Otto: A Lagos community where maternity does not matter

Otto community is an extension in the Lagos Mainland Local Government Area of Lagos, where most of the pregnant women prefer the Traditional Birth Attendants (TBAs) to visiting the supposed first contact primary health facility built by the government for the community. LARA ADEJORO reports.

Somewhere in Lagos mega city is Otto community, where women depend on Traditional Birth Attendants (TBAs) for the delivery of their children. They believe the TBAs can avert any evil or complications before and after delivery.

Otto is accessible through Ijora or Oyingbo.

Even though, the headquarters of the Lagos State Waste Management Authority (LAWMA) is just about five minutes’ drive to the community, the path leading to the homes of over 11, 000 residents is filled with squalor, with stench from the repugnant water and waterlogged potholes. People say it is worse during the rainy season.

A further walk through the street is a sign post which serves as a directive to the Primary Health Care Centre on Osugbayi Street.

With some of the buildings in planks on stilts, the residents looked happy and carefree as children played around and some, with pants. Most of their parents are artisans and petty traders.

While trying to locate the health centre, two mothers with their babies pointed to the centre at the extreme end of the street.

When Daily Times asked them about the health seeking behaviour of mothers in the health centre, one of them said, “I don’t come here when I’m pregnant. Though, the nurses in the health centre don’t collect anything from us. They only ask us to buy exercise book to keep record of the days our children come for immunization but I don’t come here for delivery. One can choose to use the centre or use any other means.”

The second woman who identified herself as Mrs Julie Obinna said she gave birth to her baby in a chemist shop. “When I came for ante-natal, they told me it wasn’t a day for ante-natal so I had to look for someone else who can take care of me. When I was due for delivery, I went to his Chemist and everything was successful.

“I only go to the health centre to immunize my baby. Most women who go to the centre only come because of their children, pregnant women can’t put to bed there. You can go there and see for yourself.”

Daily Times learnt ante-natal holds only on Thursdays while immunization holds Mondays to Wednesdays.

“Any expectant mother will do a laboratory test and she will come with N2000 for booking but they don’t deliver here. When it’s time for delivery like when the pregnancy is 8 months, she will be referred to Simpson Primary Health Centre and she will be attended to at any time she wants to put to bed. The health centre here in Otto only opens on Mondays to Fridays and it is closed by 4pm,” an authoritative source disclosed.

Then came the real shock at the extreme end of Osugbayi Street where the Oba Ganiyu Odesanya Primary Health Centre is situated is a heap of refuse dump.

A man who came out from the mosque beside the health centre said, “The way you are looking at that place, is it befitting? Look at hospital just beside it and here is a mosque. Many people who work for the government like you have been here severally yet, the government has done nothing about this. I know after taking these shots, the government will pay you while we suffer.”

The man popularly called Alhaji is said to be the muezzin (the person appointed at a mosque to lead, and recite, the call to prayer for every event of prayer and worship in the mosque) “There is no light, no good hospital, the one here is beside a heap of dirt with stench from the waterlogged gutter. You people are just full of deception,” he continued. “I know camera people will still come, you people keep coming but the government is doing nothing about it.”

When asked if he had ever visited the health centre, he said, “I don’t visit the health centre yet I still clean up this place and it is because of the mosque, this place is an eyesore.

“I can’t visit the hospital, I have my money. If I’m sick, I will visit another hospital. I have two kids and my wife didn’t come here at all for delivery. God owns our lives and nothing will happen to us.

“What will it take the government to clean up and fix this place? It can’t be up to N200,000. Government is doing nothing for us, no light, no road, no water. When we have light, it’s like a privilege.”

Another woman who came out of the centre said she opted for a TBA because, “My father-in-law stays here, so when I was pregnant, I didn’t visit the health centre. It was after delivery, I started coming here.”

Another woman said, “initially, they said there was a labour room in the health centre in 2011 but they later directed me to another hospital. When I had my second baby, I didn’t bother coming to the health facility, I went to a hospital in Apapa, though it’s far but I got what I wanted but I come here for my baby’s care.”

For Abosede Rafiu, she had her three children at home.

“I had all my three children at home. The woman who attended to me is my friend and there has never been any issue before and after delivery.

“As my friend, she only collects money for drip and any other thing she uses for me. She’s my friend and we assist ourselves. Here, we have many TBAs. There’s one beside my house though she’s not around for now. They are trying in the health centre too but I prefer delivering at home,” she said.

“In the hospital, there is nothing anybody can do if there is an issue because there are things ordothox medicine can’t work for. Though, the nurses in the hospital can be helpful but their attitude can be annoying,” said Mrs. Olawunmi Bolaji, an elderly petty trader in the community.

“For me, there are times unforeseen circumstances will arise during delivery, the TBAs know how to deal with such issues. Sometimes, it could be that the child is delaying or the child wants to come out with its leg but they know what to do. Meanwhile, if anything goes wrong in the hospital, they will only tell you sorry. There is a man I know that even work with nurses even as a TBA. I have five children and I used the TBA.

“Another reason I don’t like using the government hospital is because of their attitude to patients. When my last child had a health problem, we were kept waiting even when my daughter was dying, I had to rush her to a private hospital. Even for the immunization of my children, I used a private hospital because in government hospitals, the delay and their attitude to work is annoying and there is no time to waste.”

A young mother of two who identified herself as Mariam said, “I didn’t come here when I wanted to put to bed, though I came here initially but I already have a TBA who takes delivery of my babies. We’re used to them. When I came, they asked me to go for scan and after the scan, I didn’t even bother coming. We’re used to the TBAs in my house and they can come to your house when it’s time for delivery.”

On the cost, she said, “The TBAs can take any amount from you depending on how financially buoyant you are. Some collect N15000 below but if you don’t have and you know them, they can help you out. The TBAs here are always ready to attend to us, they are around us. The health centre at Simpson is far. To get there, one will have to get to Oyingbo first and then take a Keke Napep or bike to the health centre.”

Only mothers with children were at the centre, our correspondent observed when she went into the centre.

At Simpson Primary Health Centre, a lady at the centre said mothers who are due for delivery at Otto are brought to the centre. “Once the pregnancy is 8 months, they are referred here and their files are brought here too.”
However, Pathfinder Nigeria’s Family Planning & Reproductive Health Project Manager, Dr Habeeb Salami said, women who visit TBAs are at risk of complications during delivery.

“A lot of women die from visiting TBAs during delivery. What we will keep telling them is that they must visit a health facility. They need to be enlightened on the benefits of visiting a health facility; either they choose Simpson health centre or have complications during delivery because of the bad road.”

Salami who is also an expert in obstetrics and gynecology, “Also the government need to explain to them on the gains of visiting a health facility and the government can also improve the road there. There is need for more enlightenment campaign and the dangers of visiting the TBAs.”

Complications of pregnancy and childbirth are a leading cause of maternal morbidities and mortalities for women of reproductive age.

Statistics in Lagos states show that one in 40 women will die from pregnancy or delivery-related causes in her lifetime and one in every 15 children born in the state dies before his or her fifth birthday.

In Nigeria, 145 women of child-bearing age die daily and a woman’s chance of dying from pregnancy and childbirth is 1in 13 according to the United Nations Children’s Emergency Fund (UNICEF).

Ironically most of the conditions leading to death in the mothers (complications of pregnancy and delivery, anaemia made worse by malaria, HIV etc) and in the newborns (severe infection, breathing difficulties and premature delivery) are preventable or treatable with basic measures such as quality reproductive health services, antenatal care, skilled health workers assisting at birth, access to emergency services and after delivery care (postnatal) for both mother and newborn, adequate nutrition and education to promote healthy practices for newborns and their mothers.