A topic we don’t want to discuss but one that is necessary. Sadly I have had far too much experience in this area over the last two years.

Three babies from the orphanage I volunteer at have passed away. One from sickle cell anemia, one from malnutrition and a third from tuberculosis. All three were premature deaths with two of them completely avoidable. Multiple other babies have been hospitalized for malnutrition and saved by our small volunteer groups efforts to provide some regular high nutrition meals to the kids every day, buy high nutrition formula for underweight babies, pay for hospitalizations as needed, fund a doctor to come every month to examine the children, and paid for a private nurse to focus her care on the malnourished and sick babies.

Our drivers father died a few months ago. He went blind when our driver was a young boy. Our driver then was raised by his grandfather. Still when his father passed he was called home to bury him. Burials for the elderly are big celebrations here. The pallbearers actually dance as they carry the casket. It is part of the application for the job. A brass bland plays joyful music as the casket is moved.

I have been at the hospital when elderly, suicide, and accident victims have been brought in and they passed away.

Two different guards have dropped dead while at work. Most likely from heart attacks. One was only treated with blessed oil before he died. Don’t even get me started on the number of Nigerians that rely on prayer, blessings, anointing and religion instead of healthcare. I had a heated discussion with a woman at the clinic who was 36 weeks pregnant with a full placenta previa who had been told by her ultrasound radiologist to pray for the placenta previa to go away and then did NOT note the placenta previa on his report. If she wouldn’t have had an additional required scan at our hospital who knows what would have happened when she went into labor. Study after study has shown that the less resource stable a country is (lack of employment, food etc.) the more likely that country is to be religious. This explains why many highly stable European countries like Sweden, Denmark, and Norway place little emphasis on religion while countries like Bangladesh, Somalia and Nigeria place a high emphasis on religion. The more likely you are to not trust your country, the health system and those around you the more likely you need to believe that there is someone somewhere who can help you.

I have witnessed a couple of preterm losses at the clinic. Always difficult but unavoidable in some circumstances. The most difficult to endure was a woman who I had become very close too and cared for from the time she discovered she was pregnant. We shared a name, something I haven’t seen much of here, and she had a hearty laugh and an easy going nature. We saw her weekly right away as she had high blood pressure that was not well controlled with the medications provided by the clinic. They had referred her to a specialist. She claimed she didn’t have the money to see the specialist, about $55 USDollars. At her 24 week appointment I counseled her that if she didn’t come up with the money she would be having a preterm baby delivered by cesarean section due to uncontrolled maternal blood pressure. We computed the costs for such a delivery and she promised to see the specialist later that week. Her water broke the next day. She remained on bedrest for two weeks with the baby still alive until finally the baby passed and she went into labor. It was terrible.

I have interviewed hundreds of pregnant women at their first intake appointment and 1 in 10 have had a late term pregnancy loss, a stillbirth, lost a baby or young child. So many tragic stories. The most tragic was a woman whose house, and whole neighborhood, had flooded during the rainy season. She had breastfed her baby during the night and in the morning discovered her baby had rolled off the bed during the night and drowned.

My very favorite batik fabric artist recently lost his two week old daughter. Some of our friends and family may have table cloths or similar items made by him as we brought quite a lot back to the US as gifts. He was traveling when the baby was born and was eager to return to meet his new family member. As soon as he arrived home his wife showed him their daughter was ill. A doctor was consulted by phone and medication purchased but the baby didn’t improve. She was hospitalized the next day but did not survive. My artist friend still made his appointment he had to show his wears to a group of us the next day because he didn’t want to break his word. My heart is breaking for his family. His wife who attending university told all of her school friends that the baby is with her mother. There is such a stigma with loss.

A woman I work with at the clinic lost her brother during the recent gubernatorial election. Her brother, a father and recent college graduate, was standing in line waiting to vote when a fight broke out near by. He stepped in to break up to fight and was stabbed multiple times. He was placed between two men on the back of a motorcycle taxi where they rushed to get him to a hospital. He bled to death before he arrived. It was devastating. He was trying to do his duty and make his country better.

The hardest loss of all has to do with a topic that is near and dear to my heart. Women’s health. Three women I care for have been hospitalized in the last month for severe anemia caused by periods that have been too heavy for too long. One is an expat. She had good care and after a few days of hospitalization was able to return home.She will still require a blood transfusion when she returns to the US. The second is a doctor at the clinic. She had 3 blood transfusions at the local teaching hospital. She is yet to return to work. The third woman is a Nigerian and is married to an expat working here in Lagos. She was a dear dear person. Yes, was. Blessing was hospitalized at a nice expat hospital and given a blood transfusion and 8 hours later she was gone. She died, all three of these women could have died, simply because they were women!!! Women who because of biological design bleed every month.

Everyone was grief stricken at the funeral. She was too young, only 42. What a purposeless reason to die. She was one of my first friends in Lagos. When we first met it was at a social gathering with a bunch of Europeanish ladies. They all do the two, or sometimes three cheek kiss. I was, and still am terrible at it. The first time Blessing met me she kissed my cheek then pulled me back looked me straight in the eyes and said “Oh my dear, you are terrible at that. You just get hugs from now on!” She kept her word. Always greeting me with an enthusiastic hug. She always had others needs in mind. A kind word to check up on how you are doing. A little gift from the market she knew you needed. Advice for navigating a Nigerian world. She helped me tremendously in understanding the culture of childbirth here in Nigeria. Her father was a Nigerian trained doctor, and her sister a UK trained NICU nurse but she still loved her traditional tribal ways, herbs and remedies. She was perfect balance to discuss the cultural issues I was missing here.

“Why wouldn’t the midwives bring be a placenta to teach the how to do a placenta exam with?” Blessing ” Because if you touch the placenta and anything happens to the baby the family might accuse you of putting juju on the baby.”

“Why do the midwives rub the babies with black soap or olive oil after they are born?” Blessing “Because it makes the baby breathe and clear their lungs and scrubs their skin to a bright pink and makes the baby as fair skinned as they can be.”

“Why do mothers talk about using a hot iron for their baby when the baby has stomach problems?” Blessing “A baby with stomach issue, who cries, doesn’t sleep well or is fussy is said to be bothered by its umbilicus. They take a hot rock or cow dung and press it up against the belly button to cure the belly issues(also can cause tetanus but..).”

And dozens more tidbits. I’m still crying regularly over our loss of her. And I wasn’t even as close to her as some of my friends are. I am so thankful I got to attend her funeral. It was loud and bible filled as everything here in Lagos is but it gave us a chance to say goodbye. Blessing, we love you. Blessing wanted a baby and she bled too much and died of complications because of that desire and because she was a woman in subsaharan Africa.

Welcome to my soapbox regarding women’s health. Be prepared to be astonished and hopefully dismayed in how we are failing women in Nigeria and around the world.

Maternal Health in Nigeria: Facts and Figures – APHRC

Visit this website: aphrc.org/…/APHRC-2017-fact-sheet-Maternal-Health-in-Nigeria-Facts-and-Figures.p…

Maternal mortality in Nigeria is staggering.  Pregnant Nigerian women face a lifetime risk of maternal death of 1 in 13 compared to 1 in 31 for sub-Saharan Africa as a whole. 

Nigeria’s estimated annual 40,000 maternal deaths account for about 14% of the global total. The country is also the second largest contributor to maternal mortality worldwide, after India. 

One Nigerian woman dies every 13 minutes – that is 109 women dying each day – from preventable causes related to pregnancy and childbirth. 

Many babies in Nigeria die in the first 28 days a life leading Nigeria to place 8th in the world for most babies lost per 1,000 born. In 2017, the neonatal mortality rate for Nigeria was 69.8 deaths per 1,000 live births. One in 10 children in Nigeria will die before their 5th birthday.

I have done some good volunteering at the clinic weekly. I found statistics that said that only 30% of all trained medical providers in Nigeria were trained in neonatal resuscitation and those that had been trained never received updated training. 30% people!! The hospital I volunteer at was already making huge strides to reduce neonatal and maternal mortality and had good statistics however a big push for me was updating neonatal resuscitation technique at the hospital. After training the doctors and midwives another midwife was able to teach to training to another hospital in a different part of the country. Small steps, small steps.

Women around the world essentially die because they are not listened to regarding their own personal health. Their symptoms are looked at as complaints and they are given less pain control medication than men. It takes longer for them to get a diagnosis and they often have to research and advocate for tests that otherwise would have been offered to men with similar symptoms. Patriarcal cultures don’t value spending money on women’s health care needs compared to what they would spend on men. Please read this article for a greater understanding.

Let’s do better people. Those of us coming from developed countries, we can do more, we can do better.