Women in Abuja receive lifesaving postabortion care in "MVA rooms" like this one in Abuja, Nigeria.

Melodie Hunter

In July, Ipas’s Africa Region Coordinator Melodie Hunter took her first trip to Nigeria to meet her colleagues at Ipas Nigeria and experience firsthand Ipas’s work in the country. For one week, Melodie visited hospitals in three cities, shadowing Ipas Nigeria Country Director Ejike Oji as he met with doctors and public officials.  Ipas.org will feature segments of Melodie’s travel diary over the next several weeks. 

Located in West Africa, Nigeria is home to more than 140 million people, making it the most-populous country in Africa. Pregnancy-related deaths, including deaths from unsafe abortion, represent a significant health problem: Each year in Nigeria, there are 1100 maternal deaths for every 100,000 live births — compared to 400 in South Africa and 11 in the United States — and more than 100,000 women are hospitalized with abortion-related complications. Ipas is helping to ensure that health-care providers have the skills and materials to provide postabortion care.

Monday, July 21, 2008

My first day in Abuja! After a long flight from Paris via Malabo (the capital of Equatorial Guinea), I finally arrived in Abuja, the capital of Nigeria. Chudi Ene, the program coordinator and grants manager for Ipas Nigeria, was there to pick me up. For the next week, Chudi and Ipas Nigeria Director Ejike Oji will be my guides and travel companions. Our first stop is the University of Abuja Teaching Hospital to check out the “MVA room” – the room equipped to provide postabortion care (PAC) to women who come to the hospital with complications of incomplete or unsafe abortions. MVA stands for “manual vacuum aspirator,” a medical device used to treat the physical symptoms of an incomplete abortion. However, postabortion care also incorporates counseling, to ensure that women have access to information and services to prevent unwanted pregnancies in the future. 

From Abuja we will fly to Owerri where Ipas has a sub-office. The weather is warm here, and I’m wondering where all the rain is that people were warning me about!

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Our visit to the University of Abuja Teaching Hospital was brief but informative. The hospital is located on the outskirts of Abuja and sits in a large, green compound. Doctor Onafowukon Tunde, chairman of medical services and Ipas’s partner, led us on a short tour of the hospital. We visited the small MVA room where Ipas instructional posters were tacked onto the wall. The room was very simple: one small bed with stirrups for the procedure and a larger bed where a woman can rest afterwards. There was also a sink and two buckets containing disinfectant to clean the MVA medical instruments. Health centers with limited financial resources, such as this one, may not be able to afford the autoclave machines used to sterilize instruments in U.S. hospitals (or may not have reliable electricity); instead, they rely on chemical disinfectants to do the job. 

Outside the MVA room, the hospital was busy and there were many patients walking, talking and waiting. Dr. Tunde showed us the large register that records all the patients that come through for postabortion care — an average of 20 women per month. He explained that the MVA technology was extremely helpful in preventing deaths and treating injuries from unsafe abortion, and was very proud to show us the MVA room and tell us about the interns and doctors they are training in the procedure.

From the hospital we drove straight to the airport to catch a flight to Owerri where Ipas Nigeria has a satellite office that oversees programs in Southern Nigeria.

Tuesday, July 22, 2008

Owerri is situated in the rain belt of Nigeria and its countryside is lush and green. Our first visit was to the Federal Medical Center of Owerri where our partner Dr. Emily Akuabia Nzeribe, an ob-gyn consultant and the PAC Network (PACNET) coordinator for Imo state, led us on a tour and introduced us to the hospital staff and partners. The hospital was large and very crowded, and it gave me a strong sense of the real challenges women face as they seek reproductive health services in Nigeria. Before our tour, we were invited into a classroom full of medical officers who were studying at the hospital. One of Ipas’ first supporters, Dr. Emmanual Ebeneme, was in the crowd and told the students about his early involvement with Ipas. It was incredibly rewarding to listen to someone who was there when Ipas started and who had so many warm things to say about the organization’s work.

Following the meeting, we made our way through the hospital to the MVA room. The MVA room is located down a hot, dark hallway. It was a far cry from a U.S. hospital experience: the electricity wasn’t working in that part of the building and people were crowding around doorways, hoping for medical attention. We walked by large rooms overflowing with patients. When we came to the MVA room, there was sign on the door, proudly stating that it was “funded by Ipas.” Although the room was very simple, it was bright, clean and restful, in contrast to the hallway. As in Abuja, there were two beds, one with stirrups for the procedure and one for recovery. It was brightly painted and, again, Ipas MVA instructions were tacked to the wall.

Seeing the place where Ipas actually conducts its most important work — ensuring that women have access to safe and respectful, high-quality postabortion care — was incredibly important for me. While the health centers are simple and modest compared to health clinics in the United States, these rooms save women’s lives.  It helped put all the work we do at Ipas in perspective. It’s hard to imagine the significance of this small MVA room when I’m sitting at my desk in North Carolina. Now when I read reports from our colleagues in Nigeria, I can see it, I can smell it. It makes me feel much more connected to the work I do. I can revisit that dark, crowded hallway in my mind and remember that we are working so that women can be treated properly and respectfully, in a place that is clean and well-equipped.

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