"We want the government to understand that we are Nigerians and we vote," he said. "We need proper healthcare facilities here."
At about 10 p.m. on 21 February 2024, Kehinde Ogundipe suddenly went into labour, unaware of the shock that awaited her.
The herbal tea seller from Obele, a border community in Ohunbe Ward of Yewa North Local Government Area in Ogun State, south-west Nigeria, had gone through her pregnancy without a single antenatal visit, relying instead on traditional herbs--just as she had done for her previous children.
But on this particular night, everything took an unexpected turn. Without any medical assistance, Mrs Ogundipe delivered not one, not two, but four babies--three boys and one girl, in her home.
She did not know she was carrying quadruplets, and by the time the last baby arrived, panic had set in. Realising the urgency of the situation, her neighbours rushed her and the newborns across the border to Hôpital De Zone De Pobe, Pobe in Benin Republic, the nearest place they believed could provide adequate care.
"I didn't know they were four. I also did not feel much discomfort to guess how many they were in my belly," she told PREMIUM TIMES.
None of her five other children, she said, was born at a public health facility in Ogun State because of the poor state of the facilities.
What happened in Benin
The day after Mrs Ogundipe and her newborns were admitted to Hôpital De Zone De Pobe, they were transferred to Centre Hospitalier Universitaire Departemental De L'Oueme in Porto-Novo, Benin's capital, for more specialised care.
For two weeks, the quadruplets received intensive medical attention before the family was moved back to Pobe, where they found accommodation in the Ahoyéyé district, close to the city's general hospital. This was to ensure they could still access medical care when needed.
In Pobe, the Ogundipes received overwhelming support from the local authorities and residents, many of whom felt they were fellow citizens. Donations poured in, covering medical expenses and other essentials.
The Mayor of Pobe, Simon Dinan, made a public appeal for assistance, prompting Rachidatou Fatolou, a member of the Benin Republic House of Assembly, to visit the family on 27 March with cash gifts, groceries, and toiletries.
"From Pobe to when they moved the children to Porto-Novo, people gave us food and clothes. We spent over N400,000 from the cash donations on medications and other needs within two months," said David Ogundipe, the children's father, who lost his driving job a year earlier.
Then, in April, tragedy struck--the family lost one of the baby boys.
Struggling to survive
Now, a year later, Mrs Ogundipe and her surviving triplets remain stranded in Benin, unable to return home.
The initial wave of support has dwindled, leaving them in uncertainty - caught between a foreign land where they found care and a homeland whose healthcare system had failed them.
According to Akande Abdulwaheed, Mrs Ogundipe's brother-in-law, the donations slowed once NGOs and individuals who had supported them realised they were Nigerians seeking care, not Beninese.
"It is really difficult now. Even if they return to Obele, they will have little or no access to healthcare. The Nigerians at the border who helped before are also struggling," Mr Abdulwaheed told PREMIUM TIMES. "At this point, the family desperately needs the Ogun State government's support."
Their story further highlights the deep inadequacies of Ogun's healthcare system, especially in border communities, and the measures residents of its border communities take to access basic medical care.
Why Nigerians look to Benin for healthcare
Reaching Ohunbe and its surrounding communities was not easy. This reporter navigated deeply rutted, pot-hole-filled, dusty roads where commercial motorcycles struggled to manoeuvre. At some points, this reporter alighted and continued on foot.
While access to the community is tough because of bad roads, accessing healthcare is tougher.
Many residents of the border town lamented the poor state of health facilities and the lack of skilled birth attendants. For some, attending Benin hospitals is not just an option but a necessity.
Some of the residents showed this reporter the birth certificates they received from Benin after giving birth in the country.
Ohunbe ward has four public PHCs: Agbon Ojodu, Ibeku, Pedepo, and Ohunbe healthcare centres--but they are in such poor condition, with inadequate personnel and resources, that patients fear they could "contract infections" there. As a result, many residents prefer seeking treatment across the border in Benin.
When this reporter visited Pobe General Hospital in Benin Republic, the reason Nigerians in Ohunbe seek healthcare across the border became evident. Unlike the deplorable roads leading to Ohunbe and its surroundings, the road from the Nigerian border into Pobe was well-constructed, making it easier to transport a pregnant woman or commute efficiently.
Also, the hospital had a stable power supply and running water, and health workers were available in their numbers. The wards were well-lit, and the general environment was clean - compared with the under-equipped and poorly maintained PHCs in neighbouring Nigerian communities.
Despite previous reports by PREMIUM TIMES detailing the dire state of Primary Healthcare Centres (PHCs) in select LGAs of Ogun State--especially in Yewa North--and the government's acknowledgements of the findings in 2023, no tangible improvements have been made. Instead, conditions have worsened.
Arriving at Agbon-Ojodu PHC, this reporter was met with a disheartening sight. From the outside, the centre looks like an abandoned, unfinished building. Bats fly in and out, leaving droppings on every surface. Inside, the air is thick, with a foul stench from leaking roofs, cracked walls, and rotting furniture.
At Ohunbe PHC, the closest facility to the Ogundipes, this reporter only met one health official who spoke anonymously. The official admitted the dire situation of the facility, which has only one ward that they "manage for pregnant women."
"The roads are bad, and we are not fully equipped," the official admitted. "I can't blame the people for choosing Benin instead. Imagine trying to rush a pregnant woman or an unconscious patient here. When we encourage residents to use our facility, they tell us they prefer Benin. But we remain hopeful that the government will intervene and provide the necessities to regain their trust."
When PREMIUM TIMES contacted Ogun State's Commissioner for Health, Tomi Coker, for an update on border community healthcare facilities and a response to the previous report, she ended the call, saying, "I am in a meeting."
Subsequent attempts to reach her were unsuccessful, and messages sent to her went unanswered.
In 2023, while reacting to the initial findings, Mrs Coker stated that there were 531 registered PHCs in Ogun State.
The Special Adviser to the Governor on New Media, Emmanuel Ojo, added that 42 PHCs had been renovated and equipped, with work ongoing at 60 others. However, the reporter saw no traces of renovation at the PHCs covered in this report.
ECOWAS and Regional Health Cooperation
Nigeria and Benin are member states of the Economic Community of West African States (ECOWAS), an organisation established to foster economic cooperation, improve living standards, and drive regional development.
In December 2023, ahead of the ECOWAS Summit 2024, Nigeria's President, Bola Tinubu, welcomed Benin's President, Patrice Talon.
At the meeting, Mr Talon sought to strengthen trade relations and reinforce the free movement of people and goods, while Mr Tinubu described both nations as "conjoined twins held together at the hip."
Beyond trade and mobility, ECOWAS has made efforts to improve regional health security. It established the West African Health Organisation (WAHO), a specialised agency responsible for safeguarding public health across member states.
Through WAHO, ECOWAS has promoted cross-border health initiatives, developed regional policies, and worked to reduce health inequities.
However, persistent public health challenges--such as outbreaks of Lassa fever, yellow fever, monkeypox, measles, and cholera--continue to expose gaps in Nigeria's healthcare system, particularly in border communities.
In Ogun State's border towns, inadequate health infrastructure and staff shortages also force many residents to seek medical care in Benin.
When PREMIUM TIMES reached out to Rolande Kougbi, Communications Manager at the Beninese Agency for Integrated Management of Border Areas (ABeGIEF), she confirmed that her country placed no restrictions on Nigerians accessing healthcare in Benin.
However, she emphasised that individuals crossing over must acknowledge they are entering Beninese territory.
"The people on both sides of the border are brothers," Ms Kougbi said in French. "As the African Union recommends, they can benefit from basic services in a neighbouring country if those services are lacking in their own."
This open-door approach has arguably allowed the Ogun State Government to evade accountability, as residents, rather than demanding better healthcare, have normalised seeking treatment across Nigeria's borders.
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Olugbami Kehinde, a resident of Gbokoto, another community under Ohunbe, had his three children in Pobe, Benin.
"I was born here, and we have never had a hospital," he said. "All my children were delivered in Benin. Now, my children are having their kids there too."
For antenatal care and delivery, Mr Kehinde said families spend between 40,000 and 50,000 CFA (about N70,000 to N90,000), while a caesarean section can cost up to 100,000 CFA (about N180,000).
Mr Kehinde, a reverend, noted that many residents even acquire Beninoise voter cards, called LEPI, just to access healthcare.
"We want the government to understand that we are Nigerians and we vote," he said. "We need proper healthcare facilities here."
For Ruth Fanihun, a woman in her late 70s, the struggle has lasted decades. She had her five children in Benin because her village had no health facilities.
"The government has neglected us," she lamented.
"Since the days of Obafemi Awolowo, we have voted with the hope that our community will develop. But we still don't have good healthcare."
She described how pregnant women sometimes trek long distances or rely on motorcycles to reach Benin for delivery.
"Some give birth on the way because of the distance," she explained. "If you're lucky, you find a bike near the border. If not, you walk."
Pulling out some CFA banknotes, she added, "We use Benin's money here more than naira."
Bose Kushade, another Gbokoto resident, has seven children, including two caesarean sections, all in Benin. She lamented the economic hardship, saying, "With the way the naira has lost value, it's even harder now."
The late traditional ruler of Gbokoto Ketu, Oba Ganiu Olakunle--who died in August 2024 after speaking with PREMIUM TIMES--said he had spent 26 years advocating for basic amenities, yet little had changed.
"The medicine I'm using now came from Benin," Mr Olakunle said. "Without Benin, many lives would have been lost. If a woman goes into labour at midnight, where do we take her?"
His community, Gbokoto, still has no health centre--not even a small dispensary.
"We are Ogun State indigenes. Just because we live in border communities doesn't mean we should be forgotten. We have land for a hospital and are willing to collaborate with the government. We also need improvements at the Ohunbe PHC," he appealed.
Reality of Nigeria's Border Communities
Nigeria has border communities in 21 states, spanning 105 of the country's 774 LGAs. Many of these areas suffer from poor infrastructure, limited government presence, and weak public services, leaving residents vulnerable to economic and health disparities.
Speaking with PREMIUM TIMES, Simon Adebayo Dinan, mayor of Pobè Municipality and President of the Beninoise Association of Border Municipalities (ABCF), emphasised the deep ties between border towns in Ogun State and their Beninoise counterparts.
"Out of the 36 municipalities under ABCF, 16 share borders with Nigeria, while others border Niger, Burkina Faso, or Togo," he said.
Like ABeGIEF's Ms Kougbi, Mr Dinan reiterated that there are no rigid boundaries between Nigerians and Beninese.
"From Ifangni, Sakété, Adja-Ouèrè, Pobè, Kétou, Savè, Ouèssè, and Tchaourou, we speak Yoruba with our people and brothers in Ogun State," he noted.
While language differences--French in Benin and English in Nigeria--could serve as a barrier, Mr Dinan highlighted Yoruba as a unifying factor that enables communication between the two nations.
He stressed the need to strengthen cross-border cooperation, particularly in infrastructure, healthcare, and education, to enhance residents' quality of life.
"A convention on border cooperation has been signed between Benin and Niger, as well as between Benin and Togo," Mr Dinan said. "We finalised the agreement with Nigeria last year, but the change in government delayed its signing. However, I believe it will be concluded soon."
Government interventions
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To address developmental challenges in its border communities, Nigeria established the Border Communities Development Agency (BCDA) in 2003.
Speaking to PREMIUM TIMES, the Director and Special Adviser on Special Duties to the BCDA's Executive Secretary, Atarhe Akpohwaye-Abuh, described the conditions in some Ogun border communities as "a sad situation," citing a lack of water and electricity as well as poor educational facilities.
While the BCDA has yet to assess the specific communities covered in this investigation, Mrs Atarhe requested details on their challenges.
"We are compiling a list of communities that need boreholes for next year's budget. We are also planning a medical outreach in some border areas," she said.
However, she stressed that the BCDA cannot work in isolation. "We need collaboration with state governments. Any structure we put in place must be supervised at the state level. Even for PHCs, we can't send doctors from Abuja; the state government must deploy healthcare personnel."
For Ogun State, she said the collaboration is just beginning. "Once the borehole projects are completed, we will pay a courtesy visit to the governor."
Yewa North LGA Chairman, Ogunyomi Oluwole, told PREMIUM TIMES that the local government was unaware of the birth of the quadruplets that prompted this investigation. Mr Oluwole noted that the porous nature of the border makes it difficult to distinguish between Nigerians and Beninoise.
"Many people in Oja Odan live in Benin but claim to be Nigerians, and vice versa," he said. "We coexist as one."
"Development is gradual. The government is trying, and we will get there. People in cities are more fortunate, but border communities will experience improvements in time."
Consequences of inadequate healthcare access
Public health experts warn that the lack of healthcare in border communities has far-reaching consequences, particularly for women and children.
Isaiah Owolabi, a public health expert, noted that the absence of adequate healthcare leads to high maternal and child mortality rates, the spread of preventable diseases, poor reproductive health outcomes, mental health challenges, and increased social inequality.
"Inadequate access to healthcare is a multifaceted issue with significant health, social, and economic implications," Mr Owolabi, project director at HACEY Health Initiative, said. "By prioritising women's health and investing in accessible and affordable healthcare, Nigeria can make significant strides toward a healthier and more equitable society."
Olorunfemi Olorunsaiye, a public health physician at the Department of Community Medicine and Primary Care, Federal Medical Centre, Abeokuta, emphasised the role of PHCs in delivering equitable healthcare to grassroots populations.
However, Mr Olorunsaiye identified poor road networks, inadequate funding, infrastructure deficits, and skill gaps as major barriers to effective service delivery.
To address these challenges, Mr Owolabi recommended "increased investment in healthcare infrastructure, particularly in rural and underserved areas, alongside adequate staffing with trained healthcare professionals."
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