Pregnant Ogun women flee to Benin Republic as healthcare crumbles

Despite being just a few hours away from Lagos, Nigeria’s bustling commercial capital, Igbokofi, one of the rural communities in Ogun State, continues to suffer years of neglect, particularly a lack of access to basic health care. In this report, SEGUN ODUNAYO journeys into the heart of the sleepy settlement to uncover the harrowing health crisis silently gripping its residents

It had been over seven years since the ordeal, yet to Folake Olaniyi, the memory remained fresh, etched deeply into her heart like it happened just yesterday.

Her face, lined with pain and lingering anger, betrayed the weight of a loss that time hadn’t healed.

A resident of Igbokofi village in Yewa, Ogun State, Olaniyi was overwhelmed with joy in 2017 when she discovered she was pregnant again.

This time, medical checks confirmed she was expecting a boy, something she had longed for after previously giving birth to girls.

But that joy was short-lived. The absence of a functional healthcare facility in the community would soon shatter her dreams and push her to the edge of death.

Staring into the distance, Olaniyi paused to gather her thoughts before recounting the painful episode that would alter her life forever.

When I got pregnant, I wasn’t living here,” she began. “But I returned to Igbokofi with my children after facing challenges where I was staying. My husband just left the house one day and never returned. Here in the village, I started going to the locals who worked as healthcare professionals. When it was time to deliver, I left home around 6:30 p.m. and went to the place they use as a health centre, but I was told to go back because I wasn’t in active labour yet.

“Later that night, I returned as the pain intensified. They tried to assist me with the delivery, but for several hours, nothing happened. I was in excruciating pain. Around 1 a.m., they said I should be taken to Ijoun, another village miles away from Igbokofi. There, they gave me drips to hasten the process, but there was still no progress. By morning, the doctors realised I was experiencing severe blood loss, and the specialist they had contacted for an operation said he wasn’t in town.”

Pausing to regain composure, she continued, “They advised that I be taken to Aiyetoro, a village even farther away. When we got there, I was rushed into the theatre while the head doctor hurried out to buy blood for me. Unfortunately, my baby was delivered stillborn, and I was still bleeding profusely.

“Things took a turn for the worse, and I had to be rushed again, this time to Laantoro in Abeokuta. By the time we got there, I was barely conscious and torn between life and death. The doctors needed my husband’s consent to proceed, but my brother-in-law, who had been with me throughout the journey, signed on his behalf.”

After spending about a month in the hospital, Folake thought the worst was behind her. But fate had another blow in store.

“After I was discharged, I went to live with my brother-in-law in Ijoun. I couldn’t walk on my own and had to be helped out of the car into the house. Three months later, I still felt unwell and needed medical attention again. That was when I was told my womb had been severely damaged during the delivery process and had to be removed,” she said, her voice heavy with grief.

Harvest of maternal deaths 

An elder in Igbokofi, Idowu Bamgbose, sat outside his modest home, enjoying the cool evening breeze, when Saturday Punch approached him. His face bore a look that blended warmth with lingering sorrow—memories that still stung deeply.

A few years ago, his household had been filled with laughter as one of his sons married the love of his life. But the celebration would soon turn into tragedy.

“This incident happened in 2021,” he began, his voice tinged with pain. “My son’s wife went into labour around 2 a.m. We were confused and didn’t know what to do. Eventually, she was rushed to a traditional healing home in the village. Sadly, despite the best efforts of the traditional birth attendants there, she died before morning.

“My son’s wife died during labour simply because there was no proper medical facility here. We’re deeply pained by the state of our health centre, as we have to travel miles just to get any meaningful medical help.”

Another resident, Kunle Garb, echoed Elder Bamgbose’s sentiments, adding that the village had become a graveyard for many women who died during childbirth.

“We’ve lost many women here. It’s heartbreaking,” he said solemnly. “Most families keep quiet about it out of fear or shame. But I know people like Tosin Ayeni, who bled to death during childbirth. There was also Silifat Kudebi and Maria Ogunyomi, both of whom died while trying to give life. It keeps happening.”

Garb went on to decry the rise of quack medical practitioners in the community.

“Untrained nurses and doctors use all sorts of unregulated tools and methods to deliver babies here. It’s dangerous. People still go to them because we don’t have a government-owned health facility anywhere nearby. It’s either them or nothing,” he lamented.

Crossing borders for Survival

Ruth Bamgbose, wife of the village chief, offered a startling insight into the community’s desperate search for healthcare.

According to her, many residents now travel across the border into neighbouring Benin Republic for medical attention.

“We consider Benin Republic our medical safe haven,” she said. “We often have to go there just to get injections or buy basic drugs. It’s even closer than Ijoun or Abeokuta. Benin is just behind us. But once they realise we’re from Nigeria, they hike the prices of everything. It’s a constant struggle.”

Ruth added that women and the elderly bear the brunt of this hardship.

The burden is heavier on us women, especially when it comes to our children and ageing parents. If we can’t afford treatment in Benin, we try Ijoun. But the losses we have suffered in this village are just too many. There are a few people here who’ve learnt the medical trade, and while they try their best, it’s not the same as having a proper health centre.”

Elder Bamgbose said, shaking his head slowly,  “It’s true. The hospitals in Benin Republic charge us double. Whatever they charge their own people, they double it once they realise we’re Nigerians.”

Troubling statistics

In 2020, over 80,000 Nigerian women died from pregnancy-related complications such as obstructed labour, severe haemorrhage, pre-eclampsia, and eclampsia.

The World Health Organisation recommends one doctor for every 600 people; however, Nigeria’s ratio is roughly one doctor per 4,000 to 5,000 patients.

The United Nations suggests healthcare should account for about 15 per cent of a country’s annual budget, but Nigeria often falls short of this.

Nigeria’s maternal mortality rate stood at 1,047 deaths per 100,000 live births in 2020, the third highest in Africa and far above the UN target of 70 deaths per 100,000 to be achieved globally within five years.

A 2023 report by the Nigerian Primary Health Care Development Agency revealed that over 60 per cent of Nigeria’s rural population lacks access to functional primary healthcare centres. Many of those that exist are understaffed or lack basic amenities such as electricity, clean water, or essential medicines.

How health centre become deplorable

An elderly man, Mr Ogunyomi, is no stranger to how the once functional health centre in the community became history. He worked there as a security officer before it ceased functioning in 2008.

“When this health centre was newly built, it was just Mummy Lekan and Mummy Fatima who served as nurses there. They cared for the sick and pregnant women. Everything was fine, and drugs were regularly supplied. The problem began when bats infested the roof, damaging it and dropping faeces, which made the entire place smell terrible.

“This drove many people away; they said they couldn’t stay in such a foul environment. That’s when the decay started, and people stopped using the centre. Eventually, drug supplies also stopped,” he explained.

Another resident, Thomas Sagunbi, confirmed the former staff’s account.

“It used to be a thriving facility back then; we never imagined it would fall into such ruin. Pregnant women were frequently delivered there, but once the stench became unbearable, the place was abandoned. After some time, the staff stopped showing up for work,” he said.

Alternative not in use

About five minutes from the dilapidated primary healthcare building stands another structure constructed for the community by the National Boundary Commission.

Donated alongside other buildings in 2004, this facility has reportedly never been used.

Garb, a resident, who earlier spoke with our correspondent, said, “A five-projects-in-one complex, comprising a police post, market, workshop, school, and health centre, was donated to the community by the National Boundary Commission in 2004, but it hasn’t been put to use.”

A visit to the building showed that it was structured like a health centre, but it lacked beds, equipment, or any medical supplies.

Distance made recruitment impossible — Ogun health commissioner

During a meeting with our correspondent at her office in Abeokuta, the Ogun State Commissioner of Health, Dr Tomi Coker, highlighted the challenges in addressing the lack of healthcare facilities in Igbokofi and the wider Yewa area.

He particularly mentioned the difficulty associated with recruiting medical personnel due to the remote location of the area.

“Yewa is a hard-to-reach terrain. It’s difficult to find qualified personnel from the Yewa area willing to work there. I believe in work-life balance, you should work where you live because you’re more likely to be invested in your community. For example, I returned from England to work here because I feel connected to my people and want to serve them. We try to recruit, but it’s challenging because it’s hard to reach. I can’t expect someone living in Abeokuta to relocate to Yewa; that wouldn’t be fair.

“We do strive as a ministry to ensure equal distribution of staff. I’ve pleaded with traditional and local government leaders to provide five qualified candidates we can train as local community midwives, since we have representatives from all local governments. But rarely do we receive applicants from Yewa. We’ve tried everything.

When asked why the facility built by the National Boundary Commission remains unused, the commissioner said many communities and politicians build health clinics without consulting the Ministry of Health, which causes problems.

“There are many communities that have built primary healthcare facilities without involving the Ministry of Health. When politicians decide to build, they do so without considering staffing, drugs, and other necessities. They then abandon these structures,” she explained.

Nigeria needs more primary healthcare centres — Experts

Former Chairman of the Nigerian Medical Association, Abeokuta branch, Dr Kunle Ashimi, noted that Nigeria requires far more than the existing primary healthcare centres to deliver quality care at the grassroots level.

He said, “Nigeria needs over 30,000 primary healthcare centres because the majority of health issues people present with are treatable at this level. It is only when conditions become complicated or involve non-communicable diseases requiring specialist attention that patients should be referred to secondary healthcare centres such as general and state hospitals.

“Cases beyond their capacity should then be escalated to tertiary hospitals, including teaching hospitals and specialised medical centres. Common ailments like malaria ought to be managed at primary healthcare centres.”

A resident doctor at the Federal Medical Centre, Abeokuta, Dr Olorunfemi Solomon, highlighted that primary healthcare facilities must provide high-quality services encompassing prevention, treatment, and rehabilitation.

“Primary healthcare should offer comprehensive services that are preventive, curative, and rehabilitative to individuals within communities. This includes health education, routine check-ups, treatment of common illnesses such as malaria, and follow-up care for chronic conditions like diabetes and other infectious and non-infectious diseases. Referral to advanced facilities with specialists should only occur when cases surpass the capabilities of primary care,” he stated.