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Sokoto residents resort to self medication as epidemic spreads amidst dearth of medical personnel

Sokoto

For rural dwellers in Sokoto State, self medication has become the order of the day as doctors and other medical personnel are nowhere to be found. SHAFA’ATU SULEIMAN reports

Thirty-year-old Raliya Mousa had experienced high temperatures and excessive vomiting over the night and lost some energy. Her husband, Adamu Mousa, a peasant farmer was startled by the unexpected illness but there was no hope of calling a medical personnel, nor could anyone suggest a diagnosis of her condition.

Aside from this, the only healthcare facility provided in the community has been abandoned due to lack of health workers attached to the facility in Kwarakka village in Tangaza Local Government Area of Sokoto State where she lives. According to Raliya, she has been treating herself with some herbs without medical or diagnostic instructions from any qualified medical personnel.

“I was sick and the only healthcare facility in the community has not been functional for years, so I decided to treat myself but the sickness got worse by the day. I was having a serious fever with my stomach rumbling every minute.

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I was dehydrated and unconscious when I was taken to a primary healthcare centre in Tangaza town. During this period, my wife’s vomiting and stooling increased, coupled with restlessness at night. We lost all hopes of her surviving the illness, says Adamu. “My situation got worse after being admitted for two days.

I was referred to Usmanu Danfodiyo University Teaching hospital in Sokoto with the intervention of the doctors there I regained my health. Raliya told DAILY TIMES. The poor state of health care services in Tangaza Local Government Area of the state has made many people lose their lives and many others have resorted to herbal intake or self-medication for remedies.

Binta Yau’s story is similar to that of Raliya. At an early age of her pregnancy, the 29-year-old housewife had a miscarriage due to lack of antenatal care. “We don’t have any hospital for antenatal service. I felt sick when my pregnancy was three months. I assumed it to be the normal fever but it persisted.

My husband got me some herbs which I took only for me to start bleeding after some hours,” she recalls.

She was later rushed to a primary healthcare centre in Gidan Madi, headquarters of the local government council where a community environmental health worker suggested it could be typhoid symptoms.

She eventually lost the pregnancy having discovered that excessive intake of herbal substances might have caused her miscarriage. For years, most people from the community who fell sick have been using herbal medicines, concoctions made from roots and leaves, for treatment and self medication.

The World Health Organisation (WHO) estimates that 80 per cent of the world population relies on complementary and alternative medicine or traditional medicine, which includes all healing practices indigenous to different cultures. Medical experts believe some of these herbs when not utilised properly, are poisonous and life threatening.

Waves of epidermic

Illnesses such as malaria, typhoid, cholera, measles are epidemics in Sokoto communities, according to various media reports.

Between January and July 2021, a report by the Nigeria Centre for Disease Control and Prevention showed cholera claimed no fewer than 653 lives in Nigeria, with Bauchi, Kano and Sokoto leading the list with 9,405, 5,215 and 2,651 suspected cases, respectively.

In August 2021, there was an outbreak of cholera that caused havoc across some local communities in the state. Officials in the state say no fewer than 265 cases of the disease spread across the thirteen local government councils with about 23 deaths were recorded.

Tangaza was among the affected local government councils. Also in 2022, widespread measles outbreak was recorded with no fewer than 390 patients admitted, while when five deaths were recorded. School children were among the dead. The recent was in November 2023.

The Nigeria Centre for Disease Control and Prevention also confirmed the outbreak of dengue fever in the state with over 1,000 cases of measles recorded in Sokoto from January to date. According to the 2019 report by the World Health Organisation, 20 per cent of all global maternal deaths occur in Nigeria with an estimated over 600,000 maternal deaths and no fewer than 900,000 near-miss cases between 2005 and 2015.

No standard measures at PHCs

Despite the Federal Government’s benchmark stipulating modern facilities for primary health centres, such facilities across Sokoto State are still operating far below the benchmark. Checks by DAILY TIMES revealed that there were no suitable wards, labour room, doctor visitation schedule, ambulance for referrals, drugs and medical equipment in some primary healthcare posts in many communities.

This has continued to affect the wellbeing of the people who are in dire need of biomedicine remedies for their ailments. In 2016, the Sokoto state government claimed to have deployed 175 medical doctors, nurses and midwives to primary health centres across the local government areas to complement the existing health workers.

It further said the measure was to bring quality healthcare closer to the people, as well as improve immunisation, maternal health and strengthen primary healthcare of the rural dwellers. A visit to some primary healthcare centers in Tangaza in November 2023 showed most of the facilities were either abandoned or in a state of disrepair.

There was no presence of medical personnel in the facilities. Many community health officials in an interview with THE WHISTLER, lamented how their facilities have remained without qualified medical personnel and in dilapidated condition without any concrete efforts by the state government to add a new leaf and maintain their standards.

In Kwarakka ward, the only health post is in a state of collapse as the building is dotted with broken fences and surrounded by outgrown grasses while its ceiling boards are dangling from different corners of the building. It’s the same story in other healthcare facilities visited within the Tangaza community.

Like those in Kwarraka, there are no labour room, children and female wards, doctors’ office, staff quarters, ambulance, drugs or equipment for immunisation. Abel Martins, an epidemiologist at the University of Abuja Teaching Hospital, said public health facilities across the federation and the Federal Capital Territory have continued to deteriorate while the experiences of community members seeking healthcare have consistently been awful. He admitted that most PHCs are faced with poor distribution of health workers, poor quality of health services, dilapidated infrastructure, and lack of supply of essential drugs as at when due.

One doctor, 12,000 patients

Dr Umar Mukhtar, Chairman of the Sokoto State chapter of the Nigeria Medical Association (NMA), of observed that lack of incentives is a major drawback. He also noted that non implementation of recommended salary structure is discouraging the state’s medical personnel across the rural areas from offering their services. Mukhtar noted that most of the population are in the rural settlements and have difficulty in accessing standard hospitals in the cities.

“Will they be able to afford the cost of transportation or medical bills? Even some don’t even know where to start from because they don’t know anyone in the city,” he Mukhtar submits. Continuing, Dr Mukhtar said, “So we’re calling on the state government to look at it critically and implement the federal structure and those doctors that are patiently working in the local government hospitals should be given special incentives.

“The World Health Organisation (WHO) recommends one doctor to take charge of 600 patients. But in our last briefing, here in Sokoto, a single doctor is saddled with over 12,000 patients.”

He also revealed that many medical doctors are leaving the state in droves for greener pastures for better conditions of service. “Some of our medical personnel are leaving the state for other states or to federal government hospitals which are paying far more than what the state government is paying.”

Sokoto
Sokoto

He noted that the only panacea to the absence of medical personnel across the state healthcare facilities is to implement the salary structure stipulated by the federal government to prevent the few available doctors from leaving the state. Mukhtar called on the state government to declare a state of emergency in the health sector by improving the welfare of doctors and other health workers in the state.

We ‘ll revamp primary healthcare facilities — State Govt.

Bello Garba, Executive Secretary, Sokoto State Primary Healthcare Agency, said the government is committed to ensuring standard healthcare services are provided in the rural communities.

He further told DAILY TIMES how the current government intends to revamp the primary healthcare facilities across the state. “We have it in our current budget to increase medical equipment and personnel”

Commissioner for Local Government and Chieftaincy Affairs, Ibrahim Dadi Adare, also said the state government plans to reintroduce mobile healthcare services in rural areas and free medical care targeting pregnant women and children. “During the administration of former Governor Aliyu Magatakarda Wamakko, there was free medical care for pregnant women/children and rural mobile care programmes. We advised the government to bring back such programmes because they are laudable and important,” he stated.

Garba explained that rural mobile healthcare services involve deploying ambulances with teams comprising medical doctors, nurses, pharmacists, and health record specialists. “We are going to access communities to get residents’ immediate attention and provide in-home services, while those requiring further medical attention get referrals,” the commissioner said.

This story was produced for the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science.

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