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How a Village Head built Primary Healthcare Centre to curb infant and maternal mortality in Kano

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After retiring from civil service in 2003, Alhaji Kabiru Yahaya would return to his community in Kano to witness a deteriorating health situation thousands of people, especially pregnant women are going through. And he would, eventually, be saddled with the responsibility to head the community as “Dakaci,” Village Head. But the appointment would come after the once Executive Director of FBN Merchant Bank took the bull by the horn to single-handedly plant the seed to solving the health challenges in the community, by building a Primary Healthcare Centre to meet the needs of the community. He named it “Hotoron Arewa Community Health Centre,” the second but community-owned PHC in Hotoro.

Hotoro is a fast-growing community in Nassarawa Local Government Area (LGA). It’s about a 9 kilometres drive to the Emir’s Palace in Kano city. The population of the town has been growing “geometrically,” according to Alhaji Kabiru, mainly due to the humanitarian crises in northeast Nigeria. Most of the people migrating settle around that axis.

This sudden increase in population, Alhaji Kabiru found out, has put a lot of pressure on the single existing primary healthcare centre (PHC) built by the government many years ago in the community, and is already in a bad shape. “And perhaps,” Alhaji Kabiru explained, “because of the economic situation in the country, many people in this community, especially women, find it rather difficult to travel 5-6 kilometres to get medical attention in secondary and tertiary-level health facilities.”

Addressing maternal mortality in Hotoro

A pregnant woman, Salma Alhassan, visited the facility for the first time to book an antenatal appointment because it’s closer to her than any other hospital. She learnt about the PHC from community women who have been recommending the facility for other women, and through the “friends of the hospital” who went to their house for an outreach.

Prior to building the Hotoron Arewa Community Health Centre, Lami Ibrahim, a pregnant resident of the community speaking, said they used traditional means of delivery because of distance to the government-owned healthcare facility in Hotoro and, also due to the cost of services in private hospitals in neighbouring communities.

But according to the facility’s health extension officer-in-charge of the Hotoron Arewa Community Health Centre, Aisha Muhammad Ahmad, things have now changed. Since April 2020 when she assumed duty, antenatal care services are now rendered to about 150 – 160 women of Hotoro and neighbouring communities. She said about 5 – 6 births are attended to in the facility, monthly.

Receiving antenatal care from skilled providers usually at a healthcare facility isn’t just important in monitoring pregnancy; it also reduces morbidity and mortality risks for both the mother and child during delivery and 42-days after delivery (postnatal period).

Data from the 2018 National Demographic Health Survey shows that 34.7% of women in Kano are still not receiving antenatal care from a skilled provider and only 23.2% receive postnatal care compared to the 13.8% and 72.8% in Lagos state respectively. The North-Western region – where Kano has the highest population – has the least number of women attending a healthcare facility for antenatal care in Nigeria.

“Friends of the hospital” and management

After the completion of the Hotoron Arewa Community Health Centre, Alhaji Kabiru handed over its management to the Nassarawa LG. To help in the management of the healthcare facility, they set up a committee the locals called “The Community Friends of the Hospital.” The 15-member committee consists of religious influencers and health workers who also organise awareness outreach in the community, educating people on prevailing health problems and the methods of preventing and controlling them. This, according to the committee chairman, Dahiru Adamu Hotoro, has helped reduce ‘self-help’ and the use of traditional means of treatment and has increased hospital attendance by pregnant women.

I am truly happy with the establishment of this facility,” said a resident of Hotoro, Nura Ahmed Bello. “In the past, we must travel to other places for medical attention. But you can now see we’ve everything within our reach.

The facility renders services under the GOPD, antenatal, immunization, family planning, and growth monitoring and evaluation units with no free services but considerable discount. Whenever there’s a malaria outbreak in Kano, treatment is rendered free of charge at the facility as the district head pays for everything.

Like other government-owned health facilities, all professionals in the Hotoron Arewa PHC are posted by either the State Primary Healthcare Management Board (SPHCMB) or the LG, and they are on their payroll. But support staff such as the securities and cleaners are ‘donated’ by the community which has developed a sense of ownership with the facility. 

“Not enough to lament, someone needs to do something”

In May 2013, while Alhaji Kabiru was flipping through the pages of The Economist magazine, he read an article on Sub-Saharan Africa titled “Where not to be a mother.” The article focused mainly on a non-governmental organisation (NGO)’s annual report, Save the Children, about the high rate of child and maternal mortality in the region.

In the report, Nigeria ranked 172 out of 176 countries on five indicators, including the risk of dying during pregnancy or childbirth and income level. This, Alhaji Kabiru believed was true about northern Nigeria where he said: “the poorest health facilities and the chances of women dying during childbirth are higher.” It’s especially true about his community where women die giving birth at home without having access to any healthcare facility “due to proximity and ignorance.”

Alhaji Kabiru feels “it’s not enough to read and lament, someone has to do something about it.”

Few months after reading the report, he used a portion of his land measuring 100 x 35 feet to single-handedly build – from foundation to roof – and equipped the Hotoron Arewa Community Health Centre. 

The need for more citizen participation

There are currently 2,100 PHCs in Kano State, including the one built by Alhaji Kabiru. While this number is still not enough, many of the PHCs are monumentally inefficient in rendering quality services, due to ineffective and explicit primary healthcare policies and especially citizen participation in the state.

Alhaji Yakubu collecting an award of recognition from KNSG

On July 27, the Kano State Governor, Abdullahi Umar Ganduje convened for the second time in 3-years, the PHC Investment Summit in the state. Stakeholders in attendance including development partners, government agencies, and philanthropists, traditional and religious leaders – including Alhaji Kabiru who was officially recognised by the Kano state government for his contribution towards a healthy Kano, and community members in attendance donated cash in millions to support healthcare delivery in the state.

But the philosophy, according to the governor, was to create and strengthen the synergy between the state and those in attendance that is critical for the overall improvement of the health of the Kano people. “Cash donation isn’t all the state needs,” said the executive secretary of the State Primary Healthcare Management Board (SPHCMB), “it needs intervention from all and sundry to build more PHCs, or improve the existing ones in providing quality services”.

Shortages of health personnel, as well as other socio-cultural and economic barriers, affect the quality of care and it increases the women’s use of alternative health care services.

Recounting on the report he read on The Economist, Alhaji Kabiru said “if people like me who are privileged to have gone to school, got a good job and even buy these papers to read such a report would do something, then a number of health problems would automatically be solved.

Asked whether he faced any negative surprises during the project, Alhaji Kabir said “there were no serious challenges rather, pleasant surprises. From my experience, I will advise anyone willing to take this path to just go ahead.” He said the management of health in Kano State are very “proactive, friendly and business-like officials; they do not act with the usual lacklustre attitude of most public servants.

He added that the health officials in the state are very passionate about seeing health facilities being built and developed in the state.

Hotoro itself needed more

As the population of Hotoro increases, this hospital has only solved a fraction of the community’s need for affordable healthcare services. There’s still not enough space for antenatal and immunization services as the women attending always come in increasing numbers. The hours of operation are also of concern as the facility operates on an 8 am – 4 pm basis. To make the facility do better, there’s more the local government should do as it’s donated to her in good faith.

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Tribute To Late Justice Ahmad Belgore

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By AbdurRaheem Sa’ad Dembo

Death is an inevitable
visitor. When it strikes its victims it’s usually the end of an era. It was in the morning of Eid-l-Fitri, which was 10th April, 2024 I read the news of the demise of Justice Ahmad Olanrewaju Belgore, who died the previous night. He was a star in the judiciary because of his piety, consistency and fairness.

Many prominent Nigerians have sent their condolences to his family, Ilorin Emirate and Nigeria judiciary. One significant thing about late Justice was the fact that his life as a judge was filled with face of humanity.

Emir of Ilorin Alhaji (Dr) Ibrahim Sulu-Gambari and Chairman of Kwara State Traditional Rulers Council in his condolence message described the demise of Justice Belgore as a big loss to the Ilorin Emirate and the Nation at large.

According to the Emir “Belgore was one of the finest justices that the Ilorin Emirate had ever produced, who contributed in no small measures to the growth and development of the judiciary in particular and humanity in general.He prayed that Almighty Allah accept his good deeds, forgive his shortcomings and admit
him into aljannah firdaus.

The Turaki of Ilorin Emirate, Senator Saliu Mustapha has also expressed grief over the death of the legal luminary, described him as a renowned jurist who lived and served the country with his knowledge of the law as an examplary member of the bench.

Senator Mustapha while commiserating with the Nigerian Bar Association on the death of Justice Ahmad Belgore noted that the late jurist contributed immensely to the development of his community and the state in general. Recalling his years of service in the judiciary where he worked with utmost dedication and bowed out in glory last year.

The Senate Committee Chairman on Agric production and Services condoled the Belgore family, The Emir of Ilorin, Ilorin Emirate Descendants Progressive Union, the people of Balogun Fulani Constituency, Associates and friends of the deceased over the demise of illustrious son of the Ilorin Emirate.He prayed Allah to overlook Justice Belgore misdeeds and grant him eternal rest.

Meanwhile, Kwara state Governor,AbdulRahman AbdulRazaq equally expressed sadness over the death of Justice Belgore who passed on Tuesday night.The Governor sent his heartfelt condolences to the entire Ilorin Emirate, and to the Belgores who have lost a rare gem.His Excellency prayed to Allah to forgive justice Belgore of his shortcomings, and admit him to aljannah firdaus.

The Nigerian Bar Association,The Lagos Lawyers and other prominent Nigerians have also mourned the late Ilorin born jurist, but mentioning all of them may not be necessary.

It is imperative to say that late Justice Ahmad Belgore was an incorruptible judge as he retired meritoriously last year.This was aptly captured by the words of Shehu Bashir,Esq “Justice Ahmad Belgore was a jurist with decency of conscience.He journeyed the delicate profession of adjudication with distinction and came out unblemished.

He was an incredibly tolerant, calm, generous, religious and extremely patient man.His propensity to generosity would almost make you think he had more than he was giving,yet he was undoubtedly incorruptible. And he would never make public his generosity to a third party.He was such a responsible gentleman.”

According to a retired judiciary staff who craved for anonymity, disclosed that in 2015 when his benefit has not been paid,he reached out to late Justice Ahmad Belgore and he gave him 120,000 naira as at that time.

Significantly,the late Justice has been described by many as an embodiment of humility, generosity and accessibility. In the words of Pharm Munirat Bello “He was a great icon of peace and beacon of hope to the less privileged, reliably a dependable pillar of support. His act of kindness could be likened to the scent of the natural musk, very calming yet so impactful. No life hardly gets in contact with him and fail to progress. He was gifted with a divine heart of generosity. An upright jurist to the core, an impeccable symbol of Islam. I have never for once seen him angry to the point of passing derogatory words, he could be stern but in a loving way”

Sheikh Saidu Ibrahim Maimasa is a close associate of late Justice Ahmad Belgore and he is also the Public Relations Officer of Markaz, recounted how helpful he was to him and other friends.He said describing his magnanimity and generosity would be inexhaustible.

He cited a case of a person whose house was forcefully taken and he approached Late Justice for possible redress at the Court of law.He explained that the justice told the man not to go to court, because there was no point going to court and win, and thereafter he lost his life.He later ensured that another house was erected for the man from his personal purse.

Furthermore,A family source disclosed that anything that has to do with Belgore’s family, the late Justice Ahmad Belgore was always at the forefront.Meaning he had imbibed the sunnah of Prophet Muhammad (SAW) in uniting the family.

In unraveling his unwavering support for the less privileged, a young man was said to have gone to his GRA residence and appealed to him that he wanted to go to school but he had no sponsor.The late Justice embraced him and sponsored his education throughout.

Parts of the traits of great men are humility and accessibility. If you are the type that cannot render help to people until an influential person in the society recommends them, then you may be far from circle of great men.Your door should be open for help , that is when you would be able to identify those whole truly need succour .

Justice Ahmad Belgore was never a religious bigot,According to Sheikh Saidu Ibrahim Maimasa “He had an open door policy, because he was very accessible.His security orderly was a Christian from Oyo State and he did not only sponsored his wedding but he was also there in person.He did not discriminate”

He was born on April 18,1953, Belgore studied Law at the prestigious Ahmadu Bello university (ABU),Zaria, where he bagged LL.B (Hons.) with specialisation in Islamic Law 1975 to 1978.He attended the Nigerian Law School, Victoria Island,Lagos between 1978/1979 session.

He was the presiding Justice of the Ilorin Division of the Court of Appeal before his retirement in April,2023.He was also former Chief Justice of the Gambia.Justice Ahmad was younger brother to former Chief Justice of Nigeria (CJN) Alfa Belgore.

There is no doubt about the fact that late Justice Ahmad Belgore had lived a life worthy of emulation.He was a regular reciter of holy Quran and a great scholar in his own class.He was the president of Darul-Uloom Alumni Association.

Perfection, they say, belongs to God. I pray Allah forgive his shortcomings and grant him aljannah firdaus.

abdurraheemsaaddembo@gmail.com

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A Tribute to Barrister Sulaiman Ahmed Assayouty

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Late Barrister Suleiman Ahmad Assayouty

 

By AbdurRaheem Sa’ad Dembo

Death is a reminder that this world is fleeting and interim. It has yet corroborated the assertion that we are strangers on this planet called, earth just as Barrister Assayouty has left us unannounced through the inevitable shackles of death

I was shocked because he was a brother that I knew very well as an undergraduate in Bayero University, Kano.He wasn’t a regular student as he was preoccupied with hustling in photography business.He usually stationed at the old site of Bayero University Kano where he carried out his business activities

I was at the new site and we had our regular photographer in person of Hope Photo there but whenever we were at the old site we patronised him.In fact his business point was a regular station for Ilorin Emirate students and other customers whenever they did not have lectures.

Since I left the University I have not heard or seeing him until the day he graduated from Law School and the same was posted on the BUK Alumni WhatsApp Group, Ilorin Emirate chapter.I knew within me that day that he struggled to attain the feat and I rejoiced with him through my comments.

We were all in BUK but Assayouty was an hustler and we patronized him not just because he was one of us but he’s very humble. He had a dream and he pursued it with tenacity, hardwork and prayers so he became a certified lawyer eventually. I was not even aware that he later had a Sayuti Cafe on campus,i got to know through BUK Chat zone on Facebook; an online medium for BUK students and others. I’m sure it was after we have left the school he operated the cafe business

From the Account of my friends and brothers that are resident in Kano, they said he was going to a Police Station in Tofa with his wife and his child yesterday 8th April,2024 before they had an accident that claimed his life and injured his wife and his child who are still in the hospital. I pray to Allah for their speedy recovery.

When a promising young man died it is usually tremendously painful because a dream has been shattered and retrogressed.The demise of Assayouty was one too many as it reinvigorated and rejuvenated the futility of this world.He laboured so hard to become a lawyer. He was studying Law in pari passu with hustling. How great would it have been if He had lived long to enjoy the fruit of his struggle?

According to Mallam Zakariya Bayero “we were staying in an uncompleted building together in 1998, he was running a diploma programme then”.

Barrister Yakubu Abdullahi reacted to my Facebook post about his demise thus “May Allah admit him to Jannat, his death is shocking, I know him as a struggling lawyer, despite his commitment to law practice,he has other struggles he did around Janguza axis. May Allah forgive his shortcomings”.

In Quran 62 Verse 8, Allah says “Say, indeed, the death from which you flee.Indeed it will meet you”. Today it has met our brother but our solace is that Barrister Sulaiman Assayouty died as a Muslim in the holy month of Ramadan, he never tarnished the image of his family and lived a dignified life.May Allah grant him aljannah firdaus and give his immediate family, the Ilorin Emirate BUK Alumni and friends the fortitude to bear the huge loss.

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Kano Water Scarcity: How Long is Governor Abba’s ‘State of Emergency’?

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_By Misbahu El-Hamza_

Kano State makes headlines almost every year, and coincidentally, during Ramadan for water scarcity. The frequent headlines are often attributed to electricity system failures, which disrupt water pumping, or equipment faults at water treatment plants, exacerbating the situation.

About ten months ago, upon taking office, Kano State Governor Alhaji Abba Kabir Yusuf declared a State of Emergency to address water scarcity across the state, urging for patience and maximum cooperation from residents. Although I haven’t seen or reviewed the governor’s plan during this emergency, I recall that resolving Kano’s water issues was one of his campaign promises.

I remember when the governor inspected the Challawa Water Treatment Plant in May 2023 and expressed dissatisfaction with its condition. It was said that only two of the six pumping machines of the facility were functioning at the time.

Following that, the governor give a one-week ultimatum to the Kano State Water Board to submit its demands in order to end the water shortage in the state. There was a sigh of relief by the public. Personally, I had hoped that we’re finally getting over this hardship.

Unfortunately, nearly a year now, the situation is not only prevalent in urban areas but is even worse in rural communities. We are not only seeing those trending headlines of water scarcity in Kano, we’re experiencing the brunt of it.

Recently, the price of a 25-liter jerrican of borehole water in Kano surged by ₦50 to ₦150. Someone told me that he bought one at ₦200 around Kurmi market. In areas like Hotoro, Nassarawa LGA, where I reside near Kumbotso LGA housing the Challawa water plant, prices rose from ₦40 to ₦70 or higher. The Chalawa water plant is believed to have the capacity of supply the whole of Kano with water, but we rely heavily on individual boreholes for water, with little to no infrastructure connecting us to the water plant.

While I resides in a suburb and can afford buying a jerrican of what seems to be clean water, in the rural areas where I often visit for work, the situation is dire. Many communities lack access to clean water sources, with broken or dried-up boreholes and wells being common. Residents, including young children, often resort to fetching water from stagnant ponds shared with cows, donkeys, camels, and even dogs. This water is what they use for all daily activities, posing serious health risks. It’s evident that both state and local governments have neglected these communities, offering little to no solutions for their water woes. Where you see boreholes or wells in these communities, they are either constructed by individual donors or (charity) organizations and a handful ones by politicians.

Governor Alhaji Abba Kabir Yusuf must be aware of the current water crisis in both rural and urban Kano. However, the pressing question remains: how long will his State of Emergency address the suffering caused by the persistent water scarcity or total lack of it across the state?

Three days ago, I heard a jingle apologizing for the water scarcity in Kano metropolitant, blaming the repair works at Challawa and Tamburawa treatment plants. It’s said to have been sponsored by Kano State Water Board. To me, the jingle suggests the governor partly fulfilled his pledge, now it’s the board’s turn to restore water supply. Or at least that’s my assumption.

I know this isn’t the first time the the board apologises. In 2022, the then Managing Director of the board was quoted apologizing to Kano residents for failing to supply water during Ramadan. At that time, 25-liters jerrican of borehole water cost between ₦30 – ₦100.

I remain hopeful that before his remaining three years expire, Alhaji Abba Kabir Yusuf will emerge as Kano’s hero by addressing the water scarcity issue, providing relief to the growing population, including those in rural areas.

As the governor continues to address our water problem within this emergency period, I hope the demands the water board submitted to him as requested include: establishing new plants and resaviors or enhancing existing ones, extending mainline pipes to suburbs and rural areas, ensuring independent power supply for the plants, and securing permanent employment for existing and additional staff. If the board manages its expenses independently, perhaps shifting it to the state payroll would improve also efficiency.

With reliable service and effective system in place, the board and the state government should be rest assured that Kano people will be more willing to pay for water, and the board does not need to heavily depend for its revenue from the industries it diverts our little water to.

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