Reducing Maternal Mortality in Nigeria

Reducing Maternal Mortality in Nigeria

Martins Adebo

We wish to thank the National Assembly for their concern about maternal and infant health, which has led to the consideration of this Bill. To begin, we would like to recall the story of the Trojan War.

Paris, a Trojan, carried off Helen, wife of Menelaus, King of Sparta, in Greece. War broke out between Greece and Troy. When the Greeks had unsuccessfully laid siege to Troy for ten years, they pretended to retreat. They left behind a huge wooden horse, in which many Greek soldiers hid. The Trojans, in spite of warnings, moved the horse inside the city as a war trophy. While the Trojans celebrated their victory, the Greeks left the wooden horse, attacked them and finally conquered Troy.

Could the National Institute of Reproductive Health be a Trojan Horse? Could it be used as an instrument for the demographic suppression and sexual perversion of Nigerians? Or is it really what it seems, an instrument for the emancipation of the Nigerian people from ignorance and disease? This will depend on the Bill enacting the Institute, its ideology and its proponents.

The Institute is to provide for “the improvement and sustenance of Sexual and Reproductive health.” Sexual health includes having any safe and pleasurable sexual experience freely and without discrimination. Reproductive health includes fertility regulation and safe motherhood. Subsumed in these words are · Reducing maternal and infant mortality · Curbing the spread of sexually transmitted infections (STIs) · Disseminating knowledge about sexuality and reproduction.

Also understood as rights are: · Abortion on demand (See Protocol to the African Charter on Human Rights) · Sterilization · Homosexuality · Contraception · Aggressive sex education independent of parental consent.

It is the duty of this House to define clearly what Sexual and Reproductive Health in Nigeria means, and the principles on which it will be based, and to include these in the Bill by way of a Recital.

We would suggest that these principles include: ·

Human life begins at conception and ends at natural death.
All human beings are equal in dignity irrespective of economic status, age, tribe, health etc.
Human beings are biologically marked as male or female; there is no other gender.
A couple refers to male and female who unite among other things for procreation.
All human beings have religious freedom; their convictions must not be dismissed a priori as fundamentalism.
Parents have a natural right to educate their children; the State supports and respects this right.
Parents are to be consulted in the education of their children especially about Sexuality and Reproduction; parents’ wishes must be respected.
Education must foster the development of intellect and will power in order to achieve human potential and prevent degeneration to bestiality.
Each person has a right to full and unbiased information with respect to treatment options.
It is also important to include an Exclusion Clause such as: The Institute and all its agents will never · Coerce health workers or any Nigerian to dispense or receive any form of fertility regulation contrary to personal convictions.
Attempt to reduce by any means the population of any ethnic group in any of the six geo-political zones in the country.
Promote sterilization or abortion in any form as a reproductive right. (See Appendix 1) · Withhold information about potential side-effects of any medical or surgical intervention.
Exclude any group of law-abiding Nigerians from its facilities and services.

This will make the Bill acceptable to Nigerian women who see in its current plenipotentiary powers a potential obstacle to their freedom of choice and a means of population control.

Indeed, population is often touted as a cause of economic underdevelopment: greater population density is equated to poverty. Compare the following July 2005 estimates: Country Population Density(people/km2) Monaco 16,620 Singapore 6,389 Netherlands 395 Japan 337 United Kingdom 243 Switzerland 181 Nigeria 139 129 million people on 0.9 million km2 If then, population is not our problem, what is? Corruption. Corruption means wasted resources, wealth for a few and deprivation for the masses. Moral decade nce and poverty are concomitants of corruption.

Although there are numerous factors in the spread of HIV/AIDS, it is largely recognised as a disease of poverty, hitting hardest where people are marginalised and suffering economic hardship, where immune systems are already compromised.

Maternal mortality is also linked to poverty and lack of education. Educated women have a mortality rate one fourth of those not formally educated. Research has shown that patents with Vasico – Vaginal Fistulae (VVF) tend to be disadvantaged socio-economically and educationally. Most are from rural areas, malnourished, with stunted growth, lacking access to medical care and coping with poor physical amenities. These women are usually taken to rundown hospitals only when it is too late.

Consider this: an expectant mother in the rural area, working on the farms and fields, on her feet for a minimum of 12 hours a day, drinking garri, sleeping< BR>with mosquitoes, shabbily clothed, unschooled, and unable to afford medication. She is offered two choices: on the one hand, nourishing food, clothing, shelter, antenatal care, health awareness and education; on the other an abortion and contraceptive tablets. Which do you think she will choose? If she is not already driven beyond reason by poverty and neglect, would she go for an abortion? Deep within womanhood, there is a longing for fertility and a drive to nurture, nourish and protect life. Women instinctively reject abortion.

The WHO defines unsafe abortion as ‘terminating an unintended pregnancy either by persons lacking the necessary skills or in an environment lacking the minimum medical standards or both. It has nothing to do with being legal; abortion can be legal and still ‘unsafe’. In America, with a 30 year history of legal abortion, abundant medical facilities and willing clinics, abortion is rampant but not risk free. Complications are inevitable. These complications include infection, perforation of the uterus, uncontrolled bleeding, cervical damage, death. Apart from immediate consequences, a comprehensive meta-analysis of 61 studies concluded that abortion must be included among ‘significant independent risk factors for breast cancer’ regardless of when and where the abortion is done. (J. Brind et al, Journal of Epidemiology, 1996) Institutionalising abortion does not remove its health risks. Is it sensible for our medical system to take on breast cancer? Do we not still face the challenge of containing cholera, malaria and other less sophisticated conditions? Granted that the woman does not need an abortion, does she need contraception and male/female condoms? Do condoms eliminate STIs? J. Richens et al in “The Lancet” published a paper “Condoms and Seat Belts: the Parallels and the Lessons,” showing three ways in which a large increase of condom use could fail to positively impact transmission.

It appeals to risk-averse individuals who contribute little to epidemic transmission.
Increased condom use increases the number of transmissions caused by condom failure · It reflects a change in the decision of maintaining one partner to having more partners and relying on condoms.

In other words, the condom is not fool-proof. The condom is not ‘safe’. In fact, even international bodies are dropping the term ‘safe sex’. Do we now want to be the ones to take it up? Is it fair that the developing world always latches on to concepts and items discarded by developed countries? We cannot misinform the public: conduct, not contraception is the answer. Education and economic empowerment are the panacea for our sexual and reproductive health challenges. The right to choose isn’t. Abortion is merely a quick fix, which only contributes to the problem. A powerful and vocal minority for reasons of their own, are constraining us to accept reproductive ‘health’ as an index of development.

In conclusion, we appeal to the house to substantially modify this Bill in order to clearly delineate the priorities of the Institute or other agency that will address Reproductive Health issues. These priorities should include · Provision and maintenance of ultra modern women’s hospitals with trained and caring staff in all six geo-political zones of the country.

Provision and maintenance of relief centres for victims of any form of abuse.
Providing education that emphasises the dignity, rights and responsibilities of the human person.
Training parents on how to communicate with their children, and other parenting tasks.

As it stands now, this Bill appears to be a Trojan Horse for the decimation of our population and the corruption of public morality, under cover of guaranteeing sexual and reproductive rights. For example, in Section 4 of the Bill, · The composition of the board does not state what principles its members are to uphold. NAFDAC is today a success story because of Prof. Dora Akunyili’s personal and professional integrity.

The infrastructural capacity the Institute is to develop is undefined; these could include abortion clinics and facilities for the sale of aborted baby parts. See Appendix 2 · The Institute has unlimited powers to co-ordinate policy formulation, without indicating the source of the policies, effectively ousting our lawmakers, and laying us open to possible foreign manipulation.
Programming adolescent sexual and reproductive health could include curricula that effectively brainwash the young.

In South Africa, abortion was legalised before it was implemented. People resisted. Now, applying the lessons learned in South Africa, in Nigeria, under cover of this Institute and in the guise of Reproductive Health, abortion is to be implemented before it is legalised.

History will judge all of us by the decisions that we take today. We are laying a foundation on which the lives of our children will unfold. It is critical that this Bill is extensively restructured so that it can address the real developmental needs in Nigeria. Thank you.