Makoko: Thirsting for Good Health Facilities

For pregnant women and children in Makoko Community of Lagos State, only the fittest patronise the Primary Health Centre across a double-lane road on Yaba Road. Rebecca Ejifoma writes on the sordid state of health facilities in the community

It was about 8a.m. that Friday morning. I had dressed up purposely, in a casual manner, for Makoko Community, a town on the outskirts of Yaba in Lagos State. It is a suburb of people living the carefree lives of our forefathers – on awful, black water full of fish, crab and crap.

Makoko is a place you enter and realise your spoken English sucks; you lose words to explain yourself or communicate with the inhabitants effectively. They speak and understand Yoruba, Egun and French languages and the pidgin English, as Makoko dwellers are the Ijaws, Ilajes and the Eguns, who hail from Badagry – another far suburb of Lagos.

Their homes are levelled both on land and on the black water clustered with dirt of various dimensions including human waste. There are queues of canoes and young boys beckoning you to their crafts whilst ferrying fisherwomen and their hand woven baskets full of fish like tilapia, mackerel and even crab among others.

Funnily enough, at every turn you take there is a wooden structure, where a young wife is roasting fresh fish and exhibiting them on hand woven baskets in a beautiful order. The stunning thing about the women is how they sit amid the thick gray smoke exuding from the fire woods and sawdust grilling the fish. Even little children of ages two and above perched beside the smoke, unfazed by its discomfort.

On a one-day investigative tour around the town, I observed a riot of dirt in square-shaped structures at various junctions in the small town, waiting to explode. And each had both perishable and non-perishable things.

Oye Hospital in Makoko

After touring the town assiduously the entire day, I gathered that there were four hospitals in the slum town: Dauda, Davido, Jero and Oye.

You could see a symbol of a cross painted in blue on the wooden wall of Dauda hospital. There is a square-shaped transparent basin filled with sachets of tablets – drugs – to the brim. So, I knocked at the door. A lady in her 30s responded. She looked rather weak and reluctant to speak. When asked of the doctor, she replied, “Doctor no dey” (Doctor is not on seat).

While waiting, two young men walked briskly into the room carrying a bowl of hot pap. Out of curiosity, this reporter enquired from the neighbours, who said the men were the doctors. Hence, I knocked again, then opened the drape only to see that the two men were carrying out termination of pregnancy (abortion) for the young lady.

Now, there stands Oye hospital just five minutes’ walk from Dauda. I climbed up the scanty wooden flight of stairs to enter the hospital.

There is a very small room on the right like a restroom. It looks private. The one-room hospital has three small windows covered with cotton and towel as drapes. There are two wall fans on the north and west sides of the wood walls. On the floor are triple beds. There are two foams – flattened by years of use – on only two. Above the beds on one side are dangling mosquito nets. It’s crystal clear. Oye uses herbs to treat its patients. An old white transparent plastic bottle with a brownish substance in it sits in one corner. When asked what that was, the little girl said, “mericine” (medicine).

The two young men sitting on two beds in the room identified themselves as apprentices in the clinic. “Doctor is not around now. He travelled to Benin Republic for some reasons. We don’t know when he will be back,” one of them, Malik, disclosed.

On who attends to patients in his absence, “We treat people: children and adults including pregnant women,” they chorused.

Interestingly, in a cursory look at Oye, one could easily conclude that it is a clinic not a hospital. But what is confusing is that it admits patients including children, pregnant women; and carries out normal delivery including Caesarean Section.

With the pathetic-looking beds, the apprentices lamented that once, they heard that the state government sent some people to distribute beds to them (the hospitals). “But they didn’t give us.”

“Currently, we have 15 pregnant women in our hospital. Our charges are not high here. It is between N5,000 and N6,000 for all delivery. Then, we charge N1,500 monthly for ante-natal. We, also, have family planning programmes but people don’t come for it.”

According to a nursing mother, who walked into the room, Oye takes good care of them. “We deliver here. And our babies are healthy. Doctor even talks to us about family planning. But he is not around.”

Exposure to Mosquito Bites

It is July. Schools are on holidays. So, there were more children at home than expected. They were running around unclad and even without any foot wears. They walked and played in the drenched sawdust on their ground. Some played in spoilt and abandoned canoes besieged by fungus. You could see many little children with large, protruding bellies like calabash set upside down. They range from ages five-month-olds and above. While the very little ones cried almost the entire tour, the older ones played without limits.

According to one Malik, the most common ailments among their little children are typhoid and malaria fever. “It’s much here. The children come up with vomiting, coughing, weakness of the body and catarrh.”

Now, a survey by the United Nations International Children Fund (UNICEF) in 2013 states that Nigeria is the second largest contributor to under-five deaths worldwide as 2,300 children of age five years and below die daily in the country.

“At Oye, we prescribe drugs that we don’t have for patients and provide necessary treatment. But if any case needs to be referred, we refer them to Subairu or Eko Primary Health Centre,” Malik added.

Now, in an inquisitive search for a Primary Health Centre, I gathered from other female residents that the community had none. Residents patronise the Simpson PHC on Simpson Street in Yaba and Subairu in Iwaya or Eko. So, I visited Simpson PHC on foot. It takes about 20 minutes to get there excluding the long walk out of the slum. Now, since Simpson is on the other side of a major road, a pregnant woman crosses at her own risk.

True, most vehicles do not halt for pedestrians on the Zebra crossing let alone a busy road without one. Hence, pregnant women from Makoko will have to wait until the road becomes vehicle-free before going across.

However, it is a five-minute-drive after a long walk out of Makoko community by bus. Then a pregnant woman will alight from the bus and cross the two-lane highway to the other side of the road to board yet another bus and then wait for it to be filled with passengers.

A resident of Makoko, Mr. Agbeba Solomon, explained that they enjoyed electricity more in the community. But he lamented that they ought to be enjoying other basic amenities like potable water and good health facilities from the state government.

Sadly, all efforts to speak with the Lagos Ministry of Health for several days proved abortive. At the Simpson PHC yet again to see how things are done in the rainy season, the centre was dry. The security man instructed that I pay N50 for an exercise book, which I did. He was too impatient to respond to any question.

There was no one on seat, except the young woman sitting on the guests’ chair. She approached me, took the book from me and took down my bio-data. “Go upstairs and see the doctor,” she instructed. Looking rather unconcerned and introverted, she simply responded to only one question from me, even though I disguised as a mother. “When you bring your child, you will pay for another book for him.”

I tried to see the doctor, a female, who was speaking to a patient. There were three other persons, including one man, waiting to see the same doctor. Seeing that the conversation between doctor and patient was not ending any time soon, I had to leave.

Undoubtedly, the health facility workers need to be trained and retrained on client relation skills as this is obviously poor and may be one of the reasons people hardly visit. With their manners of approach, there is no doubt that the attitude of health workers towards patient is still a big issue in Lagos and Nigeria as a whole.

Means of Livelihood

There are small kiosks at various corners in the town. But the most common trade you find there is fishery. The women of Makoko are strong and industrious. While their men paddle canoes, they go fishing.

Having disguised as a student who wanted to learn fishing trade, a fish seller allowed me witness the grilling process; from the washing of the fresh fish to the finishing with bamboo stick for a perfect circle shape.

Interestingly, this woman simply identified as “Iya” set three stones on the ground, fused in dry woods and added some amount of sawdust to kindle the fire. She sprinkled a large quantity of kerosene blended with nylon and plastics to support the flames.

There is their usual huge aluminum smoky-can which is stationed around the stones. A large grill is placed on the can. Then she begins to set the fish on the grill beautifully as the fire intensifies.

But ultimately, Makoko women and children are in dire thirst for a better health system; upgrade in their hospitals and competent doctors, not just apprentices. “We need government to help us with good roads and provide borehole water for us and health facilities. We are also Nigerians,” Agbeba said.