When the Doctor is Just a Truck Away

Vanessa Obioha reports on how MTN Nigeria Foundation intervention in the healthcare sector is helping underserved communities to access and accept primary healthcare services

Access to primary healthcare remains a challenge for most local communities in Nigeria. In Lagos State for instance, with an estimated population of 20 million, some areas are difficult to reach and are marked as difficult terrain, riverine areas or slums. These areas have little or no access to healthcare compared to the urban areas where it is easily accessible. Even as the health sector confronts the myriad of challenges ranging from infrastructure deficiency to shortage of personnel, primary healthcare centres which are relatively domiciled in grassroots areas are not widely accepted by locals.

The perception that healthcare can only be accessed by the rich still pervades most of these communities such that even if a healthcare facility is close to their doorstep, they are reluctant to accept the services. Therefore, it is not uncommon to see many rely on self-medication or ignore medical treatment.

It is against this backdrop that MTN Nigeria Foundation launched its medical outreach programme called MTN Y’ello Doctor which is targeted at underserved communities. The initiative provides primary healthcare services to women and children in communities using state-of-the-art mobile clinic trucks.

“We recognise that health is also an economic issue. A lot of people do not go to the hospital because they cannot afford it. And it’s also an education issue, so the project is about closing the last mile. We diagnose you, however, we take up the burden of you having to buy your medication,” said the Executive Secretary of MTN Foundation Odunayo Sanya.

Partnering with state governments and health ministries, the programme was rolled out in 2014 with six mobile clinic trucks in communities across six states. They are Abia, Ogun, Delta, Taraba, Niger and Katsina.

States are usually selected based on existing data from the Ministry of Health, the National Bureau of Statistics and some economic data.

Coloured yellow, the trucks are adequately equipped with doctor and nurse stations as well as a pharmacy. They are stationed in areas where the poor can easily access them such as the marketplace. Each mobile clinic has at least six medical professionals to render medical services for free such as the treatment of malaria and pneumonia and other common ailments. They also screen patients for tuberculosis, blood pressure, diabetes and Sexually Transmitted Infections (STIs) as well as give referrals to secondary facilities. And with the ongoing pandemic, vaccinations have been added to their services.

Since its inception, the Foundation has had three phases with the third phase kicking off last November. The first two phases which ran from 2014 to 2018 had benefited over 710,000 individuals nationwide. According to the Foundation’s statistics, a total of 611,405 individuals were reached with health messages and 97,844 patients were treated for various ailments.

However, in 2019, the Foundation paused the initiative to restrategise and by 2020, when the pandemic kicked in, the initiative was delayed to this year. For the third phase, the mobile clinic trucks were sent to Gombe, Lagos, Anambra, Kano, Kwara and Rivers. Gombe recently received its mobile clinic truck which will cover the 11 local government areas of the state.

In partnership with Market Doctors, a team of medical professionals who take affordable healthcare to the doorstep of Nigerians with minimal disturbance to their economic activities, the mobile clinic trucks will visit selected communities, mostly on their market days to offer their medical services.

The Chief Executive Officer of Market Doctors, Yetunde Oyalowo explained that the marketplace is a natural habitat to many in the rural areas.

“What we do is that we take healthcare to the people where they are, using the market as our focal point because the market is very unique. People come there to buy, sell, compare prices, buses pass through the market so there’s hardly any Nigerian that doesn’t have anything to do in the market. So we feel that if we take health care to the markets, people will be able to access it in their natural habitat.”

Most times, the people are so fascinated by the trucks that they approach the market doctors just to get a peek at the inside of the truck.

While the intervention is providing free healthcare services for all, it primarily focuses on maternal and child health. As Oyalowo puts it, getting expecting mothers to access healthcare on time ensures safe delivery.

“When they don’t access care when they get pregnant, they are likely not to have a safe delivery. That’s one of the things the Y’ello Doctor will address; to ensure that when people get pregnant, they can come to the truck and get antenatal care without going to the hospital. It encourages them to visit the hospital eventually.”

Sanya added that a lot of advocacy around HIV and contraception will be carried out in this phase.

“We recognise that it will be a big issue for us because, in 2050, our population is going to be huge. So it’s good to also complement all this effort with an awareness so that people understand that they have within them almost a natural power to live a good life by watching the number of children that they have.”

Apart from making healthcare accessible, the MTN Y’ello Doctor initiative has helped identify prevalent diseases in regions across the country. For instance, during the first two phases, it was discovered that malaria was common in the north and south regions. It was the most diagnosed in Ogun State while respiratory tract infection was prevalent in Abia and Delta States as well as in some of the northern states. Diarrhoea and hypertension were found to be rampant in states such as Niger and Katsina.

With these findings, the Foundation can work with health ministries to seek solutions to eradicate these diseases. As pointed out by the Senior Special Assistant to Lagos State Governor on Health, Dr Ore Finnih–Awokoya, the intervention is a laudable one as it helps the state reach the underserved in inaccessible areas. She emphasized the need to develop and implement a sustainable and effective approach in improving healthcare outcomes of people living in hard-to-reach riverine areas while strengthening access to healthcare to those areas as it constitutes a biosecurity threat.

“It could lead to increases in diseases and what this means is that as people gather more and more and push more and more into the environment, they come closer to animals. When there is no space, people live in closer proximity with animals and diseases from animals spread. So, epidemics and pandemics ensue as well as increases in communicable diseases like cholera, Lassa fever, and this causes a decline in the working population, and time is spent sick, leading to a reduction in the working population and ultimately decrease in the IGR and subsequent GDP. It could lead to disharmony and anarchy as when many people die in a place, there is a crisis.”

For the Commissioner of Health in Kwara State, Raji Abdulrazaq, Y’ello Doctor is in line with the vision of the state government which is to take healthcare to the doorstep of residents as a way of entrenching democracy to the people.

Although lauded for its level of impact, the numbers reached are still a trickle compared to the over 200 million people that make up the country. Only one-sixth of the 36 states in Nigeria access these services in each phase.

This limitation is not lost on Sanya who said that the Foundation is doing its best to ensure that each state enjoys free medical services. However, the most daunting challenge is changing the mindset of the people.

“Based on data from the previous phases, people just don’t believe in going to the clinics. But you know that something is wrong but they don’t come up. So that’s the other huge challenge but there’s a lot of education ongoing here.”

“Healthcare has to be affordable, available, and culturally acceptable. People tend to look at healthcare from afar, like it is for the educated people, that it is very expensive. But when you go to the market, you have come to their natural habitat. Then they can easily approach you and ask questions about the health services. So we are making it acceptable, that’s the barrier we are trying to break,” added Oyalowo.

*This story has been supported by Nigeria Health Watch through the Solutions Journalism Network, a nonprofit organisation dedicated to rigorous and compelling reporting about responses to social problems, solutionsjournalism.org*