Konduga, Aug 26 (AP) In northeastern Nigeria, where maternal mortality rates are among the highest globally, Aisha Muhammed’s story is a harsh reflection of the ongoing healthcare crisis. Despite experiencing severe eclampsia symptoms during the last trimester of her pregnancy—a condition that significantly contributes to maternal deaths—Muhammed’s village clinic had no doctor. The nearest medical facility was 40 kilometers away, situated in a conflict-ridden zone.
Nigeria holds the grim record for the highest number of maternal deaths worldwide, according to the World Health Organization. However, Muhammed was fortunate to reach Maiduguri and undergo a cesarean section, resulting in the birth of twins this past April. “Even though children are a source of joy, if I have to endure the same ordeal again, I am afraid of getting pregnant,” she confessed, tears in her eyes.
The conditions for pregnant women in northeast Nigeria have never been more dire. The resurgence of the deadly Boko Haram militant group, coupled with the withdrawal of hundreds of millions in US foreign aid—previously Nigeria’s largest donor—has exacerbated the situation. Fighting has led to road closures, and many healthcare providers and aid organizations have fled.
In an effort to compensate for the loss of US funding, the Nigerian government has injected an emergency $200 million into its health budget. Even before these challenges, Nigeria accounted for over a quarter of the world's maternal deaths in 2023 with an alarming figure of 75,000, as per WHO data. At least one in 100 women in Africa’s most populous nation dies during childbirth, a result of chronic underfunding in a healthcare system serving 220 million people.
“If you count five people away, you know a woman who probably faced issues with maternal morbidity or mortality,” stated Jumoke Olatunji, co-founder of the Lagos-based Alabiamo Maternal and Child Wellbeing Foundation. Maternal morbidity refers to the health complications endured by mothers who survive childbirth.
The Associated Press visited Borno State, a region under severe threat from the Boko Haram insurgency. The militants, infamous for mass kidnappings, have been waging a 14-year battle to impose Islamic law and have intensified their assaults, with nearly daily attacks throughout the area despite military efforts.
It is becoming increasingly challenging to recruit doctors and healthcare workers, especially outside Maiduguri, the relatively safe state capital. “There have been times when there were advertisements, but no one is willing,” explained Dr. Fanya Fwachabe, Borno State’s sexual and reproductive health manager for the International Rescue Committee, one of the few remaining aid agencies operating in the region. Doctors can expect a monthly salary of merely $99 to $156.
Aid workers recount tragic stories of local mothers dying because they lacked access to necessary care. Previously peaceful communities have turned into military garrison towns, causing the collapse of some healthcare systems. Acknowledging the issues, Borno government representatives attribute the challenge primarily to security concerns.
“We must first guarantee the safety of health workers,” emphasized Abubakar Kullima, Chief Medical Director at the Borno State Hospitals Management Board, in conversation with the AP. He described the abrupt end to US funding as a profound shock. “We were unprepared for this stop-work order, and its impacts are significant.”
The global gaze has shifted, and resource reallocation has resulted in dwindling support for the region. Falmata Muhammed vividly remembers her labor in 2021. Without hospitals in her village, Bulabilin Ngaura, she set off for Maiduguri. Her attempt to reach medical care ended tragically with the stillbirth of her child during the journey. The emotional weight remains immense, and pregnant again, she now lives in Magumeri, a town where the major hospital was torched during a Boko Haram attack in 2020, leaving only an inadequately equipped mobile clinic.
Prospects for increased healthcare resources seem bleak. US foreign aid data indicates that Nigeria received close to $4 billion from the erstwhile US Agency for International Development between 2020 and 2025, with $423 million allocated for maternal health and family planning. Now, that assistance is no more, and the US Embassy has been silent on the matter. World crises such as those in Ukraine, Gaza, and Sudan have prompted donors to pivot their priorities. With the Nigerian government slashing the family planning budget by nearly 97% in 2025, even women hoping to avoid additional pregnancies face stark choices.
Asked what she would wish for if she becomes pregnant again, Muhammed listed essential needs, counting them on her fingers: hospitals, medical staff, drugs, and open roads during emergencies. “With these necessities, women wouldn’t have to lose their lives here,” she concluded. (AP)
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