Here is another story from a primary health care center in Kano about a difficult delivery they took in the dark. A quick explanation; many health care workers have resorted to using the light from their cell phone as their primary means of light at night. When taking a delivery, they will shove the cell phone into the front of their head wrap as a make shift head lamp. However, as you will hear in the story below, that method does not work out very well.
If subtitles do not immediately show up, hover your mouse over the arrow on the bottom right of the video and click on “CC” to turn it red.
We are continuing to post stories from health care workers about the difficulties they encounter when delivering babies at night without light. Here is one of my personal favorites taken from a primary health care center in Kano.
If subtitles do not immediately show up, hover your mouse over the arrow on the bottom right of the video and click on “CC” to turn it red.
As we spend time at health facilities in Northern Nigeria, we hear more and more stories from staff about the complications they encounter when having to deliver a baby at night. Listen to one of these stories below:
If subtitles do not immediately show up, hover your mouse over the arrow on the bottom right of the video and click on “CC” to turn it red.
One of our current projects entitled “Safe Delivery: Portable Solar Suitcases to Support Emergency Obstetric Care,” which we are implementing with WE CARE Solar, is working to give women the ability to deliver their babies safely in the night by bringing solar systems to the maternity wards at primary health care centers and general hospitals in Kano and Kaduna states.
While spending time in health facilities across Nigeria, we encounter many different types of experiences and hear all kinds of stories. We would like to share these with you through a new blog category, “Stories from the Field”. These blogs will explain what we experienced or what we were told and will not exaggerate or embellish the story line. We will also try to keep our opinions surrounding the topics to a minimum sense the point of the blog is just to say what happens, not to give an opinion about it.
We will kick off with a story written by one of our Project Coordinators, Hussaina Martha. Please feel free to leave comments in the box below. Names of health facilities have been ommitted and names have been changed for privacy.
Stories from the Field: Aug 16, 2011
On the afternoon of August 16, a seizing woman was carried into a near-by PHC in Kano. She already had 2 seizures while at home and began to have her third on the way to the health facility. Two men, her husband and a friend, carried the woman through the door to the maternity ward where the waiting CHEWs instructed them to put her on the floor. The head CHEW, Maryam, quickly administered 1 dose (10 ml) of Magnesium Sulphate and the woman’s seizing stopped, although she was left barely conscience. Using a standard blood pressure cuff, the woman’s blood pressure was found to be 200/150. Since the PHC is not equipped to handle eclamptic patients, Maryam told the husband that he would need to take his wife to a General Hospital and that she would need to administer a second dose of MgSO4 to ensure that his wife would arrive there safely. MgSO4 is difficult to find in Kano and is therefore quite expensive at a cost of N1,500 ($10) per dose. Initially, the husband began to protest over the cost of the drug, however, the friend who was with them asked the husband “What is N1,500 compared to life?”, and the husband agreed to pay. The second dose of MgSO4 was administered as the woman continued to lay lifeless on the entrance floor.
In order to send the woman to the General Hospital, a referral card had to be filled out which contained the woman’s date of birth, religion, address, blood pressure, and the drug and dose she was given. A copy was given to the woman’s husband to take with them to the General Hospital while another copy was kept for the Population Council (the NGO responsible for providing the MgSO4 to the PHC). With the referral card in hand, a wheelchair was used to transport the woman to the local kekenapep (little yellow buggy) that was waiting outside the facility to take them on the 30 min ride to the General Hospital.
Although this man said he would take his wife to the General Hospital, Maryam said there are some cases when patients refuse to go to the referred facility. One particular case she narrated happened on the August 5th, 2011. A woman was brought to the PHC with a seizure. After giving her MgSO4, her bp was taken and she was referred to the General Hospital for further treatment. At the General Hospital, the doctors made a list of the drugs the woman would need during labour and delivery and told the family to go out and purchase those drugs for the woman. Her family decided instead to take the woman back home to deliver the baby. During delivery, she developed 3rd- degree lacerations to the vagina and anus and experienced a great amount of pain. For the next three days, her family treated her by bathing her with hot water. On the third day, her family finally took the woman back to the primary health center to seek treatment. Unfortunately, the family waited too long to bring the woman to the health facility and after only 20 minutes of being at the PHC, the woman passed away.
Maryam explained that the woman’s husband was not willing to pay the hospital bills and that is why he took her home to deliver. Maryam was the head nurse when the woman was brought back to the PHC and was still very upset over the situation that happened only a few days before we spoke with her. She told us that after the woman died, the family wanted to sit in the health facility to mourn and cry over her death. However, Maryam refused to let them stay in the health facility because she said it was their ignorance and selfishness that caused this woman to die.
We have been working on the Mobile Community Based Surveillance Project (mCBS) with the Population Council and the Population and Reproductive Health Initiative now for 8 months. Visit our mCBS webpage that has a complete project description, reports, and training guides. More will be added to this page as we continue to collect data from the field.
Check out this short video that gives an overview of the project and how RapidSMS is being used to collect vital maternal and child health events.
eHealth Nigeria is partnering with WE CARE Solar to perform installations of WE CARE Solar’s “Solar Suitcase” in 12 health facilities in northern Nigeria. WE CARE Solar received a grant from the MacArthur Foundationto install their portable solar systems and collect data on the effect their solar systems have on health care. eHealth Nigeria is partnering with WE CARE Solar to assist them with the project implementation and data collection aspect of the project.
From July 11-25th, 2011, eHealth Nigeria and WE CARE Solar conducted assessments at health facilities across Kano and Kaduna states. The goal of the assessments were to determine which facilities would benefit from the light provided by the solar suitcase and which facilities had staff that would be willing to participate in collecting data for 3 months after the solar suitcase was installed. The assessment consisted of 5 different sections; Facility Statistics, Power Infrastructure, Cell Network, Maternity Services, Facility Layout, and Emergency Response System. In total, 27 facilities were surveyed.
Read the full report which includes our initial findings at the health facilities.
eHealth Nigeria has partnered with WE CARE Solar to install 12 solar systems at health facilities in Kano and Kaduna state. The solar will be installed in the labor and delivery rooms and possibly the operating theaters. The installations will begin in October of this year and will be followed by 3 months of data collection on how the solar system is being used in the facility and its effect on healthcare.
For the past 2 weeks, we have been doing site assessments at hospitals and primary health care centers in Kano and Kaduna to determine which facilities will benefit the most from solar lighting.
Last week, the Daily Independent wrote an article entitled “Nigeria: Telemedicine Centre Brings Affordable, High Quality Healthcare.” The article describes a new tele-medicine center that is being created in Lagos for Nigerian’s wishing to seek expert medical advise from abroad. Normally, in order to get health care advise from leading physicians in Europe, India, or the US, a Nigerian must actually travel to that location and see a doctor in person. The tele-medicine center will allow Nigerian’s to communicate with doctors abroad electronically, eliminating their need to travel.
I can not find any details on the progress of the tele-medicine center. It may or may not already be in construction. However, I am pretty sure it is not open. If anyone has any more details about the center, please feel free to write them in the comment section below.
From December – March, eHealth Nigeria worked with the Population Council on a project entitled “Formative Assessment and Mapping of Female Drug Users in Kano, Kaduna, Ogun, and Lagos, Nigeria”. An overview of the project has been posted on Population Council, Nigeria’s website.
