After 18 months of investigative reporting at a private health facility in Accra, The Fourth Estate’s Evans Aziamor-Mensah and Seth J. Bokpe have uncovered a frightening case of ‘Matron Gaga’, an unlicensed midwife whose 30-year track of malpractice has resulted in numerous medical accidents including the death of at least two newborn babies.

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June 24, 2020: the case of Kate

Inside the labour ward of New Generation Medical Centre, a private clinic in the South Odorkor Estates at Sakaman in Accra, Kate Tetteh (not her real name), a heavily pregnant beautician was writhing and groaning in pain from her first labour pangs. As her contractions peaked, her screaming grew louder.

But the nurses on duty found that funny: they laughed out loud.

“They were even teasing me,” Kate, 28, recalls in disgust.

All she wanted at that point was professional assistance, as one would expect from a health facility. What she got at New Generation was derision. Her request for her fiancé and her mother to be allowed in to soothe her was summarily dismissed.

The ordeal became even heavier than she anticipated.

The beautician says she felt like she was between life and death, alone. She says the professionals who should have been her helpers became her tormentors.
“When my baby’s head was visible, the midwife who was the one delivering me wasn’t around.”

The ‘midwife’ in question is Francisca Quaye alias Matron Gaga. Matron Gaga had apparently taken some time off her busy cooking preoccupation to visit the nuisance of her patient who was admitted to the facility to deliver a baby. Kate says Matron Gaga walked into the labour ward to check on her holding a cooking utensil in one hand and vegetables in the other.

“When she returned, she was holding a knife and an onion or something; I don’t remember. I didn’t see her again for like five minutes.”

Kate’s ordeal and loss

Kate, who lives in Accra, says she first visited the New Generation Medical Centre on June 24, 2020. According to her antenatal records, she had a normal pregnancy, with her baby kicking from time to time as expected. According to her scan, she could deliver any day between June 19 and 30,2020.

And then a strange thing happened: even though Kate still had a week left within the expected delivery window, Matron Gaga, contrary to all established medical practice, decided to artificially induce labour by prescribing the oral medication Cytotec.

And then she asked the confused expectant mother to go back home.

Cytotec is used to induce labor in women. It works by softening the cervix to allow easier dilation and producing contractions. In most cases, Cytotec is a safe and reliable medication that can make labour easier for women in distress when administered correctly. The Reproductive Health Centre of the Korle-Bu Teaching Hospital however warned in 2011 that Cytotec abuse can cause infertility and even death.

Kate recalls the ordeal that ensued after the unnecessary artificial induction.

“I felt weak, [but Matron Gaga] asked me to go home, [and] roam until I felt pain, then I could come. I boarded a taxi and went home. But I couldn’t sleep. The pain was unbearable. I was feeling the pain and I called her and she said I should come when I felt more pain. I went through pain from 10 am to 6 pm”.

Kate says she cried until her neigbour convinced her to return to the clinic. Then her nightmares began.

“Initially, my baby was kicking. My baby was very strong. He used to kick me and I would even be crying. When [the midwives] started pressing my stomach, I didn’t feel him again. But it was my first time, so I thought it was normal,” she recalls.

Kate remembers Matron Gaga using “something sharp” to cut her “down there and “pulling” her baby boy out.

“When my baby came, I didn’t hear him cry. I expected the baby to cry because there were days I went to antenatal and would hear newborns cry. When I didn’t hear mine cry, I asked [Matron Gaga] why. She said the baby was tired and that he would eventually cry.”

Mother-child bonding is essential for normal infant development. New mothers will hold their babies next to their bodies, rock them gently, strive for eye contact, sing or talk to them and begin to nurse. Often within just hours of birth, mothers report feelings of overwhelming love and attachment for their new baby. As a convention, newborn babies are handed over to their mothers as their first opportunities for bonding. In Kate’s case, this did not happen.

“I forced [Matron Gaga] to put him on me. It didn’t even take a minute and they took him off me and placed him on a chair,” laments the horrified beautician.

The nightmare continued.

“I raised my head and saw one nurse cleaning my baby’s nose. There was blood from the nose. I asked the nurse what she was cleaning. They didn’t want me to know what was happening.”

Instead, Francisca Quaye and her team turned to congratulate her. They even poured powdered talc on her, a ritual to celebrate victory.

“Someone went to call the doctor. But I didn’t hear what they were saying because I was in pain. I saw his facial expression, and it wasn’t good. What I heard was [the doctor asking]: ‘Why didn’t you come and call me?’”

Matron Gaga then followed him outside. When they re-entered the labor ward, the doctor proceeded to “beat” the newborn baby.

“[He] was beating [my] baby. I didn’t know what was happening. I thought it was [normal] so I kept quiet for them to do their work,” Kate recalls.

Kate was then moved to a recovery ward where the horror continued.

Kate’s mother suddenly came in crying. When asked why she was crying, no answer came. The Fourth Estate can confirm that the clinic’s poorly kept records show, however, that Kate had a stillbirth.

She became suspicious when she saw her baby wrapped tightly, but Matron Gaga falsely assured her that her baby was being referred to the Korle-Bu Teaching Hospital because “it wasn’t breathing well”.

That was Day One.

The next day, she was discharged.

“I was told I should go home for like three months before I could come for my baby,” Kate tells The Fourth Estate in disbelief.

When she insisted that she wanted to be with her “sick baby”, Matron Gaga assured her that she would be assisted to visit her child at Korle-Bu that night.

That night, the clueless mother held a vigil in pain and in anticipation. Needless to say, Matron Gaga’s call did not come. Instead, she lied to Kate that she tried to reach her during the night, but she was deep in sleep.

“She said she came and called, and I didn’t mind her, so she went with the doctor and my baby to Korle-Bu and [that] they put him in a machine.”

Soon, the reason for the baby’s referral changed from respiratory complications to the presence of a brain tumor. When she expressed confusion, Kate says Matron Gaga put her through to a “doctor” in Korle-Bu.

“She put the phone on loudspeaker and the person was talking. [The person asked]: ‘Are you Kate? Your baby has a brain tumor, and a lot of issues,” narrates Kate, who believes a New Generation Medical Centre staff member conspired with Matron Gaga for that call.

“They said my baby had a brain tumor so they would want to leave him in the machine so that he dies in the machine because if they brought my baby to me, it would become a burden on me,” Kate explains.

On day three, Kate’s worst fears were confirmed: her mother confessed to her that she lost her baby at birth.

Kate says almost two years after that fateful experience, New Generation Medical Centre is yet to officially communicate the death of her baby and its cause to her. Normally, each health centre in the district is required to submit monthly reports to its supervisory facility, the Ablekuma North Municipal Health Directorate. But these reports, The Fourth Estate has learned, are often “sanitised”, and do not reflect events at the private clinics.

The phony matron, Francisca Quaye, said she sometimes delegated the preparation of the report to her junior staff. The head of New Generation, Dr. Ralph Obeng Owusu, admitted to The Fourth Estate that he does not pay attention to such records.

According to Kate, “Even when I went for the dressing and asked [Matron Gaga] if my baby was dead, she asked me who told me my baby was dead, and that, I shouldn’t mind them.

“It was later that I whatsapped her that I knew my baby was dead and that she should forget it.”

“My baby would have brought me a lot of joy because my baby daddy said he would marry me after [I give] birth. Now, he couldn’t marry me. I don’t think I can give birth again. Maybe I’ll adopt or something like that.”

Stitching gone bad

Going through the ordeal and losing her son at birth was not the end of Kate’s suffering at the hands of the fraudulent midwife Francisca Quaye. The bereaved mother discovered that her perineum was very badly infected. The perineum, which is the area between the vagina and anus, is liable to tear during childbirth. After delivery, the doctor or midwife usually closes the perineal tear with stitches. The stitches usually dissolve in a week or two, so they will not need to be removed. In Kate’s case, the suturing was done so badly that the entire region was septic.

“[Matron Gaga] told me to sit on hot water after 10 days. I did, but the thread tore, and it became sore and became big like a gutter. I took a picture and sent it to Dr Ralph Owusu. He got pissed and asked who did that to me. I told him it was Francisca [Quaye]. He told me to come so they could stitch it again.”

When Kate arrived at the clinic, she met an angry Matron Gaga who demanded to know why she sent the picture to her boss when it was, she who did the stitching.

“She got pissed… said I wanted to get her sacked. She said the doctor insulted her that she didn’t [close the perineal tear] well. They had to re-stitch it,” remembers Kate.

For the next three months, Kate couldn’t walk.

“Since then, I deleted all their numbers. I don’t [want to] have anything to do with them,” she told The Fourth Estate in July 2021.

That series of painful episodes at the New Generation Medical Centre has destroyed many things in Kate’s life — her baby, her relationship, and the idea of ever-carrying a baby. The trauma has left a scar in her life.

“My baby would have brought me a lot of joy because my baby daddy said he would marry me after [I give] birth. Now, he couldn’t marry me. I don’t think I can give birth again. Maybe I’ll adopt or something like that.”

“A midwife cannot do induction on her own”

Unconventional midwifery

When Kate’s induction ordeal was reported to the Midwives Association of Ghana, the President of the group, Mary Ofosu, described Francisca Quaye’s action as unconventional and 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.”

She was not done yet.

“You can do induction of labour when the client is post-date. That’s when the doctor can prescribe induction of labour or when there is maybe some medical condition like pregnancy-induced hypertension,” the professional midwife with 16 years’ experience explained.

In addition, regarding the secrecy around Kate’s stillbirth, Mary Ofosu made it clear that a mother who loses her child at birth must be told before she leaves the health facility.

July 6, 2021: the case of Esther

On Tuesday, July 6, 2021, Esther Baker, 31, delivered her first baby. For a period of four hours, she suffered the most excruciating pain in her life. This was the longest four hours of her life.

She nearly bled to death. Medical practitioners call it post-partum haemorrhage, which research says accounts for 24% of all maternal deaths in Ghana. Experts say it happens within the first 24 hours after a baby is born. The most critical time for post-partum hemorrhage is the period from the birth of the infant until the placenta is delivered.

The night before she went into labour, Esther, a worker at a savings and loans company, said a part-time midwife who ran the night shift at the New Generation Medical Centre wondered why she had not been referred to a bigger hospital. She recalls:

“She said my age and [my] past record [with] miscarriage could cause some problems. She was like, immediately, they had to give me a transfer and that I shouldn’t deliver there.”

Given her history, Esther was very concerned, but she put her trust in prayer for divine intervention.

But that night, a midwife, whose name Esther remembers as Abigail, assured her that all was well. With that assurance, Esther prayed silently that Abigail would be the one to deliver her first bundle of joy, four years into her marriage.

Alas, this was not to be.

The night passed at the New Generation Medical Centre without any incident. The clinic is popular for affordable care. The icing on the cake for its poorer patients is that it accepts National Health Insurance. At the height of the COVID-19 pandemic, it was one of the vaccination centres.

And then morning came. At the point when Esther was fully dilated, her body became the grounds for a turf war between midwife Abigail and the clinic’s matron, Francisca Quaye.  Matron Gaga, disagreed with her staff’s professional assessment of the situation and proposed a rather bizarre remedial action. The two argued: in the end, Abigail had her say, and Matron Quaye her way.

“Abigail is a professional midwife,” observes Esther. “It’s like a ‘by force’ something that [Matron Gaga] was doing. She doesn’t take her time attending to the person in pain. Hers is to just rush you and that you shouldn’t be that soft.”

From janitor to midwife

The Fourth Estate’s investigations have revealed that Francisca Quaye has 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 Nursing and Midwifery Council (N&MC) renewable annually. Any exemptions to this rule may only be granted by the board of the N&MC.

Francisca Quaye has neither a license nor an exemption.

Eventually, Francisca Quaye delivered babies, undertook incisions (episiotomy, which allowed the birth canal to open for childbirth), and stitched afterward. When the doctor got too busy with patients, she handled consultations for outpatient cases too.

In the last 18 months that The Fourth Estate has been digging into malpractice at New Generation Medical Centre, a long list of frightening medical accidents has been uncovered.

Our investigations found at least two deaths under disturbing circumstances while she was in charge.  A new mother nearly bled to death. Two other new mothers needed urgently to have perineal tears re-stitched due to unprofessional sutures and infection and a newborn had her arm dislocated.

Francisca Quaye allegedly also charged National Health Insurance cardholders unapproved fees.

Who is Francisca Quaye alias Matron Gaga?

An ‘O’ level-holder from Ebenezer Secondary School, Matron Gaga claims she cut her teeth in midwifery under the tutelage of her mother at the Dora Quaye Maternity Home at Takoradi in the Western Region. After school in the 1980s, she got a job at the Susan Clinic, where she multitasked— mopping, manning the front desk, and filing forms.

This was where Francisca Quaye met Dr Ralph Obeng Owusu who had returned to Ghana in 1988 after a seven-year stint in Nigeria. For five years, Dr. Owusu ran the Susan Clinic, and when the time was ripe, he poached Francisca Quaye. The two started the New Generation Medical Centre in 1993.

Her multi-tasking became handy at the new facility. With time, she shifted from administrative work to helping as a medical hand—attending to pregnant women on antenatal visits and assisting during deliveries. Eventually, she delivered babies, undertook incisions (episiotomy, which allowed the birth canal to open for childbirth), and stitched afterward. When the doctor got too busy with patients, she handled consultations for outpatient cases too.

“There were times her procedures [were off], and you would prompt her, and she’d tell you that she knew better.”

For the past 30 years, therefore, she has been Dr. Owusu’s sidekick in all respects of the term.

Still, in her early 50s, not everyone views Francisca Quaye as a villain. Some past New Generation patients swear by her care and kindness. They say she lends her ear even to their domestic problems.

“When it comes to marriage, relationships, and life in general, she was very lively. When it comes to communication, she is nice,” a midwife who worked briefly at the New Generation Medical Centre in 2020 remembers.

“She has no limits to love. She pampered and even fed me before,” Kate recalled the days before Matron Gaga’s professional incompetence got in the way of their patient-nurse relationship.

On occasion, Francisca Quaye would offer freely unconventional remedies for medical problems. One former patient recalls her recommending residual water from a washed fufu mortar to treat sores.

Science and superstition mixed freely in her practice—one that has a lot of question marks, The Fourth Estate has learned.

Even many junior midwives doubted her competence.

“I didn’t really know if she was a professional midwife. I still can’t figure it out. There were times her procedures [were off], and you would prompt her, and she’d tell you that she knew better,” a midwife who wants to remain anonymous told The Fourth Estate.

“There was a time I received a baby [Matron Gaga had delivered]. There is this creamy thing on newborns. To keep them warm, you don’t have to clean all of them. She told me what I had learned in school was not what was [done] on the field…She undressed the baby and cleaned everything,” the midwife said.

The midwife is referring to the vernix on newborn babies. The World Health Organization also recommends not wiping off the vernix at birth. The main reasons to wait with your baby’s first bath include keeping them warm and stabilizing blood sugar levels. Babies who are bathed too soon after birth are more likely to become cold and could develop hypothermia.

The trained midwife said she left the facility because she was afraid of losing her license working in a facility where her boss opposed best practices.

What Francisca Quaye lacks in an imposing figure, she makes up for in assertiveness and aggression. Some of her former co-workers describe her as bossy, domineering, and sometimes, insensitive. She is not averse to verbally sparring in the presence of patients.

Some patients find her brutish. With a laissez-faire Dr. Ralph Owusu as her supervisor, her influence has grown to the extent that she can override the decisions of even qualified midwives, earning her the nickname ‘Matron Gaga’.

June 14, 2021: the case of Bernice

As was the case of Kate Tetteh, qualified midwives at New Generation Medical Centre identified that Bernice Owusu’s (not her real name) cervix needed a little expansion to make way for her baby to be delivered.

The 28-year-old delivered her first baby, safe and sound.  Her birth experience with Matron Gaga was however far from smooth.

“When you’re in labour, you’d need someone who is patient with you. For me, I won’t lie, she wasn’t [patient] with me at all. She did everything as though she was in a hurry to attend to something else,” Bernice says, in reference to Francisca Quaye.

Pad left in the vagina

Before long, she felt something was not quite right with her—it was another case of botched stitching after crude episiotomy. The needle and sutures were worked by none other than Matron Gaga.

Bernice says despite the anaesthesia, she felt the pain while the needle went through her flesh.

“She injected the place, but I don’t know how she injected it. When she was stitching and I was screaming, she didn’t want me to scream. The pain was unbearable.”

Bernice took home medications and adhered to the dosages and instructions from Matron Gaga, but the pain in her perineum region was like a vortex. She was caught in a deep pain that gnawed at her sanity.

In about a week, her vagina area started smelling foul. Bernice says she has always prided herself on taking good care of her personal hygiene. Upon some scrutiny, however, she says she was mortified by what she saw.

“I noticed there was something left in my vagina. The Faytex pad they used in draining the blood. It was left there. I had not given birth before. No one told me that I had to take it out when I get home. The thing was there for about a week and started smelling.

“My mom had to check before she realised that the Faytex pad was there and … [the stitches were] torn and my cervix open.”

She quickly reached out to Abigail, the professional night-shift midwife, who advised her to rush to the clinic.

“When [Abigail] took out the thing, the whole room was smelling. She treated me very well and re-stitched the thing. I don’t know how she injected me but when she was sewing, I didn’t feel anything until she was done. I didn’t feel any pain like the first time and she did it very nicely,” Bernice says.

Bernice said she is psychologically scarred following what she went through at the hospital.

Unlike Kate, like Bernice, Esther Baker gave birth to a healthy baby. But it nearly cost her, her life.

The 35-year-old first-time mother switched from Barnor Hospital in Laterbiokoshie to New Generation Medical Centre about five kilometres North West. She was in her fifth month of pregnancy, but the switch was needed for financial reasons.

Each time she visited; she saw red flags. But when poverty conducts an orchestra, it is the poor who nod to the melodies, so she closed her eyes to the flaws.

On July 6, 2021, Esther delivered but there was trouble. Her baby weighed 3.7 kilogrammes.

Nearly fatal

Despite the excruciating pain she suffered, Esther says the resident doctor, Dr. Ralph Owusu made light of her situation and left her to attend to “other” things.

“About five hours after delivery, I started bleeding profusely. I fell unconscious. I don’t know what went wrong.”

According to her husband’s account, Matron Gaga panicked and called for Dr Owusu’s attention. He said she screamed Esther’s name a couple of times before giving the unconscious woman a bottle of malt in an attempt to revive her. A call to Korle-Bu for a possible referral did not yield any results. As luck would have it, Esther’s sister-in-law, who’s a nurse, intervened and got her transferred promptly to the Greater Accra Regional Hospital (also known as Ridge), even as efforts were being made to resuscitate her.

At Ridge Hospital, the New Generation nurses who accompanied Esther were unable to answer basic vital questions posed by their fellow nurses at the referral facility.

“No record was taken of me. Even the quantum of blood I had before delivery. They were just fumbling,” Esther recalls being told by the nurses when she gained consciousness at the Ridge Hospital. This raised curiosity among the Ridge Hospital professionals. Before they could make sense of the cause of the emergency, their counterparts from the New Generation Medical Centre had resorted to a solution to the embarrassment – they bolted.

Fortunately, Esther’s condition stabilised the following day. Apparently, the medical team detected and immediately discontinued a medication that was wrongly administered.

Again, prior to delivery, Esther recalls that the team at New Generation Medical Centre had administered Cytotec “when I went to antenatal in the morning and when I dilated, one [Cytotec] came out.” The doctors at Ridge “suspected that to be the cause of the excessive bleeding”.

More horrifying tales from New Generation Medical Centre exist.

May 7, 2021: the case of Selasie

Selasie Awaworyie went into labour at 7.45pm on May 21, 2021. But there was a complication: the baby which weighed 4kg got stuck in the birth canal for almost 30 minutes.

The 4kg weight should have alarmed the clinic to refer Selasie to a specialist facility, Dr. Ralph Owusu would later admit to The Fourth Estate.

…And then  Zekiya

What happened to Kate, Esther, Bernice, and Selasie were more than isolated accidents by a midwife. Malpractice at New Generation Medical Centre is more the norm.

Zekiya Abubakari commuted 19 kilometres from Tuba, a dusty community near Kasoa in the Central Region, to the New Generation Medical Centre for antenatal care until she delivered.

Her first three children had everything intact at birth, but the fourth gave her heartache. Her experiences in delivering two children in a public hospital weren’t worth repeating so she opted for private healthcare for her third and fourth.

Within two hours of arriving at the New Generation Medical Centre, Zekiya gave birth. Matron Gaga was on duty. It was a few minutes after noon.

Baby’s arm broken at birth

“When I was delivering the child, I had difficulties and was told that the child had opened her arms while coming. It blocked her safe delivery. It took the intervention of the resident doctor to help deliver the child.”

When the baby’s father took her into his arms on the first day, she was screaming. The family took it for her reaction to a new environment.

But on day three, the baby’s aunt noticed that the baby’s right hand had gone limp. Her elbow had also twisted. When the sponge touches her right arm during bath time, the little girl screamed.

“I suspected that it was the process of delivery that got my child’s right hand dislocated.”

When Zekiya called Matron Gaga to report the state of her daughter’s health, her response was that there was nothing wrong and that her daughter’s arm was normal. She told the anxious mother that many children were born with such defects and that the mother should let the hand be. She said it would heal.

The bonesetter

But the little girl was restless. She couldn’t sleep. She was suffering what is known as Erb palsy, a condition characterized by arm weakness and loss of motion. It can occur in both infants and adults. Experts say it’s typically caused by a physical injury during delivery or by traumatic force downward on the upper arm and shoulder, damaging the network of nerves near the neck that provides movement and feeling to the shoulder, arm, hand, and fingers.

Furious, Zekiya contested Matron Gaga’s false assurance, saying that she was experienced enough to know that there was a problem.

For a second opinion and on the advice of elders in the family, the baby’s parents took her to a traditional bonesetter famous for resetting the bones of accident victims.

The bonesetter, Issah Tetteh, confirmed to The Fourth Estate that little Afua’s shoulder joint had dislodged, and her elbow twisted when she was brought to him.

He took to massaging her and bandaged the arm in a manner that breathed life into it.

“My child is getting better,” Zekiya says.

Mr Tetteh said it was likely there was still some pain left in the arm and it needed some extra work.

While the investigation was ongoing, Dr. Owusu sacked his sidekick “midwife” Matron Gaga, but she [Francisca Quaye] got a new job at another health facility just about three kilometres from the New Generation Medical Centre.

The Fourth Estate tracked her there…
Part two of this story will be published on Wednesday, May 24, 2023.

EDITOR’S NOTE:  The family of Dora Quaye, a renowned midwife who operated a maternity home in Takoradi, has reached out to The Fourth Estate and denied Francisca Quaye’s claim that she was the daughter of the popular midwife and picked her midwifery knowledge from her. They say she was a distant relative who lived in the Quayes household. 

You can reach the writers via email at [email protected]/[email protected], or on Twitter: @thekekeli/@evansdelasie 

 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.