In Nigeria, how much does a baby cost? Reflections of an intern in a public hospital in Nigeria

I am going to start by sharing a defining experience in my nursing career here in Canada. On this day, I walked into my shift as a labor and delivery nurse and my patient assignment was a Ghanaian that had just moved to Canada. Naturally, our shared African heritage instantly forged a connection between us, and we bantered about the friendly rivalry between Nigeria and Ghana. While it is normal for first-time mothers to feel a bit nervous, I couldn’t help but notice that my patient seemed unusually on edge. She reacted anxiously to every random monitor alarm, and her constant questions revealed a deeper level of worry. My lighthearted attempts to ease her anxiety, like jokes about jollof wars and playing African music, proved ineffective. Unfortunately, her anxiety worsened, leading to a rise in blood pressure and coupled with several other factors ultimately led to her needing a c-section.  

 Later, cradling her healthy newborn, she opened up to me about why she was so anxious. A friend of hers had tragically died during childbirth in Ghana and she was scared she was also going to die. Her revelation shocked me. Mainly because throughout the time she was in my care, not once did the fear of her dying cross my mind. I mean there was the fear of her baby’s heart rate suddenly going down and having to rush for an emergency c section, but that was it. I knew if anything happened, I could press a button and have a team of professionals in the room within minutes. My conversation with her was a brutal awakening to the privilege I practiced medicine within, a privilege that shielded me from the terrifying reality of maternal mortality. This experience wasn’t just a lesson learned, it was a reminder that in so many parts of the world, for many women, it is not just about going to the hospital to have a baby, it is about confronting a fear born of a healthcare system’s limitations. A fear so deeply ingrained that it often overshadows the joy of childbirth. It is about the unseen battles many mothers fight to bring life into the world. It is about the costs of having a baby.

And so I decided to go intern in the obstetrics department of a Nigerian public hospital. And in the midst of the frustration, sweltering heat, self doubt and questioning, I took away some valuable lessons that will last a lifetime. Because I know long posts can be overwhelming, I divided the lessons into 3 and I will share the first one today and the other 2 in a different post.  

Lesson 1: Small Steps, Big Impact

One of my biggest takeaways from Nigeria is the power of the little. Michelle Obama’s book, “The Light We Carry,” was one of my first introductions to the concept of focusing on the little things rather than being overwhelmed by the “big”. When reflecting on Nigeria, especially its healthcare system, it is easy to feel discouraged by the multitude of issues that need addressing for meaningful change to occur. I remember being so discouraged after my first shift in the hospital and ranting to my mum about how dysfunctional the system is. Why are we relying on relatives to go find blood, medical supplies, and medications?  How come there is no in-hospital or unit supply of these essentials? Why are emergency surgeries taking 2 hours from decision time to incision time? Why are we still listening to fetal heart rates with fetoscopes in the 21st century? Why is the air conditioner in an operating theater not working properly?

The danger of feeling overwhelmed is that it can quickly lead to discouragement, trapping us in a cycle of complaints with no solution. I saw this a lot in a number people I encountered, the feeling of resignation, their spirits dampened by the seemingly insurmountable obstacles of the Nigerian system. It was palpable in the way they said “This is Nigeria for you o” each time they observed my disbelief at encountering yet another obstacle.

And so I asked myself, instead of looking at the big things I cannot change, what little things can I help with? I might not be able to change the Nigerian healthcare system in 4 weeks but can I raise funds for an ultrasound machine in the antenatal department? Absolutely! And so I did it! How about creating educational pamphlets for pregnant mums so they can access some of the things they learn in antenatal clinic? Yes! And so I put together an easy-to-understand take-home guide. These seemingly small actions proved to be immensely impactful.

So, I urge you today, focus on what you can control. Consider the little things you can do within your sphere of influence. Small actions can have a ripple effect, and they are far more productive than simply complaining.


I will be sharing the other 2 lessons in another post soon, so be on the lookout

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