How COVID:19 lockdown is increasing patronage of TBAs

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Mrs. Patrick Nnnena trekking to new mile one hospital in Diobu, PortHarcourt from CFC, junction Aba road ,where The Guardian reporter met her.

Empty roads in PortHarcourt.

The strange COVID:19 virus which is ravaging many countries across the globe appears to have taken a severe toll on pregnant women.

Given the present challenges and government responses to prevent the spread of the deadly virus, especially the lockdown measures, some pregnant women in Rivers State seemed to have resorted in patronizing Traditional Birth Attendants (TBAs) at the moment.

TBAs are people (Mostly older or middle-aged women) who are traditionally independent of the health system and community-based providers of care during pregnancy, childbirth and postnatal period. These categories of people are much more accessible and affordable than the professionals but they did not receive formal medicine training unlike other health experts such as the obstetrician and gynaecologist.

In Rivers State for instance; where the two major Local Government Areas, Obio/Akpor and Port Harcourt are locked down by the State government, movements are totally restricted except those on essential duties, but recently after a consultant Obstetrician, gynaecologist, Dr.Eli Sukarime raised an alarm about a pregnant woman he operated but was refused access to the hospital for medical checks by some overzealous security personnel and COVID:19 task force members implementing the lockdown rules, the pregnant women and postnatal mothers in the State have now been granted permission to access the healthcare systems though still with more stringent dares.

Findings revealed that a lack of transport system for those who registered in hospitals that are far away from their homes and the harassments abuses their husbands or taxi drivers who conveyed them to the clinics are subjected to by the security men explains the unwillingness of some women to deliver in health care facilities.

Careful checks revealed that the husbands of some of these women are arrested by security operatives after dropping their wives at the hospitals. Also, commercial taxi drivers have severally fallen to similar traps, thus compelling them to snub calls by pregnant women to convey them to hospitals due to uncertainty about their return.

During pregnancy, women are supposed to visit health care facilities from antenatal clinics, doctors appointments, emergency appointments and delivery appointments.

The COVID-19 rising challenges, therefore, has compelled some of the pregnant women who do not have vehicles or other means of transportation to the hospital facilities to resort to TBAs.

Sometimes, a local birth attendant lack of knowledge and use of traditional practices can be risky to these women. Research shows that unsafe practices leave women at risk of mortality which results in exposure to infections, haemorrhages, obstetric emergencies, meningitis amongst others.

Seemingly, the Millennium Development Goal 5 (MDG5) set by the United Nations is to improve maternal health by reducing the Maternal Mortality Rate (MMR) by three-fourths by 2015 and due to the high maternal mortality rates occurring in the country, Nigeria was identified as one of the countries that needed to achieve the MDG 5.

Though the MDG 5 is yet to be realized, sadly, the COVID: 19 challenges appear to be worsening the already vast challenges of pregnant women in the country. Due to the lockdowns, some pregnant women who attempted to trek long distances to hospitals where they registered sometimes collapse on their way while some feel dizzy and weak. Since the COVID_19 outbreak, about 19, 000 women are said to have died in pregnancy, during birth or within 42 days after death.

While carrying out this report on the streets of PortHarcourt and Obio/Akpor, The Guardian reporter met one Mrs Patrick Nnnena, who lives around Garrison junction by Aba road and was trekking to new Mile one Clinic where she registered for antenatal clinics, (A journey of about three hours by foot).

She looked pale and was barely lifting her legs for the required movement, moved by her pathetic plight, the reporter carried her in the vehicle and while conveying her to the hospital, Nnenna disclosed, “I am trekking to the hospital at new Mile one clinic because I have been sick, I went to see my doctor last week and he said, I have malaria, He asked me to take Palodrim two times daily for seven days, I have done that but I am still feeling very sick, dizzy and weak, so I decided to return to the hospital again today”

“ My husband has a car and he is in the house but he could not drive me to the hospital because last week when he drove me to the hospital he was arrested by the State COVID:19 task force on his way back home and was taken to the isolation center, so because of fear, he declined taking me to the hospital again”

Nnnena who is still in her first trimester, however, appealed to the State government to review its strategies on the lockdown measures to enable pregnant women to access the health care facilities with ease.

Also, another preggie who lives at Elekahia Housing Estate in Port Harcourt City Local Council, but registered at the University of Port Harcourt Teaching Hospital (UPTH), Mrs Agnes Thomson told The Guardian that she has started going to see a local birth attendant near her house because she could not cope with the lockdown stresses.

Asked if she is acquainted with the possible risks associated with TBAs, she said, “, there is no access to the formal health services, so what do you want me to do, the government should have had pity on us and grant the permit to taxi drivers to return with ease after dropping us at the hospital, however, I trust my God will grant me safe delivery.

Another pregnant lady who lives with her mother in Diobu axis but registered at Ogbunabali, Mrs Stella Dombari, said, “ It is very stressful, I am staying with my mother at Diobu while I registered at Ogbunabani, a journey of about two hours if there is labour now, I don’t even know what to do, that is why I have started going to a local birth attendant at Nanka street in Diobu ”

Further Comprehensive findings revealed that a large number of pregnant women who registered in hospitals that are far away from their homes have resorted to TBAs.

However, a visit to some health facilities showed that improved number of women came for antenatal clinics unlike previous weeks when the units were empty.

The consultant Obstetrician, gynaecologist, in the State, Dr Sukarime also confirmed this when he told The Guardian, “ I am just coming from the clinic, most pregnant women who have vehicles were in the clinic but the challenge is those who do not have vehicles. Some hired commercial taxi drivers, sometimes while going back, they get arrested by security personnel or task operatives”

He stressed the need to sensitize and inform the government and security agencies about the activities of their men which is posing serious challenges for pregnant women to accessing health care services.

Dr Sukarime said, “Some of the security personnel go along way arresting the husbands of the pregnant women, or the taxi drivers that brought them to the hospitals, the government should modify the lockdown to see how they can allow total access to pregnant women and those conveying them to hospitals”.

Meanwhile, the United Nations Emergency Fund, (UNICEF) recently dished out a warning that lockdown could kill more people, predicting that there could be 1.2 million child deaths.

Chief of Health at UNICEF, Dr Stefan Peterson noted that “ Indiscriminate lockdowns were an effective way to control COVID-19 and could contribute to a 45 percent rise in child mortality”

Undoubtedly, a total lockdown will bring more pains to these vulnerable group unless measures are taken to improve their wellbeing and ensure access to clinics with the aim of ending preventable deaths, maternal and child mortality in the current pandemic.