By Alex Uangbaoje:
“It’s so painful and I don’t want to talk about it. Each time I remember them, I feel traumatized, that is not a good experience for a father or any parents, death of 8 children is enough to frustrate any family for life.”
That was how Nuhu Kassim, a farmer and husband of 3 wives with 10 children living in Agwan Dan Yamman settlement within Likora community, Rigachikun Ward of Igabi Local Government Area of Kaduna State, started the narration of how he lost 8 children to the cold hands of death within fifteen years, amidst tears, because of difficulty in accessing medical facility.
This newspaper had launched an investigation, following information that maternal and child deaths is rampant and very high in Likora community, where a projected number of over 20 women and children die annually.
The community is located in the eastern part of the state, directly behind Kangimi Dam, with major access road through Maraban Jos, across 3 rivers, including River Kaduna. The distance is about 10 kilometres, while another link road from Kujama in Chikun Local Government Area takes about twenty five kilometres southwards. The people said their forefathers started living in the community over 300 years ago.
The farming and fishing community which have an estimated population of about 10, 170, are predominantly Hausa’s, Gbagyis and Fulanis, with 17 settlements under it. Amongst them are; Likora itself, Angwan Dan Yamma, Angwan Izam, Baka, Namaje, Kwatakwara, Borkonu, Tunga Tokache, Gidan Gyaro, Goburawa, Makodi, Ruga Fulani, Ruga Sani, Ruga Achibobo, Ruga Ibrahim, Ruga Yaro, Ruga Makodi, Ruga Barka and Ruga Idris.
It was observed that the only healthcare facility in the community is dilapidated without any equipment and even single drug, according to our findings, this has made antenatal care and child delivery very difficult for women in the community that has resulted to high birth complications, despite Nigeria’s commitment to the Universal Health Coverage (UHC), aimed at allowing every citizen certain amount of access to health care services for free, access to healthcare still remains a tall dream for so many Nigerians.
Investigation revealed that pregnant women in the community have to trek about about 10 kilometres to Maraban Jos General Hospital, Rigachikun General Hospital, Kujama General Hospital or any other in Kaduna main town to access healthcare services for their antenatal and whenever they are facing serious health challenges, because there are no equipment and staff in the health facility close to them. The only person working as an attendant at the facility is the accountant.
Their only means of transportation is “achaba” (motorbike), and when they get to the river bank, they have to alight and board a canon to cross over to the other side of the river bank and continue their journey on a road which is not motorable. Imagine a pregnant woman needing an emergency in this situation at the middle of the night!
Narrating his ordeals to our reporter, amidst tears, Nuhu Kassim, whose 3 wives, at different occasions has lost 8 babies all together to child birth complications, explained that, “issue of birth complications are just normal here, and we lose children and women here as if life is not important.”
“For me as a father, I have lost 8 children to birth complications, what I mean is due to difficulty in giving birth, my wives sometimes, lost the babies before they are delivered and most times they died immediately and sometimes 2 to 3 days after delivery. It’s so painful and I don’t want to talk about it. Each time I remember them, I feel traumatized, that is not a good experience for a father or any parents, death of 8 children is enough to frustrate any family for life.
“It seems the state government is not seeing our communities as part of it, sorry to say. They only come here during election campaigns that’s all and they will tell you all sorts of lies but ones you have elected them, you won’t see them again. Even NGOs don’t even visit here, but you cannot blame them, if government does not think you are important why even talk about NGOs.”
Kassim, added “as big as our place is, we don’t have any government presence here, no water, even the school at Likora is not fit to be called a school, the only health facility is zero.
On what he has been doing to avert such deaths, he said, “i later find out that the main causes of those deaths was lack of antenatal, so now I have ensured that all my wives attend antenatal regularly. I personally carry them on my motorbike to Kujama in Chikun LGA, during raining season because of the river on Maraba Jos road which most times are full and we cannot cross except you have money to pay for canon.”
It was gathered that in the last 10 years, no organization, whether government, NGO or individual have organized any medical outreach of any kind in any of the communities. This it was learnt was responsible for the high level of ignorance to basic healthcare education in the area.
It was also learnt that most women in the community are no longer interested in going to health facility for delivery because of the pains they will have to go through before accessing one.
This made Hajiya Hausis Isiya, a 40 years old mother of 4 in Kwatakwara settlement of Likora, concludes that, “i prefer that young women stay at home and give birth rather than go to the health centre that has become a death trap”.
“How can you call that place a health centre, when there is virtually nothing on ground there? Government has not been faithful to us, not even a single development in our place, my friend and her baby died just because of delivery.
“Before, the person in charge was not always around for antenatal, so i lost hope of going to the place and all my children were giving birth to at home without any complications, yet those who go there, we hear, some die and some they have to refer to Maraban Jos or Kaduna.” She laments.
A 20 years old mother of 1, Beauty Nuhu, who is also pregnant as the time of this report, said she had to move to Kujama at the early stage of her first pregnancy when she was having lite bleeding and later continue with her ANC there to avoid complications because as far as she is concern, there is no health centre in Likora that can deliver pregnant women.
20 years old mother of 1, Beauty Nuhu.
Beauty, therefore called on both the state government and the LGA, to come to the aid of the communities and treat them the way they are treating other communities that have government presence in them by upgrading the facility and providing it with equipment’s and drugs.
A man who lost his wife and baby in the process of giving birth 4 years ago, who simply identify himself as Abdullahi Mai Gona, vowed not to step his foot on the health facility in the community again, but will rather move his new wife to his brother’s place at Pambegua, anytime her pregnancy is above five months to avoid what happened to the first one.
Another man Suleiman Y’au, a Rice Farmer, and father of 5, who also shared his sad experience of suffering in accessing medical facility, expressed disappointment saying, “we have lost hope, we don’t even know who to run to anymore, because we are tired of going to the LGA for help. My wife has given birth five times and has had three complications of serious bleeding that she was rushed to general hospital in Kujama, Chikun LGA, though it’s far but the road is better than that of Maraban Jos which is in our LGA.
“But I have learned my lessons now, despite the bad roads, once she is pregnant now, we quickly register for antenatal so as to avoid the complications. I realized that if we continue to wait for this government to come to our aid, every one of us will die, so we are taking the pains to be visiting Maraban Jos general hospital, despite the distance and roughness of the road.”
It was gathered that the communities have made frantic efforts at ensuring that government at the LG level intervene in what has become deaths sentence to them. For instance investigation revealed that they have written series of letters to different LG chairmen that has worked at the council in the last 10 years, yet none of them ever sent anyone to go and assess the situation talk less of doing anything about it.
Abdullahi Hussein, is a teacher in one the schools in the LG, who hailed from one of the settlements within Likora community. Abdullahi, laments government neglect of the communities in the area, doubting if they are truly part of Kaduna state, because according to him, Kaduna government don’t care about their people at all.
“The situation in our community is terrible and we have been in it for a long time, despite all our appeals to the state government through the Local Government, it seems nothing is ever going to happen.
“There was a time we were losing our pregnant wives, newborn babies on a regular basis, we had to cry out to the LGA chairman at that time who assured us that something will be done about it, but unfortunately they came back with the excuses that there is a Health Centre at Likora, already and that they will upgrade it, but as we speak now, that centre is a shadow of itself.
“No single equipment there, they used to have liked three staff servicing over 10,000 people, because we are a clustered community made up of several villages. The most unfortunate thing is that, since the man who was in charge, who was not even a health expert died, government refused to bring in someone else. As we speak now, the person that is serving as an attendant at that HC is the accountant. And you know what to expect when you leave the life of your pregnant wife in such person’s hands.
“The major problem is when someone is requiring an emergency, that is where we are mostly hit by deaths, there was this woman in our compound that was in labour and we took her to the HC at Likora, when we got there we realized that there was nothing the attendant could do to help her so we quickly arranged for Achaba (motorbike) to take her to Maraban Jos, this was around 2am midnight.
“The distance is over 10 kilometres from our village, and there are several rivers we have to cross and the road is terribly bad, so before we got there her situation became very critical and the General Hospital at Maraban Jos couldn’t do anything either and they have to refer us to Barau Dikko Teaching Hospital. They tried their best but it was too late and we lost the baby but God saved the mother. She has to be operated on, to remove the dead baby.
“We have had so many cases like that, there are so many of them that the mothers even died in the process. The funny thing is that whenever we write to the LGA over our plight, rather than reply by writing us, they just give verbal responses that are not documented. The problem is not just in our village, but also in the other surrounding villages that made up the cluster that are using the HC.” He explained.
When our reporter, visited the facility, to see for himself the situation as projected by the people of the communities, what he met on ground was appalling, a situation that can best be described as pathetic.
On arrival at the facility, he met a young man (whom the people fondly called Dr. Donatus), who introduced himself as “Donatus Joseph, Accountant and In charge of this facility (Senior Community Health Extension Worker).”
When he was asked why is he, an accountant the ‘in-charge of a health facility servicing over 10,000 people, he said, “though am the accountant of this place officially, we lost the health attendant that was in charge to death sometimes ago and since then, they didn’t bring anybody, so I took over since I am the most senior person here.
“Ya’u Zakari, was in charge before he went to study environmental health to enable him work here, but presently now he is late. I am the one managing the place now. The government is aware that I have taken over as the one in charge here, and the work is getting too much for me.”
Donatus, it was observed may be getting tired already because of the kind of frustration in his facial expression and the way he speaks, because of the way the facility now look.
“We (him and the community people) have been writing to government for assistance and letting them know how stressed up I have become because of the facility, they kept saying they will consider the issue, but nothing is being done about it. I used my money to buy drugs that I administer to patients here.
“I can’t remember the last time government brought a single tablet to this place, not to talk of equipment. Even on the issue of staff, I am the only one working here now, they told us that in every HC, we are supposed to be at least three workers, but am alone here doing everything myself.
“I have been working here as a casual worker for about four years now, there is no salary, nothing, the only way I survive is to use my money to buy drugs and resell to patients because government don’t even bring anything for them. Most of us health workers at the LGA are casual without pay and they are aware of it. He lamented.
According to Donatus, as the senior community health assistant, in charge, he handles delivery of pregnant women by himself. Adding, “according to our standing order, any case I can not handle, I normally refer them to General Hospital Rigachikun, General Hospital, Kujama or Maraban Jos. But all these facilities are very far from us, they have to go on motorbikes or trek.
“There are cases where because of the bad roads, before bike could convene the pregnant women to the next facility, they delivered. Sometimes we record both maternal and child deaths, but the ones that we record at the facility, honestly are not more than 3 for maternal and 5 for children in a year, all these normally happened during deliveries.
“When it happened in the various communities, they don’t report to you, you only sometimes hear them outside, so you cannot record them. Most of them prefer to deliver at home by themselves and because most of them don’t come for antenatal, they also have still births.
On his part, Ismail Adamu, Assistant Health Focal Person of Rigachikun Ward, who confirmed that the communities has written many letters, made series of courtesy calls to the LGA and the Legislators representing them, said all to no avail, but that all they get are promises upon promises that has yielded nothing.
“The situation of the facility in Likora, is so terrible that even the structure is collapsing and will soon go down. The main reason am sure they are not seeing development is because of access road to the area. Am aware that the Director PHC at the LGA knows about their situation, but what I don’t know is if he has reported it to the state government.
“For the last 10 years or so, those communities have not seen anything like development, worst of all is the health sector, as we speak the only activity that takes place in that facility is routine immunization. No single drug there anymore, yet the person in-charge there still take delivery of pregnant women sometimes. Adamu, explains.
When contacted, Director PHC, Igabi LGA, Habila Barem, denied the fact that anybody was asked to take over the facility, not to talk of handling delivery of pregnant women.
“Nobody has instructed anyone to takeover that facility, those in charge there are just for referral purposes, not that they are doing anything. Not just Likora alone, there are so many others like that in some other facilities at the LGA. Some of them are voluntary staff, some are casual, others are attendants. We have short of staff across the state. Some facilities have even shutdown because no one to run them.
“Am assuring you that we don’t have a staff that can take delivery there, but if the person there is a trained official or nurse, they can take delivery, but if anybody who is not trained takes that risk, he or she is on his or her own.
“We have a process in the department of PHC which is that there is a ward referral centre which is at Rigachikun, and that ward referral centre is supposed to carter 24/7 Rigachikun, and because we are starting, the Governor has renovated all the referral centre, we have twelve of them in the ward headquarters and those serves are ward referral centres.
“The one in Likora is Health Post, that supports any case that is minor and refer the rest to the ward referral centre. Ward referral centre will now refer to the general hospital when the need arises. So we have a world class health system with a structure that is built on ground, we are trying to strengthen the ward referral centres now and then we will go to health facilities.
“However, even the ward referral centres we have, we are not being able to settle the staff, some of them are doing two shifts instead of 24hrs. Likora been a health post, there are categories of staff that are supposed to work there, their duty there is to see a patient are refer them. Bye and large, we are trying to fashion out how all this things can work better for us. He said.
Mr. Barem, added that the PHC department has already began the upgrade of some facilities within the LGA, saying, “three of such facilities were repaired last year and some others have been slated for upgrade this year and Likora is number one that will commence immediately after the elections.”
On the fate of the Likora people’s health before the upgrade will take place, the Director PHC hinted, “we have mobile services that we conduct around those communities, in fact I am part of the mobile services, we go to some of this hard to reach because they are under-served and I am assuring you that Likora is one of our very next point of call.