Toyin Saraki, wife of Nigeria’s senate president wears many caps; on the global stage, she’s a WHO Africa Regional Special Advisor. She is also a global goodwill ambassador to the International Confederation of Midwives and is founder and president of the Wellbeing Africa foundation. HANNAH OJO met the former Kwara State first lady at the 71st World Health Assembly in Geneva.
Ever wondered how a personal tragedy thaws into a life time commitment? Ask Toyin Saraki. At age 27, the former Kwara State first lady had a life-changing experience which changed her outlook on philanthropy.
“I never in my life read the footnote of any book because all I had to do was read the book and absorb it and sail through life happily. On December 6, 1991, I gave birth three months prematurely. I had twins, I lost one and I got married, all within the space of 24 hours. My previously lovely life suddenly collided with the footnotes of life. In that harrowing period, I really did experience what was never intended for me and I was most unprepared but what I experienced was an unavoidable reality for majority of the women in my country,” she said in a Ted talk hosted in the U.K that has been viewed by over 57, 000 people.
As she survived that experience committing to help reduce maternal mortality, Mrs Saraki would later be confronted with two other jarring instances of life lost when she became the first lady of Kwara State. First was the death of Chinwe, the wife of the then Kwara State commissioner for health, who went into labour a month early while on a visit to her mother-in law’s place.
Reliving the experience to an audience, she said: “She was taken to the nearest hospital where they didn’t have her health history. They were trying to get her health history from her and she was groaning with pain, so there was a life-changing delay of about 45 minutes. In those 45 minutes, her baby became stuck in the traverse line. By the time they realised that she needed a caesarean, they couldn’t get the theatre open because somebody else has had a caesarean three hours earlier and the auxiliary nurses had cleaned the theatre, locked the door and closed for the day. Chinwe died with her baby in her stomach.”
From 2003 to 2011, when her husband was governor of Kwara State, one of the activities she enjoyed was going to the hospital to welcome babies born in the New Year. It was at one of such visits to a general hospital in Ilorin where she had gone to present gifts to the first baby of the year that she encountered another mother in tears.
“I asked why she was crying and she said her baby needed a blood transfusion. I asked why the baby hadn’t been given a blood transfusion and they said they couldn’t get through the hospital with the blood bank. I dropped the first baby of the year and I carried the baby that needed the blood transfusion and I said, ‘let’s go’. As I was carrying this child, I suddenly felt a wetness. That was when I realised that people pass water when they die.”
The child died in her arms and the first sign was the urination.
Realising that the inadequacies of the Nigerian health system which manifest in lack of reliable information, the absence of an effective referral system and the deplorable attitude of health workers, are the reality for many Nigerian mothers, Saraki founded the Wellbeing Africa Foundation and her advocacy for maternal and child health became full blown, gaining recognition on the global stage.
She was appointed as the global goodwill ambassador to the International Confederation of Midwives (ICM), an organisation which works closely with United Nations agencies in caring for mothers and newborns. It was while preparing for her address at the ICM event during the recently held World Health Assembly that The Nation ran into her in Geneva. A strait-laced society woman who carries a sartorial grace, Saraki confessed to being honoured to be the voice and lens through which the world sees midwives and midwifery.
“Midwifery is an unsung heroine of the medical world. Midwives are with mothers’ right from the point of pregnancy. They educate mums and see them through to safe deliveries. If a woman has had the experience of a qualified midwife from the beginning to the end of the pregnancy and has attended ante-natal, she is by a huge margin more likely to have a safe delivery,” Saraki, said whilst emphasising that mid wives need to be properly remunerated since they give mother a better chance of safe delivery.
With Nigeria’s grim index as the country with the second highest rate of maternal mortality around the world, Saraki believes inequality in Nigeria is most pronounced in child birth. Does this mean she supports the argument of acknowledging the roles played by Traditional Birth Attendants (TBA) in providing care for pregnant women during deliveries? She disagrees. “A TBA can never be a substitute for a properly qualified midwife,” she intoned firmly.
“The way government has been training TBAs to be more hygienic is a welcome step, but it is not a substitute for trained and qualified midwives. I would like to see a situation where TBAs, because they are there in the communities and the women are familiar with them, are paired with qualified midwives. I think that would actually be a wonderful situation,” she submitted.
Asides her role in the international midwifery communication, Saraki also recently became a special advisor to the WHO Africa regional office. Her not-for-profit organisation, the Wellbeing Africa Foundation, also implements programmes tailored towards the three SDGs centred on good health and wellbeing, gender equality, and clean water and sanitation. She also has a role cut out for her as the wife of Nigeria’s senate president and it’s in this capacity that she canvasses for the implementation of the Abuja declaration where heads of state of the African Union countries met and pledged to set a target of allocating at least 15% of their annual budget to the health sector.
Asked how the implementation of the Abuja declaration could impact Nigeria’s health sector, she responded: “The Abuja declaration actually started in 1978 with the Alma-Ata conference which declared universal healthcare should be available to all. A lot of countries have struggled with funding health care but the one message I’m taking to leaders is that health care is a performance indicator of democratic governance and if you do nothing else but to provide quality health care service for your citizens, that is the smartest investment you can make. Leaders who provide healthcare for their citizens, win elections; it’s as simple as that!”
Conscious of the nexus between universal health coverage and improvement of maternal and childhood care in Nigeria, Saraki, a U.K trained lawyer, has also been at the fore front of the Nigerian private sector primary health care revitalisation support group pushing for the one percent consolidated revenue to fund basic health care provision, opines that strengthening primary health would also strengthen the referral systems and get the right level of care to the right places.
“It is really important to strengthen primary health because that is where you deal with non-communication diseases. That is where we should be spotting cancer in order to deal with it at the first point where it can easily be treated,” she said, decrying the fact that people often go to secondary health facilities to present primary health concerns.
As an advocate of WASH, she’s keen on the theme of hygiene and medical facilities, especially with research revealing sepsis is on the rise, since only 29 percent of health facilities have clean running water. She made a special case for this at the 71 WHA and impressed the point at a meeting with the DG of WHO, Dr Tedros Ghebreyesus.
“I think it is imperative that hygiene in health facilities should be an indicator of the strength or weakness of a national health care system. I look forward to that going into policy around the world. It’s as simple as everybody cleaning their hands with soap several times a day, particularly for health workers. My message is very simple; hand washing saves lives, clean hands saves lives.”
In the area of early childhood development, one of her chief concerns is the low immunisation coverage in Nigeria. The National Immunization Coverage Survey (NICS) indicated that only 33 percent of children aged 12-23 months had three doses of pentavalent vaccine against the global target of 90 percent. During the WHO session on making a business case for vaccination, she made a case for Nigeria to be given a special category. She would later clarify her point to the reporter, saying her call is not for more Nigeria to be put in a special category of aids.
“I’m asking for Nigeria to be put in a special category so that we can develop in-country, a very strong and vital strategy that addresses our needs. If you look at our 35 percent vaccination coverage, you would assume that is the same in all parts of the country, it’s not! Some places have 75 percent coverage and some places are not reached at all, that is why we need to be in a special category.
“As at the time when I had my experience on which the Ted talk was based, nobody thought about pregnancy and certainly nobody talked about losing children or still birth. You will just take your unfortunate situation, go and cry or pray.”
She also emphasised the role of communication, saying: “communication allowed us to know that the country was in crisis where maternal and new born survival was concerned. I also think that communication can be community-ordered.
“If you look at a country like Rwanda, they actually know in their parliament every time a woman dies in delivery. We need to get to that stage; it would actually be very good for that type of information to go in real time to the federal ministry of health,” she said.
In keeping to her commitment of reducing maternal and infant mortality, her foundation pursues a respecting maternity care initiative which trains midwives, nurses and health workers on how to treat patients with dignity. The initiative was piloted in Kwara and it became the first state to pass the respectful maternity care charter.
“I think not providing health care services is probably the biggest corruption of all. It is a crime to humanity,” she said, beaming a smile as she rises briskly to signify an end to the discussion.
Born into privilege, Toyin is the daughter of industrialist parents who wielded influence in Nigeria’s business circle. Her father, Oloye Adekunle Ojora, hails from the Ojoro and Adele family.
Recalling her childhood at the Ted talk in Euston, she said: “My parents always told me that I was so small when I was born that I made up for my lack of size by developing a loud voice and being very feisty and almost owning the space in which I was in despite being the smallest and the only girl.” There’s no doubting the fact that even on the global stage, she is owning the stage as far as maternal and child care is concerned.
