Kwara: Communities where pregnant women prefer herbalists, traditional birth attendants

PremiumTimes investigation reports that in most communities in Kwara state, pregnant women abandon health centres in preference for herbalists and traditional birth attendants
Kehinde Adebayo speaks boastfully of his traditional medical practice. His pride is rooted in the curious fact that Egosi and Odo-owa families seeking care for their pregnant women prefer him to the community health centres.
“Most times I take three deliveries in a night,” he told our correspondent. “I’ll handle one, my wife and eldest son will handle the two others.”
Adebayo, aged and popularly called Baba Apiri, is described by residents as a “renowned herbalist” who specialises in child delivery.
Handling child delivery without any licence or any formal training in obstetrics, Adebayo does not use hand gloves, he said, not even after attending a health seminar reportedly organised by the Oke-Ero Local Government Area of Kwara state in which Egosi and Odo-owa communities are located.
Justifying non-use of hand gloves, the old herbalist said, “There are times one needs to recite some incantations on the bare palm before touching the pregnant women’s private parts.”

Possible blood contamination
So, in his own way, he exposes himself, the mother and the foetus or baby to risks of possible blood contamination that could have been prevented by hand gloves.
Apart from exposing himself to health risks, he also endangers his life alongside that of the pregnant woman and her baby as hand gloves are meant to prevent contamination of blood or body tissues.
Nevertheless, Adebayo remains popular and well-patronised by residents who describe him as “a renowned herbalist.”
His popularity also grows due to the absence of what could have been a more
But the state of the health centres in Egosi and Odo-owa has not made a hero in the old herbalist alone. There is also a heroine, a woman operating within the premises of Christ Apostolic Church in the town, just within a walking distance of one of the health centres. She is popularly called ‘Mummy’ but her real name is Janet Oyelowo.
Mummy told PREMIUM TIMES she has received training in midwifery. She is also limited in terms of manpower and facilities. She handles child delivery alone, except with the assistance of a friend and all she has got in her pharmaceutical box are anti-malaria drugs.
“When they come for deliveries like that, we test them for malaria parasite and we treat them,” she said. “That’s all.”
But when there are complications, she said her patients would be transferred to the general hospital, some nine kilometres from her house.
“By the Grace of God, we don’t usually have many complications,” she replied in response to a question on the referral statistics.
However, despite the dangerous gaps in the practices of Baba Apiri and mummy, the testimonies from residents of Egosi and Odo-Owa have been positive.
Morenikeji, a pregnant mother, explained how she gave birth to her current two children at Oyelowo’s residence without complications.
“This pregnancy will also be delivered at Mummy’s house,” she said, smiling as she touched her belly
She and other residents spoke of the poor state of the health centres, and trust in Mummy, as reasons for not using them.

State of health centres
During visits to four health centres in Oke-Ero local government, reports from the Community Health Officers (CHO) showed that most of the health centres had not recorded any child delivery for over three months.
Folashade Olokundu at Odo-Owa primary healthcare centre (PHC) pointed at the Church area when asked for the number of deliveries taken in the last three months.
“That’s where the pregnant women in this town visit. They go to the midwife (Mummy) over there.”
It is the same situation at Egosi, where the old herbalist resides. The CHO in-charge of Egosi clinic, Matthew Ajolaogun, attested to the boom of the herbalist’s business at the expense of the clinic.
“They’ve abandoned the clinic for the herbalist’s home close-by,” he said.

Lack of health personnel
However, a simple review shows the clinics are in deplorable conditions. There is lack of health personnel, water facility and clean toilets in the health centres.
“The borehole outside is no longer functional. There is no water in the toilet,” Olokundu said.
During our visit, early April, just one health officer and two health officers reported for duty at Odo-Owa and Egosi PHCs respectively.
Moreover, added to the absence of necessary equipment, the health facility at Egosi is unkempt. On a tour of the centre, it was discovered that the rooms were dusty and dirty as a result of uncleanliness on the part of the officers. That negated the neatness expected in a health facility.

Uncompleted buildings used as health centres
Kajola and Iloffa health centres, established a year ago, are products of the agitations of residents of both communities in Oke-Oro. These health posts commenced health care delivery on the finances of the communities.
Residents said they were promised by the Oke-Oro Local Government Area, through the health department, that government will take over the centres by sending health personnel and providing drugs.
None of those promises were kept.
Both health facilities are substandard in comparison to the minimum requirements set by National Primary Healthcare Development Agency (NPHDA) in 2017.
The building used in Kajola is an uncompleted one – yet to be plastered, without ceilings, windows and doors. Nuibat Sulu, who is in-charge of the centre, complained of the unavailability of drugs and necessary facilities.
“Even this uncompleted building is a rented one,” Sulu disclosed.
That of Iloffa was donated by the king of the town. The limitation to quality healthcare dispensation in Iloffa is the lack of necessary equipment. According to the CHO, Mayowa Agboola; “The BP (blood pressure) apparatus is not okay and the only bed in the PHC was borrowed from the cottage hospital.
The need for a good building and necessary medical equipment and facilities are what these health officers say will make their work better.

Health director speaks
At the Oke-Ero LGA, the health director, Motunrayo Ibrahim, blamed lack of finance for the poor state of the health centres in the logal government.
Ibrahim confirmed that none of the health centres has access to a good water source as well as basic medical facilities.
Like other local governments in the state, Oke-Ero is financially handicapped to respond to the needs in the health sector, the director said.
“The health centres in Kajola and Iloffa have not been in a good condition because the government only supplied insufficient health officers and not medical equipment and facilities,” she said.
Despite admitting the poor state of the health centres, she decried the activities of uncertified individuals, who parade themselves as birth attendants and handle child deliveries in their homes without a government permit.
She described people like Baba Apiri and Mummy as quacks who should be resisted by the communities.
“Even with the government’s efforts, it is left for the communities and residents to reject those quacks. Many patronise them and that’s risky,” she said.
On the claim of Baba Apiri of attending health seminars organised in the local government, Mrs Ibrahim denied such.
“No health seminar has been organised for birth attendants, talk less of quacks by the government,” she said.
On certification for willing traditional birth attendants, Ibrahim said, “Such person will have to tender his/her certificate, go through a test and we will issue a license of operations.”

Hope in the way
The state of health centres in Oke-Oro is similar to those of other communities across Nigeria, investigations by PREMIUM TIMES have shown. Even some of the 109 health centres the federal government pledged to revitalise (one in each senatorial district) are still in bad situations.
To address some of these concerns, the National Assembly has, for the first time ever, included some funding for PHCs directly from the federal government’s budget.
Although not included in the 2018 budget proposal by President Muhammadu Buhari, the lawmakers earmarked N57.15 billion for the basic health care provision fund as mandated by the National Health Act, a law passed in 2014 but which has not been fully implemented.
Although the budget is yet to be signed into law, the move has been commended by experts in the health sector.
“For the first time, the Senate has put the Consolidated Health Care Fund on the budget. That one per cent will go into revamping the Primary Health Care system and the National Health Insurance Scheme, NHIS,” Francis Faduyile, the president of the Nigeria Medical Association said in an interview with PREMIUM TIMES.
A large part of the money is expected to go directly to many of the poorly funded and maintained health centres across the country.
“This is monumental. It is one of the greatest things that can happen in Nigeria. We believe this will change the trajectory of the country’s health system,” Faduyile said.
Source: Premium Times

Can Nigeria’s presidential system affect good governance?
During a public lecture organised by the Ahmadu Bello University Alumni Association, Bauchi state branch, to commemorate three years in office of the Bauchi state governor, Mohammed Abubakar, speakers raised a critical question on the relevance of the country’s presidential system. NAJIB SANI, who was at the event, reports.
History of democracy in Nigeria
Democracy which is defined by Abraham Lincoln as ‘Government of the people, by the people and for the people’, is the most popular, accepted and practised system of government in the.
Advanced countries do not only practise democracy but advocate and promote it in others.
The history of democracy in Nigeria started in 1960, when it got independence from British colonialists but the system had not been stable those days due to several military juntas for decades.
However, in 1999, democracy returned to the nation at last and sustained for five consecutive periods without military intervention.

First republic, parliamentary system
It would be recalled that during the first republic, parliamentary system of government was adopted where Dr Nnamdi Azikwe, from the south was elected President and Sir Abubakar Tafawa Balewa, from the north was elected Prime Minister.
Under that system, Azikwe was head of state while Tafawa Balewa was head of government. The function of the head of state was serving as ceremonial president, representing the nation at international ceremonies as well as receiving other world leaders that visited Nigeria. The prime minister on the other hand had the duty of executing government projects and policies with the support of his cabinet ministers. The ministers were also selected from parliament. Thus, they served as both lawmakers and ministers thereby saving the cost of governance.
But after the first republic that lasted between 1960 to 1966, parliamentary system of government was abolished in Nigeria and replaced with executive presidential system. Alhaji Shehu Shagari emerged as first executive president of Nigeria in the second republic.
Though there were series of military coups thereafter, executive presidential system came to stay in Nigeria until now.

Three independent arms of government
Under the system, there exists three independent arms of government, the executive (Presidency or governors with their cabinet members), the legistlature (Assembly) and the judiciary (Courts).
However, the questions are, is the system the best for Nigeria and how bountifully have citizens reaped democracy dividends in 19 years? (From 1999 to date).
Analysts observed that elected leaders at all levels ‘blow their trumpets’ whenever democracy anniversary is being celebrated by enumerating their achievements within the period under review.
In Bauchi state, his year’s democracy day was marked last Tuesday 29th May 2018 with series of activities including public lectures.

Public lecture
Blueprint reports that a public lecture was organized by the Ahmadu Bello University Alumni Association, Bauchi state branch to commemorate Governor Mohammed Abubakar’s three years in office.
The occasion was attended by the state governor, top government officials, politicians, APC stalwarts and academics.

Sober reflection
Although most of the speakers at the event opined that it was a time for sober reflection, the chairman of the occasion who is a former Secretary to the Government of the Federation (SGF) and ‘Waziri’ of Fika emirate Alhaji Adamu Fika however observed that the country has not yet reached the desired destination considering the myriad of challenges it still faces.
He attributed the problems to the current system of government being practised in the nation suggesting that unless the principles and practices of good governance bequeathed by the founding fathers are re-visited and re-adopted, ‘Nigeria would continue to wallow in backwardness and cannot attain its potentials’.
Represented by a former Registrar of the Bayero University Kano (BUK), Alhaji Sani Ibrahim Aminu, the waziri of Fika, advocated the re-introduction of the parliamentary system of government in the country based on the 1963 constitution with necessary amendments to bring it up-to date.
“We should do away with this expensive and corrupt executive presidential system which lacks genuine checks and balances. It has proven to be unsuitable for our country. It was never the wish of Nigerians but was imposed on them by the military”. He lamented.

Costly to maintain two legislative chambers
The elder statesman also recommended that the nation should consider if it is necessary to continue to have two chambers of the legislature which he opined is too costly to maintain.
According to him, before 1960, there was no senate pointing out that it was introduced as a counter balance for the northern region which had no more members in the then house of Representatives than the number of members for the three regions of the south combined.
“The senate was created with nominees of the regional governments as members, with each regional government nominating the same number of senators. Thus, the north had 12 senators while the southern regions being three in number had a total of 39”. He recalled.

Way forward
On the way forward to the problems of the nation, Fika advised that with regard to the management of the economy, the country should go back to the past practice of launching five-year periodic national development plans.
This is even as he recommended that in public service, Nigeria should return it to its original system of merit based system by restoring to the service commission and the electoral commission ‘in view of their political neutrality, impartiality and making them completely outside the control of politicians.
The guest speaker Professor Saminu Abdulrahman Ibrahim, who is the Vice Chancellor of the Abubakar Tafawa Balewa University (ATBU) Bauchi, while presenting a lecture entitled ‘Unleashing Agricultural Potentials for Diversification of the Nigerian Economy’, said the event, topic were timely and relevant.

Harness its agricultural potential
He asserted that the country should properly harness its agricultural potential in order to diversify its economy and complement oil revenue.
In his speech, Governor Abubakar expressed appreciation to the ABU Alumni Association for organizing the event in his honour saying the topic discussed was in line with his government’s and federal government’s blueprints aimed at boosting agriculture for jobs and wealth creation.
He noted that agriculture is the mainstream of Bauchi state economy adding that 80 percent of the state’s population practise one form of agriculture or another.
The governor therefore said his administration is duty bound to support farmers saying 500 tractors were recently procured for farmers with a view to promoting mechanized agriculture.
Governor Abubakar claimed that despite inheriting a workforce of 105, 000 people with monthly salaries of N5.1 billion, his government has been able to pay them regularly when some States could not.
In addition, the governor embarked on other projects such as roads construction across the state particularly the ongoing 105, 000 kilometers Misau-Udubo Road.

19 new primary health care centres
Aside that, he said government had built 19 new primary health care centres in parts of the state and was rehabilitating secondary primary health care centres and schools across the state.
“We also have vocational centres for male orphans in Bauchi and female orphans in Misau, where they are being taught skills and trades for self-sustenance”, he said.
This, he stated were achieved within the ‘just’ three years of his administration which he claimed receives not more than N5 billion monthly as federal grants.
He solicited continued support and prayers of the citizens to the administration so that it could deliver on dividends of democracy.

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