In November 2018, I was with ALIMA NGO in northeastern Nigeria, where people from around the region of Borno State are being forcefully displaced in escape of extremist terrorist groups. They are hosted in IDP camps where food supplies are limited to donations, which increases the rates of malnourished children. Dedicated medical teams based in Maiduguri and Monguno provide free health care for malnourished children under the age of five as well as free maternal health care.
Children gathering for a photo at Dalti IDP settlement camp in Maiduguri, November 2018
While filming in Maiduguri, the largest city in Borno state, Florence Mahon from the ALIMA team and I, had been waiting for a security approval to take a helicopter and go to Monguno, a city that has been deeply affected by the presence of extremist groups, and as a result, unsafe to travel to by road or at random without previous security scanings.
Monguno is a small secluded area of 1,913 km². In 2015 it was captured by ISWA militants therefore many people had fled to IDP camps in Maiduguri.
In 2016, as the security forces of Nigeria began to recapture villages and towns, the severe humanitarian needs began to show. And in June 2016 ALIMA screened 12,000 children in Monguno, revealing that 32% were suffering from acute malnutrition. Infant and maternal mortality rates are also high due to malnutrition.
We wanted to go there to meet Dr. May Murithi - we had heard a lot about her and we didn’t want to be that close and miss out on the opportunity to meet her and share her story.
We finally received a clearance and were allowed to go and spend only one full day.
Dr. May had worked for years in South Sudan before moving to Nigeria to cofound, with ALIMA, one of the first maternal health clinics in that area.
In Monguno the only mean of communication is the radio, no phones. For their security and due to frequent attacks, Dr. May and the medical team are not allowed free movement - their movement is restricted between the base where they rest, sleep and eat, and the clinic which is across the street from that same base.
Near the street market in Monguno, November 2018
Amidst these harsh conditions, doctor May manages to lead and train her team of nurses with passion, energy and a lot of motivation that she transmits to her team while also attending to patients, providing free maternal health care: pre and post natal consultancies, including delivery, sexual health and family planning, as well as treating severely malnourished children under the age of five.
The clinic we filmed at is a vital lifeline in a town like Monguno. Many of the women who go there live in internally displaced camps. Some women walk long distances through the desert in order to get the free medical care solely provided by the clinic.
Monguno’s free maternal health clinic, November 2018
We had arrived late in the afternoon and caught Dr. May learning French with one of her colleagues. Together, we then planned for the next day, our only day to capture a glimpse of their story, hoping that a mother would come in for delivery in order to film her process as well.
The following day, at 10am, 18 years old Hussana Adamou arrived to the clinic to deliver her first baby. Dr. May was in charge of the delivery while training, at the same time, the nurses that were assisting her in the delivery room.
Throughout her labor Hussana was very anxious. Whenever she felt the contractions she would hold the pain in and refrain from pushing. Although Dr. May and the nurses were trying to explain to her what her body was going through and asking her to help push through, the intensity of the pain was keeping her from cooperating. The baby was pushing fast, the head was almost out and it was too late to do a C-section because for this procedure she would have to be transported to a hospital since we were at a health clinic that provides free maternal healthcare without surgeries.
30 minutes in and the baby had to be taken out, Hussana was still not pushing, the nurses asked for a relative to come in to support her and to help release her anxiety. Hussana asked for her mother-in-law to be brought in.
With the mother still resisting, and in fear of losing the baby inside its mother’s body, Dr. May had to perform an episiotomy - an incision of the vaginal wall to enlarge the opening. Two large incisions were made. The mother was exhausted, the baby was out. Dr. May asked Hussana to cough several times to get the placenta fully out of her body. Hussana was then given another shot of anaesthetic to ease her pain while she was getting stitched.
A baby girl was birthed, she was to be named after 7 days.
The following morning and before taking the helicopter back to Maiduguri, I passed by the clinic to check on Hussana and on her new born.
Hussana: “I’m ok, the cramps make my stomach hurt. My baby is healthy and I am proud to have delivered my first born after years of marriage”.
Hussana Adamou and her baby a day after her birth, November 2018
Dr. May: “There’s that feeling that during the pregnancy you’ve been with the mother, you’ve been able to help prevent unforeseen complications, and once you see the baby and the mother’s smile, it makes your heart glow. It just feels good… It’s wonderful!”
Dr. May Murithi
The series of photos in the following link is a celebration of life and of the female body. To Hussana Adamou, who gracefully accepted the documentation of her first birthing experience: https://www.ghinwadaher.com/childbirth-in-monguno-nigeria
Link to photos from Maiduguri IDP camps: https://www.ghinwadaher.com/borno-state-northeastern-nigeria
Link to the video from Monguno told by Dr. May Murithi: https://www.ghinwadaher.com/documentary/maternal-health-care-monguno
Project produced by What Took You So Long
