News-Strange island where pregnant women must not go into labour at midnight

A trip to Igbologun community, located on Snake Island, Lagos, can be scary. The town has a population of over 20,000 people. A two-day visit by Sunday Vanguard to the community was an eye opener. The journey began from Coconut Bus Stop to the quayside during a downpour. It was followed by a N100 boat ride with 14 other passengers. But in the middle of the restless ocean, the engine coughed and went off, setting off panic among the passengers. The boat was in danger of tipping over as the passengers shifted about, several of them thinking the end had come, but the driver and a few level-headed passengers appealed for calm. During several attempts to restart the engine, a boat loaded with sachet water passed by, also on its way to Igbologun while a canoe, with a lone female occupant, equally sailed by.

• The community’s toilet and refuse dump site Finally, the driver brought the engine back to life and the journey continued. As passengers disembarked at the destination, the reporter was accosted by two young boys of about 12 and 16. They were there to help offload passengers’ luggage from the boat for a fee. Commercial motorcycle riders (Okada) also swarmed around the passengers. Welcome to Igbologun, a community made up of different tribes, cultures and religions. It was gathered that Snake Island, on which the community sits, derived its name from the (snaky) way it appears on the map, contrary to the belief that it is so called because of the large population of snakes there. Snake Island has so much beach sand such that, as you walk, your legs sink in and it is as if you’re being pulled back. Interestingly, the hugely populated island, situated in the heart of Apapa, is under Amuwo-Odofin Local Government Area. Despite being so close to the hub of trade and commerce, and all its modernity, what would seem like another shocking discovery, for a first-time visitor, is how typically rural the island remains. Igbologun, despite a history of existence that precedes even the Nigerian nation, is dying for government attention for the provision of basic social amenities like schools, standard hospitals, tarred roads, potable water, stable power, standard market place and means of waste disposal, among others. The first impressionable building to behold is Igbologun Senior Secondary School. Close to it is a police post that offers the community the only source of drinking water and it is about 30 minutes-walk into the heart of the community. Trooping out were young and old women carrying trays of all sorts laden with wares of smoked fish (Egun Fish). Young children were also hawking. A striking feature that immediately becomes apparent across the community is the high number of pregnant teenage girls. This reporter soon gathered that even though pregnant, majority of the girls are not registered for ante natal care, mainly as a result of financial constraint and cultural beliefs. Findings showed that there is a sense of laxity that enables these young girls engage in sexual activities. The development is essentially fuelled by the high level of poverty in the community. Many of the girls are lured with money by the young men who are boat drivers or Okada operators. “Most of these guys you see riding Okada or driving boat have more than three girlfriends each because they make quick money from their businesses and live like kings in the community,” said Mr. Jude. Further investigation revealed that whenever a pregnant woman in the community goes into labour, particularly at mid-night, they are usually in a dilemma. This is due to the inability to afford to register in a standard hospital, and for those who could afford it, reaching the centre at mid-night is a tug of war while obstetric complication that may require surgery is out of the question. The result is that many pregnant women and newborns often lose their lives. The only Primary Healthcare Centre in Igbologun is defunct. David lost his wife during childbirth. Emeka, who lives in Mama P compound in the community, also lost his wife along with a set of twins while Daramola lost his wife and is left to bring up their baby alone. What the three men have in common is that their wives fell into labour at night. Bolanle, David’s wife, 27, may have been alive today to experience the joy of motherhood, but her dream was cut short because she found herself at Igbologun. Bolanle’s desire to give life led her to the great beyond. She fell into labour in the middle of the night. “When she went into labour in the middle of the night, we already knew there was a problem. Her mother called for help, but there was little anyone could do because there was no means of conveying her to the other side of the lagoon for medical attention”, said Mr. Gbenga Sosanya, a neighbour. “Prior to her delivery time, Bolanle registered for antenatal at Tolu Hospital in Ajegunle, but no boat could convey her there in the night. She and her baby died after several hours of labour in the hands of traditional birth attendants”. Pointing to the spot where Bolanle was buried, Sosanya said that the trauma forced her parents to leave the community. He hinted that several of such cases were recorded in the community until few years ago, when someone set up a small private hospital. “The only Primary Healthcare Centre in the community can simply be described as an empty building because there are no doctors or nurses and, most of the time, it is locked.” Agony of motherhood

• Charity Felix (left) and • Elizabeth Luke (right) Sunday Vanguard visited the private hospital. It has seven rooms for the over 20,000 residents. The doctor in charge was battling to save the life of Pasca Kapo, a year and six months old child who was brought in a breathe away from death. Pasca was brought in gasping for breath, his legs and arms cold. After administering first aid, the doctor said he had severe malaria and anaemia with PCV of 10 percent. To worsen matters, Pasca is O-negative, a rare blood group. The doctor required a transfusion urgently but the child’s parents were broke. They were running from pillar to pole to raise money. After a lengthy persuasion, John Kapo, the boy’s step father, spoke with our reporter. “I am not the biological father of Pasca. I married his mother when she was rejected while pregnant with him. It is the present pregnancy she is carrying that belongs to me, but I just have to help save him even though he is someone else’s child”, he narrated “We tried our best at home in the first three days when he was showing the signs, but when it went beyond us, we took him to the traditional birth attendant where he was for two days. When he was at the point of death, they said we should take him away.” In the nursing ward was Charity Felix. The 30-year-old woman recounted how the doctor saved her life. “I went into labour around 2am. I had registered at Sonnex Hospital in Ajegunle where I had my second child who is presently six years old. My first child, who is 10, was delivered by the Ijaw women here in Igbologun. I could not cross to the other side of the ocean for delivery. When the Ijaw women tried all their best to take the delivery, with no success, they sent me to this private hospital”. In tears, Charity said her first two children were delivered normally but the third was through C-section and she had been in the hospital for two weeks and two days because they could not settle their bills. “Recently, my husband lost his job, and to eat became a problem. We have property to sell, but nobody is ready to buy. Even to pay the house rent is very difficult.” Charity, who hails from Igueben local government area of Edo State, has lost contact with her parents since she lost her handset. Next to her was Elizabeth Luke, 20, who was rushed from a nearby Island, Sabokogi. She went into labour around 7 pm and, after failure by traditional birth attendants to deliver her of the body, around 4am, she was transported with a chartered speedboat to Igbologun Medical Centre where she went through a C-section. Elizabeth said there is a Primary Health Care, PHC in their community but no doctor and no drugs. Several hours later, our reporter engaged Dr. Sodipo Gbolahan, who opened up on the pathetic status of healthcare services in the community. Only doctor in the community The only doctor serving the over 20,000 residents of Igbologan graduated from University of Ibadan in 2005. He served at Bishop Shanahan Hospital, Nsukka and later joined Ibadan Central Hospital for a year and a half before moving to Tolu Medical Centre in Olodi-Apapa. While at Olodi-Apapa, a patient attending ante natal facilitated his relocation to Igbologun. “When one of the pregnant women who came for ante natal told me they lost a pregnant woman with twins overnight because there was no means to transport her to the hospital, I was surprised and asked why they did not call for an ambulance. She said no ambulance could get there,”the doctor said. Gbolahan discussed his intention to relocate with his wife who kicked against it. “But as God will have it, she was having problem with her own pregnancy; so I quickly took her to the United States of America and, before she returned, I had moved to the community.” Over the past five years, he has been practising in Igbologun. Most of his patients have been vulnerable groups, children, pregnant women and the elderly. He explained that most of his patients come to his clinic after trying so many options and only come at the point of death. “Few (pregnant women) register across the ocean in Ajegunle but usually have no means to cross the ocean and end up dead in the hands of traditional birth attendants or are brought to me very late. There was a case I just discharged, she presented very late, but eventually we saved her life but lost the baby. She went to be delivered in a church in the community, where there was no nurse. After several hours of prayer and miracles did not happen, they sent for me,” the doctor said. “When I got there, there was no nurse to take the delivery. The woman was already weak, the baby distressed. She couldn’t push, so we had a C-section to bring the baby out dead, but the mother was alive. She spent three weeks here and they were able to raise the N70,000 bill. Sometimes when patients present, I don’t expect them to survive but miraculously they do. “Generally here, people don’t go to hospital for delivery. They believe that strong women should deliver at home. There was a lady who, during her first pregnancy, tried to deliver at home but lost the baby. When she got pregnant a second time, she ran to me and said doctor, ‘nothing must happen to this baby’. “When I came here five years ago, they told me there was no light two years before my arrival and in my five years of staying, there was no light. The situation persisted until January this year when we had light because Governor Akinwunmi Ambode came to our aid. But for three months now, it’s been blackout”. Running the hospital Gbolahan began running his hospital inside a room, self-contained, but later expanded. “I purchased used beds from doctors in Ajegunle. I keep one room as private ward in which those admitted are able to pay their bills. It is from there I settle my own bills, pay my staff and buy drugs. I am here until the day I will not be able to cope again. Probably before that time, government may have come to their rescue.” Way forward He urged the state government to partner with private facilities because Igbologun is just one of several islands. “If you go to Igboejo, Tomaro, Itu Agan or Sabokoji, government can put three secondary healthcare centres which will feed Island Maternity or the Lagos General Hospital,” the doctor said.“Also in this community, there is nothing to motivate the younger ones. After their primary school, the next thing is to be a boat driver or a fisherman. They seduce females and impregnate them and later go for abortions that result in complications. “I was trying to talk to the school principal to start a scholarship. There could be potential doctors here. If a doctor is from among them, they would be committed. Half of the girls drop out in SS2 due to pregnancy. Most of time when I talk to the ladies, they say after secondary schools they will get married.” Religious leader The Chief Imam of Igbologun, Osani Saka Olaribigbe, who complained bitterly over the state of healthcare in the community, said the only PHC in Igbologun can best be described as an empty building. “In that health centre, they don’t have any equipment, no drugs, no doctor; so we cannot call it hospital, it is just an ordinary building. The two nurses there only refer people to urban areas to seek healthcare and once it is 2pm they close the centre,” Olaribigbe said. “The last delivery I could remember they took in that PHC was in 2004. Even when they refer us to across the ocean, there is no means of transporting our pregnant women to the General Hospital or Cardoso Hospital in Ajegunle”. Traditional ruler The Baale of the Igbologun, Chief Amisu Alao Gegeiyawo, also complained that they have tabled their challenges on several occasion to the government without favourable outcome. He said that among the challenges confronting the community was lack of waste disposal facilities and source of potable water. Gegeiyawo said that it’s been long since they enjoyed government services in the area of quality healthcare service. “The only intervention we enjoy once a while is from non -governmental organisations, which come to distribute drugs and mosquito net to our people,” the traditional head explained. “The PHC is under Amuwo Odofin Local Government and I have complained on several occasions about the unavailability of medical personnel at the centre and no drugs, but the situation remains the same.” At the PHC, the Health Assistant, Mrs. Aminat Ogungbemi, declined to make comments. The compound was overgrown with bush while the doctors’ lodge was under lock and key.