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In Igbokofi, a sleepy community nestled in the Yewa North Local Government of Ogun State, no functional healthcare facility exists, thus leading to high maternal and child mortality. SODIQ OJUROUNGBE writes on the harrowing experiences of residents, especially pregnant women and the high price they pay in this neglected enclave.
Behind the amazing greenery and quiet façade presented by Igbokofi, an agrarian community lays gloom, grief and deep-seethed anger that boil from being denied one of life’s fundamental rights – accessible healthcare. Here, maternal and infant deaths appear to be a norm and a fate they have come to accept. Governance, to Igbokofi’s residents, is just a mirage and one that happens in a faraway land. The story of Tosin Ayeni is one that breaks the heart because her death due to pregnancy-related complications was avoidable.
As she lay on a hard bed in a small, dark room that fateful night, all that this first-time mother (primigravida ) wanted was to cuddle her bundle of joy after going through the rigours of labour. Drenched in sweat and shaking from the effects of excruciating pains travelling from her waist down to her legs, she looked at her husband with fear in her glazed eyes.
They would have rushed her to the nearest health centre had it not been abandoned years back by the state government and overtaken by thickets. The nearest primary health centre to them is located in Ijoun, which is a two-hour ride on a motorcycle, on a rough, unmotorable road.
While another alternative, though shorter and could be life-threatening to a pregnant woman due to its mountainous layout is a hospital that can be annexed within 45 minutes in the Republic of Benin.
However, after considering the two options and realizing that they could be dangerous for Tosin, her husband, Sanjo and his father-in-law, Ayeni, had to make a last-minute decision to seek the assistance of a popular traditional birth attendant in the next community.
The elderly TBA after taking one look at the pregnant woman, told them she was in very bad shape and her life was in danger but assured them that she would try her best. Sadly, the TBA skill was limited and could not do much without proper equipment. After hours of groaning and grunting, she gave birth to a baby girl, but minutes later, life ebbed out of her.
As the family grieved, they also had to care for the newborn baby, who was a prototype of her later mother. “I watched my wife suffer and then die. There was nothing I could do. She left a hole in my heart,” Sanjo said with bloodshot eyes. Tosin’s father, PUNCH Healthwise learnt, never recovered from the death of his daughter. And days turned into weeks, and rolled into months, overwhelmed by grief, Ayeni’s health deteriorated, and he became a shadow of his former self. In early September of 2023, he slept and never woke up. The deaths of Tosin and her father were just two among the long line of tragedies witnessed in the community.
Yet another loss
Folakemi Olaniyi is yet to get over the death of her child after being mismanaged during childbirth in a private hospital. According to her, she was later taken to Ijoun Primary Health Centre after her baby’s head and hands got stuck in the birth canal. Olaniyi told our correspondent that she was referred to the Ayetoro General Hospital by the health workers when they realized that she had lost a large amount of blood.
The woman was later moved to Lantoro Hospital in Abeokuta, where a caesarean section was carried out to remove the baby, who had become distressed at the time. “The doctors battled to save our lives but my baby did not survive. If the community had a working, well-equipped hospital, my baby would still be alive,” she cried.
However, PUNCH Healthwise learnt that Olaniyi not only lost her child, but she can no longer conceive as her womb was badly damaged due to a rupture during labour. “I spent two months in the hospital. If there was a qualified government hospital here, I would have been attended to immediately. “I have four children, and whenever they are sick, I take them to a health centre in Ijoun, which is very far, or to a hospital in Benin Republic. If there is no money, they are treated with herbs. The government should please provide the community with a hospital.
Another resident, Bernice Ogunyomi, said she always takes her child, who requires regular blood transfusions to the Republic of Benin for treatment. She lamented that even the health centre in Ijoun could not attend to her child’s medical needs. Expressing her frustration, She lamented, “Whenever we take our children there (Benin Republic), we pay through our nose. Many people have no choice but to go to Benin Republic for treatment, and as for me, my priority is to get good treatment.”
A community without primary healthcare
PUNCH Healthwise learnt that Igbokofi, a town with about 9,000 people, which borders the Republic of Benin, has witnessed decades of deaths, while residents face an uncertain future. Some of the villages under Igbokofi are Bode-Igbokofi, OkeEyo-Igbokofi, Omilende-Igbokofi, Asaga-Igbokofi, Idigbo-Igbokofi, Owode-Igbokofi, Ipinle-Igbokofi, Igbonla-Igbokofi, Oosada-Igbokofi, Baginiwo, OriOke, among others.
Most of the residents told our correspondent that the death of Tosin and her father did not come as a surprise to them because such happens often. They claimed that they have lost of the number of people that have died from preventable diseases and childbirth-related complications due to the absence of a primary health centre.
Maternal/infant death is a norm
PUNCH Healthwise investigation revealed that pregnant women and their unborn infants are at serious risk due to a lack of healthcare facilities and the absence of competent healthcare providers.
Speaking with our correspondent, a field missionary to Ohori Nations, and the proprietor of Christ Way Academy in Igbokofi, Pastor Kunle Garb, said the community once had a government hospital, which was eventually shut down due to a lack of health workers and government failure to provide necessary amenities. He revealed that another hospital constructed by the National Boundary Commission, and handed over to the Ogun State government was never put to use, lamenting that residents now deal with high rates of maternal and child mortality.
Tortuous road
For Igbokofi residents, the lack of a functional health centre is just part of the many challenges they are faced with as the community lacks other infrastructure like good roads, electricity and potable water. Accessing the place from Ayetoro, a major town, was treacherous. The main artery leading to the community was unpaved and narrow and often became impassable during the rainy season.
PUNCH Healthwise observed that the road was uneven and lined with deep potholes filled with murky water. Travelling on the road, our correspondent observed, would be dangerous for pregnant women or those in need of urgent medical care. The residents told PUNCH Healthwise that they have over the years lost many of their loved ones while transporting them to the health centre in Ijoun.
They described the road as a source of great frustration and appealed to the state government to intervene. Garb, who is also one of the community leaders in Igbokofi said during the last campaign, the state government promised to repair the road leading to the community as well as other roads, and lamented that the indifference to their suffering after the election is mind-blowing “Despite being a community of about 7,000 registered voters, we have not felt any evidence of good governance. The only time we see any government official is during election season when they come to the village to make empty promises.
“But after the elections, they would disappear, leaving the people of Igbokofi to fend for themselves. The lack of government support is a major factor in the community. Without access to education or healthcare, many people will struggle to find jobs or improve their living conditions. Without proper roads, we are isolated from the outside world and can’t access markets or other opportunities. The cycle of poverty will be difficult to break. The people of Igbokofi feel trapped,” “ he blurted in anger.
Child deaths high in Ogun
According to the United Nations Children’s Fund infant and under-five mortality rates have remained steady in Nigeria, at 74 and 117 deaths per 1,000 live births, respectively. UNICEF noted that at these mortality levels, one Nigerian child of every 13 born dies before reaching age one, while one in every eight does not survive to their fifth birthday.
Meanwhile, a UNICEF report released in 2022, revealed that Ogun State recorded the highest number of children’s deaths in the southwestern part of the country. The survey conducted by the Nigeria Bureau of Statistics in collaboration with UNICEF and other partners indicated that Ogun recorded the highest figures in neonatal mortality, infant mortality, and postnatal care for newborns, among others in the region.
The Social Policy Specialist of UNICEF, Mohammed Okorie, while speaking on this at a two-day media dialogue on the 2022 Multiple Indicator Clusters, explained that the estimations were “part of the MICS 6 results released by the NBS on August 16, 2022.”
Quoting the NBS, he said, the survey estimated that 56 out of 1000 children between the ages of zero and 11 months died after birth in Ogun State. Okorie stated further that 68 out of 1000 children between the ages of 0 and less than one year died after their birth in Ogun State.
He noted that the state has also ranked the highest in deaths of children under five years with a record of 85 deaths out of 1000 children. He further said that Ogun also recorded the lowest newborn care with an estimation of 77 per cent.
According to the World Health Organisation, as of 2017, Nigeria’s maternal mortality rate was estimated at 917 per 100 000 live births and increased by nearly 14 per cent in 2020 to reach 1047 deaths.
Ogun State Government refused to save us – Community leader
Corroborating this data, the acting Baale of the community, Pa Jacob Ogunyomi stated that in the last two years, childbirth complications claimed the lives of about five pregnant women, while more than 20 children have died before they clock five. He said several letters have been written to the government highlighting the community’s dire predicament, but none of them have been treated as urgent or important.
“The greatest challenge we have is that we don’t have a hospital, those that were working have been abandoned and were later closed. When we try to patronise private hospitals, we don’t get good medical treatment and they are very expensive. The other option we have is to take those who are sick and pregnant women to Ijoun, which is a two-hour journey from Igbokofi.
“The government should provide a good hospital, health workers, and a motorable road. One of the issues is that whenever they transfer new health workers here, they will stop coming because of the bad road. If there are good roads, then it will be better,” he explained in smattering English.
Hospital built by National Boundary Commission rots
PUNCH Healthwise further gathered that a health facility built by the National Boundary Commission in 2010 was abandoned. Our correspondent learnt that it the commission handed over a five-in-one project which included a hospital, school, market, police station, and workshop to the state government.
However, while the market, police station, and school were put to use by the residents, the hospital was shut despite the state government being aware that one of the main reasons for building the hospital was to curb the high rates of maternal and child mortality recorded in the community.
During PUNCH Healthwise visit, it was observed that the building was already falling apart, while the paints had practically washed off, revealing just bare cement. The premises had been overtaken by weeds, even as the windows were broken and doors sealed with wood to prevent entry.
It was clear that no one had set foot in the building for years. The residents said the hospital was built to bring healthcare closer to them but that the aim was never actualised. While inspecting the abandoned hospital, our correspondent discovered that the damage went beyond the peeling paints and broken windows, as it was discovered that the floorboards were rotting.
Ambulance taken away
Garb told our correspondent that some of the burglaries had been stolen. He said, “The last time government officials came was the day the Boundary Commission came to hand these properties to them. They did not do anything since then. The ambulance that was handed over to the government with the name of Igbokofi inscribed on it was taken away that same day. “The hospital was never equipped and the building was left to rot since 2010, and nothing has been done about it. Several efforts to get the attention of the government have not yielded any positive response.”
Corroborating Garb’s claims, some residents claimed the state government took away an ambulance donated by the Boundary Commission and gave it to the Ayetoro General Hospital. They accused the state government of turning a blind eye to their plight and exposing them to needless deaths. The residents insisted that the Toyota Hilux ambulance would have been a lifesaver, as it would have been used to transport sick people to the nearest hospital within minutes.
They also claimed it was taken away because there was no intention to equip the hospital or provide an alternative one – a primary health centre in the community. They lamented that in the absence of an ambulance, they use other crude means to transport the sick and injured, and in most cases pregnant women to the Ayetoro General Hospital.
Dilapidated primary healthcare
PUNCH Healthwise observed that the only Ogun State Primary Health Centre in Igbokofi is overgrown with weeds, and according to the residents, it stands as a stark testament to years of indifference. Garb told our correspondent that the health centre, which serves about 16 villages around Igbokofi, was shut down 12 years ago because of the bad road.
“The hospital was closed down 12 years ago and people left in the hands of quacks who claim to be doctors. People have died due to lack of health facilities in the community and around. Even the Ijoun community that we usually rush to doesn’t have a well-equipped primary health centre. It is just so unfortunate.”
Left in the hands of quacks
Residents of Igbokofi revealed that they are forced to rely on traditional healers and quacks who operate private clinics, lamenting that they do more harm than good. A Cocoa farmer and resident of Igbokofi, Ogunyomi Benjamin, said they prescribed drugs without proper medical tests.
He said, “My wife gave birth at home, and that is the same for others here. Most women give birth by themselves at home, and this has resulted in many deaths because there is no doctor to take care of them. Also, when our people get sick, we don’t have anywhere to take them for treatment and many of our women have died from being prescribed the wrong medications after childbirth.
“It is only God that is taking care of our children because there is no hospital and no qualified doctor. We just mix several drugs and give them to take. God is the only one helping us. We want the government to give us a good general hospital and they should put enough drugs there for us to use, with a qualified doctor.”
Quacks contribute to high maternal and child mortality
A study titled, ‘The Impact of Quackery and Unreliable Health Facilities on Maternal and Child Mortality in Nigeria’ by Dr Abibat Fakunle of the University of Ilorin Teaching Hospital, found that lack of trained healthcare professionals and unreliable health facilities are major factors contributing to high maternal and child mortality in the country.
The study discovered that the prevalence of quackery in the healthcare sector was a major factor contributing to high maternal and child mortality. While describing quacks as unqualified or untrained individuals who practice medicine without proper training or certification, the study noted that such people often provide substandard or even harmful care, leading to poor outcomes for patients.
The study found that this practice was common in rural areas, where access to qualified healthcare professionals is limited. It also found that many patients were unaware of the risks of seeking care from unqualified practitioners. The study recommended increased funding and regulation of the healthcare sector to ensure that quality healthcare is available to all Nigerians.
According to a gynaecologist and reproductive health expert at Federal Medical Centre, Idi-Aba, Abeokuta, Dr Adetola Olayinka, quackery and inadequate healthcare facilities are major factors contributing to maternal and child mortality in Nigeria He, however, pointed out that quackery is not the only factor contributing to maternal and child mortality, adding that environmental factors such as poor sanitation, lack of access to clean water, and exposure to toxins can also have a major impact on health outcomes.
Healthcare is every Nigerian’s right – Physician
The medical practitioner underscored the importance of access to qualified healthcare professionals and the need for better regulation of the healthcare sector. “Healthcare is a right, not a privilege. All Nigerians, regardless of their socioeconomic status, deserve access to quality healthcare. I call on the government to invest in healthcare facilities, train and retain qualified healthcare professionals, and regulate the healthcare sector to ensure that the people are protected from quackery.
“Poverty and poor health go hand in hand. Children who live in poverty are more likely to suffer from malnutrition, which can lead to lifelong health problems. We must do more to address the underlying causes of poverty and improve access to basic needs like health,” he noted.
Govt keeps mum
When our correspondent reached out to Lekan Adeniran, the Chief Press Secretary to Governor Dapo Abiodun, he was directed to the Commissioner for Health, Dr. Tomi Coker. However, the commissioner’s number was not reachable but four messages sent to her WhatsApp indicated that they were read. When our correspondent reached out again to the governor’s CPS, Adeniran, he was told to either go to the commissioner’s office or wait for the commissioner’s response.
