Binta Nuhu is a Traditional Birth Attendant (TBA) in Igu, a community in Bwari on the suburb of Nigeria’s Federal Capital Territory. In this interview with Premium Times’ Nike Adebowale, Mrs Nuhu talks about her practise, experiences and challenges.
PT: Can you give a brief detail of yourself?
Nuhu: My name is Binta Nuhu but everybody in this community and outside calls me Mama. I am 55 years old and I have seven children, among which six are married and blessed with children. I assist pregnant women in this community during delivery, so most people know me very well. I have lived here for several years, my children also live here with their families. Apart from being a TBA, I am also a farmer. I go to the farm regularly to avoid sitting at home and also to provide food for some people around me
PT: How did you become a TBA and how long have you been practising?
Nuhu: I have been delivering pregnant women for over 25 years now. I have taken deliveries of over 400 children and some of them are already married and have their own children. Many years ago, I knew some women that practiced the profession. Some were trained as nurses while others were not but also acquired the skill from their mothers. So when I developed the interest of delivering women of their babies, I attended a seven-month training at Rural Health Centre, Kafi Koro in Niger State. That was where I learnt how to take delivery of children. And that is the only training I have received as a TBA.
PT: Do you receive payment for your service? If yes, how much do you charge per delivery?
Nuhu: Yes, I receive money or gifts like clothes and food after delivery. I charge N1,000 per delivery. But because of how difficult and expensive things are in the country now, I take N2, 000 and sometimes N1,500. I charge same amount for either twins or just one baby. Most people don’t even pay after delivery. The women or their husbands will promise to bring money at a later time but I would not see them again until when the wife is coming for another delivery. So most of the time, it is almost free. But when a patient comes to me for treatment of typhoid or malaria, I collect money from them and get drugs and injection from the chemist. I was selling drugs but I stopped because people don’t pay for the drugs. When a patient comes to me, from the look on their face, I know the illness the person has. I don’t have a test kit, I just use my instinct. (Laughs)
PT: Do you encourage women to go to hospitals for antenatal care and what do you do to ensure they comply with your advice?
Nuhu: Yes, I do encourage them to attend antenatal in the clinic. I was taught during the training to always encourage pregnant women and also tell them the importance of attending antenatal during pregnancy. If you go to the clinic and ask the nurses, they will tell you women here attend antenatal on a regular basis.
PT: Can you recall the most serious complication a mother or her child has had during delivery and what happened afterwards?
PT: In my years as a TBA, most times I foresee some problems so I quickly refer them to the general hospital before it gets out of control. The complications that occur most times is when the baby is too big or if the woman is not pushing well. In a situation where the child is too big, I have to cut the mother’s private part so the baby can come out. And sometimes, I just refer them to the hospital immediately before it gets out of hand. The general hospital is far from Igu community, so the earlier I tell them the situation the better. So they make arrangement of how to transport her to the hospital. Either with machine (bike) or borrow a vehicle. The health clinic is closer but most times, the health workers are not always available.
PT: Are you aware of HIV/AIDS and do you insist on women being tested for it?
Nuhu: Yes, I am aware of HIV/AIDs and I tell my patients to always go for HIV test. If any patient comes to see me and I notice loss of weight, rashes, coughing and any other uncommon symptoms, I tell them to go for HIV test. I was told that if the result is positive, I should always encourage them to keep going for treatment. I can’t read or write, so whenever they come with their results, my daughter reads the result for me. Fortunately for me, I have not had a patient with HIV or maybe I don’t know they had the virus.
PT: What advise do you give mothers about breastfeeding?
Nuhu: I advise mothers to practice exclusive breastfeeding for six months. That means they should feed their babies with only breast milk for the first six months of their lives. No water, food or any other milk should be given to them. But in a situation where the mother cant breastfeed exclusively for six months, then she can give breast milk for three month without water. After the six or three months of giving only breast milk, the mothers can start giving the baby little water and other foods like pap to support the breast milk. After delivery, I visit the mother on a daily basis to know how she is doing and to make sure she is following all my instructions.
PT: What can government do to make deliveries by TBAs safer? Should government employ and give them better training?
Nuhu: I want the government to give us equipment to make our work easier and safer. Most equipment we use are not the standard equipment for delivery services. So if government can provide us with good equipment, we will be of better services to the people. If the government is willing to train us, we will be happy. Personally, I will be happy to attend a training that will help improve my skills as a TBA. This is my service to the women in this community, and it is a job that gives me joy whenever I am doing it.
PT: What equipment do you use in taking deliveries?
Nuhu: (Laughs.) I have scissors, syringe, thread which I use to stitch women’s parts after tearing and hand gloves.