Poor health facilities put us at risk of complications, death –Abuja IDP camp pregnant women


Birth attendants wear nylon as gloves to take delivery

Angela Onwuzoo

Childbirth has become a nightmare for women at the Internally Displaced Persons camp, in Durumi, Area 1, in the Federal Capital Territory, Abuja, as poor healthcare facilities put expectant mothers at risk of serious complications while giving birth. ANGELA ONWUZOO reports: 

Mrs. Zara Muhammed, taking shelter with her husband and four children at the Internally Displaced Persons’ camp in Durumi, Area 1, in the Federal Capital Territory, Abuja says she narrowly escaped death in May 2021 while giving birth to her fourth child.

The problem, she said, was due to lack of access to healthcare facilities and obstetric care in the camp, which has been in existence since 2014. Muhammed said they were driven out of their ancestral home in Bama Local Government Area of Borno State in 2014 by the Boko Haram insurgency.

According to her, two of her children had been born in Borno before they were driven out while the other two were delivered in the camp.

“Being pregnant in this camp is a dangerous venture,” she told our correspondent during a visit to the camp.

“Giving birth in this camp is full of risk because there is no healthcare centre here. The only health facility in this camp, called NAFHA clinic, has only one bed for delivery and there is no other equipment. The clinic (a container) was established in 2018 by Network Aid for Humanitarian Assistance, a non-governmental organisation, in Abuja.

“There is no drug in the clinic; even ordinary folic acid to give to pregnant women is not available. Because of this, many women now deliver at home. The trauma I faced when I had my fourth baby two months ago is something I wouldn’t pray for anyone to experience,” Mrs. Muhammed said.

Speaking with PUNCH HealthWise, Muhammed said it is usually a sad tale for pregnant women in the camp who develop complications during delivery.

Giving birth in camp matter of life and death

“Giving birth in this camp has become a matter of life and death. When I heard some of my neighbours discussing the horrific things that they faced when they had complications during labour and how the clinic in the camp failed them, due to lack of equipment and drugs, I thought it was a minor thing, until I experienced it.

“I gave birth on May 23, 2021, through an unplanned caesarean section at the Maitama General Hospital, here in Abuja. I registered for antenatal care at the camp clinic and I knew my expected delivery date.

Mrs. Aishah Ali
Mrs. Aishah Ali

“When I fell into labour, I came to the clinic and was here for two days in serious pain, without any medical interventions. The staff could not help me because they don’t have the equipment to work with.

“The third day, when I couldn’t deliver, they checked me and told me that my baby had breached. So, they referred me to Maitama General Hospital for CS. Going to Maitama was a huge problem because of lack of money and my husband is jobless.

“It took the intervention of the chairman of the camp who mobilised people in the camp to raise money for a deposit before I was finally rushed to the hospital in pain,” she said.

Continuing, Muhammed said, “Getting to the hospital, they billed me N170,000 for CS, which was far from what was raised by the chairman. The chairman, however, pleaded with the hospital staff to collect the little amount he had with him and save my life and that of my baby first.

“In the end, we were able to pay N140,000 and a good-spirited doctor at the hospital helped us to complete the N30,000 balance. I almost lost my life because, at one point, I became very weak. The pain that I went through wasn’t palatable at all.”

Pregnant women and children living in starvation

Muhammed further told our correspondent that beyond the challenges of childbirth, pregnant women in the camp were also faced with hunger and starvation.

She lamented, “When I was pregnant, I scarcely ate because there was really no food to eat. And since I gave birth, I have been living in starvation. The government banned okada business and that made my husband, who is an okada rider jobless, and he can no longer provide money for feeding.

“Worse still, there is no government intervention or assistance. The little food that we eat comes from kind individuals and some non-governmental organisations.

“But it does not come always. I am not the only one experiencing this; a lot of nursing mothers in this camp are suffering. Nobody is feeding well. Most times, we only feed once a day.”

In the camp, our correspondent gathered that some of the women who had complications had similar experiences asMuhammed.

Many deliveries taking place at home

Those who had vaginal delivery, PUNCH HealthWise gathered, also have sad stories to tell.

Aisha Ibrahim, 26, also from Borno State, told our correspondent that she gave birth to three out of her five children in the camp.

The mother of five shares her experience, “I came to the camp in 2014 with two children. But I have five children now. I gave birth to three in the camp and I delivered them at home. My neighbour took the deliveries for me and helped me cut the placenta. I gave birth to them at home because there was no money to go and register in a hospital outside the camp, while the clinic in the camp has no delivery facilities.”

Asked if she was aware of the risk of delivering at home, Ibrahim said, “When you are left with no choice, what do you do? At the camp clinic, they don’t even have drugs to stop bleeding, if a woman is bleeding; no injection to relieve a woman of pain after delivery. They don’t even have ordinary hand gloves. So, what is the essence of going there?”

An expectant mother, Aisha Ali, 26, who is pregnant with her sixth child, told PUNCH HealthWise that she had not registered for antenatal care, despite being six months pregnant.

The housewife said, “No money to register for antenatal care and, at the clinic here, drugs are not available. They don’t have ordinary folic acid to give to pregnant women.”

A community Health Worker at the clinic, Grace Maikano, who confirmed the plights of the women, told PUNCH HealthWise that the clinic could no longer handle simple health conditions, due to lack of drugs and equipment.

“The clinic only manages a few health cases, like malaria, cough and diarrhoea, and also takes delivery. For any case that we cannot handle, we refer to the National Hospital, Abuja. It is the only well-equipped hospital close to the camp, though not too close. But we still have Area Two and Durumi Primary Healthcare Centres around,” she explained.

On challenges faced during delivery, Maikano said, “No instrument is available for delivery. No forceps, tray, plate, even common mucus extractor, we don’t have. The drugs and injections needed after delivery are not there. Most of the time, we don’t even have hand gloves to take delivery.

The only bed at the clinic
The only bed at the clinic

“With all these inadequacies, you can imagine the risk that the women face giving birth. Many of them don’t even have access to mosquito nets or tetanus injection. We have a lot of home deliveries here and some of them lose their babies.”

Five pregnant women and their babies die from complications

A nurse, Isa Umar, who is in charge of the clinic, told our correspondent that about five pregnant women and their babies had died between 2018 and now.

“They had complications and were referred to the National Hospital Abuja. The delay in raising money for their hospital bills and the distance between the camp and the hospital is actually what caused their deaths. By the time the doctors came to attend to them, it was too late,” Umar said.

No hand gloves, disinfectants at the clinic

Mrs.Liatu Ayuba, 50, who is the women leader of the camp and also a traditional birth attendant taking most of the deliveries at the clinic, also shared her experience with PUNCH HealthWise.

“I volunteered myself to help save the lives of the women. My grandmother was a traditional birth attendant before she died, so I learnt the practice from her. Unfortunately, there is no equipment to work with at the clinic. Sometimes I wear nylon on my hands to take delivery because there are no hand gloves.

“Even disinfectants, such as bleach, are not available. Before, I often used my money to buy hand gloves, but now they are very expensive. I can’t afford them anymore.

“It is even more disheartening that most of the women, after delivery, go home without receiving injections or any form of medication because we do not have any to give to them. There are no drugs at the clinic. It is only God that is saving these women from infection and bleeding. We are appealing to the government to come and help us,” Ayuba narrated.

In 2015, Nigeria’s estimated maternal mortality ratio was over 800 per 100,000 live births, with approximately 58,000 maternal deaths during that year. In comparison, the total number of maternal deaths in 2015 in the 46 most developed countries was 1,700, resulting in a maternal mortality ratio of 12 maternal deaths per 100,000 live births.

The World Health Organisation noted that a Nigerian woman has a one-in-22 lifetime risk of dying during pregnancy, childbirth, or postpartum/post-abortion; whereas in developed countries, the lifetime risk is one in 4,900.

The WHO added that poor women in remote regions were the least likely to receive adequate health care, especially in regions with low numbers of skilled health workers, such as sub-Saharan Africa and South Asia.

The IDPs camp in Durumi, Area 1 in the Federal Capital Territory was established on February 15, 2014, due to the Boko Haram insurgency, with a population of 2,830 persons.

Statistics show that the number of households in the camp is about 215, comprising adults above 45 years of age — 103; youths between 15 years and 45 years of age — 1,750; children between one year and 15 years of age — 740; while orphans are put at 22 persons.

Our correspondent found out that the camp was also facing the challenge of toilet facilities, even as it also struggles with poor refuse disposal. The pit toilet available is located beside a dump site, thereby making the toilet unsafe for use.

PUNCH HealthWise also learnt that the issue of water supply is a problem to the IDPs, as the borehole provided for them by an NGO does not have access to electricity supply to power it.

IDPs in need of healthcare, education and security

Speaking on the challenges in the camp, Mr. UmaruGola, the Camp Public Relations officer, said that the major issues the displaced persons are facing centre on health and education.

Gola told our correspondent that government intervention towards their welfare is only five per cent and the rest is from some good-spirited Nigerians and NGOs.

“The number one challenge we are facing is lack of healthcare, especially around women and children. Then we have the problem of food. A lot of the IDPs are starving. The government is not trying. Sometimes, we go to the streets to beg for money to save the lives of women in labour, especially those that present with complications.

“We are calling on the government to come to our aid; we don’t love being here anymore. Whatever intervention you see in the camp was provided by individuals and NGOs and not by the government. We are passing through a lot here. The government should provide us land in Nasarawa State to farm and earn a living. The government should provide us health centres, schools, and security. These are things we are asking for”, he said.

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