By Yinka Shokunbi
Dr Osahon Enabulele Dr kayode Obembe
When in October 2010 a bomb exploded during the Independence Day celebrations in Abuja killing about two dozen people, Nigerians couldn’t have dreamt of a time bombing would become a serial occurrence as we now have today.
Nowhere is immune to bombing by the dreaded Boko Haram sect-religious houses, Bus parks, markets and commercial centres, relaxation centres, health posts and residential areas have all been hit and thousands of people have been killed and hundreds of women and children abducted as well.
This serial occurrence of bombings, wanton killings and kidnapping of people across parts of the Northern part of the country our correspondent gathered is already having its toils on the health situations of the Northern area of the country.
In her welcome remarks at the just concluded Sixty-seventh World Health Assembly (WHA) Director General of the World Health Organisation (WHO), Dr Margaret Chan, observed that at the beginning of 2014, the world began to witness a sudden re-emergence of wild polio virus which two years back it was almost certain there would be eradication.
She noted that this re-emergence prompted the recommendations for vaccination certification of travellers from the three countries known to be seeding outbreaks elsewhere – Pakistan, Afghanistan and Nigeria.
According to Chan, “The factors responsible for this setback are largely beyond the control of the health sector”. These she enumerated to include: Armed conflict that flies in the face of international humanitarian law, civil unrest, migrant populations, weak border controls, poor routine immunisation coverage, Bans on vaccination by militant groups and the targeted killing of polio workers.
From the WHO data, across the world, each year, nearly 1.4 million people lose their lives to violence. Women and girls experience specific forms of violence that are often hidden. And globally, one in three women experience physical and/or sexual violence at least once in her life. For every person who dies as a result of violence, many more are injured and suffer from a range of adverse physical and mental health outcomes.
In Nigeria, the insurgence of Boko Haram since 2010 has not only led to deaths of people it has equally led to the disruption in healthcare delivery in many parts of the affected states, our correspondent learnt.
“We have on record that health posts were burnt down in some of the affected villages in Yobe State and as such it is not possible for pregnant women and their children to access routine immunisation at these health posts”, says former President of the Nigerian Medical Association (NMA), Dr Osahon Enabulele.
The states of Borno, Adamawa, Nassarawa, Bauchi, Kano and recently, Plateau and Benue are not left out of the effects of violence and insecurity on healthcare delivery.
One of the bomb blasts, which occurred in Jos town, was close to the Teaching Hospital gate and many were afraid that the terrorist may be close to targeting health facilities of that magnitude having succeeded in burning down village health posts previously.
As at the May 23, Nigeria has a record of three new polio outbreak in 2014 spread across Yobe and Borno states. The re-emergence of wild polio in parts of Nigeria in 2014 explained Enabulele, “is an indication that Nigeria may be on the verge of reversing some of its gains in healthcare unless the insurgence is tamed at this present level.
“It is only when the situation returns to normalcy that the state can only know the extent to which the current violence has affected state of health of our women and children”, Enabulele told our correspondent.
According to him, “there is indeed a strong relationship between healthcare delivery and violence and this we are already experiencing in the country as not only are human resources threatened, facilities built for healthcare delivery are destroyed and people are prevented from using them, people are scared of accessing care at government facilities for fear of stepping into danger out their homes, drug delivery to the unsecured areas are threatened and consequently, lives are at risk”, Enabulele pointed out.
There is already an indication that a number of health workers serving in the Northeast Nigeria are relocating to the Federal Capital Territory, our correspondent also gathered.
A female medical doctor and activist of the #BringBackOur Girls, Dr Fatima Zana-Gana of Purple Heart Foundation, Abuja confirmed that some of her colleagues in the University of Maiduguri Teaching Hospital have relocated to Abuja for fear of the lives.
President of the NMA, Dr Kayode Obembe, also corroborated the threat of the rising violence and insecurity to the overall health status of the country saying, “the situation is very bad and depressing” he told our Correspondent in an interview.
According to Obembe, “The just-concluded WHA had a plenary on the situation in Nigeria in which the discussion was on the Chibok abduction and for those of us who attended the meeting; it was an embarrassment that the focus on Nigeria was not on cheering news but one that put us in bad spotlight”
Although he said the association has no record that its members are relocating form the North east even as one of the bomb blast took lives of medical doctors and medical students.
“We should understand that these Boko Haram suicide bombers are not discriminating between professions or sexes so it would not be fair to say they are targeting health workers alone but then, we have been reminding government to revisit the creation of the Medical Rescue Squad which had been proposed 15 year ago; this squad like the fire service would be at standby at all levels to attend to emergency situations with the light of speed”, he pointed out.
Also speaking in similar vein, Deputy President of the Nigerian Association of Nigerian Nurses and Midwives (NANM), Femi Tonade, “there is no doubt that the insurgence in the north is taking its toils on the health of the people but from the reports of the Northeast zone, our nurses are still coping because governments have increased security around hospitals”.
He pointed out that prior to the increased presence of military in the major health facilities, nurses had fallen victims of kidnap and killings in the course of duty by Boko Haram, “but we have counted this as hazards of our profession”
On the health situation of the abducted women and girls by the terrorists, all healthcare practitioners agreed that government would need to make room for special Anticipatory Support Service for the victims and their families.
Enabulele sees the need for government to set up a dedicated support mechanism that would provide medical and psychotherapy services outside their community first, then rehabilitation and re-integration process into the community from where these women and girls come from, since it is been said that they are not all from Chibok”.
According to Obembe, “The NMA has recommended and made provision available as well to assist in medical care of the abducted women and girls so that whenever they are freed, there would be care offered to ensure those who probably got pregnant and or have delivered babies but never got immunised or receive care would be medically attended at whatever level each is assessed to need help”
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