ONDO, Nigeria – When I visited Ilowo, an agrarian community in southwest Nigeria, many of the residents were going about their daily lives of fishing and farming as I seek to uncover the many shortcomings of the region’s failing healthcare system.
Paying a visit to the only healthcare center in the coastal area for medical attention, I could not see anyone in sight for almost an hour, so I decided to return to my abode when a security guard called over to me.
“There are no health workers on duty here,” he told me. He was granted anonymity to speak freely. “This place is always locked on weekends. Doctors and nurses come here once in a while because most of them live in the city.”
Since the reason for my visit was to cure my upset stomach, he advised me to use the traditional method of drinking a mixture of cassava flakes and water.
The World Health Organization defines universal health coverage as: “All people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.”
It is not only Ilowo that suffers, neighboring Ilepete has a similar story to tell.
When I visited the healthcare center, the nurse on duty told me that she could not prescribe me any drugs because of her inability to ascertain the nature of my illness but also that drugs were only supplied by the government “once in a blue moon.”
Juliet Ayadi, aged 80, a resident, told me that the lack of access to quality healthcare in her community has claimed many lives, saying that this would not have happened if the government had actually provided adequate funding. “Many have died as a result of no doctors and nurses.”
At a health center in Ilaje, the signage on the building shows 24-hour service, but the big padlock at the entrance tells another story: the center has been closed for years.
Confirming what was obvious, Sayo, in her early forties, said that the lead doctor and his nurses had left unannounced. “They said they could not live here because the government didn’t supply them with the needed equipment.”
Now overgrown with trees, the abandoned building serves as a shelter for local animals.
Through a search of the building, I can confirm that there were drugs, I would guess long expired, arranged on shelves, a stethoscope, chairs, and tables, as well as empty and abandoned beds.
It was a sunny day at the Molutehin Healthcare Center in Ilaje, the only health center serving Ikuyinmino, Nanti, Odun-Igo, and other communities when I stopped by.
Secretively checking the number of patients registered for the day on the attendance list, I met a young nurse who was attending to a sick woman with a baby strapped on her back.
When the nurse noticed my presence, she was quick with the woman and faced me, asking what brought me to the center. After a medical test, she went into her inner office to bring me some drugs.
She had urged me to purchase another set of prescriptions from a nearby pharmacy to use.
Speaking with Ibilola Adehin, aged 70, she alleged that many people in her residence have passed away in a failed bid to move to the city to get medical attention.
“Nonstandard nature of hospitals here has resulted in a lot of deaths because the hospitals lack adequate equipment and all they could do was to refer them to the cities. Many gave up the ghost before getting there, including those who could afford the exorbitant bills for treatment in the cities. There was a time when they were rushing a man there due to the unavailability of a doctor but unfortunately, he died because they couldn’t get a boat to convey him on time.”
Tofas Adehin, an octogenarian, told me how he had been using herbs to cure severe diseases, saying he never went for any check-ups or treatment. “I make use of traditional herbs to cure myself and there’s no need to go to the hospital,” he said, adjusting his fishing net.
Corroborating Tofas’ story, research reveals that more than 80% of locals in rural Nigeria depend on herbal medicine for their basic healthcare needs.
People use herbal medicines to maintain or improve their health, believing that products labeled “natural” are always safe and good for them. “Not all sickness requires a drip at all,” Tofas said.
Tofas maintains that going to any healthcare center makes him prone to early death but using herbal medicine does work for him because there will not be nonavailability of drugs or lack of qualified health workers.
“Around twelve years ago, one woman was admitted into the [health] center and the nurses started giving her a drip. When I saw her, I intervened with some herbs, and she was healed briskly. If not for this traditional medicine, we would have lost her to death,” Tofas boasted.
For some mothers-to-be, midwives are an option
Midwives are older women or men who consider themselves private healthcare practitioners. Their main job is to assist women during delivery and immediately afterward.
In Nigeria, the Nigeria Demographic and Health Survey found that many pregnant women in rural areas use midwives rather than skilled birth attendants.
Benjamin Adunke could not imagine that the healthcare center in her area would close earlier than expected until she had to give birth around midnight. At that moment, she thought the only option was to visit a midwife, where she eventually had her baby successfully.
“It was a horrible experience because I could not remember hospitals being closed by 6:00 pm here.”
Another resident, James Abeni, recounted how she had both her antenatal sessions and delivery in a traditional birth center because she feared a lack of enough equipment to attend properly to her medical needs. “No one gives birth in a hospital because of this fear,” she said.
Kemisola Funmilayo, 78, is another ardent user of herbal medicine. Boasting that none of her children ever gave birth in a hospital, she clarified she never discouraged those who registered for antenatal care, yet she had a strong belief in the traditional method of child delivery.
She blamed the government for the increasing number of people using herbal medicine as well as pregnant women who give birth with the help of midwives. “I want the government to deploy qualified and adequate doctors and nurses here to attend to the people.”
Omojoye Supporter, a midwife with over four decades of experience, said delivery with midwives takes less than an hour, saying that most women prefer them because of the timeliness and the lack of stress.
“A woman was scheduled to undergo a cesarean session in one of the hospitals in the city but the fear of dangers in it made her husband insist that they would not operate on her. When they brought her here, I applied for all necessary medicine, and she was put to bed in less than 30 minutes.”
Experts weigh in
Seun Lawason, who works at a health center in Akure, the capital of Ondo State, explained to me that pregnant women who gave birth using midwives are prone to a plethora of diseases.
“The room used by midwives might not be disinfected, but in the hospital, there exists a proper disinfection of wards and instruments before using them. When this is not done, there will be a high risk of infection.”
“Some pregnant women end up bleeding after childbirth but midwives don’t know what postpartum hemorrhage is, let alone how to treat it thus this could lead to the death of the mother after childbirth,” she said.
Omolayo Alice, a former midwife at a health center in Oshodi-Lagos, confirmed that giving birth using midwives can lead to complications.
“Sometimes, they’ll give the pregnant women traditional concoctions or herbs which could lead to congenital malformation due to the herbal concoction, kidney or liver problem because the baby is not yet matured to stabilize the herbs filters.”
Omolayo, who has been carrying out a study on child maternity, disclosed that “women might not be aware that once the baby was removed at the local centers, their reproductive organs might get damaged with their bladder unlike what is obtainable in a good healthcare system.”
When I asked her the major reasons pregnant women do not access public hospitals, she listed underfunding of government health centers, poverty, and cultural beliefs.
Numerous attempts to get some clarity from the Ondo State Ministry of Health proved abortive. WhatsApp messages and calls put through to the Commissioner for Health, Mr. Banji Ajaka, went unanswered as of press time.
Editor’s note: This investigative report has been produced by International Policy Digest to support accountability in Nigeria.
SOURCE: International Policy Digest / Friday Omosola