Meet Jamila: a mother who has used the Emergency Transport Scheme in Nigeria
In Nasarawa State, Nigeria, rural communities are often far from primary health care services, and transport is prohibitively expensive for the majority of people. Many women are therefore unable to seek assistance when giving birth, and those that suffer life-threatening complications are often too far from help to be saved.
In 2016, Transaid funded a pilot project with a view to addressing the high burden of preventable maternal deaths in Nasarawa. Working alongside the National Union of Road Transport Workers (NURTW) and the Nasarawa State government, the pilot aimed to reduce cost and increase the availability of safe and reliable transport for pregnant women in need of medical assistance. Based on the pilot’s success, the Puma Energy Foundation agreed to provide funding for an expansion of this initiative, the Emergency Transport Scheme (ETS), in the state.
In 2018 the Nasarawa State Emergency Transport Scheme went from strength to strength, with over 1,300 women using the scheme to travel to health facilities.
Jamila Abdullahi is a 20 year old woman from Obi Local Government Area (LGA), in Nasarawa State. She lives with her husband in his family home, along with her in-laws. Her husband is a farmer, meaning he is often away from home working on his crops and taking care of his farming business, and Jamila has a small business working as a tailor. Jamila has three children, two girls and a boy. Her first-born Aisha was delivered at home by a traditional birth attendant before the arrival of an Emergency Transport Scheme in her community. Adamu and Fatima, her second and third born, were both delivered at a health facility after Jamila was transported by an ETS volunteer driver.
Sitting under a mango tree with Fatima, she recounts the story of her youngest child’s birth in January 2019. Her contractions started late at night, and she went into labour at around one o’clock in the morning. Since her husband was not at home at the time, her father in-law, Haruna, called for an ETS driver, Abdullahi. Just five minutes later, Abdullahi arrived at their home and wasted no time in taking Jamila to Kayerda PHC, the local health facility. After 15 minutes she arrived at the health facility, accompanied by her mother in law.
Jamila reports being unconscious for most of her time in labour, but her baby Fatima was safely delivered and Jamila was discharged from the health facility. However, her story does not end there. Upon returning home, she experienced post-partum complications and started bleeding heavily. Realising she needed medical attention, Jamila remembered that day was a market day – a profitable one for drivers who can usually make a lot of money taking people to and from the market. She would have therefore struggled to find a commercial driver willing to take her to a far-away health facility due to the loss of income this would represent for them.
Instead, her father in-law called Abdullahi again, who promptly abandoned his work to take her to Agyaragu Government Hospital, a facility an hour away that is equipped to provide more comprehensive care. By the time she arrived, Jamila had lost a lot of blood and urgently needed a blood transfusion. Her husband was still away, so Abdullahi offered to have his blood tested to see if he was a match. Fortunately he was, and he donated the blood for her transfusion. Jamila was then discharged from the hospital and taken back home.
When asked what she would have done if ETS hadn’t been operating in her community, Jamila recalls the birth of her first daughter Aisha, before the arrival of ETS. She had no choice but to deliver at home, as her husband was away on business at the time and she didn’t have enough money to pay for a commercial vehicle to take her to a health facility. She says the pain she experienced during her first birth felt like hell. It was not until Jamila came into contact with ETS drivers and the scheme that she realised the importance of delivering at a health facility with a skilled birth attendant.
As a result of the scheme operating in her community in Obi, Jamila started attending antenatal care visits at her local health facility, which she says have made her last two births easier than her first. She also feels relieved of the financial burden that travelling to a health facility via commercial transport would have caused. Ordinarily, the journey to and from the health facility would cost approximately 2,000 Naira (£4.65), a significant expense for Jamila and her family. With the arrival of ETS, she now has the opportunity to travel to a health facility free of charge.
Jamila believes that ETS is a vital service for women in her community, especially those whose husbands work on farms far from their homes, and who therefore may not be able to help in an emergency. She has taken it upon herself to do her best to advocate for ETS and keep promoting it within her community. When women come to her she is quick to share the numbers of the ETS volunteer drivers operating in her community, in the hopes that they too can have easier access to the health care they need.