The mobile medical outreaches and other interventions by the European Union (EU) and United Nations Children Fund are giving succour to pregnant women, nursing mothers and children in some hard-to-reach communities in Bauchi State, reports DAVID ADENUGA
Shelim, a rural settlement in Gamawa Local Government Area of Bauchi State with over 1000 people, has been without any social amenities for nearly 50 years. The dwellers who live mostly in huts and mud houses, are nomadic farmers, occupying a savanna farmland.
Only the village head in the rustic community, Saleh Ibrahim, owns a motorcycle, with which he assists the inhabitants when they are in dire need to access a health facility in the nearest town where there is a medical facility.
According to Ibrahim, lack of access to healthcare facility in the settlement has posed a challenge for them for years. He said: “We have to go to Taranka or Bulkwachua to access health facility which is almost four hours journey. The women in labour at times die on the way while some go unconscious before getting to the facility.”
That picture is finally changing, as the European Union (EU) and United Nations Children’s Fund (UNICEF), whose mobile medical outreaches seem to be restoring hopes to the rural dwellers. Having built and renovated primary healthcare centres (PHCs) in some major towns, the two bodies have a mobile medical team that takes healthcare services to the doors of those in the hard-to-reach communities. As part of efforts to improve the lives of women and children in the rural settlements, the EU and UNICEF renovated 323 healthcare centres in the state. The drastic move is to ensure the primary healthcare facilities in the state are well equipped and accessible to those in the hard-to-reach settlements.
To achieve maximum impact, the one PHC per ward functions 24 hours, seven days a week, to provide integrated PHC services to rural dwellers. In Zaki Local Government, which has 18 wards, there are 18 PHCs. Same goes for Gamawa LGA, where there are also 18 wards. With this, EU/UNICEF has so far taken health care to 144 hard-to-reach settlements in nine local councils in the state.
“We rely on the EU/UNICEF hard-to reach services here where we get antenatal care; we are given malaria, typhoid, and pneumonia treatment, and immunisation for our children. Our wives and children are being treated here. We don’t have to stress ourselves to go into town. Maternal mortality has reduced drastically since EU/UNICEF intervention and our children no longer suffer from malnutrition,” Ibrahim said in Shelim.
Until the intervention, a mother of two in Shelim village, Ramatua Adamu, 22, said the villagers used to walk to access health facility. Ramatua, who spoke with our correspondent who was on a tour at the settlement, said, “Now, I get free drugs. We no longer trek to access health facility due to EU/UNICEF intervention.”
Adiza Garba, a mother of twins who also spoke with our correspondent, said she gave birth to her two month-old babies at home with the assistance of UNICEF midwives who came to her aid. She said there was no way she could make it to the nearest health facility with the distance and the un-motorable road. She said the antenatal care and drugs given by EU/UNICEF aided the safe delivery of her twin babies.
However, the Local Government Chairman in Gamawa, Alhaji Ado Lele, blamed paucity of funds as the reason the LG cannot attend to the plight of the dwellers in Shelim. Speaking with our correspondent in a telephone interview, he said: “We don’t have money to support them. That is why we keep silent on this matter; getting finance has been our major challenge.” When asked if any attempt had been made to get assistance from the state government, he said: “I don’t know if any letter has been written so far; let me contact the local government Director of primary healthcare first and I will get back to you.” He never did.
Also in Gasamako village, an agrarian settlement in another Local Government Area called Zaki, our correspondent gathered that the community also used to encounter numerous challenges, which included maternal/neonatal mortality, malnutrition, among others.
Zaki, which was carved out of Gamawa LGA, shares also similar problems. Hassana Shuaibu, 36, one of the beneficiaries of the UNICEF New-born, Child Health and Nutrition (MNCHN) project in Gasamako, said she gave birth to her children through the traditional means of delivery with the support of the UNICEF midwives.
The woman, in her late 30s, is a mother of seven. Her last child is a baby girl who is about one month old. Despite the poor condition of living in her environment, Shuaibu is a bubbly woman, laughing heartily when our correspondent visited the settlement where she was interviewed. She cited the unmotorable road network leading to her village as the reason she doesn’t attend a maternity clinic during childbirth. She said the distance between the nearest health facility in Zaki and her settlement is about 10 kilometres. “To access the road, we rely on canoes and cart to get to the village. The cart is locally called ‘Amalanke.’ It’s only during the dry season that motorcycles can access the poor road network,” she said.
Labour for Shaibu and other women in Gasamako community has been a daunting task during rainy seasons. “During the birth of my last child, I had complications during labour. It took five hours for my placenta to come out, if not for the untimely intervention by the UNICEF hard-to-reach mobile team who came to my aid, I would not have survived it. The free medical treatment I got from the health workers has really sustained me here. The team comes like four times in a week to give us free drugs, ante-natal, and micro nutrients for my children,” she added.
Salamatu Ahmadu, also a dweller in the settlement, said she gave birth to all her three children with the aid of the UNICEF midwives. The woman, in her late 20s, said: “I had excess bleeding during the birth of my third child; it took me about 12 hours to deliver successfully. I couldn’t go to town as it will take longer time to access the maternity clinics as it was during raining season. I would have given up in the process but the prompt antenatal care I got from UNICEF really contributed to my successful delivery.”
Narrating the traumatic experience their wives do go through during labour in the rainy season, the village head in the community, Alh Bulama Garuba, said: “Transporting our wives to the nearest hospital during rainy season takes time. Even when our children are sick, we find it difficult to take them to the maternity. We have to use canoes or cart (Amalanke) to get there. We spend hours on the way that our wives even give birth on the way.”
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However, the Local Government Director of Primary Health Care in Zaki, Mohammed Ibrahim, told our correspondent that female workers are available to follow routine immunisation providers to the outreaches in order to mobilise the women and the caregivers to utilise the nearest health facility for their services. “We make use of the available female staff we have to follow our routine immunisation providers to the outreaches to mobilise the women and the caregivers to utilise the nearest health facility for their services. Like antenatal care, immunisation, family planning and other health services at nearby health centres especially where there are closer to one primary health care per ward.”
When asked about the steps taken by the PHC facilities in the local government during emergency labour by women in Gasamako, Ibrahim said: “We have traditional birth attendant who are trained at the health facility; some were trained at the general hospital in Zaki to attend to labour and they refer as soon as they see indication for referring. We have also pleaded with the Community Development Committees (CDAs) to always try to provide a means of transport in conveying them to the nearest health facility. We have been writing to the state government to at least provide us ambulances; we are optimistic that the government will intervene on the plight of these women.”
Meanwhile, the Deputy Local Government Chairman of Zaki, Shehu Liman, told our correspondent that financial autonomy is necessary for the LGA to be able to perform its statutory duties like constructing roads, building more health facilities, and others. “We have been hoping to have financial autonomy to perform our statutory duties. We have financial challenges; we need to construct motorable roads for this settlement. We have written to the state government that we have the problem of roads, shortage of maternity clinics, even dispensaries. Why it is so is because the LG doesn’t have enough money to construct this and that. We hope to be granted autonomy; when we get financial autonomy, we will come to their aid.”
Why we intervened, by EU/UNICEF
The Maternal and Child Health MCH) Coordinator of the UNICEF’s hard-to-reach mobile team in Gamawa LG, Sugura Umar, said the EU/UNICEF has made efforts at reducing maternal/neonatal child mortality in the settlements.
“EU/UNICEF has made giant strides in seeing that there is a reduction in maternal/neonatal mortality rate in the LG in developmental aspect, especially in terms of capacity building. Various programs like the modified life-saving scheme (MLSS) and prevention of mother-to-child transmission of HIV, recruitment of community resource-oriented persons (CORPs). CORPs and hard-to-each teams have immensely contributed towards the reduction by making health services available to the people in the remote settlements,” she said.
She added that EU/UNICEF supplies equipment to each health facility, especially those in one PHC per ward. She said further that coordinators of the UNICEF team were trained on mentorship, among others. “Where a pregnant woman is enrolled into antenatal care, she is given fare of N1,000. In each of her recommended four ANC visits, she gets N4,000 when she delivers in the health facility and the child receives first immunisation vaccines; and N1,000 in each of the next four immunisation schedules for the child. These amount to N12,000 for one woman from pregnancy stage through delivery to fully immunised stage of the infant. This strategy is designed to bridge the gap of financial barriers hindering pregnant women in remote communities from attending ANC; delivering in the hospital or fully immunising their children against preventable diseases. Over 3,500 women have benefitted from the scheme in the 3 supported PHCs.’’
Also, the Maternal and Child Health (MCH) Coordinator of the UNICEF mobile team, Khadijat Hassan Jabi, said: “We do antenatal care for the women, family planning, collect some deliveries and treat the under- five children with anti-malaria drugs and immunisation. We attend to about 30 women in a day and over 50 children during immunisation. The only challenge we have is the riverine terrain, which has made transportation to the settlement difficult.”
The Chief of Field Office, UNICEF, Mr. Bhanu Pathak, said the EU-UNICEF initiative was funded by the EU) in 2017 to support Bauchi State implement healthcare services. He said the 54-million-euro multi-sectoral health and nutrition project, being implemented across the three states – Adamawa, Bauchi and Kebbi – by EU-UNICEF to strengthen PHC and community resilience for improved Maternal, New-born, Child Health and Nutrition (MNCHN) outcomes in the three states.
According to him, the goal is to contribute to the reduction of maternal, new-born and child mortality and morbidity in the three states towards the achievement of Sustainable Development Goal (SDG) 3, with the objective of improving the nutrition and health status of women and children through a sustainable primary health care delivery system and improved community resilience.
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