Education Tales of pains, neglect: How Ogun communities survive using...

Tales of pains, neglect: How Ogun communities survive using one dilapidated health centre (2)

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At Igbeme, Kobejo, Ijoko, Abikanlu, and Ita-Kasia, the story was the same. However, at Itakasia we met a Titilayo Mosuro who was heavy with pregnancy. She had walked a long distance to fetch potable water for her family. W was waiting when she arrived.

Tales of pains, neglect: How Ogun communities survive using one dilapidated health centre (1)

Mosuro explained to me what she’s endured to access antenatal care. She said she has never visited the Ohunbe health centre as she had to attend a private clinic at Oja Odan, a popular town frequented by people in the 21 villages.

According to her moving from Itakasia to Oja Odan is a pathetic experience as she had to trek about two kilometres from Itakasia to reach the main road before boarding a motorbike to Oja Odan and what she has been doing in the last seven months.

Asked to state how much she pays to access healthcare in the private clinic, Mosuro declined, adding that “it is expensive as a peasant farmer”.

Birth by the roadside

Tales of pains, neglect: How Ogun communities survive using one dilapidated health centre (2)
Titilayo Mosuro, seven months old pregnant woman narrated how she treks two kilometer to access antenatal care

The village head, Chief Johnson Ayinla, narrated the challenges pregnant women in the village faced.

Chief Ayinla said: “Because of the long distance, before the women could reach Ohunbe health facility, they would have delivered prematurely on the roadside. So, the Republic of Benin has taken what belongs to Nigeria.

“For our women to give birth, we have to spend huge amount to use their clinic which is not better than what we have here. There are times that they don’t even give us the respect we deserve. Some of our women, who cannot afford the cost of delivery at the clinic in the Republic of Benin, have had to deliver their babies at home using herbal”, he wept.

At Ijoko, we met a home trained doctor who hails from the Republic of Benin. He is the village doctor.

David Agbo did not attend a medical school but was trained as a medical practitioner at a private home clinic in the Republic of Benin. He lives in Ijoko and attends to his patients from one room in the village. His clinic is named Pouvoir du Seigneur – (Power of God).

According to Agbo’s story the villagers believe in him to deliver genuine medical service to them, as he had been practicing for almost year. Agbo came to the village because the village lacks medical services.

“I did not attend any university. I was trained at a local clinic in the Republic of Benin. I don’t have certificate to practice. I do not have any permit to work as a doctor in Nigeria. I just came here and I started working”, he revealed.

When ask about his responses during emergency child labour, he said he does not handle emergence cases. “Emergence cases are sent to a better clinic in the Republic of Benin”.

State of Ohunbe Primary Centre

Tales of pains, neglect: How Ogun communities survive using one dilapidated health centre (2)
The Assistant Chief Nurse Ohunbe Primary Health Centre conducting
HIV/AIDS test for Alaba Abiodun, patient at the health centre.

Dorcas Adunni Tijani is the Assistant Chief Nurse who was transferred to the centre after the facility was locked up for almost a year in June. She came to manage the centre and resumed on June 5, 2017.

“When I resumed here, I discovered that the villagers do not attend the facility. I accosted the village chief and complain about the development. I appealed to the villagers and requested to know what I can do to ensure they attend the health centre.

“I had a meeting with the pregnant women in the villages and asked them why they have shunned the centre. I was told the women attend Pobe, Republic of Benin, for immunization and ante natal care”.

Tijani had found a way to convince the women to attend immunization session. She said: “The women even called doctors in the Republic of Benin to confirm the date of their next immunization, after they have been immunized in Ohunbe health centre. But they claimed they cannot have immunization at dual clinics”.

As a health worker, Tijani said that with the state of the centre, she also could not force herself to receive any treatment at the facility. “Look, we do not have a bed to sleep. We do not have any equipment. There is no staff but if there are equipment the patient will be glad to attend the clinic to receive treatment”, she confided.

Tijani said that since she resumed, she had been submitting her report of activities concerning the centre in a new record at Abeokuta. “I am the only person that does this. We go for outreach to administer immunization to the communities with only two staff and it’s sometimes heartbreaking.

“We need staff and equipment. I had to employ an assistant out of my own desire but the government said I cannot employ an assistant on my own,” she narrated.

When asked why the villagers preferred the Republic of Benin, Tijani said a former staff said it is because “the facility is usually unmanned whenever they visit the centre at Ohunbe. Now, I am also sick. I need treatment”, she complained.

Tijani said she has no other staff to assist with the work load in the facility but a woman named Rachel had been volunteering since 2014 at the clinic. But Rachel had not received any compensation.

Tijani said she met Rachael, a woman who has been volunteering at the health center since 2014 without any motivation or salary to support her.

When I met Idowu, the volunteer staff, she said she has been at the center since August 2014. “When we were first employed, we were being paid stipend at that time but few months later they stopped it and later urged that we should endure that whenever government want to employ, they will employ us but since then I have been coming since, no salary. It is Nurse Tijani that gives me 2,000, 3,000 and that is how I survive every month”

“When I first got here, noting was happening here, I was just sleeping. People were not coming; they were going to Republic of Benin. We later did sensitization for the people and to some of these villages, it was then that few of them started coming once in a while” Idowu exposed.

In an inspection to the facility, Idowu took me to all the rooms to show me all what the center has. They were all empty rooms. No mattress. No basic equipment. There was no ceiling in the main room Idowu described as ward to me.  Another thing she showed me was a big clay pot at the one corner in the labour room. “What do you use this one for”, I asked her. “That’s where we fetch water”, she replied and laughed.

She also showed me the pit toilet and incinerator where burn waste.

Patient’s Experience at Ohunbe Health Center

Tales of pains, neglect: How Ogun communities survive using one dilapidated health centre (2)
Inscription showing the delivery room at Ohunbe Primary Health Centre

Alaba Abiodun, mother of five lives in Ohunbe, a community in Ketu Local Council Development Area of Ogun State. Abiodun who was pregnant and told earlier by the nurse at the center to come to the center to complain on how she feels.

In her explanation to Dorcas Adunni Tijani, the Assistant Chief Nurse in charge of the PHC, Abiodun said that she has been coughing for many days with body temperature and the right part of her belly paining her.

The nurse who paid key attention to what she was saying asked Abiodun what medication she has been using when she has been noticing the symptoms, “I have been using different kinds of concoction to abate the symptoms but did not seemed to be working”, she replied.

Again, the nurse asked her if her husband knew about the symptoms, Abiodun who was skeptical and her face shirked to the left said that her husband works in Benin Republic and it’s been long that he came home last.

Abiodun was looking frail and feeble, and was advised to do HIV/AIDS with two other tests to know the state of her health and pregnancy after she has narrated how she was feeling to the nurse. “You are going to do HIV/AIDS test now, I will give you cough syrup, other drugs and injection which will make you very fine”, the nurse said in affirmation to her.

After the HIV/AID test was done for her free of charge, Abiodun result read negative and was given cough syrup for the incessant cough to cease, paracetamol for the body pain to relief her and to subside the body temperature.

She was also given ferrous sulfate to treat iron deficiency in her body, paracetamol to treat the frequent pain and ache in the right part of her belly, Vitamin c to help her regenerate tissues, protect against heart disease and aid the absorption of the iron in her body, Clofenac 50 MG Tablet, a Non-steroidal anti-inflammatory (NSAID) drug to treat pain associated with conditions sprains of muscles and joints.

In her further explanation on the benefits of the drugs, she told Abiodun that B Complex is an essential water-soluble vitamins that will convert all the foods she eats into cellular energy, with all the drugs and injections adding to one thousand naira but she only had five hundred naira and had taken only pap before coming to the health center after she was asked how much she was holding and if she had eating before coming.

With keen interest, I listened to their conversation and how Abiodun was responding to all the information that was given to her. She looked stunned and forlorn after the whole conversation was abruptly ended due insufficient fund.

I intervened and told the nurse that I will add the remaining five hundred naira that she should give Abiodun all her drugs and injections. She was elated and thanked me for the kind gesture.

Government Intervention

Hon. Moses Adegbite is the new Executive Chairman of Ketu Local Council Development Area, council area where Ohunbe health center is located and an area council that was carved out of Yewa North Local Government admitted that the Ohunbe health center is short of staff and faced with some challenges due to paucity of fund in the council.

Adegbite said that government in its own effort has been coming up with some program to alleviate some health challenges in the state in primary health center.

On access to the healthcare, the council boss said that there is a program from Federal Government with the support of World Bank Assisted program to make all villages in the country to have access to the health and markets centers

He also maintained that the state government has been doing well in creating programs for children it takes care of the women and children from age 1 – 5, provide free medical services for them.

He cited the maternity center in Oja Odan as one of the beneficiaries of the initiative.

Adegbite mentioned that as soon as the council get funding, there will be total change in Ohunbe Community Health center that will make people in the villages access the health center.

“We want to do a lot of renovations to the health center so that it will be of good look, we will renovate it, bring new equipment to the facilities”

“We have another center at Obele that is being process by World Health Organisation, We want them to assist us put structure so that our people will not be going to Republic of Benin to give birth”, he called for support.

Commissioner for Health in Ogun State, Dr. Babatunde Ipaye largely put the blame of the condition of the health center on the  local council authority of the area for not to have informed and requested for support from the state government on the pathetic situation of the health center.

“We are not responsible for managing primary health center and we don’t also provide human resource because of principle of separation of power, it is in the purview of local government to provide all these functions but what we do is to provide technical and material supports for PHCs in the state”

Ipaye promised to call the Chairman and the medical officer of health of the LCDA.  “Tomorrow I will interrogate the issue, I will call the medical officer of health and the council boss, I will ask for the details and why they have not solicited for our supports”, he promised.

He said that the state has acquired some equipment that have been distributing to PHCs in the state.

Economic Implication of Nigerian babies born with Beninese’s Birth Certificates

Data bar chart showing number patients that gave birth at the Ohunbe Primary Health Center between June to November, 2017

Tales of pains, neglect: How Ogun communities survive using one dilapidated health centre (2)
Data Chart showing number of pregnant women that received antenatal care at Ohunbe Primary Health Center between June to December, 2017

If it has any economic implication for the development of the Nigeria when babies that should have being born in the Nigeria are born in neigbouring country due to poor state of the health in the country, most especially when they are carrying birth certificates of Republic of Benin, Dr. Temitope Ogunniyi of Department of Economics, University of Lagos opined that the pregnant women can be described as free riders.

“They saw an opportunity and they tapped into it. However, the host country is using her recourses to provide health care for foreigners. Moreover, it is irrelevant to say that getting or the giving Benin’s birth certificates hampers our economy, not at all”

“The so called children have dual nationality which they can exploit for progress and settlement in the future. They have the choice of claiming where they may wish to settle when they are of age”, he said.

He advised that with such situation, one should alert the government of the needs to provide basic amenities, drugs and equipment for people those communities to avoid such disgraceful act and allow the citizenry have their own share of the dividend of democracy at the border villages in order to reduce the risk encountered in the course of child delivery.

“Having most of the pregnant women to trek kilometers to Benin Republic for antenatal care is inimical to their life, knowing that Nigerians and tax payers”, he explained.

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