State of Healthcare in Nigeria: Field Report From Our Volunteer
Yetunde Ogundele in Igan, Ogun State
A bright and sunny day it is in Ayetoro area of Yewa South LG of Ogun state. My destination is a village called Igan and my aim is to conduct an assessment of the state of healthcare facilities there.
Using UNICEF’s data, only 39% of Nigerians get skilled help at childbirth. The question top on my mind is what qualifies a ‘help’ to be ‘skilled’? Surely, this goes beyond a certificate in midwifery or attractive health structures.
With my bags packed and eyes hopeful, off I went on a foray into the unknown, for God, country and Brown Button Foundation.
Riding on a bike into the Igan community, there was no hotel in sight so I suspected I will have to put up in the health facility there. I dreaded staying in a facility but when the bike stopped in front of the health centre, I sighed in relief. This healthcare center happens to be the only one, both private and public, in the locality. It was a modern bungalow, newly painted, so I felt this must be conducive enough and I was impressed such a rural settlement could have a nice healthcare centre.
All that was about to change! Disappointment welcomed me into the facility and I made my first shocking discovery; there is a huge difference between appearance and reality.
The interior was a far cry from the outside look. The reception was a sorry sight. The only seat there was for the attendant on duty; the implication of this was not lost on me. If you come in sick into the health center, you will have to remain on your feet till you are attended to. In a certain part of the center, I saw about six to seven teenagers, male and female, occupying the ward and beds there. Out of curiosity, I asked the attendant if they were patients and she told me the teenagers were merely students writing the General Certificate Exam (GCE) so she accommodated them because they did not have anywhere to stay. What she did not tell me however was that she lets out the center to such students for a fee!
My assignment started the next day and lasted for 5 days. I stayed at the health center all through in total darkness as there was no electricity and I constantly lived in fear of a midnight emergency.
Two days after I got there, the nurse's shift was over and she travelled, leaving just me at the facility. She said a mid-wife will come over to take up her shift since the doctors posted to the locality never show up. By evening, a mid-wife came around. Thankful that no emergency came up during the period the center lacked attendant, I asked if she had any medical background but she stunned me by saying no but that she knows what drug or injection to give patients when they come in with one ailment or the other.
At about 4pm on Wednesday, I returned to the health center after a short walk to find a pregnant woman in labor in the labor room. The woman looked so skinny and lifeless that I concluded almost immediately she did not feed well during her pregnancy. The mid-wife kept telling me the pregnant woman was not ready for delivery yet and checked her at intervals. At about 5.30pm the same day, another young lady came in for delivery. My fear rose when darkness came and I wondered how the midwife would take two deliveries in the dark. All we had was a lantern and torchlight.
Both women laid side by side, in the same room, in labor, battling for their dear lives and treading the throes of death in an attempt to give life with only one ‘midwife’ and no other health assistant.
The midwife kept switching from one woman to the other. At a time she said to me " Aunty Yetunde, e ma gbebi ni ale yi o, e ma mura sile" - "aunty Yetunde, get ready, you will take delivery tonight". I did not know a thing about taking delivery and I only got more scared with the midwife’s declaration. I held the torchlight all night to assist the midwife.
At about 11pm, the screams were louder with so much tension and confusion. The woman who came in at 5.30pm seems ready for delivery, so we focused on her. I stood directly in front of her open thighs, focusing the torchlight while the midwife guided her through the birth process. After the birth, the mother remained there in her own blood, while the baby was cleaned up, in a rush-rush manner.
Attention shifted to the other woman who became more and more tired; she wasn’t even moaning any more. At a point, the mid-wife didn’t know what to do as the nearest hospital was about 30mins bike ride from Igan. At about 1am, frantic attempts was made to convey her to the hospital but there were no vehicle or bike was available. After all effort failed, the midwife gathered the security man and students to join us in the labor room for prayers to save the woman’s life. Some white-garment priests nearby were also called in to pray and pour incense all over the woman. It was almost like a horror movie.
The lack of skill and proper referral facilities have made childbirth look like a spiritual exercise!!
Around 2am, she finally gave birth with d umbilical cord tied to the neck of the baby, already choking him. By the time the placenta came out, it was already scattered, it came out in pieces. She got cleaned up and the baby too while effort was made to evacuate the placenta remains from her. Whether it was properly done is another issue.
As I left the next morning, the thought of the dangers of childbirth and the fact that that woman could have been me, you reading this or any of the 69million women in Nigeria left a hollow in my heart. No one is immune from this risk.
If only doctors will stay at their duty post, if only traditional birth attendants will refer timely, if only government will provide basic amenities such as water and electricity, if only hospitals will have standby ambulances, if only referral points aren’t so far away, if only you reading this will take action on maternal health today and do the best you can for our community, then surely, skilled help will reach everyone!
I am acting now to save future generations. What about you?