Nigeria: caring for communities in the creeks
After years of armed violence, health care for the hundreds of communities along the creeks of the Niger Delta is very limited. Since 2010, the ICRC and the health ministry have been running an outreach programme for 7,000 people in over 40 remote communities.
It is 7.30 on a sunny, breezy morning in the city of Port Harcourt in the Niger Delta. Outside their office, Annick Hamel and Chinenye Anyaeriuba load their vehicle with vaccines, medicines, first-aid supplies, life jackets, raincoats and waterproof boots. With all supplies loaded, the two ICRC health workers drive to the jetty, where Captain Denis and his mate Dike are waiting by a small motorboat. The cargo is transferred to the boat, everyone dons life jackets, and the engines roar into life.
After a bumpy half-hour ride, the boat stops to pick up two vaccinators from the ministry of health. There is a brief discussion concerning the day's itinerary, and Denis advises the team on the best order in which to visit the communities, taking account of the tides.
The boat passes through the main channel, with large ships at anchor and the hulls of wrecks off to the sides. Soon, narrower creeks appear amid lush vegetation. The water there is calmer and the ride less bumpy. The boat slows down close to the checkpoints of the Nigerian armed forces' Joint Task Force. The soldiers, seeing the fluttering Red Cross flag, wave the boat off to let it continue its journey. This area, which saw a decade of fighting between the armed forces and militant groups, now benefits from the fragile peace that emerged after the 2009 government amnesty for armed groups. However, the armed forces still patrol to preserve law and order.
After another half hour spent criss-crossing innumerable creeks, the boat comes to rest at Namasibi, a small fishing community. The health staff disembark and wade through shin-deep water bearing their precious cargo of vaccines and other items, taking care not to slip on the muddy bottom of the creek. The smell of dry fish and oil slick hangs in the air. Namasibi is a small village with a hundred or so inhabitants. The houses are made of mud and thatch, and a few fishing boats and nets lie at the water's edge.
Village chief Amagino welcomes the team and talks about the situation. "We have no clean drinking water," he explains, "That's our biggest problem, because water's a source of many ailments, and children are particularly vulnerable." This village, like so many others in the creeks, still suffers the effects of the armed violence and security problems that have damaged health services, leaving communities almost defenceless against malaria, respiratory infections, skin complaints and waterborne diseases.
Soon, women and children carrying their vaccination booklets assemble in a hut with thatched roof but no walls. The health staff quickly get down to business, with the ICRC personnel handling registration and the ministry of health vaccinators administering drugs. Children begin to cry even before the needles touch them. Mothers cajole and reassure. Anti-worming tablets are distributed and pregnant mothers receive health tips. The scene is noisy but orderly.
When all the patients have been taken care of, the health staff pack up and leave by boat for the next settlement, Tangbulusunju, which is larger. It looks slightly better off too, but the water and health problems are the same. The work takes longer here, because there are more patients. The clouds that have been building up suddenly let loose. It starts to rain, hard. The thin thatched roof starts to leak and people seek shelter. At the same time, the tide is going out. Denis and his mate are doing their best to keep the boat afloat, but the heavy rain is making things difficult. Once the rain starts to taper off, it is time to leave, but the boat is stuck in the mud! Boys from the village come to the rescue, pushing the boat into deeper water. Everyone scrambles back on board after slipping and sliding through the knee-deep waters.
Almost 4 p.m. Everyone is tired. The team share a light meal of meat pie and bottled water, relaxing as best they can on a boat riding the waves at full throttle. Chinenye and Annick review the day's statistics. A total of 78 children below the age of five were immunized, along with 32 women of childbearing age.
Chinenye and Annick finally arrive back at the office around 6 p.m. The unused vaccines are securely stored away, the rest of the items checked and sorted. Annick looks at her watch and smiles; tomorrow will be another long day!