Rebecca Ejifoma, who recently toured Ibasa Ijegun Egba, a riverine community of Oriade Local Government Area in Lagos, reports that the dilapidated Primary Health Centre that services 24,000 residents excluding persons under 18 does not boast of a single health worker or daily operation despite the myriad illnesses plaguing their community. It brings to the fore the need to revamp PHCs across the state, especially those in underserved areas
Oriade Local Government Area of Lagos State is a riverine locality with 10 communities sandwiched by a murky lake. The communities are: Ibasa, Ibeshe, Imore, Ilashe, Igbologun, Igbeseore, Igbesun, Ireke, Ikare, and Iyagbe.
With 24,000 inhabitants excluding persons under-18, they only boast of one non-functional Primary Healthcare Centre (PHC) at their disposal in Ibeshe town. Worse still, it takes a 15-minute boat ride from the Ibasa community at the price of N100 to ferry across the water. Then it takes another 10-minute bike ride at N200 from the shore of Ibasa to Satellite Town, where residents can begin to scout their way to any private clinic of their choice.
Now, for the people of Ibasa Ijegun Egba, where the Awori language is spoken, it has been a futile call for a PHC to save them from the illnesses plaguing their children. Sitting on local mats on the floor of their balconies, it was interesting to hear the tales of desperate mothers whose children continuously get down with cold, cough, catarrh, diarrhoea, smallpox, and chickenpox, and malaria, among others, with no medical help in sight.
Use of TBAs, Self-medication for Immunisation, Others
Through the innocent and fragile gaze of Ajara Lawal, a 19-year-old new mom, it was clear what many of the mothers have had to bear daily in their quest to access quality healthcare for their infants and children.
“My baby is three months old. I got married in this place and also live here. I usually enter the boat with my baby on my back to Mude to find a hospital,” said the teenage mother. “We don’t have any hospitals here.”
Ibasa dwellers have entrusted their sick children to traditional birth attendants (TBAs), who charge N5,000 for all kinds of ailments. For Mrs. Giwa Ganiyat, she and other women seemed troubled about neglect on the government’s side. This is because when children require surgical emergencies or have serious injuries or a chronic condition, they are left with the option of either the TBAs or travel by speedboat to receive appropriate care at a private clinic.
While noting that she has been in Ibasa for many years, she admitted, “We get treated at Iya-alagbo (TBA). It’s not just treating the children when they fall sick. The TBA also does immunisation for our babies”.
Stuck with Dilapidated PHC for their Health Needs
Oluwatayo Odunsanya is another mother of two that couldn’t hold back her frustration. She is perturbed about emergency cases of infants and other children in a community where they have to travel to Ibeshe (about 25 minutes walk) to access a lifeless PHC.
“Our children always have cough, catarrh and cold. Although that might be normal with children, if the government can help us renovate the health centre and bring back the nurses, we’ll be happy. We need a standard hospital because of emergencies. We need bridges, too,” she pleaded.
Neglect of Health Workers Resulted in Abandonment
Despite the eyesore state of the PHC, residents said it was manageable to an extent because one or two workers would come to attend to them. However, all of that went south by lack of care on the part of the government.
When THISDAY visited the PHC located in Ibeshe, it was deserted. Its only companions were the tall, intimidating grasses on the left side of the compound, heaps of refuse, shattered glasses, and the cobwebs adorning the walls. The reason for the desertion may not be far-fetched.
“The government didn’t take care of the nurses. The nurses were doing their best. Although not all of them used to cross the water, once like that, they did come,” Odunsanya disclosed. “We pay N100 for transport fare to cross the water on speedboats or canoe, then pay N300 for a bike if it is an emergency or N100 for a shuttle bus to Agboju, Festac or Alakija. We want the government to build a health centre for us.”
Since the PHC remains void of humans, residents of Ibasa continue to stick with TBAs and self-medication more as the perfect substitute to saving their kids’ lives. With her baby girl strapped to her back, Mrs. Kalesanwo Oladunni explained that she takes a speedboat for approximately 10 minutes, then a commercial motorcycle to access a private clinic in Festac Town.
“Our children are always stooling, having chickenpox, and malaria,” stated Oladunni. “So I always go to Festac (about 20 minutes to access if a boat loads on time) to get treatment for my child,
The mother of three, 11-year-old twins, and a year-four-month-old girl said despite years of waiting on the Lagos government’s promises, none came to life. “We have been talking, but the government has not been hearing,” she decried.
Elders’ Donation of Land for PHC
The Baale of Ibasa Ijegun Egba Land, Chief Modiu Abayomi Tolani, revealed that through “our member of House of Assembly, Honourable Wale Rauf, sent some people to request from our king a place where they can build a PHC.” The government got two plots of land. “Although they promised to come last year, we haven’t seen them,” added Tolani.
While noting that the Ibasa community still has faith the government would come, he said that the entire riverine communities in wards H, I, and J in the riverine communities of Amuwo-Odofin Oriade are subjected to a critically sick PHC.
“It is in a dilapidated state. So we implore the state government because if our pregnant women are in labour or children need emergencies, we will have to hire a bus to carry them upland, and the upland we are talking about is the Ijegun, Iba, Satellite road that is a no-go area to take a pregnant woman in labour; tankers will block everywhere,” Tolani stated. “You can spend two to three hours in traffic before you manage to get to Agboju, Amuwo, or Festac, where you can access a good health centre.”
Emphasising the need for a functional PHC, Tolani mentioned that “although we have this oral therapy that we give the children by ourselves when they have diarrhoea, we need the PHC for the safety of our women and children.”
Lack of Basic Amenities
While decrying the lack of government presence in Ibasa, Tolani added a lack of potable water, contributing to their woes. “Those who don’t have money to make a borehole or buy sachet water, drink water from the well. We have serious issues with dirt disposal. The King has made a dumping site, but many people will not go there to dump.”
Chief Adeshina Jubril, the Bashorun of Ibasa Ijegun Egba Land, echoed every word of Tolani. “A community that has been existing for 14 centuries has such a PHC, one primary school since 1958 till date. If the government can help with a school for the children because they wake up as early as 5:00 a.m. to cross the lake,” Jubril explained. “It is dangerous. The worst part is our children graduate from universities but have no employment. Our needs are many. However, the basic and most pressing are a school, employment and a health centre.”
Numbers Don’t Lie
The Nigeria Demographic Health Survey (NDHS) 2018 cited that 13 per cent of children under age five had diarrhoea in the two weeks before the survey. Children from Ibasa likely contributed to this figure.
While acknowledging that childhood ailments like diarrhoea are preventable and treatable, the NDHS said that about 1.7 billion cases of childhood diarrhoea are recorded annually, killing about 525,000 children under five globally every year.
The under-five mortality rate has slightly decreased since 2008 from 157 deaths per 1,000 live births to 132 deaths per 1,000 live births in 2018. This implies that more than one in eight children in Nigeria dies before their fifth birthday.
Solutions for Common Diseases in Children
In a research ‘Standards for Improving the Quality of Care for Children and Young Adolescents in Health Facilities,’ the World Health Organisation (WHO) recommends a complete, accurate, standardised, up-to-date medical record, which is accessible throughout their care, children must be checked for immunisation, and appropriate vaccines, assessed for growth, nutrition, breastfeeding, acute malnutrition, risk of tuberculosis, HIV/AIDs, fever, diarrhoea, pneumonia, cough or difficulty breathing, and bacterial infections in sick infants.
According to WHO, in its research, better and quality care for children is recommended and the provision of medicines, medical supplies, equipment, doctors, nurses, midwives, pharmacists, and paramedical staff, all of which the Ibasa community desires.
Expert’s Position
“To ensure that the public has adequate coverage of primary healthcare intervention, it’s recommended that every ward in every state should have a primary health centre that is close enough for the people to access healthcare,” a public health physician at UNICEF, Dr. Ijeoma Agbo, advised.
She further pointed out that the PHC has to be free, accessible and in good condition to provide good services.
“UNICEF does weekly outreach where community mobilisers go out and let them know. They’re supposed to come with their children zero to five years to access immunisation, vitamin A supplementation, nutritional counselling.”
The physician also suggested that where there is no PHC, the government should build one or renovate the one in a dilapidated state.
“The Lagos governor has been committing to that,” while recommending that the right information on healthy practices, proper hygiene.
In line with their call for a PHC and health workers, health experts believe that if a functional PHC is provided, it would not only improve the health status of Ibasa people, but it will also help Lagos attain Sustainable Development Goal 3, which champions good health and well-being for all.
