By Gabriel Olawale
It was about midday in the sleepy town called Sogunro Community. Quietness pervaded the environment as if there were no human lives present. It was later discovered that most of the residents had either gone to their offices out of town or had gone about their business and trades. For the housewives or older residents; they were either resting in their own homes or just minding their individual business.
As Saturday Vanguard roved the community, it was hard to realise that this location is situated within the bustling Lagos city. Originally, the essence of the reporter’s visit was to ascertain the claims that lives of pregnant women in the community were at the mercy of a TBA popularly called ‘Baba Eja’.
Sogunro is a community on the Makoko/Iwaya Waterfront. It is regarded as one of the largest aquatic trading communities on the suburb of Lagos Mainland coast of the Lagos Lagoon. Sadly, so, it lags behind in some of the social amenities that make life comfortable.
A trip by Saturday Vanguard to the community leaves much to be desired. As the canoe man paddled our reporter on musky water, Sogunro which inhabits over 100,000 people can simply be regarded as an “isolated community in its own world”.
History has it that Sogunro community comprises of displaced villagers in the late 1950s who lived in one of the villages such as -Abule Odubayo, Igan Oko, Abule Moso, Abule Aladiye, Pedoro, Sogbodie, Abule Elejo, Akinwunmi, Agege-odo -surrounding the present day University of Lagos (UNILAG) axis.
On the waterfront are different ethnic groups from across Nigeria and the Republic of Benin whose economic structures revolve around fishing, wood logging, sawmilling and boat making.
Despite a history that precedes even the Nigerian nation, Sogunro is dying for government attention for provision of basic social amenities like schools, standard hospitals, roads, potable water, security, stable power, standard market place and sanitation, among others.
Trooping out of the community to join the canoe that will paddle dwellers to the other side of the community were young and old women carrying assorted trays laden with wares of smoked fish known as ‘Egun Fish’ their major staple among several other items to be sold at the markets. Young children of school age were also seen hawking.
Sogunro Community –Breeding town for ‘Baby Mothers
The sight was striking and one that would naturally force a first-time visitor to halt and ponder. In their numbers walking aimlessly across, or so it seems, were a teeming number of pregnant teenagers between ages 14 and 19. Shame or sense of remorse was not in the picture. To them, it seemed all right. Teenage pregnancy seemed like a way of life that is readily acceptable in the community.
And by the minute, it was as if their numbers were getting higher. Instinctively, the reporter began to probe. A respondent named Emeka, a fisherman in the community hinted that: “Here, teenage pregnancy is no big deal.
There is a sense of laxity that enables these young girls engage in sexual activities. Education is not necessarily enforced due to so much poverty in the community. Poverty is the major factor fuelling the development. We have a situation in which many of the girls are lured with money by young men who are mostly Okada operators.
“Another very sad aspect is that majority of the girls are not registered for antenatal care, mainly as a result of financial constraint and cultural beliefs. Again, the belief is that because we are surrounded by water, once the young girls or ladies feel cold, they believe that the best way to shake off the cold is to see someone that will warm them up.
It doesn’t matter whether they have a formal relationship or not as long as cash is exchanged. And they do it with no sense of remorse like I said earlier. And to shock you, they don’t really believe in condoms as many of them say condoms deny them full enjoyment of sex.”
Asked how they cope with labour and delivery when they are due, Emeka said: “That is so sad and many of them do not really seem to be bothered. Time and over again, whenever any of the pregnant girls go into labour, particularly at mid-night, they are usually in a dilemma. This is basically due to their inability to afford to register in a standard hospital. And for those who could afford it, reaching the centre at midnight is a tug of war while obstetric complication that may require surgery is out of the question.
Honestly, unless there is urgent government presence with sensitization programmes, a well-equipped public health centre at least, the situation here may escalate to the point where our young girls will be dying like fowls and their babies going down with them. It is a sad story my brother,” he noted with finality.
Encounter with Baba Eja
As Saturday Vanguard moved round the community to locate the major Traditional Birth Attendant, TBA, Mr. Elijah Paul, a.k.a ‘Baba Eja’, the stench from stagnant waters and refuse at different spots filled the atmosphere bellowing ‘epidemic on the prowl’.
On arrival at Baba Eja’s place, he had just delivered Mrs. Fatima Balogun, of a new born baby. She later told the reporter that she lost her first child due to complications in delivery two years back.
While waiting, the reporter did a quick survey of the delivery room. It is a single wooden room surrounded by stagnant water and refuse. Its interior was ‘decked’ with several herbal ‘tools’ serving as Baba Eja’s ‘medical items.’ There is also a single chair, table and a mat laid on the bare floor which represents the ‘labour bed’.
The floor is a sandy platform devoid of concrete or plastering on the wall. The side-walls made of wood were full of holes that served as easy access for mosquitoes.
But to Baba Eja, all these were the reporter’s cup of tea as he retorted with pride after cleaning up Fatima and offered her a warm bowl of pap.
Three hours later, both Fatima and Baba Eja were ready to answer the journalist’s questions.
“I have been taking delivery in this community for over 25 years. And if we are to look at the number of deliveries, it cannot be less than 20,000. That is actually the reason I am being called Baba Eja meaning ‘Father of Fish’.
“I am available 24/7 for any pregnant woman,” he bragged. “There is no time of the day or night time they knock on my door that I won’t respond to their distress call. I want to assure you that I have the necessary documents to practice as a TBA. Really, my initial focus as an herbalist was not child delivery. I began to step in when many pregnant women were dying during delivery in our community here.
“The closest health facility is about 10 kilometers from this town. And then, if you inquired, you would be told the women died yesterday why trying to give birth either because she could not get to the health centre on time or there were no health officials to attend to them. And when the situation was becoming worrisome and repetitive, I stepped in.”
Further, Baba Eja said he actually mixed his practice with some level of conventional medical practice. “I do encourage them to go for scan to ascertain baby position. And if the result comes out contrary, I have herbs that I give the pregnant women to enable the baby position properly.
Also, I have a trained nurse that I call in whenever there are challenges because delivering a baby is not something only one person can face as it has to do with life.
“I demand N10,000, but most of them have never paid beyond N5,000. And I don’t see them again until probably during another delivery.”
Amid the interactive session, Baba Eja, who hails from Ipokia Local Government Area in Ogun State said he was planning to leave the Sogunro community very soon. The question is: ‘Is Sogunro community willing or ready to leave Baba Eja?’
The old man, who does not even know his real age, has lived and practiced herbal medicine for over 25years in that clan. In the thought of every pregnant woman in the community is ‘Baba Eja’ to rescue them in the delivery of their babies.
However, Baba Eja is appalled by the depth of poverty the residents of that community are subjected to on a daily basis. And to say that such a community is within Nigeria’s commercial heartbeat, the city of Lagos, is something very hard to fathom. He lamented: “Honestly, It is due to challenges of life that make many people to live here.
It is not that they are happy to do so. Given other choices, many of us will live in far better spots in Lagos. This seems like a forgotten part of the State. The community is never considered when the government is doing anything good for the state. So sad.”
Looking frail and pale was the newly delivered mother, Fatima Balogun, 22, as she laid on the only mat serving as bed on the sandy floor.
She told the reporter that she had registered for antenatal with Baba Eja after she lost her first child at the age of 20.
Narrating her story, Fatima said: “I lost my first child about a year ago. I would have died with the baby but God just preserved my life. My labour pains started at midnight and my two female neighbours promptly responded. They tried all they could to help me deliver the baby. But it proved difficult. So, they quickly took me to a nearby TBA where I later give birth to the baby around 6:00am. But the baby died a few minutes after delivery.
Fatima, who is a hairdresser, later registered with Baba.
On a woman’s delivery process at Baba Eja’s shelter, Fatima gave an insight.
“Before delivery, Baba Eja gives the intending mother some herbs to drink and bathe with. He also makes the woman to eat some concoction to ease labour pains and make the passage of the baby easier. “But for this particular delivery, Baba Eja had experienced some challenges that made him call in the nurse to come and inject me.
I really did not know the exact challenges. After the injection, I experienced some labour but still the baby didn’t come out on time. So, Baba Eja told the nurse to administer infusion drip while he also gave me another concoction. After all these, the pressure to push intensified and I was able to push and the baby came out.”
In Fatima’s view however, the baby’s delay to exit her womb was not Baba Eja’s fault.
“I believe that the delay in my delivery was due to my failure to carry out some sacrifices Baba Eja recommended much during my pregnancy. I was unable to do them as a result of financial challenges. He had told me to appease the witches that prevented my first baby from staying but I could not due to poverty.” Both mother and baby however, survived this ordeal.
As the reporter continued the investigations on the maternal plight of women in Sogunro community, it was obvious others have tales of woes to tell.
Mr. Kunle Adigun, a resident, told Saturday Vanguard regretfully that he lost both his wife and baby boy during childbirth.
David, 27, also said his wife, Bolanle, could have been alive today to experience the joy of motherhood, but her dream was cut short because she found herself in Sogunro community where good life and health facilities are scarce. “Her desire to give life led her to the great beyond. She went into labour in the middle of the night.
We suspected that was a problem on its own. Her mother, who was with us at the time called for help. But there was little anyone could do because there was no means of conveying her to the other side of the canal for medical attention,” David lamented.
“Prior to her delivery time, Bolanle had registered for ante-natal at a private hospital in Yaba. But there was no canoe to convey her there at that time of the night. That was how she and her baby died after several hours of labour in the hands of a TBA.”
Tanwa Kazeem, 28, a pregnant woman who is close to her delivery period lamented that healthcare delivery situation in Sogunro is worrisome, adding that when a baby falls sick, rushing that baby to hospital for emergency attention is not possible due to lack of any nearby healthcare centre.
“I registered with N5,000 for ante-natal at a private hospital in Iwaya area of Lagos. And I go there every Tuesday and pay N1,000 for check-ups. Already, I have paid the mandatory N10,000 for regular delivery and I pray that my labour and delivery will occur at a good time during the day when we can still move quickly to the hospital.
I have two children already also delivered in the same hospital and at a good time of the day. I also practice exclusive breastfeeding on my children and as well, give them the medically advised three years’ spacing interval. But government needs to come and help us here.”
Agati Ufon, related that all her children were delivered in Cotonou as she would not risk giving birth to any child in the community. She said affirmatively: “I don’t deliver in this village. Once my delivery time is approaching, I travel to my place in Cotonou. Even though I patronise TBAs here where I registered with N3,500 and do collect herbs with N500 monthly, I still will not risk delivering in this community.”
The Baale of Sogunro, Chief Yusuf Kumayon, crowned by the late Oloto of Oto in 2007 went down memory lane.
“Since the existence of this community, government only remembers us during election. That time, irrespective of the obstacle, they will find their way to our community but after election they forget us.
Once our pregnant women fall into labour at night, crossing to the other side of the water is a major challenge. Many times, the women die when there is no means of taking them to the hospital. The only Primary Healthcare Centre (PHC) is in Iwaya about 20 minutes’ drive away and it does not operate at night.
“Sogunro and two other nearby communities, Makoko and Oko Agbon have population of over 500,000 without a single PHC. Some of our pregnant women register in private hospitals in Yaba, Adekunle and Gbagada but to get them there at night has been a Herculean task. On our own, we use planks to construct bridges. But, immediately rain falls, the planks are washed away. We want government to support us in construction of roads, hospitals and schools for our children.”
Kumayon disclosed that so far in 2017, “about 20 women have been lost to pregnancy-related deaths. Of the 20 women less than 10 children survived because both the mothers and babies got exhausted during labour.
“Once in a while, we have benefitted from the Lagos State Immunization Programme just as some non-government organisations do come here. However, we need the government of Lagos, our own state, to come here and see our plight. We don’t think that those representing us are really presenting our case to the Governor because we can see how other areas of Lagos are being transformed. We believe in continuity. That is the reason we voted for him but we have not enjoyed the benefit. If we can have one PHC strategically positioned for benefit of the three communities, we would appreciate that as a starting point.”
What obtains in Sogunro community therefore shows that despite government’s provision of health services through the PHCs, many women still chose TBAs due to poverty and proximity; given the level of trust people repose in them and their newly established relevance in maternal care delivery. Ambode said his administration would strive to take traditional medicine to a higher level through innovative research and development, just as he advised the TBAs to discharge their duties well according to the ethics guiding their profession, urging them to improve their practice through training.
Much as the LASG expresses its high level commitment towards achieving a reduction in maternal mortality; the state MMMR is still below the national average because many of them lack access to services for women residing in hard-to-reach areas, among others.
In his reaction to the development, the Chairman, Yaba Local Council Development Area (LCDA), Mr. Kayode Omiyale, said the ordeal of the 500,000 people of Sogunro, Makoko and Oko-Agbo is known to government and moves are in progress to ensure the residents have access to quality healthcare.
“Since the palliative bridge built to cross the canal was swept away by heavy flood some time ago, efforts are on to build another one. We have health committees in place and they are coming up with ideas to resolve the issue.
It is however not possible for us to put health centres in all the 34 communities which we have grouped into CDAs. What we want to do is to cluster them and build PHCs that will not be too far to easily reach. We will ensure they have at least one PHC that will serve the three communities on a Public-Private Partnership scheme before the end of first quarter of 2018.
Medical Experts speak
Dr. Olusola Odujinrin, a community health expert and Fellow of the West African College of Physician (FWACP) said Nigeria has not done well in the provision and maintenance of Primary Health Facilities (PHFs) which may have contributed to the sad reports.
“Nigeria is way off the track in meeting all MDGs and SDGs’ stipulations. We are on the back row because we lack healthcare infrastructure which necessitated the high mortality rate. Our first goal in tackling all these is to eradicate extreme poverty and hunger according to the World Bank’s projection for sub-Saharan Africa.
We can still address these challenges if we have the political will to do just that. The appropriation of the PHC has been grossly inadequate, thereby putting the lives of the mother and child at risk.”
According to Mr. Bayo Onajole, a health official with the Lagos University Teaching Hospital (LUTH), “The major problem is that there have been so many programmes in place as regards the PHC. There is a need to review all these programmes. For the ones that are working, we need to appraise and for those that are not working, we need to modify them. If we do that, we will be moving a step close to solving the problem. Now, we are not calling for a complete departure, but for a change to reinforce the project to tone down the high mortality rate.
Government could help to bring down the mortality rate through appropriate financing and monitoring of the fund allocated to PHC as well as checking graft. The nation can also have periodic personnel training and infrastructure development.”