiting for an interview so she can begin work. Another nurse who was trying simply to transfer back from the private sector to the public sector was also made to work a six months unpaid orientation. Somehow a punitive mentality seems to be obscuring the vision of what is required to create a better health system. Ghana, like most of Africa, suffers from a severe nursing shortage. While it is necessary to monitor the caliber of nurses coming into the system it should be possible to streamline the process for the benefit of nurses and more importantly for the benefit of those receiving health care at public facilities.