•They don’t care about us, troubled teens claim
•Public health expert advocates special adolescent healthcare in PHCs
Demola Davies began to lose it the day he lost his father. His dad died of diabetes complication at the age of 65, when he, the last of the family, was shy of celebrating his 15th birthday.
The impact of his father’s demise shortly after writing his West Africa School Certificate examination (WAEC) hit Davies very hard.
He recalled: “I began to experience mild depression when I received my WAEC result which was not too good, and then I lost my father to the cold hands of death.”
The blow was too much for Davies to handle. Yet all around him, the attention, he said, was on his widowed mother.
“We (referring to his mother, two siblings and himself) were all grieving over the loss of the bread winner, but whenever family members and friends came to the house, the attention is on my mother who is old enough to take care of herself, and not me the youngest in the family.”
Davies became totally depressed. He stopped talking to his mum and siblings and began to hang out more with his friends. Their house became his dark spot and he had mood swing whenever he came home.
Sadly, no one seemed to notice the changes in the teenager. Some of his friends were doing alcohol and drugs and graduating to substance abuse. “They told me it makes them to feel alright,” he said.
By the time his mother began to see his condition, he had gone from bad to worse as a drug addict.
He started making excessive money demands on his mother to satiate his spiked appetite for drugs. Occasionally, he would be so desperate that he would sell his shoes and clothes to raise money or in exchange for drug. When there was no property of his to sell, he would steal his mother’s and siblings’ cash. And whenever he could not find anything in the house, he harangued them for money.
Davis became such an irritant and once pulled a knife on his mother before they realised he had gone off the grid. That was when his mother called for help.
By this time, Davies had been into drug for two years. He had become a junkie and his immediate family had no idea what was going on.
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By the time he was 17, the school certificate holder had entered a rehabilitation home and his family had spent close to half a million naira to get him patched up.
Six months in the can
He spent six months in the can and has since been released and integrated back into the society.
“I did not see the folly of my way,” Davies confessed after his dark journey into depression and substance abuse.
“I was young and confused and was on my own after my father’s death. It was as if no one cares about me. Everyone just went about their business like I didn’t matter.
“I turned to the people (friends) who cared about me. Now, I know the difference.”
Davies wasn’t alone.
He said there were 12 adolescents in his circle of addicts. They were like friends with benefits, lacking support base at home and seeing themselves as the support they needed. They share their food, drugs and misery like family and engaged in other vices together.
Davies continued: “We all share one thing in common: we feel deprived of the love of our parents and family members.
“I can share my fears with my new friends and we do all sorts of things together too. I had my first girlfriend and intimacy in the group and thought i was living a great life.”
So what was his mother and siblings doing while he was in this dark phase of his life?
To this, he said: “My mother is a leader in the church. She was in charge of the children department and was fully committed to that ministry.
“My siblings work in Lagos and we may not even see ourselves for days. It is only when I need money that I call on them.”
Sunny Michael, a member of Davies’s clan, is not lucky to have parents with the means to send him to rehab like Davies. When Davies singled him out for this reporter, it was at the local mall where he had come to shop in company of two teenage girls.
Davies said Sunny had gone deeply into the underworld. He was into internet fraud and also sold drugs. He barely recognised Davies when his old friend spoke with him. If he did, he did not show it.
Professional help lacking
Until he was forcibly moved into rehab having gone overboard, Davies said he did not know where to go for help except his immediate family.
Adolescent and Youth Reproductive Health (AYRH) expert, Mercy Aiyedun, said accessibility to professional health information and help, especially in the local hospital otherwise called Primary Health Centre (PHC) is the bane of teenage health problems.
She experienced similar health related issues as a teenager and this led her to the field of AYRH. She said hundreds of adolescents suffer reproductive and mental health conditions even today.
Aiyedun said: “As a teenager, I suffered from hygiene-related health issues due to poor sanitary conditions in our living environment.
“Sharing just two toilets and bathrooms with over 10 families and 30 people, including a bread factory’s staff, compounded the problems.
“Being introverted and lacking proper health information, I silently endured recurring infections due to inadequate treatment.
“Even when I informed my mother, financial constraints limited us to local chemists for over-the-counter drugs. In the university, access to adequate reproductive health information led me to seek proper medical treatment.”
The Nguvu Change Leader said, like Davies, Michael and herself, many teenagers are suffering untold reproductive and mental health hardship because they could not seek early treatment. “I aim to sensitise young teenagers, especially females, on the importance of speaking out about reproductive health issues and seeking early treatment to avoid complications.
“In my case, delays could have led to blocked fallopian tubes or reduced fertility.”
Lucy, a shy and introverted teenager, isn’t as lucky as Aiyedun. She could not speak out when she noticed symptoms such as increased vaginal discharge, itching caused by vaginal infection obtained from poor sanitary system in her home.
Living in a ‘face-me-I-face-you’ apartment with just two toilets and bathrooms for over 50 occupants due to the presence of a bakery that housed lots of workers, reproductive health issues such as vaginitis, urinary tract infections (UTI) and pelvic inflammatory diseases became common occurrences.
She found it difficult confiding in anyone because she believed any issue involving her genital area was too private to be discussed as it might send a wrong message that she was sexually active or promiscuous for her to have come down with such symptoms. So she bottled it all up and could only seek temporary relieve from drugs she obtained from a chemist nearby.
Lucy experienced several reoccurrences of these symptoms and resigned to fate that it was her cross to bear even though she was not in any way involved in sexual practice.
Now an adult and married, she just found out the reason for her difficulty in conceiving after three years of trying to have a baby was as a result of years of untreated infections. After visiting the hospital and series of tests were conducted, she was diagnosed with blocked fallopian tubes requiring surgery and with little or no chance of conceiving.
“This and many more are the plights young people face due to lack of accessible, acceptable and appropriate adolescence and youth-friendly reproductive health services. Other young persons have picked up harmful sexual practices due to lack of right information about their sexual health,” Aiyedun noted.
Sore statistics
According to a report released by the United Nations Children Fund (UNICEF) in 2021, one out of six young Nigerians aged 15-24 is suffering from poor mental health.
Last year, the National Drug Law Enforcement Agency (NDLEA) released a troubled report, approximating 14.3 million Nigerians to be involved in drug abuse. It added that drug abuse has surged in teenagers and that one out of every four drug abusers is a female.
Additionally, the United States Agency for International Development (USAID) ‘2023 Demographic and Health Survey’ reported that in Nigeria, an estimated 23 per cent of women aged 15-19 have begun childbearing of which 17 per cent have had their first child and 5 per cent are pregnant with their first child. Also, 32 percent of teenagers in rural areas have begun childbearing, as opposed to 10 per cent in the urban areas of Nigeria.
Adolescent pregnancy and death
Aside from unwanted pregnancy, depression and drug abuse issues, Aiyedun pointed out that reproductive and mental health problems can lead to adolescent death.
The Nguvu Change Leader said: “Adolescent pregnancy is prevalent not only in rural areas and the northern regions of Nigeria but across the entire nation.
“Several factors contribute to the rising incidence of adolescent pregnancies.
“Poverty remains a significant driver, as economically disadvantaged families may lack the resources and knowledge to provide adequate guidance and support to their children.
“Poor parental control and supervision further exacerbates the problem, leaving adolescents vulnerable to risky behaviours.
“Peer influence plays another role in shaping adolescents’ decisions, often leading them to engage in sexual activities without fully understanding the consequences.
“The lack of comprehensive sexuality education leaves many young people uninformed about safe sexual practices, reproductive health, and the importance of consent.
“This gap in knowledge is often filled by misinformation from peers or unreliable sources.
“The pervasive influence of social media also contributes to the increase in adolescent pregnancies.
“Exposure to sexual content and peer pressure on social media platforms can lead to early sexual experimentation.
“Adolescents are often influenced by the portrayal of relationships and sexuality in media, which may not always reflect healthy or realistic behaviours.”
Recent reports indicate that unattended adolescent health crises are chiefly responsible for the surge in suicide cases in Nigeria in recent years, particularly among teenagers and undergraduates.
“While physical wellness and the need to curb diseases such as HIV/AIDS, malaria, cholera, Lassa fever and recently COVID-19 have been on the front burner of government and stakeholders in the health sector, mental illness and its attendant effects is sweeping through the country, a deadly trend that needs to be tackled urgently.”
According to the World Health Organisation (WHO), suicide is the fourth leading cause of death among 15-19 year-olds and 77 per cent of global suicides occur in low and middle income countries.
Nigeria ranks 15th in the world for its suicide rate and 7th highest in Africa.
While suicide is severe, mental health problems manifest in many other subtle yet deadly forms such as depression, substance use and learning disorders.
While today’s youths grapple with poverty, dysfunctional homes, sexual and physical abuse, self esteem and increased educational workload and pressure, there is a shortage of mental health care personnel to cater to their behavioural and emotional well-being thereby resulting in suicides.
It is not uncommon to read reports of young men and women ingesting pesticides to end their lives over failed exams or heartbreak.
Solution
Microbiologist Aiyedun is calling on governments at all levels as well as stakeholders in the health sector to integrate adolescent and child-friendly reproductive health services into PHC facilities.
“This is crucial to provide young people with the support they need.
“Health workers should receive specialized training in confidentiality, communication, and interpersonal skills to gain the trust of adolescents and youth.
“Rather than creating separate facilities, we can establish dedicated units within existing PHCs, staffed by trained personnel focused on addressing the unique needs of young people.
“Constructing new facilities would strain an already overburdened health system. A more sustainable approach is to integrate dedicated units within existing primary healthcare centres (PHCs), leveraging current infrastructure and enabling quicker implementation.
“The primary challenge is training personnel to address the unique health needs of adolescents and youth. This requires comprehensive training programmes on issues such as sexual and reproductive health, mental health and substance abuse.
“Healthcare workers need to provide non-judgmental, youth-friendly services. Also, having a robust referral systems within PHCs are essential for specialised care involving partnerships with higher-level healthcare facilities and community organisations.
“Adolescents and youths should be involved in planning and implementation to ensure services meet their needs and create a supportive healthcare environment.”
Furthermore, she advocates urgent execution of robust awareness campaign among parents, educators and the community about the importance of adolescent and youth health.
“Educational campaigns and outreach programmes can help reduce stigma and encourage young people to seek care,” Aiyedun said.
In order to achieve all this, Aiyedun believes that Nigeria should improve its health budget, which she said is grossly inadequate.
She said: “The healthcare budget in Nigeria is woefully inadequate to meet our current healthcare needs.
“Allocating less than 5% of the total national budget starkly contrasts with the commitment made in the Abuja Declaration, which proposed allocating 15% of the budget to healthcare.
“This shortfall severely impacts the healthcare system’s capacity to provide essential services and adequately respond to public health challenges.
“Meeting the 15% target outlined in the Abuja Declaration would significantly relieve the burden on Nigeria’s healthcare system.
“It would enable increased investment in healthcare infrastructure, personnel training, medical supplies, and essential medications.
“This, in turn, would enhance the overall quality of healthcare delivery across the country, ensuring that more Nigerians have access to timely and effective medical care.”