…communities in despair, resort to self-help
…abandoned PHC centres now home to reptiles….
By Emmanuel Bagudu
Some communities in Kaduna, Kano and Jigawa States have thrown up their hands in despair as a result of unattended health needs in their communities. TNG’s correspondant Emmanuel Bagudu who went on an investigative tour in the three States made horrible discoveries. From the use of boats, bicycles to the use of traditional medical practices to access health care, citizens are forced to make do with available options to rescue themselves and their families from any health challenge. “We have lost hundreds of children and as the whether and climate keep changing we are already panicking …we need help….” Ladidi Haruna, a Citzen of Makwalla, a village in Kaduna told TNG. This piece explores the poor health care delivery system in some areas in Northwestern Nigeria and it’s corresponding effects on vulnerable communities with reference to some communities in Kaduna, Kano and Jigawa States.
Visiting Kaduna, Kano and Jigawa States from Abuja was quite adventurous. The over 500km journey was full of shocking revelations. Health centres dysfunctional, residents keep expressing mixed feelings. While some seems relentless in calling for help, others seems despondent and have resort to self-help.
First state to be visited was Kaduna.
Third largest state in population in Nigeria, Kaduna now boost of quite an impressive revenue generation record of over N40billion annually as well as a yearly budget of over N200billion. But this however is not reflecting in some of the areas in the state especially those that requires urgent intervention on healthcare.
Makwalla is a small community of about 800 inhabitants, located on the far-bank of River-Kaduna confluence in Igabi local government area of the State. The major occupation of Makwalla locals is subsistence farming with high fertility rate.
In Makwalla, the reproductive aged women have reportedly been educated about child-spacing (family planning) methods, but they don’t have access to it. They don’t also understand how to make use of what they have as traditional pregnancy spacing. There is no single health facility that can take care of the over 800 persons in the community. This made a lot of persons to fall victims of unattended illhealth.
The latest victim is a 30-year-old mother of 12, Zainab Abu also called “Mama Dozen” for her ability to birth and nuture 12 children all alive. Her husband Kabiru Hassan is a subsistence farmer. Through Zainab, the family has unique records of twins. She had given birth to twins three times after having eight children, lost two, before she eventually gavebirth to the quadruplets.
Like many other women in her category, the idea of going for antenatal care was a mirage. There was never a time she knows how many foetuses she’s carrying until she delivers, sometimes with the help of traditional birth attendants and sometimes, through self-help. She is one of the lucky few to be alive after given birth to a dozen without visiting a hospital.
Many other children who where born either alone or in sets in Makwalla hardly celebrate one year birthday. The mothers, sometimes, lose their babies after going through prolonged child labour.
To Zainab, the absence of a nearby primary healthcare centre or health post frustrated her thought of getting medicare each time she was pregnant. Although Zainab is not the only woman that found herself in this category but her giving birth to quadruplets brought her to the public space. On daily basis Journalists and researchers throng Makwalla in search of Zainab and her likes so as to furnish themselves with facts.
“….The major problem we have here is distance. There is also no safe transport means to go to the hospital inside the town….” Zainab said
Zainab added that she has gone through serious pains and stress while trying to birth her Quadruplates. “ban taba sani irin zafin na ba” meaning “she has never had this pain” she said in Hausa language.
TNG gathered that the closest reliable hospital to Makwalla is faraway across the River-Kaduna which involves using the local commercial canoes to cross the River to get to the hospital or alternatively, motorcycles can be used to go to a nieghbouring communities whose health system are not reliable but better without non.
“….once it is 6:30 pm, the canoe operators are off the river bank. So, any woman on labour at night can only be managed within the village” Zainab said.
For his part, Zainab’s husband, Kabiru Hassan, who confirmed that what his wife narrated is true, expressed his displeasure over government negligence on Makwalla considering it’s location. “If you go to the southern states, you will notice that riverine communities are given serious attention but here in the north it is different…..” Hassan said. He added that his wife has never gone for any medical diagnosis or antenatal since they got married. We have been giving birth at home with or without assistance from traditional birth attendants. “My wife has 12 kids but some have died.” Hassan said.
The District Head of Makwalla who lives on the other side of Makwalla called Kurmi, Mohammadu Bashiru, lamented the plights of reproductive aged women in his community, calling on the authorities concern to build, equip and staff functional Primary Health Care (PHC) Facilities in the area to handle the health needs of the people.
From Kaduna to Jigawa, the story didn’t change. TNG Proceeded to Jigawa State where more shocking revelations emerged.
Jigawa borders the Republic of Niger to the north and the Nigerian states of Yobe to the northeast, Bauchi to the southeast and south, Kano to the southwest, and Katsina to the northwest. The state consists mostly of plains covered by wooded savanna in the south and scrub vegetation in the north. It is drained by the Hadejia River, a seasonal stream that flows northeastward through the state. The state’s major crops include peanuts (groundnuts), sorghum, cotton, cowpeas, millet, and the rice grown in the river valley. The herding of cattle, goats, and sheep is widespread.
Jigawa is a largely rural state with roughly 50% of the population living in poverty (Annual Abstracts of Statistics 2019). In particular, 9.3% are living in extreme poverty and 41.4% are living in moderate poverty. This has not change the attitude of governance in the state as the state still cannot afford health coverage for everyone. TNG touched down Ruru town where the health care delivery system remains the same.
Located in Dutse Local government area, Ruru town is 10.5 km from the state capital Dutse with more than 30, 000 population Ruru has only 1 dilapidated antenatal hospital with no single staff. This forces pregnant women and nursing mothers to treck on feeder roads about 6.5 km weekly for vaccines and antenatal.
Hafsat Umar living in Kudai town told TNG that Kudai hospital is the only nearby hospital for Ruru’s inhabitants to attend every Monday, Wednesday and Friday for weekly return (feedback) and emergency delivery. “You will see pregnant women and nursing mothers from Ruru town in group trecking under the sun or rain in this feeder road to Kudai for vaccines and weekly routine despite them having high ranking politicians, government officials and business men in the state and national levels….” she added.
Mallam Bala, a neighbor to the hospital said Journalists and researchers have been coming to check, and and take photograph of the hospital and promised to take report to the government but yet there has not been any improvement.
TNG ran into a lady of about 19 years with her baby in her hand. “….My name is INDO…I am coming from Ruru going to Kudai… I am trecking because I don’t have money and my husband too is broke, and the vaccine is very important and our antenatal clinic is no longer functioning…. I trecked for 4 hours….”
Second most populous state in Nigeria and most populous state in Northern Nigeria. Kano Population is very significant to the political class considering the key determinant of election results which is numbers.
Over the years, the people of Kano having noticed their advantage of numbers have continued to pride themselves as the most valuable persons in the country hence their motto in Hausa language “Kano ta dabo Timbin Giwa Koda me kazo an fi ka” meaning tranliterarilly “Kano the heritage, the Elephant’s big Stomach, no matter what you arrive here with, we are better than you….” This general pride has sinked into generations in Kano. Politicians are aware of this fact and so they play along with what they feel the people of Kano wants. But this did know show in some areas of health care delivery.
In Gada, the last village in Kano State before one crosses to Jigawa state from kano, there are three communties living their, there major work is fadama farming. They have only one antenatal clinic with 2 staff, they have to reach birnin kudu local government or Dutse general hospital when there are emergencies such as accidents and delivery. The distance between Gada to Birnin kudu is about 20km like wise Dutse the Jigawa state capital another closer city to them.
These three villages according to locals who spoke to TNG jostle for any means of transportation going to either Birnin Kudu of Dutse.
One funny fact is that Gada and it’s surrounding communities are under Kano State but are depending on Birnin Kudu and Dutse, which are towns under Jigawa State, a state far poorer than Kano.
Conclusive Kaduna, Kano and Jigawa remains the gate way to Northwestern Nigeria from any part of the country and while they are battling to secure their terrain from the influx of banditry, it is also very important that the three states take the welfare and health of their citizens into consideration.