Nigeria is currently bracing for another cycle of elections with the Federal Government under the watch of President Muhammadu Buhari of the All Progressives Congress (APC) still not living up to the country’s human rights obligations on healthcare.
Since the inception of his administration in May, 2015 the electorate are yet to experience any significant departure from the menace of the past. The way things are still in the country, it seems the Change that was promised was a mere vote-winning gimmick. Yet, women voted massively for the APC in 2015 with the hope that the supposed ‘progressives’ will vigorously address their health nightmares. Arguably, it seems nothing remarkable has taken place.
For instance, last May, the family of a woman who was allegedly detained illegally for the inability to clear her medical bill and denied emergency services leading to her death, had their case dismissed by a Federal High Court due to a procedural irregularity that should not have been applicable if the court had addressed the case as a human rights violation case.
The case was brought to court in 2015 by the Women Advocates Research and Documentation Centre (WARDC) with technical support from the Center for Reproductive Rights.
For the women group, it was a travesty of Justice for the Folake family. ‘’Folake was denied emergency care when she needed it most and left to die for her inability to clear medical bills despite efforts by her family to raise part of the money’’, Abiola Akiyode-Afolabi, Executive Director of WARDC said.
Continuing, she said it was a blow to Nigerian women who seek maternal health services at both private and public health facilities and are faced with this kind of treatment, adding, ‘’it is the duty of government to ensure that Nigerian women and girls have access to quality and affordable reproductive healthcare services.’’
Justice Abdulazeez Anka however, struck out the case, ruling that it was the wrong mode of commencement of action, and that a writ should have been applied.
‘’Illegal detention, abuse and mistreatment of care-seekers by health care providers at public health facilities should be strongly condemned and those involved should be held accountable’’, Onyema Afulukwe, Senior Counsel for Africa, from the Center for Reproductive Rights said.
‘’The government and law enforcement agencies must take the necessary steps to protect patients from unlawful detention in healthcare facilities and enact laws and policies that will end this shameful act of detention and ensure women’s human rights’’, he further said.
Nigeria is rated to have the highest number of maternal deaths in the world, with more than 58,000 women dying from causes related to pregnancy or childbirth each year, according to the World Health Organization statistics, yet most of these deaths and health consequences are preventable.
In respect of our case study here, in September 2014, Folake Oduyoye was admitted to Lagos University Teaching Hospital (LUTH) on due to complications from a caesarean delivery at another hospital on August 30. After receiving treatment and being discharged in October 2014, she and her husband received an outstanding bill of N 1,382,700. He paid N 300,000, but that was not sufficient for the hospital and they detained Folake—keeping her in a heavily guarded ward that lacked a toilet, electricity or mosquito netting.
She was denied any medical attention because the hospital claimed she had been discharged, yet was locked in a ward against her will and needed post-surgical care for her caesarean. Her husband made multiple pleas for her release, assuring the hospital that they would pay the remaining balance monthly.
But weeks went by, and she started having serious health complications. Their cries for help were ignored and Folake died in the hospital on December 13, 2014 from puerperal sepsis and pneumonia.
Yet, the right to health is guaranteed in the African Charter which has been domesticated in Nigeria and necessitates that the Nigeria should take positive action to safeguard her citizens’ health.
WARDC engaged the public in Nigeria on the need to ensure the reduction of maternal mortality through the Not Again Campaign. WARDC’s work has contributed immensely to development in the field of maternal health in the country, such as securing justice for Mrs. Omowunmi Shonuga who died as a result of neglect and negligence by the Aregbesola Flagship Health Center in ALimosho Local Government, Lagos. WARDC’s accountability work has also led to the closure of Gbagada hospital Blood Bank in 2016 over non- compliance with international standards of managements of blood banks.
Interestingly, the Center for Reproductive Rights has filed a number of cases in Africa related to the mistreatment of women during delivery in public hospitals. In March of this year, in the Josephine Oundo Ongwen vs the Attorney General & 4 Otherscase, a Kenyan High Court found that national government, county government and the Bungoma District Hospital had violated Josephine Majani’s rights and ordered for her financial compensation resulting from the damages. Josephine was physically and verbally abused during delivery.
In 2015 in a separate case filed by the reproductive rights group, the High Court of Kenya ordered the Ministry of Health to end the discrimination and abuse experienced by women in public maternity hospitals, and provide financial compensation for Margaret and Maimuna, two women who were illegally detained at Pumwani Maternity Hospital for their inability to pay their hospital fees and were subjected to physical, mental, and verbal abuse.
The group has been working in Africa for more than a decade advancing women’s access to reproductive health care through law and policy reform. In 2008 for instance, the Center and WARDC release the report Broken Promises: Human Rights, Accountability, and Maternal Death in Nigeria illustrating the systemic failures of the Nigerian government to live up to its human rights obligations, including access to quality maternal health services.
Broken Promises: Human Rights, Accountability, and Maternal Death in Nigeria, a report by the Center for Reproductive Rights and Women Advocates Resource and Documentation Centre, tends to illustrate the systematic failure of the Nigerian government to live up to its human rights obligations. That so many women die due to pregnancy related complications can be directly attributed to political and economic factors the government has the power to address but does not seem to be willing to do so.
As the report documents, Nigeria has both the policies and the resources to make good maternal healthcare a reality for all women. Institutional and structural problems, combined with a lack of political will, leave Nigerian women underserved and often desperate.
The responsibilities for healthcare are separated between local, state and federal governments, increasing bureaucratisation and diminishing accountability. Though maternal health policies exist, they are frequently not implemented. Low levels of funding for healthcare are made worse by financial corruption throughout the system.
Broken Promises is still calling on the Nigerian government to make good on their commitment to saving women’s lives by implementing systematic changes to improve maternal health throughout the country. And, as power seekers are parading their constituencies for electoral support in 2019, it will be interesting to hear their commitments on women healthcare issues.