Speeches

For the last 9 years or so, because I have been working so close to the frontline, in far flung villages and towns, I had never even heard of TEDx, but the power of e-connectivity meant Chikwe was an online friend!  I blithely thought that I was doing him a favour in appearing here today, then looked at the videos and thought again! So inspiring to be here with leaders of thought, innovation, grateful for the opportunity to share my experience and lessons learnt.

I arrived in this world as a premature baby fighting for life and with the grace of God, I survived with a tenacity that left me small, feisty, with a loud voice and a confident attitude. My parents say my zeal for life was evident from the start.

I was brought up in a loving lively environment as an industrialist’s daughter; had a very comfortable life where gender equality was actively promoted. Contrary to the traditional Yoruba culture, we were encouraged to speak and speak freely. I was close to my father and my relationship with him shaped my views of men as an equal, facilitating partner.

I would spend Saturdays with my father visiting his various construction sites while my brothers played football; this required some ingenuity as I was escaping my mother’s weekly torture of a hairdressers visit, but my father was a willing accomplice, and while he held site meetings, he would give me his copy of West Africa to read quietly in a corner, whether I understood it or not.

My primary education in Nigeria was excellent, despite the resource constraints of not being able to take the imported textbooks home, we had to absorb, remember and retrieve all acquired learning without the opportunity to refresh by revision, this stood me in good stead in later years while training as a lawyer.

If life could be a textbook, my life followed its predestined path smoothly. I flipped through its pages happily, absorbing all I needed, with no need whatsoever to read the footnotes. By my late 20’s I had graduated, worked for a couple of years in banking, and was both pregnant and excitedly planning for my ‘wedding of the year’ when the inconceivable occurred.

On December 6^th 1991, I got married, gave birth three months prematurely, had twins and lost a child, all in the space of 24 hours.

During this harrowing period, I experienced that which was never intended for me, but which is an unavoidable reality for the majority of the women in my country; the inadequacies of the Nigerian Health System, the lack of reliable information, the absence of an effective health referral system, and sometimes comically, the deplorable attitude of some health workers, and the difference between the textbook and the reality. The footnotes I had never even glanced at became my reality and I was most unprepared.

Three days after birth, let me call it Engorgement Day, I was told the baby needed breastmilk and prepared myself to cooperate. A bowl was placed into my outstretched hands. I looked at it disbelievingly, and the midwife said ‘start pressing’. I will spare you the gory details.

As for bereavement counselling, it did not exist, I was simply told that my baby had been transferred to another hospital and had to work out the true facts for myself. I have been looking for that child’s grave ever since.

Like many in a critical situation, I felt powerless and turned to prayer for the extra strength I needed for the immediate challenge of survival for both myself and my two and a half pound daughter. I made greater and more fantastical promises to God, that if He would just spare her life, I would work to ensure that others received help when they needed it.

I also turned to medicine, reaching out from my hospital bed and harnessing the key survival tools as fast as I could, a detailed knowledge of logistics was quickly acquired.

God was kind and so were the doctors, the union of faith, tenacity and medicine was truly fortuitous, and the seeds of The Wellbeing Foundation were conceived, a marriage of bringing key medical empowerment into the hands of mothers, for themselves and for their children

My initial actions were charitable in nature, I tried to give out my resources and knowledge to the individuals I encountered along the way, and hoped that my interventions would be replicated as they helped others too.

It wasn’t until my husband became governor of Kwara State that I truly realised how alarmingly high our national mortality rates had become for women and children! Yet, in an early tour of the state, the late Maury Albertson of Village Earth, my very first development partner, had taught me his philosophy that the seeds to development in each community lie within that community; every community has its own intelligence, you just need to uncover this and they will help themselves to development.

This I know to be true, even with the growth and evolution of The Wellbeing Foundation as every single program started with one person.

Chinwe’s Story

In 2003, a lady called Chinwe, the wife of the then Commissioner for Health was pregnant and went into labour while visiting family members some distance from home. She was taken to the nearest hospital. She needed a caesarean, but died while waiting for the key to be found for the operating theatre that a nurse had diligently cleaned and locked up. Why could this not have been anticipated? Because she had no health records to present at the hospital which would have revealed that her baby was in a transverse lie, and could not be turned. The caesarean denied her in life was performed on her dead body to no avail. The baby died too.

The Dying Baby At Centre Igboro

In 2004, I was carrying a baby who died in my arms because of a delay in referral for blood transfusion. Why did the baby die? Because no one knew the number for the presiding doctor of the clinic with the blood bank, so a messenger had been sent via motorcycle to find out. A life changing or life ending delay occurred, and another life ended. That was the day I realised that humans pass water when they die, as the nappy-less baby died in my arms.

I have seen babies die because their bloodtypes were not compatible with that of the mother. I have seen children die because their parents cannot pay the registration fees in hospitals, I have seen mothers die because vascular surgeons are not called to sew up veins during operations, despite being in the staff room down the corridor. I have seen lives lost, because even within the same facilities, the health of the newborn is not viewed as related to that of the mother.

Because of my education, my experience, and my endless quest for the wellbeing of women and children, that is to say, health, education, empowerment and rights, I have also seen the good; a delivery where all key information has been recorded and analysed, a situation where every possible or probable eventuality has been anticipated, even predicted, and a caring yet competent public health attitude to help mothers prepare for the battle of a lifetime, that of safe delivery

Yes, I have seen countries, and health systems that have the same challenges, but their people are surviving. And I had seen enough. Enough to convince me that we have to stop making excuses, stop blaming resource constraints, stop trying to do just enough, and start doing the right things. It is not reinventing the wheel, the factors for mother and child survival are the same the world over.

· An empowered health-seeking mother

· Birth preparedness and regular antenatal visits

· Skilled medical attendants at birth

· An accessible record detailing history and all interventions.

· And professional accountability for any eventual outcome

While I pondered on how best this could be delivered to my people, and how to make this attractive to my people, I had delivered three more children safely, including another set of twins. They too, did not have an easy ride out to this world, but I was prepared, and in Britain, where the referrals and emergency procedures kicked into place flawlessly. In other words, I had the same challenges, a labour preceded by haemorrhage, a lengthy stay in intensive care, and although I experienced the same fear, and similar complications, I realised a happy outcome as all systems were working in perfect synergy without delays as the health workers had all the information they needed at their fingertips to make quick, informed, and life saving decisions.

So back to my question of how to bring this standard of care to my country? How to achieve this standard of synergy? How to ensure this standard of survival would be available to every woman, whether rich or poor, learned or illiterate, urban or rural?

The answer was in my own hands, a red book, designed to empower me and my child, given to me freely by the National Health Service of Great Britain. This was a Personal Health Record that detailed what the government provided to every mother and child, whether they like it or not, AND what that mother and child did with this provision. After all, if you don’t know something, you cannot avail yourself of it. It also contained all the key information and targets that govern not just living, not just survival, but healthy wellbeing!

And my mission crystallised. Good intentions met tangible impact, the WBF Personal Health Record was born, the critical contact point between the woman, the health facility, the health worker, the health policy, and yet in the hands of the woman at all times, and most importantly, when she needs it. Mothers can, and should be trusted to take responsibility for the health of their children, and not just their care.

From this great confluence, all things could now flow. In Nigeria, we’ve always had the health facilities no matter how basic, and we always had the health workers and even the policies. Childbirth is as old as time itself. What we lacked was a meeting point, a crucible, where all interests became the same, the target of ensuring life.

Domesticating the Personal Health Record was not a simple process of copy and paste, I spent the next years years laboriously shuttling between doctors, hospitals, public health institutions, midwives, and research facilities both at home and abroad.

I had to ensure that all contents were regionally relevant, trading sunscreen advice for bednets and oral rehydration therapy, and on top of that, I was begging the government to agree to actually provide free medical services to pregnant women and under 5’s.

Initial reactions were mixed, particularly from many lettered doctors used to unquestioning respect, who were irked that this ‘lady lawyer’ suddenly wanted them to write down everything they were doing to women! I had to remind them that the very first patient custody health record worldwide was designed and implemented by the renowned Professor Morley in our very own Nigeria and then adopted and adapted abroad!

With increased advocacy, they suddenly realised, that all over the world maternal survival is not only an indices of a functioning health system, but that of a functioning government too. The world is rejecting guesswork in public policy, we all want evidence-based solutions and the evidence is that if you invest in women, particularly in health, if you give mothers the tools to access solutions, they will invariably make the best decision every time for their child.

I often ask myself, in command economies, there is a calculation called VSL, The Value of a Statistical Life. How can Africa calculate the value of a statistical life of a pregnant woman or a child under five years. Do our governments know that it costs three times as much to bury a woman than to give her four maternity visits in her pregnancy? It costs the public system in Nigeria, N150,000 minimum to bury a child , while you can educate that same child for N36,000 per year. It costs the same N150,000 to bury a woman (the minimum burial rates don’t change according to the size, age, or creed of the corpse), yet you can provide that woman with life-saving focused antenatal care for under N10,000 per pregnancy.

I cannot compute the Statistical Value of Life in my country because the data analysis is simply unavailable. But I can count the human cost for our preventable losses, the cost of deprivation, and the pain and sorrow felt by families and communities each time a valuable life is lost.

What is leadership? Is it something one is born with? Or something one is groomed for? Or is it the quality of human response to he challenges one has faced? No one is born into leadership, or can be made a leader; leadership is how you deal with situations. I can state categorically, that despite fortuitous attributes, my experience and grief, and sorrow and loss were the same as that felt by any and every woman worldwide that has ever experienced the harrowing pain of losing a child, the frustration of knowing that child could have lived, if only this, and if only that…..It is how we respond to the “this”, and what we learn from the “that”, which determines whether we are vanquished or victorious, and whether we choose to squander our knowledge or share that knowledge that others may succeed. I'm probably the most unlikely activist on this earth but I hope my story inspires other people.