Chasing Dreams… My Journey to Nigeria.

CHAI Colleagues

First and foremost, I’d like to thank GSK, PULSE, GCSD, colleagues, family, and friends who supported me during the past year. It’s because of your support, generosity, and kindness that I was able to make this life-changing opportunity a reality, and volunteer with the Clinton Health Access Initiative (CHAI) in Nigeria.

Early January 2019, when I applied for GSKs PULSE Program, I had two requests. First, I wanted to work internationally, and second, I wanted an assignment where the NGO was working with women and children. To my surprise, I was extremely fortunate to receive both; however, what I wasn’t expecting was to be in Nigeria. When I found out I was in an immediate shock, just confused and left scratching my head, “Why Nigeria…” I thought. I didn’t know a single thing about the country, not the capital, or even a landmark. The only association I ever had with Nigeria was internet scammers I had experienced in the past, and this wasn’t a good feeling at first. At that point, six months seemed very long, but then I remembered that I was ready to go anywhere regardless of the destination because what mattered more was the assignment and the journey. Fast-forward to almost two months later, I’ve come to realize that Nigeria and CHAI turned out to be best assignment for me, and it was exactly the role and opportunity I was seeking.

Now before I speak more about what I’ve been doing at CHAI and Nigeria, let me say that I was more nervous about leaving home than being in Nigeria. Call it an instinct, but I’ve just grown to embrace change and new things in life without much fear and just going in headfirst. As far as home, as the days inched closer to leaving and the to-do list continued to grow, I just realized that my daily routines, family, friends, and responsibilities would have to be on hold for six months. I also realized how much I had been carrying around, and it wasn’t until I let go, when I realized how much I had been holding on.

Since I’ve been here, it’s been an adjustment all-around, from the work-life, people, food and new routines. Myself and the other GSK volunteers have take the weekends to explore Abuja, and have had great opportunities to bond over the last 2 months. As for CHAI, it’s been a completely new turf compared to GSK, and it’s been breathtaking to see how much non-profit work CHAI supports across Nigeria. Not including my assignment which is focused around Sexual Reproductive Health (SRH), Newborn and Child Health, CHAI is also involved with HIV/AIDS, Malaria, Vaccines, Hepatitis & Universal Health Coverage.

Eyes blurred intentionally.
Sister carrying sister on her back.

For my assignment in SRH, I’ve been supporting CHAI through a grant received from the Bill and Melinda Gates Foundation (BMGF), where I am responsible for Monitoring and Evaluation. The SRH Niger State program is in an initiative to provide comprehensive training and clinical mentoring support to Healthcare Workers (HCW) in Niger State. The training program focuses on the overall improvement of HCW skills and knowledge in providing quality services in BEmONC, IMCI, Family Planning (FP) and SRH for women and children. Although this training program isn’t countrywide, CHAI elected to focus the first phase of the training in Niger State, which has the worst maternal and newborn statistics across Nigeria. Niger state, in North Central Nigeria, has one of the worst maternal and newborn health indices in the region. Only 21.6% of all deliveries occur at a health facility, while only 33.5% of assisted deliveries are provided by a skilled health provider. Likewise, the treatment of the three leading causes of under-5 mortality in Nigeria – pneumonia, malaria, and diarrhea is poor in the state, with only 46% of children receiving the recommended treatment for diarrhea, 23% receiving the recommended treatment for non-severe pneumonia and only 5.9% of children receiving treatment of non-severe malaria. Not only in Niger State but, in 2015, Nigeria contributed the highest number of maternal deaths (58,000, 19% of 303,000) of any country. Globally, Nigeria also has the third most neonatal deaths (247,000, 9% of 2,614,000), and the second-highest number of stillbirths (313,700, 12% of 2,600,000).

CHAI & National trainers (MDs) in Minna, Nigeria.

Since being here I’ve made three trips up to Niger State (2-3 hour drive), and Abuja (the capital) is indeed a bubble, inside a bubble, inside another bubble. When I was in Niger State to help train HCWs, I had the opportunity to see some primary health clinics. I’ve shared some images to show what I’ve seen, but imagine a primary health clinic with one room for labor & delivery (your average living room size) with 1-3 beds, providing more or less than ten delivers in 1 day. Now imagine 19% of those births leading to maternal deaths and 9% to neonatal deaths. This is the case across Nigeria in most states and clinics where it’s becoming very challenging to train HCWs, plan for sustainability and raise the standard for care. Across Nigeria, the training and qualifications required to be a nurse or midwife are much lower than most developed nations. With HCW knowledge, skills and inadequate facilities being some of the leading causes for maternal and neonatal deaths, at CHAI we hope to raise the standards across Niger State and be an example for the rest of the country.

Labor room leading into post natal room. 
Labor & delivery room.

In Mid-July my two other GSK volunteers and I had a very close encounter with an incident that woke me up to the quality and cost of care in Nigeria. Late afternoon on a Saturday, we were home, and our house guard abruptly went down with severe abdominal pain. Early that morning, he was doing just fine, as I saw him mowing the lawn, and taking care of the property as he usually would. Soon as we heard, we rushed outside to find him on the floor in pain. We feared the worst at that time and possibly thought it might be appendicitis or GI related so we elected to rush him to a private hospital, as a public hospital would generally be overcrowded, and he’d have to wait. We then called his mom and brought her to the hospital sometime later. After bloodwork at the hospital, the doctors diagnosed him with malaria and possibly a bacterial infection as his CRP levels were 2.9. Now, why is this story relevant? The truth is that some people see healthcare differently. For all the care he received, he nor his family could have ever afforded to pay for the hospital visit or his treatment. We asked him later, and he said that if it weren’t for us, he would’ve waited out the pain and tried a local remedy. When I told a friend of mine from Nigeria this story, he said to me, “There’s a running joke in Nigeria, that the reason the churches are so full is that it’s the cheapest forms of remedy”. Seems to be true because the churches are PACKED every Sunday.

Woman carrying bins in Abuja, Nigeria

With all that said, I’m going to end this post here. I will update again within the next month. 

12 comments

  1. Ashwin, I’m so happy to read your post. Last year around this time I was in Abuja for my assignment and shared the same sentiments about the place. In the 5 months I was there I grew to love it and miss the people. The best with your work at CHAI.
    Elizabeth

    1. It’s great to read about how and what you’re doing out there, Ashwin! It seems like much needed work and I know you’re a tremendous help for the process. Can’t wait to read your update posts!

  2. Wow Ashwin, what an incredible and transformative adventure! Really eye-opening to read your post and see the pictures. Please send another update when you can. Take care!

  3. Ashwin,
    Thank you so much for explaining what you are doing over there. It was very informative. I have never known about Nigeria. You have opened up my eyes to what goes on in other countries. I am proud to know you and am very proud of the work that you are doing. You are a great example to represent GSK. Keep up the good work!!

  4. Ash, it is good to hear from you:-) and the heart wrenching about the conditions in hospitals – pictures say it all. I am glad you are there and you are able to help and change it.. hopefully the statistics will go down, thanks to your and many other volunteers efforts. Best wishes as you continue your very important work with CHAI. Keep us updated. We of course miss you, but you will be back soon, Graz

  5. @Ashwin, so nice to hear from you! And so very glad to hear that you feel this assignment was meant to be! Thanks for sharing about your work with the Sexual Reproductive Health (SRH) unit and what you are seeing on the ground in terms of healthcare reality! Must be an eye-opening experience! Looking fwd to your next update. Best wishes, Manu.

  6. Ash thanks for sharing. Keep the faith and openness to the experience and continue to give your self time to reflect. Look forward to your next post.

  7. Hi Ash, thank you for sharing your reflection on your experience with CHAI in Abuja. The work you’re doing with CHAI in Niger State supporting the HCWs is much needed and hopefully it will serve as a model and allow for broader rollout and ultimately raise the standards of human resources for health but also the care provided and received. I’m looking forward to speaking soon.Take care.

  8. It sounds like a great start to your assignment Ash & so glad to hear that your assignment met you desire to work with women & children. CHAI are doing fab work in Nigeria & I am glad to get to be a part of it!

  9. The fact that you came to Nigeria with a positive attitude is commendable. I’m Nigerian and there are many great things about Nigeria you won’t see on the net like the hospitality of the people, their hustling skill(hard-working qualities) , their tendency to enjoy life and bring out the best from everything and anything and so much more.
    Do enjoy the rest of your stay…

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