….How pregnant women suffer from lack of healthcare facilities in Niger IDP Camp
In April 2023, 26-year-old Serah Adiza woke up one morning with signs of the onset of labour, and despite losing her first child after prolonged labour over a year earlier, she was not deterred as she made up her mind to deliver her baby by herself.
Hours turned to days and after three days of excruciating pain, she was rushed to a health facility where the doctors recommended an emergency cesarean section.
“On the third day, around 2 pm, I tried pushing. I did that till 6 pm but the baby didn’t come out. That was when everybody got scared and they rushed me to the hospital,” she told ASHENEWS.
She would later be delivered of a baby boy.
While Serah and her son had escaped being counted as another casualty figure due to the inadequacy of Nigeria’s health system, 45-year-old Victoria Samaila wasn’t that lucky.
She got pregnant shortly after she was displaced by bandits in 2020.
She had been so sick during her pregnancy, but couldn’t afford to seek medical care at a health facility.
“We already had a lot of problems when I was pregnant. When it was almost time to give birth, I fell very sick and was asked to go to Minna (the Niger state capital) for an ultrasound. We did that and two days later, I went into labour.
“Seeing my condition, my husband took me to a private clinic here in Gwada with the little money he could spare.
“Unluckily for me, they said they couldn’t handle the delivery so we were asked to go to Kuta to get the baby removed but we had no money.
“We kept going from one health facility to another looking for a different options that wouldn’t cost us money but they all told us the same thing, I needed an operation.”
Victoria would later go to the hospital in Kuta. Unfortunately, the baby had already died.
“I lost my baby and my husband is still paying debts we owe at the hospital for the operation. We still have a debt of ₦20,000 at the hospital,” she said with tears in her eyes.
These are tales of women living in Niger IDPs camps, and who struggle to access healthcare services during pregnancy in the IDPs camps.
Both Victoria and Serah were displaced by bandits from their communities and are presently taking refuge at the Central Primary School, Gwada, in the Shiroro local government area of Niger state, north-central, Nigeria.
Gwada IDP Camp
Statistics obtained by ASHENEWS from the management of the camp revealed that there are 139 women, and 170 children all from Kaure village, in Shiroro local government area of the state.
With over 400 people, including men, the living conditions at the camp are quite challenging as the IDPs mostly rely on donations and assistance from the government.
According to rsidents, this assistance has declined in recent times and the women are forced to engage in menial jobs to be able to feed their families and meet other essential needs such as healthcare and the likes.
In early 2023, a non-governmental organization set up a health post, the only one at the camp.
The post is a tent divided into a consultation room and a ward.
Aside from a table and chair in the consultation room, there is no other equipment.
The IDPs say the medical staff at the post rarely have medicine to give, but instead, write prescriptions for patients.
Nigeria’s Maternal Health Data
Estimates by the World Health Organization (WHO) reveal that nearly 20% of all global maternal deaths occur in Nigeria.
This data, based on WHO estimates, see more than half of these deaths occurring in fragile and humanitarian settings.
Statistics from Pathfinder International also reveal that 810 women die daily from preventable complications of pregnancy and childbirth.
Out of this number, 94 percent of such deaths occur in low-resource settings, such as in camps like this.
In addition, WHO’s maternal mortality ranking places Nigeria extremely high on the list with 1000 deaths per 100,000 live births.
This staggering comparison is against the lifetime risk of 1 in 4900.
Enablers
A study by Shela Akbar Ali Hirani et al. J Nurs Scholarsh on ‘Maternal and Child Health During Forced Displacement’ published in the National Library of Medicine observes that the maternal health of women is significantly affected by forced displacement.
The study identified the key challenges such as poor infrastructure of healthcare services, and unavailability of birth attendants and healthcare professionals to manage medical emergencies among reasons that affect maternal health, especially for women in displacement.
Another study titled ‘Maternal Health Challenges in Internally Displaced Persons (IDP) camps in Nigeria’ published by the Vanderbilt Institute for Global Health says that systematic healthcare structures have not been well-established in Nigerian IDP camps, leading to increased maternal mortality in sub–Saharan Africa.
This situation is further enabled by attitudes such as poor health-seeking behaviour.
Attempts to save cost
At 24, Jemima Mika had her first child in displacement.
She had already heard stories from the other women who had had babies in the camp on how cost-effective it was to have a child in the camp rather than at a hospital and so she prepared actively for that.
But when it was time to have her baby, she found out that it was harder than she thought even with the help from other women at the camp.
Jemima refers to her predicament merely as a ‘setback.’
“I wanted to give birth at home but we had a setback. When I went into labour, the baby refused to come so I was forced to go to a hospital. We spent about ₦10,000.”
Jemima, when asked by this reporter about her preference for home delivery maintains her stand saying, “Even if I am pregnant again, I will want to give birth at home to save costs. We don’t have money to go to the hospital. That money we spent when I had my baby was money we didn’t have.”
A 27-year-old Salome Joseph was heavily pregnant when ASHENEWS visited the camp.
Just like many of these women, healthcare becomes secondary when they are struggling to get food to eat.
She narrates how most babies are born in the camp because people cannot afford the medical expenses of seeking professional care.
Having had her first and only child who is now three years old in the camp, she maintained that she would have her next baby in her room.
“I have been praying to God to give me the strength because I plan to give birth here (in the camp). That way, I won’t need to pay any money. Most women give birth in their rooms. If you are unlucky, you give birth at the hospital.”
Médecins Sans Frontiéres (MSF), also known as Doctors Without Borders has identified obstetric emergencies as a popular healthcare demand during emergencies.
The MSF identified cesarean sections as the commonest surgery undertaken by its team during emergencies, even surpassing emergency surgery for the war wounded.
In a country where a woman has a 1 in 22-lifetime risk of dying during pregnancy, such poor health-seeking behaviours pose a great risk to women and their unborn babies.
Coupled with delayed decision-making to seek maternal care due to failure to recognize danger signs and lack of readiness, maternal deaths may continue to be a challenge.
In this case, the lack of access to medical attention for women, especially during pregnancy and childbirth in this camp, can be attributed to poverty and the absence of humanitarian aid that caters to the health of the displaced persons.
The Niger state governor, Mohammed Bago has announced the creation of a state refugee commission, which is aimed at meeting the demands of displaced persons.
In the spirit of leaving no one behind, as envisaged by the sustainable development goals, the commission when estaished, must, as a matter of urgency, prioritize the healthcare needs of displaced persons, especially women and children, who make up the bulk of the IDPs in the state.
