Maternal mortality ratio has continued to increase in Nigeria, especially in the big cities. Mothers die during delivery and leave behind helpless children. In many cases children die in the presence of their mothers despite the pain of labour they experienced. In more serious cases, both mother and child die in the process, throwing the family into mourning.
The most recent estimate of the maternal mortality ratio (MMR) in Nigeria was 545/100,000 live births in 2008. According to the World Health Organisation (WHO), this was the second highest number of annual maternal deaths in the world in 2010 and 14 per cent of all maternal deaths globally. Records indicate that between 2000 and 2015, the maternal mortality rate in Nigeria reduced from 1,170 deaths to 814 deaths per 100,000 live births (30.4 per cent decrease).
With statistics like this, with many of the cases being recorded even in big cities where social amenities are available, one will naturally expect that women and children in villages devoid of signs of modernization will be most hit when talking about maternal mortality ratio.
It is therefore surprising to stumble on a community tucked in the remotest area with zero case of maternal mortality ratio. It becomes more surprising when it is known that light on telephone handsets is used to deliver women in the community since there is no electricity.
Welcome to Zhigakuchi, a community of about 750 people. Villages under Zhigakuchi include Shape 1, Aso Rock, Akoyi, Sumakpan and nine nomadic settlements. In this community, phone light is used to take delivery and handkerchief is used to do mouth to mouth resuscitation for babies in distress.
Despite this however, Samuel Kefas, a community health extension worker, who has been a volunteer in the community since 2017, said Zhigakuchi is yet to record any mother and child death. Kefas, who handles immunisation and family planning in the community spoke to members of the Horn of Revival Ministry Bible Academy (HORMBA), who were in the community for medical outreach.
He Daily Sun: “I started working here December 2017. I actually came to set up a chemist, but when I saw the opportunity to become a volunteer, I joined because I was already taking care of the patients in my drug store then. In order to prevent the clinic from collapsing, I became a volunteer, more so the health worker that was previously there, got admission and went to school. So my joining the volunteer help saved the clinic.
“When I joined the clinic, we had a lot of challenges, poor patients turn out, poor immunization, poor antenatal attendance, people use to go Mpapa to deliver for immunization, as well as for antenatal visits.
“When I came I started going from house to house, sensitising them with the help of the Dekachi of Zhigakuchi, Chief John Wambi, I talked to them about community participation, I explained the need for them to patronize the clinic through health education awareness.
“The sensitisation campaign saw the increase of those attending the clinic from 15, 20 people to 55 and 60 as contained in my monthly report sent to the area council. This improved attendance arose the interest of the area council and they started sending us the necessary things for monitoring and evaluation.
“We used to treat diarrhea, typhoid, malaria, mumps and chicken pox frequently. But now it has reduced greatly because there is improvement in personal hygiene, environmental sanitation, good water (although the pipes are broken now) and so on.
“The clinic was very dirty, lacked equipment. But with our interaction with some non-governmental organisations and outreaches such as yours, the clinic is looking improved and we have some equipment but lacking in drugs and other basics. I have been going on regular trainings and return with good knowledge to continue to serve my people through the clinic.
“It will interest you to know how we take delivery in this Zhigakuchi. Before I go into that, I need to stress that we need personnel first and foremost. Because, I am the only person in that clinic, I am a volunteer I don’t even know when I will be employed, so we need staff, some were transferred here but because of poor road network, the telephone, lack of electricity and water they have refused to come.
“On a day the clinic is busy, I run all the shifts alone. There are days I will be too tired and I begin to make mistakes but thank God not enough to endanger lives. So I need two or three additional staff that can assist me even if they are volunteers.
“It is not easy to be a volunteer even for me but because I love my people, I love the community, we understand ourselves, I live with them, eat what they eat, so we interact and I am happy serving them. It takes courage for others to do likewise. But once the road is fixed and we have electricity, people will be coming and be willing to work on our facility.
“We need generator. Do you know until recently, we were using torch and the phone light to take delivery at night until the World Bank assisted-programme installed solar? We need freezer to keep our vaccines. Right now we store our vaccines at Katampe.
“It is compulsory to give Hepatitis B vaccine immediately after birth. For instance, the Saturday before your visit, I had to go under rain to bring the vaccines to give to a new born. If we had a freezer, I won’t have to do that. In the labour room we need resuscitating materials. If we deliver a new born, we use our mouth and handkerchief to do mouth to mouth resuscitation for the baby when there is distress. So we need things like ample bags, resuscitating materials to revive a dying patient or a dying baby.
“We also need chairs for the clinic, we need pipe born water, fitted ones because our pipes are broken. The one in chairman’s house is no longer mounted because the pipes are broken we need to replace it so that our toilet facility will be fit for use.
“We need the clinic to be expanded because it is too small to accommodate the population of Zhigakuchi. The number of those attending the clinic has improved because we have other villages under Zhigakuchi and nine Fulani communities. Right now some of the equipment donated to us are kept at development control office because we lack space to keep them.
“One of the challenges is lack of funds. I make money through transportation (N7000) stipend they provide for immunisation and outreaches. We go to the Fulani communities around us during such visits.
“Drugs are not provided for the clinic, so I have to buy drugs from the funds and from the little interest I use it to take care of myself. I also attend workshops to gain more knowledge from the same money and if we are lucky we get transport stipend or honorarium. For labour, I charge N3,500 from where we get funds to buy materials for the clinic.
“We need drugs because the patients cannot afford them. If we can have the ones we can give them for free or at a very subsidised price, that will also encourage them to come to the clinic instead of embarking on self medication from unverifiable source.
“We do not have roads here. It is a miracle you got here for your outreach because it’s been raining for four days none stop. We heard your vehicle got stuck. We are also afraid there might be an epidemic breakout because people from town come and dump refuse which affects us and our little ones as well as the only source of water we have.
“We have complained to the chairman who is the closest person to us and he has promised to look into the matter, it abetted for a while but these indiscriminate dumping of refuse has not stopped.
“Another of our concern is the dilapidated school building we have. The LEA Primary School Zhigakuchi is seriously in bad shape and we were also told they will come and do something about it but nothing has been done.
“Our healthcare volunteer, we call him our doctor, is trying and we have not really been recording deaths, once the situation is critical they rush to Mpapa Hospital.
“We are at peace with in our community although we do have little clashes with the Fulani, whose cows eat up our crops but most times the police around here step in and settle the matter amicably.
“We seem to be a forgotten community but for outreaches such as yours. We also need secondary school here. It will serve other villages under Zhigakuchi. There are four villages and nine Fulani settles they all rely on the primary school in Zhigakuchi to educate their children.”