Tenage mother
The National Union of Road Transport Workers (NURTW) has joined the fight to reduce Nigeria’s high maternal/infant mortality rates by pledging to make available vehicles of its members when desirable, Damilola Oyedele writes
Beads of sweat lined Hajara’s forehead. Initially, she tried to mask her pain by clenching her teeth and fists, but after about 6 hours of pain which seemed to increase intermittently, she let loose. Her screams were echoed by the quiet of the breaking dawn. She was in the throes of labour in her first pregnancy and did not get any comfort from the presence of a village’s midwife.
Just 14, Hajara had no idea delivery was this difficult, what with the smiles that always seemed etched on the face of new mothers. But what she was sure of was that she would lose her life if the pain continued. To make matters worse, her husband, Hassan, a labourer was away from their hut in Kadowawa, a small community in Jigawa State as went through the pains.
By 5am, one of her friends, Maimuna who had stayed to mop the sweat from her face through the night decided to get help and see if somehow she could transport her friend to the nearest health facility which was about 12 kilometers away.
She approached her own husband, who quickly walked to the house of the only commercial driver in the community; Ahmadu and sought his assistance.
Hajara was taken to the hospital where she was delivered of a healthy baby boy. She experienced a few tears, which were stitched by the midwife on duty. Cleaned up with her bundle of joy by her side, she was all smiles as Hassan walked in a few hours later.
Hassan sought out the driver to enquire about the charges for taking Hajara to the hospital. Ahmadu disclosed that the emergency transport was free of charge. He, Ahmadu, had recently enlisted as a volunteer for the Emergency Transport Scheme of the National Union of Road Transport Workers (NURTW). His services were therefore free of charge.
In appreciation, the couple named their new baby after Ahmadu, a remarkable sign of honour in Northern Nigeria.
Nana Sani’s story did not end quite well like Hajara’s, but she credits an ETS driver for saving her life in the end.
“I started feeling labour pains around 4.00pm. I complained to my mother in-law and she said it was normal and that I would soon give birth. I started bleeding around 6.30pm; again, I complained to her and requested that she send for my mother, but she refused saying she was capable of handling the situation as an experienced mother,” she said in Hausa language.
“The pain continued and grew to a point where I could not stand up or even sit down. No one seemed interested in taking me to the hospital. Around 8.00pm, I started feeling dizzy because I had lost a lot of blood, I could not even talk and after a little while, I lost consciousness,” she added.
It was at this point the family, resident in Yar-riga Village in Katsina State, decided to act. They were still trying to put money together to pay for transportation to take her to the hospital when another village resident told them if they could get a driver registered with NURTW, Nana would be taken to the hospital for free. They found one driver and she was taken to the hospital.
Sadly, because she had lost a lot of blood, the baby could not be saved. Nana spent some time in the hospital getting treatment before her discharge to recuperate at home.
Before the introduction of this Safe Motherhood Emergency Transport Scheme about four years ago, the rural dwellers had to cough out sometimes as high as N5000 for transportation to the hospital. The high fee was dependent on several factors: most access roads to the villages are almost impassable, distance to the health facility, and the driver is required for ‘charter’ service.
The situation is worse on market days of bigger communities or even cities. Available vehicles in smaller communities transport the villagers to the markets. There would be no vehicle for emergencies until the driver returns.
These difficulties, encouraged by poverty, make families shun the idea of hospital delivery. These boost the use of the services of the traditional birth attendants whose only qualification is the years of experience. They usually have no idea what to do in times of emergency, thus contributing to the high rate of maternal and infant mortalities.
The free ride secured by these women and now made accessible by the union is a major relief in these areas.
In a country that contributes an alarming 10 percent of the world’s total maternal and infant mortality rates, even though the total population is just two percent of the world’s, all stakeholders have to work hand in hand. Nigeria's Adolescent Birth Rate Stands at 121 per 1000 live births.
The ETS is a project from an unlikely source; the NURTW. It is an initiative of the DFID-funded Partnership for Reviving Routine Immunization in Northern Nigeria, Maternal, Newborn and Child Health (PRRINN-MNCH) which came to Nigeria in 2007 in four operational states; Jigawa, Zamfara, Yobe and Katsina.
All the volunteers in the ETS are documented members of the union. These drivers receive training from PRRINN-MNCH on the correct way to carry a pregnant woman in times of emergency to the health facilities. This is because the actions or inactions of a driver can have an effect on the outcome of the labour process.
According to data collated by PRRINN-MNCH, 19,811 women used the services of an ETS driver between December 2009 and September 2013 in the operational states.
One of the drivers, Samahu who benefitted from a recent training in Katsina said he never realized the need for caution while transporting pregnant women.
“I have been a driver for a long time and I used to transport the few women whom their husbands agree to be taken to the hospital. One day, I was taking my wife to the hospital and she died on the way. I did not know how to carry the pregnant women into the car, I just bundle them and put them in the car without any caution,” he said.
The NURTW is now prepared to expand the scheme from the current four states to all states in Northern Nigeria as the region has been identified to have more maternal/infant mortality rates than other regions in the country.
The launch of the expansion was recently carried out with fun fare in Abuja.
Speaking with THISDAY after the launch, the National President of NURTW, Alhaji Najeem Yasin disclosed that eventually, the ETS, which is a sort of ambulance service, would be available in all parts of Nigeria especially in the rural areas, where it would be more appreciated.
“We have our drivers at various villages for those women who cannot reach the cities to deliver. The ETS drivers are summoned when these women go into labour and we take them to the hospital free of charge. We feel the area of maternal/infant mortality is one where we can contribute our quota to development. Our attention is needed more in remote areas without access to health facilities, whether at night or whatever time, they can easily get our people on ground to assist,” he said.
Yasin added that all LGAs would be given the contact numbers of ETS volunteers in their areas, so that families with pregnant women can access the drivers through the LGAs where they (families) have no mobile phones.
“The vehicles are ours and are owned by our members, this is our own way of helping the society. To take a woman in labour does not cost us much, but the end result where lives are saved is rewarding,” Yasin said.
He also disclosed that the union was already working to ensure sustainability of the scheme after PRRINN-MNCH wraps up its project in Nigeria. “The Subsidy Re-Investment Programme (SURE-P) has already been approached by the union to key into the scheme and sustain it,” he added.
The National Programme Manager of PRRINN-MNCH, Dr. Ahmad Abdulwahab also speaking with THISDAY harped on the need to forge partnerships with all stakeholders across board.
“One of the biggest challenges which is also one of the delays is transport. The first delay concerns the decision of the family to go to the hospital. The second delay is reaching the health facility, and transportation is responsible for that. So we decided to partner the NURTW because they are everywhere in the country. They have been able to adopt it as their own responsibility,” he said.
Abdulwahab disclosed that his organization did not give any form of financial incentive to the union, rather the union’s capacity to build and run the ETS was assisted by PRRINN-MNCH.
“NURTW as an organisation would outlive PRRINN MNCH. So the ETS is about them, we have built their capacity and they are running things on their own. If they need more assistance, even when PRRINN is no longer around, they can approach any other organisation working on maternal and child health to help them. They are now in the drivers’ seat, it is their programme, and just that fact attests to the sustainability of the programme,” he added.
Abdulwahab noted that the programme has enjoyed success in the four operational states where it was started. The expansion to other states, and eventually nationally, , he emphasised, would result in drastic reduction of the nation’s high rate of maternal and infant mortalities.
