Visit to Nigeria

I visited Enugu, a city in southeast Nigeria with a population of 2 million, for the interim monitor visit of a maternal and child health project. The maternal mortality rate (MMR) in Nigeria is one of the 10 highest in the world. This means approximately 40,000 Nigerian women die in childbirth every year, which equates to at least four women every hour. Following a project in Kano and Kaduna States in northern Nigeria that reduced MMR by 60 percent, the Rotary Club of Trans-Ekulu, in Enugu, initiated a second, two-year project.

I found the Trans-Ekulu club to be closely knit and truly dynamic. Although it is relatively small, with 21 members, all the members have taken an active role and are passionate about making a difference. Members have worked tirelessly and with great enthusiasm to achieve their goals. They made me extremely welcome and were keen to show me their project activities.

Their project tackles the “three delays”:

1. Women delay seeking help due to lack of education and awareness about family planning. Traditional birth assistants steeped in old traditions compound the problem. Good antenatal care and knowledge of when to call for help are key to avoiding catastrophic outcomes. Fortunately, an intensive, far-reaching educational program is underway. Outreach teams, clinicians, and Rotarians are all involved, and traditional and religious leaders and voluntary bodies have been brought on-board. There is a high-profile educational media campaign, including visits to schools, and traditional birth assistants are trained to refer to it when appropriate.

2. Poor roads and lack of transportation cause delays in accessing care. Efforts are being considered to address these problems.

3. Poor facilities and a lack of trained staff cause delays at hospitals. The project has provided essential equipment, including operating tables and incubators, and training for doctors and midwives to ensure prompt and safe deliveries.

I visited the five hospitals selected. They ranged from the university teaching hospital, which had good buildings and facilities but was underequipped and poorly staffed due to insufficient funds, to the cottage hospitals, which have much poorer facilities and are powered by generators most of the time. Some hospitals even receive water deliveries by tanker. At one hospital, it was good to see that premature babies no longer had to be transferred elsewhere because the Rotary project had provided an incubator, which had led to the development of a special-care baby unit. The project also demonstrated its worth when Rotary-provided equipment enabled staff to perform an emergency Caesarean section delivery even though another operation was underway in the operating theatre.

Initial results show a decline in maternal deaths. This is a tremendous project that will save many lives, reduce disability, and improve the quality of life for many people.