The polling booth in this Sokoto community was rowdy, cacophonous and stuffed with people, mostly men, prancing, pinging and policing all around in a decidedly Brownian motion. There was as short a supply of decorum as there was of patience. Still, there was a modicum of delicate peace for Aina’u Tukur in the privacy of her thoughts, as she entered a line that crawled at the pace of a silted stream. Her pains grew in intensity and in frequency.
Aina’u and her newborn baby
“I queued like any other person to be accredited and followed due process; nobody fast-tracked my accreditation because I was the only one who knew what I was going through,” Aina’u said.
The pains grew stronger. So, too did her resolve. At the accreditation table, the fingerprint scanner confirmed a match with that on her voter’s card and a positive check was placed beside her name; Aina’u’s name was in the national database of eligible voters. All she now needed to do was to wait for others to be accredited and then the actual voting would begin.
Soon after, she felt a dampness run down her legs whose spurts coincided with her now very regular pains at peak expression. She decided: “This attention-grabbing pain must now take precedence.” She turned around and headed home knowing that each step would accelerate the labour pains.
About the same time, in another polling booth one mile away, Aminu Tambuwal, the governorship candidate of the All Progressives Congress (APC), now Governor-elect, clad in an all-white babanriga, and white cap to match, got accredited and cast his ballot. Tambuwal, the Speaker of the House of Representatives, during the campaign, pledged to improve the lives of girls and women, especially health and literacy.
Aina’u made it home and by then, her pains had become unbearable. Trickles of dampness around her legs had become gushes. Her sisters-in-law supported her on each side and paused with her each time as her face went into silent grimace and her body stiffened then relaxed.
She was helped into her hut and on to a raffia mat less than half a centimetre thick on the cement floor. Word had been sent to Mallama Hindatu Umar, the community-based health volunteer in charge of the settlement and trained by USAID/Nigeria’s Targeted States High Impact Project (TSHIP); a project implemented by John Snow Research & Training Institute, Inc. (JSI) and partners.
There are 2439 other volunteers like Mallama Hindatu across the state trained with USAID/TSHIP support. Hindatu rushed over to the house armed with two lifesaving medicines: chlorhexidine gel to apply on the umbilical cord stump, to prevent infections, and misoprostol tablets ingested by the mother to prevent delivery-related bleeding.
One in three women who died of pregnancy-related causes in Sokoto State did so from bleeding. With Aina’u’s pain at breaking point and now three women supporting her, in one definitive pelvic push – and that moment felt like an eternity – released a beautiful, baby girl with an attention-grabbing cry that also turned her skin pink. It was Aina’u’s fifth baby.
The baby’s cord was cut with a clean, never-used razor blade and with Hindatu’s washed hands, the made-in-Nigeria gelwas generously applied on the cord stump and the skin area around the cord. All wrapped in a warm cloth, nestled on her mother’s chest, the baby took her first breast milk, her exclusive meal for the next six months. It helped that Aina’u attended three antenatal visits at General Hospital, Tambuwal, two miles away. She got iron and folic tablets to build her blood and three doses of Sulphadoxine-Pyrimethamine that pre-emptively treated her for malaria.
Aina’u was still determined to vote. “I could not cast my vote even though I was accredited because the voting time had elapsed and the election workers had closed,” she said. She continued as tears ran down her face, “What inspired me to want to vote was because we need a change in our lives…and we want to have a feel of the government in our community. That is why, even in pain, I endured and went to the polling booth.”
Aina’u received the last dose of misoprostol in stock with the community drug keeper and another four women from here will deliver in the next three weeks. There were twenty doses of chlorhexidine gel remaining. Sokoto State Government was the first government in Africa to assume financial responsibility to procure chlorhexidine gel. A local Nigerian firm – Drugfield Pharmaceuticals is the first to produce chlorhexidine gel in Africa with USAID/TSHIP’s technical assistance.
Aina’u continued: “Two of our main boreholes have not functioned in 12 years. The local primary school for 300 pupils operated by 20 teachers has three classrooms whose leaky roofs seriously interrupt classes during the rains. Many classes hold in makeshift areas that don’t work well for our children.”
During an interview with newsmen, Citizen Aina’u called for “improved healthcare delivery in public health institutions across the country.” She added: “The provision of modern healthcare service would go a long way in boosting healthcare services.”
By her singular act of going to vote while in labour, Aina’u sent a powerful message that good governance is about the provision of quality maternal newborn and child health as a right. Governor-elect Tambuwal and His Deputy, Ahmed Aliyu, the outgoing Commissioner of Health, are well placed to perfect Sokoto State’s innovative community-based system and primary health care delivery for predictable availability and delivery of life saving interventions to Aina’u and the 1.1 million women who annually deliver 242,000 babies to thrive on a sustained basis.
Four days later, Aina’u’s baby was vaccinated against polio and tuberculosis. In another three days, there would be a baby naming ceremony with mother and baby present, because they survived.
•This piece was contributed by Dr. Nosa Orobaton and Dr. Zainab Mohammed.
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