Health centre in the gutters •‘Mothers like this place although it is not conducive’

Agugu community in Ibadan North East LGA of Oyo State relies on one hugely impoverished health post, in a really small space donated by a member of the community but run by government, for the healthcare needs of the large population of mothers and babies in the area, reports Sam Nwaoko.

 

The health outpost is a mere shop, the busier of a set of twin shops attached to the home of its donor, Madam Alice Mogbonjubola Ogunlana, at Agugu community in Ibadan North East Local Government Area of Oyo State. Its twin is a liquor wholesale outlet with satchels of some of the popular Nigerian alcoholic products hanging loosely on its inner metal gate. The decrepit shop is opposite Nurudeen Islam Mosque, Abibemori compound at Agugu Oja. It’s labelled “Agugu Community Health Centre” where mostly women and children receive medicare.

Saturday Tribune located the health post on an immunisation day, and by 10am, over a dozen mothers had visited with their babies. One of the babies was born barely 24 hours earlier. She had been brought by her mother for her first vaccines.

There was hardly any sitting space. Wooden benches under the awning of the shop were upturned on one another for space. When one mother is attended to, another would immediately take her space. And many mothers simply land at the health post with the precision of someone watching proceedings from afar, or has a perfect source of intelligence.

“They do – some of them watch what’s going on from either their homes or shops and see as mothers are attended to – and then they just come knowing that it’s the perfect time,” explained Mrs. Folasade Oyebamiji, the Community Health Officer (CHO) in charge of the post. The cheery woman said she has been managing the hugely incongruous place for about six years, and is assisted by one other nurse, and one hoc staff she said she recruited.

Mrs. Oyebamiji had arrived at her post that morning like a dutiful teacher to begin her day. She parked her car on the road and only stepped across the gutter to her seat. That’s how close to the road the health facility is.

Agugu Community Health Centre came up during a two-day media dialogue on Improving Health Outcomes for Children in Oyo State through Accelerated Action for Impact (AAi), by the Oyo State government supported by the United Nations Children’s Fund (UNICEF). There, experts revealed that 2016 figures by the National Bureau of Statistics (NBS) placed Oyo and Lagos states as the two outside Northern Nigeria where most children die from preventable causes, in absolute figures. In Oyo State, Saki West, Ibarapa North and Ibadan North East LGAs ranked highest in preventable child deaths, according to the NBS figures. And Agugu is one of the communities in Ibadan North East LGA.

Olabode Kehinde of the Oyo State Primary Healthcare Board said figures from a 2016/2017 Multiple Indicator Cluster Survey (MICS) by NBS and partners, including UNICEF, placed Oyo State as third in national mortality rate, “and that’s where the issue is,” he stated. With 33 LGAs and 351 wards, the state is huge and officials say it “suffers from unequal distribution of nurses because only 10 LGAs have more than 1 per cent utilisation rate.”

Dr. Adebola Hassan, UNICEF Health Specialist, Akure Field Office, said MICS showed that Oyo State was the “third highest contributor to neonatal deaths in absolute numbers in South Western Nigeria in 2016,” saying “it ranked with 15 other states contributing 50 per cent of newborn deaths in Nigeria.”

However, UNICEF, in supporting Oyo and other high-burden states, brought the AAi to provide support and informed advocacy on preventable child deaths. The AAi is meant to fast track the significant reduction of newborn morbidity and mortality in Nigeria through interventions in the high-burden states, Dr. Hassan explained.

Various communities in the LGA have been involved through the community development associations (CDAs); traditional birth attendants (TBAs) and so on, with the National Orientation Agency (NOA) in tow. Chairman, Ibadan North East Community Development Council (CDC), Alhaji Dauda Odelade, said “we raise money among ourselves to support pregnant mothers in need. We must help them get to the hospital to deliver safely.”

Secretary of the CDC, Alhaji Ahmed Yusuf, said they “organise seminars and do house-to-house campaign to educate the people on the need to take good care of their children; and the pregnant people to be attending antenatal clinic and so on.”

Yusuf described NOA and UNICEF as “important partners” because, according to him, “many mothers didn’t want clinics due to lack of education. But with education as these facilitated and supported by NOA and UNICEF, a lot of mothers’ orientation has changed.”

The health post at Agugu Oja is a necessity but is grossly poor, with Mrs. Oyebamiji seen as literally squeezing water from stone there. “This is the only health post serving Agugu and its environs. Renovated  in 2010, this is the first clinic in Ward 9. Closing this lone clinic in Agugu is difficult because of the many mothers and others that use the facility, as bad as it is. Closing the place down will affect tracking of the patients that are used to this place. I found that many mothers like this place even though it’s not conducive to healthcare provision. They would choose to sit in the sun and take their turns rather than go elsewhere,” she stated.

“I shut one health centre at Irefin because it was close to hard drugs sellers. The place also had no good toilet. They were using buckets placed close to the centre. I had to close it down. This place could not have been in existence if the person here before me had gone the way I went with Irefin. This is not a clinic. It’s an eyesore.”

Oyebamiji said “we need a place for confidentiality and dignity of the women. We do all family planning types here except vasectomy and tubal ligation. Here, we do all the services except delivery. We receive 20 – 30 mothers on immunisation days.”

She added: “Sometimes I get discouraged and feel like quitting. But the mothers’ desire rekindles my passion and makes me to overlook all the challenges and inconveniences and continue. But it’s an embarrassing setup.”

She wants the government to “help us look for another place or they should rent the entire building and restructure it. This will greatly improve the services we render here.”

The government said they would relocate this place and they have been on it for about six years. Politicians came here and made promises. We hope something would still be done.

“So, we need a redesign of this place for the sake of confidentiality, a youth-friendly environment that would also allow the young people to use the place. Many that come here are attracted by the convivial atmosphere. The number of patients we receive here is even more than what so many other centers receive.”

Alhaja Muibat Adegoke-Lawal, leader of the Traditional Birth Attendants (TBAs) in Oyo State, is also a resident of Agugu and she noted with dismay that “this place is not good enough. It’s too small for our people.”

Adegoke-Lawal said “this place isn’t presentable as our health centre in Agugu. We have called for help at many quarters and we have sought the support of philanthropists to improve this place or build another one. The mothers and their children are under the sun, with hardly any sitting space. We are helpless.”