Though there was no signboard to indicate the nature of business going on inside Mercy House, nearly every commercial motorcycle operator in Gado Nasko area, Kubwa, one of the suburbs of Abuja, the Federal Capital City, is aware of the seedy business going on inside the building. Indeed, a visitor to the area needs only to ask the commercial motorcyclists in the area to take him or her to the ‘hospital’ where children are delivered in the area to be taken to two small bungalows that constitute Mercy House.
The two tired looking women lying down on the sofa that doubles as beds were, as was gathered, delivered of their babies the night before the visit of this magazine. The proprietor, a middle age woman, refused to disclose her name, professional background or whatever qualified her to run a maternity home.
But believing that this magazine reporter was a potential patron, she readily informed her that she charges N5,000 fee to take delivery of women who have put to bed before and N6,500 for first timers. She also revealed that an average of five women put to bed in her facility each day. If any form of complication develops in the process, such a patient is immediately evacuated to the general hospital, the Mercy House proprietor, who claimed to have been running the unlicensed maternity facility for over a decade, told the magazine.
As investigations in Abuja by this magazine unearthed last week, many pregnant women are aware the risk involved in delivering their babies in illegal maternity outfits like Mercy House. But the harsh economic climate forces them to seek relatively cheap centres where medical histories of patients and other documentation are not demanded. Some women also complain about the shabby treatment meted out to them by nurses and the long queue before being attended to by a doctor in government hospitals.
Yinka Ajayi, a mother of three who corroborated Mrs. Igbokwe’s assertion, said she stopped using government hospitals due to financial reason. She said she cannot afford the consultancy fee. She went further to explain that the last time she gave birth, to her second baby, she paid through the nose. Mrs. Okadigbo, a petty trader at Karu, another suburb of Abuja, said she was detained in a government hospital for three days, until her husband paid the bill of N70,000. She explained that the cost of accessing government hospitals pushed her to having her three other children in illegal hospitals.
Francis, an electrician, said though he was aware of the risk involved, he had his two children delivered in an ‘‘illegal hospital” just because he couldn’t afford to pay fees charged by government or registered hospitals. “Ordinarily, I prefer government hospitals but I can’t afford them. And I know the risk involved in patronising illegal hospitals, because the midwives delivered my babies with their bare hands. But I thank God my wife and my children are alive,” he said.
An operator of an unapproved maternity centre at Bazango Kubwa, another satellite town of the FCT, who identified herself as “Doctor” Ene, told the magazine that she charges between N5,000 for a first-time mother and N3,500 for those who have experienced labour before. ‘Dr.’ Ene showed the staff of this magazine who pretended to be a potential patron the small one-bedroom house she uses as delivery ward. It contains two beds, a dust-laden BP monitor and a baby cot under the bed. There are no linen on the beds. Close to the maternity centre is a river one has to wade through to gain access to Ene’s house. The environment stinks because of the refuse heap beside the hospital. Ene added that she is also in the business of training others to carry out the business of delivering babies. She directed the magazine to a woman on the same street who operates an unapproved maternity. “If my ward is full, I direct my patients to those I have trained,” Ene proudly told this magazine.
The situation is not any better in Lugbe and Mpape. At Lugbe, a small shop that is under lock and key in the daytime serves as a maternity at night. It is an open secret that both abortion and delivery take place here.
At Lugbe Federal Housing Estate, a church, Christ Apostolic Miracle Centre is also in the business. The church is very popular for child delivery. The pastor in charge claims to use only prayers to deliver women in labour.
While the general excuse given by respondents for patronising unapproved maternity homes was poverty, investigations revealed that maternity services at government hospitals are virtually free. The problems in these places, as a medical doctor in a general hospital noted, are understaffing and congestion. “You can imagine when a single doctor attends to about 40 patients per day, of course you cannot rule out human errors, like wrong diagnosis and wrong prescription,” the doctor said.
But patronising the less congested private hospitals is pretty expensive for many. The charges for maternity services at Garki Hospital, which has been concessioned to a private operator, depend on the type of service a person desires. A nurse who pleaded anonymity at the hospital said: “It costs N50,000 for normal delivery, N60,000 for un-booked delivery while ante-natal care is N20,000. However, for those who desire VIP services, the cost is N30,000 for ante-natal while the cost of delivery in the section is N100,000. To have a Caesarian section in the hospital, a pregnant woman must cough out N150,000.”
Experts believe that the widespread patronage of quacks is a major reason why Nigeria still ranks high on the list of countries with high maternal and infant mortality rates – with a ratio of 545 per 100,000 live births on the maternal mortality index and 75 per 1000 live births on the infant mortality index, according to figures from the UN World Population Prospects and the Institute for Health Metric Reports.
The report also indicated that only 58 per cent of women had access to ante-natal care. A report on the achievements of improved maternal health under the Millennium Development Goals, MDGs, also indicated that the low proportion of births supervised by skilled health workers is holding back the country’s progress in the area.
To encourage patronage of government approved antenatal clinics and as part of efforts to tackle the menace of maternal mortality, the Federal Government recently introduced the Conditional Cash Transfer, CCT, a scheme in which pregnant women are paid a token of N1,000 for attendance of ante-natal clinics. Under the scheme, which has been operated successfully in other developing countries, a pregnant woman must attend antenatal clinic at least four times and for each of the visits she will be paid N1,000.
“The scheme is being funded from the N15 billion Maternal and Child Health Care component in Federal Government’s SURE-P programme. “The woman must deliver at the facility; if she does, she is entitled to something; the woman must also ensure that the child is fully immunised. The total package is about N5,000,” said Dr. Abdullahi Mohammed, Director, Primary Health Care System Development, National Primary Health Care Development Agency.
The CCT, Dr. Mohammed said, is executed as part of the Midwifery Service Scheme, MSS, introduced in 2010 through which more than 4,000 midwives have been deployed to 1,000 health facilities nationwide. He also agreed that while antenatal clinic attendance was free, it had some incidental expenses that discouraged pregnant women from registering for antenatal care.
But many insist that only when all the problems that continue to make quacks attractive to pregnant women are tackled that Nigeria can achieve the much desired improvements in its child and maternal mortality.
—SOLA-ADOLA FOLORUNSO, Abuja/TheNEWS magazine