Photo: Maggie Fick A frail, pale and breathless woman was bleeding profusely during childbirth at the make-shift maternity ward of Primary Health Care (PHC) centre Dogon Dawa in Kaduna State, Nigeria.
Our trip was part of a routine assessment visit of the healthcare facilities that are supported by the UK Department for International Development-funded Partnership for Transforming Health Systems Phase II (PATHS2), whose aim is to reduce maternal mortality in its five focal states of Jigawa, Kaduna, Kano, Enugu and Lagos.
One of the healthcare workers on duty revealed that the woman giving birth had bled for a long time at home because, amongst other reasons, she could not afford the transport to the facility.
Rural woes
This scenario is all too common in northern Nigeria where maternal mortality rates are very high. Transport might be taken for granted in many countries around the world, but in Nigeria it remains a significant cause of maternal mortality.
But if women are to lead the fulfilled lives they deserve, then protecting their health and wellbeing, particularly through their years of bearing children, is essential. In Nigeria, pregnancy and childbearing is a dangerous business, especially for poorer women.
Africa's most populous nation also has one of its highest maternal mortality rates, at 545 per 100,000 live births. In the poorer northern states, this figure rises to as high as 1,100 per 100,000.
One of the key reasons for this appallingly elevated rate is the fact that Nigeria's northern states have largely rural populations, with many women living many miles away from their nearest health centre and access to emergency professional healthcare. Poor road networks and a poorly-organised and resourced ambulance service merely serve to exacerbate the problem.
Fare play
However, thanks to a unique initiative launched in 2012 by PATHS2 which has brought rural communities and Nigeria's powerful transport unions together, thousands of pregnant women's lives are being saved.
The scheme is working in partnership with the Nigerian government and other stakeholders to improve the planning, financing and delivery of sustainable health services for those most in need, particularly poor women and children.
In addition to this work at federal level, PATHS2 works in five focal states, including Kaduna, Kano and Jigawa in the less-affluent north of Nigeria. It is in these three states that the innovative Emergency Transport Scheme (ETS) is being implemented.
The scheme cooperates with Nigeria's powerful and well-organised transport union to use taxi drivers as volunteer ambulance drivers, using their own vehicles to get pregnant women to a hospital or clinic during an obstetric emergency.
Under the Emergency Transport Scheme, taxi drivers are given training on safe driving practice and on understanding the danger signs in pregnancy. This helps them to keep women calm and safe during the trip, which is often hastily arranged after a panicked midnight call to the driver's mobile phone.
In return, drivers who volunteer get special privileges in their day jobs, such as being promoted to the front of taxi ranks by union supervisors. Stickers for taxis are also provided, which identify their status as Emergency Transport Scheme members, and there's also special headlight signalling which enables soldiers guarding checkpoints on dangerous roads that are subject to curfew to recognise them.
Moving up the ranks
Since its inception in 2012, the Emergency Transport Scheme has helped over 2,274 women to receive timely medical help, which has probably saved their lives and the lives of their new-born children.
Talatu Sale of Jigawa State is one of the women it has helped. Sale went into labour in the middle of the night, and began bleeding. Her husband called the Emergency Transport Scheme driver. He arrived 20 minutes later and rushed her to Hadejia General Hospital:
"The midwife gave me an injection that stopped the bleeding", says Sale. "If not for the ETS, I might have lost my life and my baby."
The scheme has also attracted support from senior government levels - a wife of the former governor of Kaduna State is a huge supporter of the initiative. Other states in Nigeria are looking to replicate the system in their own jurisdictions, having witnessed just how effective it can be in saving women's lives.
I believe that we can make the scheme even stronger by getting government to support its roll-out across the entire nation. The current plan in Kaduna and Kano states, where the scheme was launched last year, is for the scheme to be rolled out across the whole nation - which the Kano state governor has committed to achieving.
Samuel Usman works as a service integration advisor at PATHS2.
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Nigeria generally is rural by nature because of the nature of our cultural profile. Here is the truth, about70 % of the nations population are rural based up to recent times. As a matter of fact it'll be safe to say that immediately after the civil war in the early seventies, our rural population accounted for nearly 80 % of the total federation population . City dwellars were routinely found more in the parts of the Western Region and some parts of the Eastern . However, that is outside the question. Population shift is a global phenomenon . People tend to go to where amenities and jobs are located. Put amenities in local or rural communities, most Nigerians want to live there than anywhere else.This is the major attraction of small cities worldwide . The North is a special case and have always been. That a Region that control 70 % of the national wealth can not help the poor and deprived within them is a hard stuff to take. Over the years, this Region hid under undeveloped part of the nation ploy to wreck everything the federation could afford with full coperation of all corner of the country . I believe this was part of British arrangement to frustrate the nation independent objectives. Ibos have often berated Dr. Nnamdi Azikiwe for going too soft with Northerners whose social and political ideology is feudal.The cause of the civil war as we now know was purely economic. The colonization of the petroleum industry in the Eastern Region and the invasion of the oil wells now being the object of debate in the nation's upper houses by Norther men have same character like invasion of a nation by foreign soldiers in todays analysis. I remember when Abiola and his co Muslim ex-Army General Yara Adua were lifting petroleum for Saudi Arabia , they both nick-named their vessels against each other's wife's name. Funtua was one of the vessel names as well as that of the wife to one of players. The next we heard was plans to bring in Muslim Bank as well as make Nigeria a Muslim Nation with no provision to debate the pros and cons in the Federal House . The North have what it takes to reduce poverty in the Region , afteralls , that is the Region that boast of one of the richest man on the planet. Enough of that game of helping our impovirished part to catch up . They're so rich today we'll never catch up with them. They have stolen enough they now have to work to bring the North and the rest of the nation together or am not sure the doves within us want the kind of alliance the North are interested in the nation .
Western media should STOP characterizing Northern Region of Nigeria with such syntax as "impoverish, restive, marginalized etc". This is the region that has been in control of Nigerian economy since independence. Besides 83% of the Oil fields in the South region is owned by Northern/Muslim politicians as bounty of civil war they won with the support of the Brits.
Since the new regime by a person from South/Christian, Western media has resorted to using problem inciting AKA to decorate the North/Muslims just to brew another crisis between the South and North of the country like they have achieved in the past.
The British economy has been sustained by Muslim politicians who are now losing loopholes of looting and banking in the UK. The Brits are now wary the policy of Sir Lord Fredrick Lugard to keep Nigeria underdeveloped is no more at work.