By Rabiu Musa
Battling to save lives in Malikawa and Yan-labi, two agrarian communities in Kiru and Tudun Wada Local Government Areas (LGAs) in Kano State has become a regular occurrence as there is no healthcare facility in the areas.
Findings by this reporter showed that maternal mortality is quite a bit of a problem in these communities due to the non-availability of health centers near the communities.
A register of medical records at Tudun Wada General Hospital indicates that about 763 women between the age of 20 to 43 were victims of maternal motility between January 2021 to December 2022 in the communities.
Also, between January to December 2023, about 1,176 cases were recorded with 38 deaths. The data showed that Yan-labi town had been worst hit with 678 cases, while Malikawa has 498 recorded cases in 2023.
Maternal mortality is now one of the most important issues that determine the quality of health services globally. This is because virtually everybody in the family and community at all levels are at some point directly involved in pregnancy and childbirth.
A 2023 report by the World Health Organization (WHO), issued on 9th May, ranked Nigeria as the second country with the highest number of maternal mortality in the world. The report revealed that progress in improving mothers and babies’ survival has stagnated since 2015, with around 290,000 maternal deaths occurring yearly.
According to the report, themed: ‘’Improving maternal and newborn health and survival and reducing stillbirth’’, 1.9 million stillbirths occur and 2.3 million newborn die annually in Nigeria.
To reduce the rate of maternal mortality and improve maternal health, the Nigerian government adopted and introduced global recommended strategies, including free antenatal care for all pregnant women, skilled care delivery and postpartum family planning information and services.
Other efforts include training of community midwives to cover rural communities nation-wide, the premise being that Primary Healthcare Centre, PHC, can bridge health inequality and provide ‘health for all’ by being an accessible first line of treatment for most.
Moreover, Nigeria is among the many countries to have committed to the 2018 Declaration of Astana, which called for investment in strengthening primary healthcare services.
Yet, many rural communities, like Yan-labi and Malikawa in Kano State, still suffer from absence of primary healthcare center.
The immediate past President, Muhammadu Buhari, in January 2017 pledged to revitalise 10,000 PHCs across the country. The promise was to build new primary healthcare centres in all the political wards of the federation with functioning equipment, human resources and equitable service provision for every patient. But after eight years in office and eight months into the new APC administration, communities like Yan-labi with eight surrounding villages and Malikawa with four still lack PHCs.
Hannatu Zubairu, 37, a female resident of Yanlabi community, in Tudun Wada LGA, told the reporter that the people have to travel for about nine kilometers to Wuna town or, sometimes, about 12 kilometres to the main Tudun Wada town to access healthcare, including delivery of pregnancies.
Hannatu Zubairu – Female resident of Yan-labi Community
“Due to the absence of a nearby medical facility, many women in our community resigned to traditional births practices where local birth herbalists attend to them during delivery with uncertainty of life,” she said.
Hannatu added that “a lot of women died in the cold hands of the traditional birth attendants particularly when it comes with complications.”
Corroborating her words, Dr. Imam Ibrahim, 47, a medical doctor at Wuna clinic, said ‘’the dire situation (of healthcare delivery) paints a grim picture of despair in the Yanlabi town and other communities within the corridor.”
The communities he referred to include Dumbulawa, Alhazawa, Gidan Koli, Hayin Waziri, Digawa, and Unguwar Alhaji Magaji. Others are Gidan Auta town, Goraji, Kafin Dugaji and Bayan Gwarfa.
“The painful journey of many residents coming from outside Wuna town in search of health services has proven to be a serious barrier, with many women in labor arriving too late and in a very critical condition’’.
Records shown to this reporter by Dr. Imam, indicated that an average of 536 individuals, predominantly women aged between 16 to 37, sought medical attention at Wuna clinic between January to November 2023.
“The patients coming to the clinic from mostly distance locations were not merely seeking routine medical care but were grappling with severe medical issues, sometimes terminal illness,”
Dr. Imam also noted that ‘’the specified aged range of 16 to 37 underscores that the affected demographic comprises young adults, a crucial segment of the Yanlabi and other communities within the corridor’’.
The implication of this, according to him may extend beyond demographic focus and individual’s health “to broader community well-being, including potential impacts on sustainable health system in the localities”.
The absence of a medical facility in Yanlabi has brough tragedy to many families, including that of Musa Ilya, 54, who lost his 38-year-old wife, 38 during labour. Aisha was a dedicated farmer who provided sustenance for her family, according to her husband.
‘’Tragedy struck on a fateful day when my wife went into labor around 1:30am, leaving us with no choice than to embark on a painful journey of about 12 kilometres to Tudun Wada town for medical assistance,’’ Musa recalled.
Continuing, he recalled, ‘’my wife succumbed to the unforgiving travails of childbirths on the road and her life was cut short before reaching the hospital’’.
Abubakar Idris, the Village Head of Yanlabi, could not contain his anger at the dire situation unfolding at regular intervals in his community when he spoke to our reporter.
Malam Abubakar Idris – Village Head of Yan-labi
Expressing his profound disappointment, Abubakar said the Yanlabi community was abandoned to its fate and continued to suffer in silence.
However, things appeared set to change four years ago when the then member representing Tudun wada in the Kano State House of Assembly, Hon. Iliyasu Abdullahi Yaryasa, facilitated the construction of a C2 type health center in the community. Sadly, to the disappointment of residents, the project has since been abandoned.
Abubakar said had the project been completed, it would have ameliorated the suffering of residents of Yanlabi and its environs.
A visit to the project site by this reporter at Yanlabi community showed that the project bears the insignia of abandonment at lintel level and the place is now a decrepit structure, which now serves as home to deadly reptiles, thereby posing a serious threat to the communities and denying them essential medical services.
The Sorry Tale of Malikawa Residents
This worrisome situation has spread to other towns in Kano rural communities. In Malikawa, a satellite village of Kiru LGA, that stretches along Zaria Road, residents have been significantly affected by absence of a health center.
A year ago, Nazifi Dahiru was enjoying a happy life with his mother and wife. Today, the cruel reality of the non-availability of health center has left him bearing the heavy burden of grief after losing both his mother and wife sometime in February 2022.
Nazifi Dahiru of Malikawa who lose his wife and mother as a result of non-availability of medical facility at Malikawa Village.
“Life took a tragic turn when my mother, Halima Dahiru, 54, lost her life last year due to a bloody injury sustained in the farm which we failed to stop the bleeding and there was no health center or pharmaceutical store in our town to give her first aid assistance’’.
‘’We drove on motorcycle through a narrow road to Badafi clinic, about 13 kilometers from Malikawa. Upon reaching the clinic, she was quickly admitted but the doctors could not save her from the hands of death. Just three months after, I lost my wife, Rabia Nazifi, 24, after a brief illness’’. A case he also attributed to the absence of health center in the community.
Another resident, Sadiya Danladi, 34, had a close shave with death when sometime in November 2023, she went into labor.
“I was in labor for about four hours and could not deliver at home. My husband took me on his motorcycle to a clinic at Kwanan Dangora’’.
‘’By the time we reached the hospital, the child had died in my womb. I was operated upon to remove the child’’. This, according to her, occurred because of there was no health facility in the area.
Unlike Sadiya, who escaped death, Salisu Labaran, 56, a resident of Malikawa, could barely hold tears of sorrow while narrating his agonizing experience of how he lost his daughter, Hauwa Salisu, 12, sometime in 2022, on their way to a distant health facility.
Mr. Salisu said ‘’my daughter, Hauwa, had fallen critically ill, she laid in pain, her fevered body trembled. Fear of death filled our minds because the health facility was miles away from Malikawa and there’s no swift means of transportation’’.
He said that the young Hauwa gave up the ghost few hours after the illness started despite concerted effort to get her to the health center at Badafi town using a bicycle.
The Yanlabi C2 Health Center Project
In 2019, the Kano state government, through the state Ministry of Works and Housing, awarded a contract for the construction of C2 Health Center at Yan-labi community of Tudun Wada LGA with a completion period of 12 Months to Iyaka Mai Nasara Nigeria Limited.
Iyaka Mainasara Nigeria Ltd, a non-existent company, as shown through a public search on the website of the Corporate Affairs Commission (C.A.C), received N11,271 million as contract fee.
How Company and Allied Matters Act, 2020 Violated In the Award of Contract to Companies.
The award of contract to Iyaka Mainasara Nigeria Limited contravened the Company and Allied Matters Act 2020.
Section 863 of CAMA 2020 specifically provides as follows:
(1) A person or association of persons shall not carry on business in Nigeria as a company, limited liability partnership, limited partnership or under a business name without being registered under this Act.
(2) If an individual, corporation or association of persons required under this Act to be registered carries on business without registration or under a name registration of which has been refused or cancelled under this Act, the individual, corporation or every partner in the firm commits an offence and is liable on conviction to a fine prescribed in the Commission’s regulations from time to time, of ₦200.00 for every day during which the default continues, and the Court shall order a statement of the required particulars for the registration of the business to be furnished to the Commission for registration within such time as may be specified in the order.
However, the law gives room for other types of businesses which can operate without registration. This category of business are those in which the business name is the true name or surname of the individual or partners. Section 814 (1) of CAMA 2020 provides as follows:
(1) Every individual, firm or Corporation having a place of business in Nigeria and carrying on business under a business name shall be registered in the manner provided in this Part if — (a) in the case of a firm, the name does not consist of the true surname of all partners without any addition other than the true forenames of the individual partners or the initials of such forenames; (b) in the case of an individual, the name does not consist of his true surname without any addition other than his true forenames or the initials thereof; or (c) in the case of a company, whether or not registered under this Act, the name does not consist of its corporate name without any addition.
These provisions make it compulsory to register a business name only when the name does not fall within any of the categories in subsection 1 (a) – (c). Section 16 (6) (b) of the Procurement Act provides:
All bidders in addition to requirements contained in any solicitation documents shall possess the legal capacity to enter into the procurement contract.
How Contractor Relocates Project to preferred community
In the same 2019, N7.55 million contract was awarded to Aba Ahmed BBJ Nigeria Ltd to construct C2 type of Health centre at Malikawa community in Kiru LGA of Kano State.
Mal. Haladu Abdu, 56, the village head of Malikawa was shocked to learn that despite the dire health challenges in his community, a contract was awarded for the construction of health center but did not witness a sign of government project for over a decade.
Village Head of Malikawa, Malam Haladu Abdu
According to him, the only government project in Malikawa is a single block of classroom constructed over a decade ago.
Reacting to this development, Alh. Aba Ahmed, the Chief Executive Officer of Aba Ahmed BBJ Nigeria Limited told this reporter in a telephone interview that he has done the project in Gurarraji community since 2019.
When this reporter visited Gurarraji community in Kiru town, he discovered that the C2 health center was constructed as indicated by the contractor. However, the community was sparse with muddy houses and not as populated as Malikawa, the official beneficiary of the project.
The contractor refused further comment on how and who influenced the change in the project location from where it’s in dire need to the low densely populated community.
The companies not listed or indicate inactive on the website of Corporate Affairs Commission are not eligible for contracts from governments.
Ministry Flouts Access to Information Law
A Freedom of Information request was sent to the Kano State Ministry of Works and Housing on November 30, 2023, to specifically provide information on the contracts, including description, approved threshold, advert date in media, procurement method, date of bid opening and date of contract awards. Other details requested included contract execution period, contract Value, approved budgetary provision, the amount paid, the level of project completion and remarks on the project.
The ministry has not responded to the request nearly a month after it was made, in violation of the Freedom of Information Act (FOIA) 2011, which stipulates a seven – day period for responses to FOIA requests.
However, an anonymous source within the ministry told this reporter that it is common practice to negotiate and arrange for change in contract location between the contractors and members of House of Assembly who influenced the award of the project due to personal interests.
According to him, ‘’several akin cases were recorded where intended location of a certain project was negotiated and shifted to other community as in the case of Malikawa’’.
In a telephone interview with this reporter, Dr. Bashir Aliyu, a developmental worker with Ashrah Foundation, said it is not coincidence that Kano rural communities were facing a lot of health challenges.
According to him, ‘’most of the data collected on health particularly, Malaria, Maternal mortality rates, Vesino-virginal fistula (VVF), and other forms of infectious diseases were more prevalent in the rural communities’’.
He charged Kano state government on the dire need to construct health centers where they’re not available and strengthen the available ones to ensure that all communities have access to affordable and quality health system.
This commitment, according to him, will create an enabling environment for safer life to the residents.
This report was done with Support from the International Centre for Investigative Reporting, ICIR.