Both the government and men in their communities failed them; but these women knew that to survive, they had to band together.
The story was told of how one afternoon in October 2013, a young woman in Gwammaja area of Kano, North-western Nigeria, went into labour. As time went on, it became clear that something was wrong. Those around tried to reach her husband, but he seemed to have vanished. They wanted to take her to the hospital, but they did not know if she could afford the costs or if they could even get there on time.
Running out of options, a child was sent to find Hajiya Gambo. By the time she arrived, the woman had given birth, but the placenta was trapped. Hajiya Gambo, who had received midwife training just a week earlier, helped remove it safely.
It was only two weeks later that the woman’s husband resurfaced. Only close family members knew of his vanishing act. They asked no questions and, in order to protect his reputation, they kept it quiet.
Disappearing men
This was not the first time Hajiya Gambo had been called in to help a woman in labour. Nor was it the first time a pregnant woman’s husband had suddenly gone missing. According to locals, it has become a trend for men to disappear when their wives go into labour. They reportedly do this to avoid having to pay any financial costs associated with childbirth and secure in the belief that their wives will be looked after one way or another.
“When you ask them why they abandon their wives, they say it’s because they don’t have money,” says the Hajiya. “This has been going on for years.”
It was because of this recurring problem that she established the Maraban Alheri Women Development Association in 2007. In the first half of 2020 alone, the organisation supported at least nine women whose husbands disappeared during childbirth.
The association is made up of around 30 members of the community. Most have little education and work as petty traders, henna designers, local perfumers, or tailors. Though their incomes are small, the women contribute an average of N7,000 ($18) each month. When someone in labour needs to go to the hospital, this fund is used to pay the costs. The association’s members have also received some external midwife training for occasions when it is not feasible to take someone to hospital.
For all the women they support, the association records the mother and newborn child’s health status in case it is relevant for future health needs. It is all written down in Hausa.
Important interventions
As well as supporting women in childbirth, Maraban Alheri Women Development Association has also been branching out into more preventative measures. For instance, members sometimes go house to house to educate women and men about family planning. In the past, this has led to some pushback.
“They said things like they don’t understand the process or pills [or that] they don’t trust them”, says Hajiya Gambo of men that have argued against their suggestions. “Then later they said children are a gift from God and shouldn’t be stopped from coming…How can you insist that your wife keep getting pregnant and yet run away when she goes into labour?”
Because of these kinds of responses, the association often advises women to take matters into their own hands.
“Just last week, I witnessed a woman bleed so much during childbirth,” says the Hajiya. “Her husband had run away when she started showing signs of labour…It was her eighth child and I knew that if I did not act fast before her husband resurfaced, we will still be back here in a year or two so I told her I would have the doctor administer a five-year birth control plan for her.”
The woman was hesitant at first but eventually agreed.
Acknowledging the difficulty of influencing men in the community, the association has tried a range of strategies. One has been to persuade local imams to intervene when husbands run away or refuse to do family planning. Hajiya Gambo says the religious leaders usually just ask her to talk to the men instead.
Another has been to run background checks on men before they marry.
“We also encourage women whose daughters are getting married to come to us and let us know who the prospective husband is,” says Memuna Musa, 50, a member of the association. “We then conduct background research into his personhood and make sure that he’s fit to have a wife.”
Members do this by going into the man’s neighbourhood and asking key questions. Does he help his mother around the house? Does he provide financial assistance to his family? Is he kind? Who are his friends? Has he been known to engage in fights? Is he Islamically grounded? What does he do for a living? Has he ever been caught engaging in criminal activities?
Navigating patriarchy and poverty
The Maraban Alheri Women Development Association in Kano is a microcosm of a much bigger phenomenon. That of local women mobilising to support each other in navigating the hazards caused by patriarchy and, often, poverty.
With little institutional recognition or backing, the group has helped multiple women who were abandoned by both their husbands and the larger system. In this environment, the association has become ever more important and has grown in scope over the years. It has even begun providing some women with capital to start small businesses and raised money to support women who fall sick.
The grassroots nature of the association has allowed it to be responsive to its members’ needs in this way, but this also presents a big and ongoing challenge if it is to sustain its work and continue growing.
“It is obvious that these women have the capacity to act with larger impact but they just don’t have the resources,” says community development expert Fakhrriyyah Hashim. “How do we create a link of contact with authorities and these women that ensure they don’t run out of money?”
2 out of 10 deliveries attended by skilled birth attendants in Kano
Meanwhile, research has revealed that only 21.5 per cent – two out of ten deliveries in Kano State are attended by skilled birth attendants.
The research which was conducted by Nigeria Health Watch traversed 49 facilities in 44 local government areas.
Presenting the report, Managing Director of Nigeria Health Watch, Vivianne Ihekweazu, said the percentage of facilities that offer maternal and child health (MNCH) services is very low.
“Results from the Primary Health Care Centres (PHCs) assessed reveal that many seem to lack some component of the basic requirements as outlined by the National Primary Health Care Development Agency (NPHCDA) minimum standards for PHCs,” said Mrs Ihekweazu.
“However, it is evident that significant effort has been made to improve health services in Kano State, as well as increasing funding to the state’s health budget.”
The director revealed that Kano State is one of the few states allocating over 15 per cent of the state budget to health services.
Mrs Ihekweazu said the results of the monitoring also revealed that there is poor power supply in many of the primary health centres.
According to her, health care services are being performed in facilities with insufficient infrastructure.
“There are appears to be a shortage of staff, especially doctors as results show that almost 90 per cent of the PHCs assessed do not have a doctor. Only 17 primary health centres indicated that a pharmacy technician was posted to their facilities. Only seven facilities indicated that they had an ambulance driver. 35 PHCs said there was no security posted there.
