It's normal. Page turns on eInk device produce ghosting: black dots on a white background which are easily perceived, and also the opposite (white dots on black parts, e.g. text).
I also have a Kobo H20, and I'm very impressed (and pleased) by the few amount of ghosting of this new generation of screen. I have no problem with refreshing each 64 pages, but I must say that I can also see some irregularities on text. But they are minor to my eyes
I made some macro pictures to illustrate this.
I took one photo just after a refresh (click to enlarge):
I turned 30 pages forth and 30 pages back to get the same picture after 60 changes without any refresh:
And there is smaller part of each picture (click to enlarge):
You can see some ghost letters on the white background but to my eyes this effect is not very strong (at least compared to the previous generation of eInk, aka Pearl). It's easier on this picture to spot the uneven rendering of black text. I guess it's what you're complaining about, right?