Rebecca Ejifoma who visited Agboyi community in Ketu area of Lagos where women prefer to give birth at home with the help of traditional birth assistants, writes that the insect-infested slum needs a well equipped hospital and other modern amenities to improve living standards
When you see the hub of Agboyi community, you remember the famous Makoko in the heart of Yaba. And when you see Makoko, the first two things that cross the bridge of your mind are malaria and poor health facilities especially for pregnant women and children. And these were the same issues on ground at Agboyi community, a slum in Ketu area of Lagos.
After the risky wooden canoe ride, this reporter had about 10 minutes walk in the very obnoxious, bacteria-infested stagnant water on the entire narrow path in Agboyi.
Now, there stood Mrs. Kafila – a mother of five – on the doorway of her house, a diagonal Traditional Birth Attendant’s (TBA) outlet. She had all her children at home. She said. “I will never go to health centre except to immunise my children. I trust TBA. They treat me well. I had my five children at home. I won’t go to health centre.”
While she vehemently affirmed in TBA and home delivery as the safest, her neighbour – whose two months old baby laid near the doorstep of her room – quickly chorused, “Yes, I also had my baby at home. Home is safer with the TBA women by you.”
Sadly, Kafila, who lost her husband about two years ago, spoke further in the Yoruba language that the TBAs are way better. Adding, she said they are like doctors themselves. “When we have any complaints, we go there. Sometimes, she refers us to the health centre. TBA is always there for us every time of the day; no closing.”
Undoubtedly, residents patronise TBAs and home birth more not minding that they are labelled unskilled personnel, whose tools are unsterilised and operate in poor environmental conditions; thereby, contributing to high maternal and infant mortality rate in the country.
Interestingly, bold and daring Mrs. Aina Abiodun is a Traditional Birth Attendant in Agboyi 3 among the only two registered in the community. According to her, she is a professional with over 15 years of practice and has registered her centre, Damy Clinic.
And with her skills, she said has been helping the women of Agboyi smile home with their babies. “I am a professional in this business. I do my job well and try my best to serve the people, too. And by God’s grace, mothers have always smiled home with their babies cuddled in their arms.”
While Abiodun charges between 5000 and 7000 naira for delivery of one baby, she told THISDAY that she takes 15,000 naira for twin delivery. “Just two months ago, I had a patient with twins of both sex. She delivered safely. I am very happy because both mother and kids are healthy.”
But then she lamented their one obstinate challenge. “But it becomes a very difficult task before we can contact the canoe riders to help us take the patients out of the community. There is no road for vehicles or tricycle.
When asked at what time or sign does she refer the pregnant women, Abiodun affirmed, that if the pregnancy is a complicated one and needs referral or the child is not properly positioned, “I refer them to hospital in nearby town like Alapere. We don’t wait until it gets to unredeemable situation. An instance is the recent case, the patient went to the hospital on foot. I did not delay her due to the experience we had. The operation was successful.”
Health status of the pregnant women
Sadly, the midwife noted that fever remains the commonest ailment among pregnant women. She explained that once they went for test at Alapere they will be presented with the causes, and scan to confirm the status of the pregnancy.
“They usually come to TBA first before we refer them to health centre for some tests. When it is time for immunisation, we refer them, and ensure they take all the necessary steps the PHC prescribes. Through their booklet from the PHC, we check to know their status; if they have HIV or other things. So, I work hand in hand with PHC.”
Now, worried about her skills in caring for the women and children, Abiodun said she had attended several training with the Board of Traditional Medicine at Onikan, Gbagada and also PATH2 training in Lagos.
“Local herb, for instance if the baby suppose to come with head but refuses, there is no orthodox medicine that can handle it, it is only herbal that can do it, also if the child bends or the placenta comes first there are things that we give them to ensure normalcy at birth,” she noted.
And to complement her efforts in easing the health needs of most pregnant women, Abiodun sells babies’ wears and women kits like diaper, sanitary pads, baby clothes and utensils, drugs, tradition herbs (agbo). “I make good sales here. The people buy from me. I even treat elder ones, too.”
Health of the children
While close to the Agboyi pedestrian bridge at the junction at my arrival, I heard screams of delighted children swimming gracefully in the brownish smelling water, which they say is the natural colour.
What are the health consequences of their action, I asked curiously, “The most common sickness among children is fever, they may be stooling and vomiting, and once it’s getting too much, we refer them to health centre and from there they can be referred to another hospital outside the community if it is beyond them.”
According to research, there are various illnesses associated with contaminated water. Recreational Water Illness (RWI) are caused by germs that are spread by swallowing contaminated water can be present in swimming pools, hot tubs, water, parks, lakes (Agboyi) and oceans.
Findings show that most common RWI is diarrhea caused by germs like Crypto and E. Coli. Other RWI infections are: gastrointestinal, skin, ear, respiratory, eye, neurologic, wound. This is as children pee in lakes and fecal matter, too.
Now, there are fishes of varying kinds and sizes -tilapia and catfish, mosquitoes renting spaces on the water, lava of various insects over your feet while in the water. It is this same water the children swim in daily and possibly swallow some involuntarily.
Chief Osolomade of Agboyi 1, Mr. Jelili Bayioku Salau decried that there is a type of insect that bites the legs; it weakens the children’s immune system, too. The water promote sickness among teenagers in Agboyi.
Swiftly on the heels of this, the chairman of Ward Health Committee, Agboyi LG Ketu, Mr. Olusegun Adeboye, said “The water causes mosquito, and makes the children have fever coupled with the unhygienic environment. It is God that is protecting us because when our children get sick or pregnant woman goes into labour at night – the health centre only opens between 8am to 3:30pm Mondays to Fridays.
“The government should let its presence be felt here. Yes. It provided mosquito-treated nets for us. But give us a good hospital. What we have now is just a health centre and community health officials. Give us better manpower in terms of medical doctors, qualified nurses. There is no way our people will not access it and our lives will improve here regarding health and environment.”
With such poor environmental condition, Agboyi residents say potable water becomes an issue, Unanimously, they chorused that a bag of sachet water costs between N170 and N200. “Water is expensive here. So, most times, we get our drinking water from the rainfall. We set our buckets outside and fetch.”
Transportation by boat
While I sailed for minutes on the river to Agboyi, there was no life jacket in the wooden rickety patched canoe filled with people. Everyone began to make confession to whoever cared to listen since it was a Friday (day of confession), “I cannot swim.”
“They cannot swim and do not own boats. Since there is no road, it is hard to cross the child to other side of the community whenever they need to go to the hospital.”
Now, Agboyi 1 alone comprises over 15,000 persons. Residents include Hausas, Igbos, Ijaws and the Eguns. It has got four compounds including Oko-Agbon, Papa, Cele and Ilaje. “All these people if they don’t get to Agboyi one, they can’t go out.
“In March this year, the Lagos State Governor, Akinwunmi Ambode and our House of Assembly representative, Tunde Ibrahim came to inspect and promised us a bridge that will connect Agboyi 3, 2 and 1. So they assured us that by 2017, the link bridge would be erected. Our prayer is that they will not forget us.”
The state of the PHCs
It was just last year that the Minister of Health, Mr. Isaac Adewole, said that the federal government would build 10,000 PHCs in the country – each in a political ward – in three years.
While many lauded this effort, the Oba of Lagos, Rilwan Akiolu, while addressing a group of doctors in Lagos recently said “The ones already available are not working. There are no qualified manpower to provide the necessary care to our down trodden people and you want to erect more buildings.
“What the government is supposed to do is train the medical manpower that will do the work 100 per cent at our already existing PHCs across the country. How many of the machines for dialysis are working? And you talk of building more structures. Our down trodden people in Lagos are really suffering.”
The PHC in Agboyi seemed abandoned but for the two persons found in it. A healthcare centre, surrounded by the stench of stagnant water with swam of bacteria and mosquito, is the current state of the centre.
Although Salau commended the PHC in Agboyi for always trying, he said it could not do beyond its strength. “We are pleading to government that before the bridge is constructed, the workers in the PHC should render 24 hours service to save the lives of our women and babies.”