Aching Stories of Pregnant Women in Enuwa Primary Health Centre
“The quality of a nation depends on the way it treats its women”
This is a fact that isn’t debatable. When the health of women is put in jeopardy, how is the nation supposed to maintain continuity, how are the little ones supposed to be raised, how are the men to find succour and companionship? The labour market would be left a massive vacuum, what would be the fate of NGOs, SMEs and other agencies?
A visit to Enuwa Primary Healthcare Centre will provide a hindsight to the travails of pregnant women and nursing mothers that patronize the facility. Despite its proximity to the Palace of Ooni of Ifè, these women are left to their fate and are made to settle for the mundane facilities in the PHC.
“The number of patients has outweighed the mossy facilities available at the health centre, the number of people we attend to during ante-natal is quite large compared to the facilities available. There are just four of us in the ANC (Ante-Natal Centre of the PHC)”, the young nurse whisper in a low voice while she put together the file of the patients that were attended to for the day.
Established in 1959 with the clear aim of providing affordable and quality healthcare to the people of Ile-Ife and neighbouring town, one would wonder if at all the Enuwa Primary Health Centre which is situated in the heart and few meters away from the central mosque and the traditional home of Ooni in the ancestral home of the Yoruba heritage – Ile-Ife has done anything to better the lives of her poor patients.
The joy of motherhood is the happiness in the face of her sons and daughter, but when either of the two fails to survive during childbirth then eyebrows need to be raised by the people and professionals in the health sector. The state of maternity centres in Nigeria is quite appalling and requires quick intervention to safeguard the lives of pregnant women and their unborn child. In 2015, Nigeria recorded 58,000 maternal mortality which is equivalent to 15 per cent of global annual death
After a twenty minutes’ drive on the popular Okada (motorcycle), we got to the PHC in a bid to get relevant information. “Ati de Olomowewe, owo mi da” (This is Olomowewe referring to Enuwa Primary Health Centre, pay me my money), the Okada man asked in a thick voice while we look around to at least check if the place he dropped us is a PHC or and abandoned residential apartment.
The approach view of Enuwa Primary Health Centre, Ile-Ife during work hour.
According to one of the residents around, Enuwa PHC got the epithet not on a platter of gold but due to services it renders in time past. “It was a refuge for the teeming number of pregnant women who cannot afford quality health care in private hospitals,” says the elderly woman who sells opposite the Primary Health Centre. According to the classified information gotten from the maternity ward, there is a downward trend in the number of childbirth in health centre predating back to June 2017 as pregnant women opt for church and traditional midwives popularly refer to as “Iya Abiye”. The visit to Enuwa Primary Health Centre in Ile-Ife provided an insight into the many challenges and incertitude of pregnant women during labour.
NO DRUGS, NO AMBULANCE, STAFF APATHY.
‘’Kosi instrument, ati wipe kosi nkan ta le lo”. The Mrs Esther Akinbiyi (Not real name) a Community Health Officer in the Primary Health centre lamented while speaking in a soft to the interviewer that there is no modern instrument to attend to the emergency situation in the Primary Health Centre, therefore, they must be transferred to a more sophisticated and well-equipped facility, she discussed with comprehensively on the state of things. Most of the referrals of obstetric emergencies in OAUTHC Ile-Ife, Nigeria come from Enuwa primary Health Centre. Further investigation shows that the PHC lack basic facilities such as electricity, pipe borne water, adequate staff and ambulance for emergency services.
“Health is Wealth”, Ilera lo ro is a popular aphorism that has firm underpinning in the Yoruba traditional setting. But the state of things in Olomowewe provide a sharp contrast to this wise saying, the health of patients has been compromised and dashed hope. The toilets used are not modernized and has a heap of refuse closely beside it.
The toilet facilities used by patients and visitors at the PHC.
“We are short of staff, says the plump and fairly short lady in her white gown who is the community health officer that was transferred to the health centre January 2017. She further explained the challenges they face in getting things done very fast. “There are two nurses per shift while the whole primary health centre can boast of only one doctor” she continued.
“We prescribe drugs for them to buy outside because there is no pharmacy in the PHC, while in case of emergencies the patients have to look for cabs to transfer themselves to the teaching hospital for further treatment,” Mrs Akinbiyi continued. While touring the PHC, a list was sighted and has in it Kerosine as part of necessary things to be bought by the pregnant women. It was after series of questions it was gathered that there are no electricity and pregnant women face danger, especially during midnight delivery. “Government O da wa lo hun, ati apply apply, won wa sibi”, these are the words of the Akinbiyi as she grumbles that the state government have not done anything to upgrade the facilities at the health centre.
The maternity ward still parades the archaic facilities that dated back to 90s while mothers are left in cold to deliver a flatable airtight sack used as a mattress with inadequate manpower to oversee the safe delivery of babies. Some of the women walk a far distance to get water for sanitation and drinking, while there is no electricity to illuminate the centre.
Further investigation shows that the PHC lack basic facilities such as electricity, pipe borne water, adequate staff and ambulance for emergency services. One would wonder how nursing mothers, pregnant women and infants survive in a Primary Health Centre where there are no drip stand, 8 hospital beds, no access to water, no sterilizer, no ambulance, no usable toilet, no power supply and complete delivery set.
During a visit to the Primary Health Centre on an ante-natal day, pregnant women were seen in their numbers waiting patiently and holding firmly to the blue thick file where their records are kept and progress recorded. “There is the only doctor in the hospital and attend to patients only in cases of emergency.”
“Se kin se ati odo Aregbe leti wa”, a young woman who appeared to be in her mid-twenties asked politely if I work for the government of Osun State, so she can send him a message and her displeasure to the governor Aregbesola while nurses shout distinctly at the maternity ward where new-born baby is sleeping. The woman (name withheld) gave birth earlier in the morning before we visited her in the afternoon. ”There was no light during my childbirth, the nurses make use of torchlight while I was in labour,” the woman continued.
The woman was seen lying close to her new-born baby who was wrapped with a wrapper made from the finest of cotton materials with a mixture of different colour. There is no water around, my mother fetch water from the well, while the relatives of some of the nursing mothers help with other chores in the health centre. Kerosene is one of the necessary things we must bring along to the health centre because a kerosene stove is used for sterilizing.
Pregnant women fetch water or bring relatives to lend helping hands this is evident when a pregnant woman who was already due for birth was seen from far away. There is no drug store, no ambulance, of cause no electricity.
THE UNTOLD STORIES
An investigation revealed that many of the pregnant women that attend ante-natal treatment in the maternal ward resolve to give birth at home or church due to the different reason. This is apparent as there is a sharp cut in the number of women that were around for ante-natal and those that eventually come to give birth there.
The story of Mr Elnathan Hezekaih who lost his wife in the public hospital in the Southern part of the country because of loss excessive blood after giving birth still pinches one’s heart and leaves a hole or wound which will take an eternity to heal. Thus, need to adequately attend to the needs of patients during child labour.
The poor woman died due to non-availability of drugs in the said hospital, while in Enuwa also there is none. The midwives services Scheme (MSS) and the SURE-P MCH program attempted to address the shortage of skilled health workers at PHC by deploying both retired and newly graduated midwives to PHCs all over the country, as well as providing for training for personnel but Enuwa never benefitted from this. The last major intervention was during the Millennium Development Goals (MDGs) of United Nation, the government have never done anything to better the lives of the patients.
The World Bank initiative of Saving one Million Lives program gave every state in Nigeria including the FCT, $1.5million dollars each was given a whopping sum of N548, 250,000 to improve maternal, child and nutrition health services for women and young children. With this interventions, there have not been any significant improvement in the primary health care centre, who will account for what has happened, or the money has been syphoned.
The primary health centre in Enuwa, Ife Central local government is an eyesore with its deplorable state that makes one’s skin crawl. To even think that’s the space where a crucial task like child delivery is being done is no different from a manger.
Investigations carried out has brought to fore some gory and unpalatable the state-owned health centre, Conveniences are the harbingers of venereal infections and events in the hospital beds are a domicile to blood-sucking monstrous creatures, hospital equipment is not sufficient and the ones that are available have gone old, rustic and tired from age. Hospital records are not well updated, so hands cannot be laid on authentic and recent records.