Nigeria faces a devastating, preventable public health disaster, holding the grim distinction of having the second-highest infant mortality rate in the world. This crisis means that over 260,000 babies die annually in Nigeria, translating to approximately 700 infants lost every single day. As articulated by Dr. Aproko TV and discussed with Dr. Oyefeso, this daily toll is equivalent to two Boeing 747 jets crashing every 24 hours. These deaths are not random occurrences; they stem from neglect, malnutrition, and preventable diseases, pointing to profound systemic failures.
The primary medical causes of these infant deaths are identified as birth asphyxia, prematurity, and infections. Birth asphyxia, defined as the inability of a newborn to breathe independently after birth, is a critical concern. While the placenta supplies oxygen to the baby in the womb, the transition after birth requires the baby to start breathing on their own. When this fails, the baby enters a state of apnea, or cessation of breathing. The sources emphasize that simple stimulation, like wiping the baby dry with a clean cloth, may revive a baby in primary apnea. However, in cases of secondary apnea, no amount of stimulation, including the dangerous practices of turning the baby upside down, spanking, or reliance on spiritual intervention, will be sufficient to initiate breathing.
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Instead, as highlighted by Dr. Oyefeso, a baby in secondary apnea must be helped to breathe using a bag and mask, commonly known as the Ambu bag. This device is described as a simple, powerful tool for resuscitation. The failure to provide this basic assistance means the baby will likely die, or if the period of insufficient oxygen (apneic period) is too long, they will suffer permanent brain damage, medically termed hypoxic ischemic encephalopathy (HIE)—damage resulting from a lack of blood and oxygen flow to the brain. The "Golden Minute" principle dictates that a skilled provider must be present to help a non-breathing baby within 60 seconds of birth, a timeframe often missed due to inadequate training, equipment, and support for providers in Nigeria. Dr. Oyefeso, who represents the organization For Breath for Life, confirms their mission is to train healthcare providers nationwide on this fundamental concept.
Dr. Aproko TV’s discussion further revealed a shocking reality: many infants whose hearts are still beating are incorrectly labeled as stillbirths and set aside. Furthermore, the lack of recorded births and deaths suggests the actual mortality rate is likely far higher than the reported 700 daily deaths, as "the system is not aware" of these lost lives.
The systemic solution, according to Dr. Oyefeso, demands that the government must be the "quarterback of healthcare". This responsibility is crucial because more than 80% of healthcare expenditure in Nigeria is currently out-of-pocket. This means serious medical conditions, such as cancer or open-heart surgery, are unaffordable for the majority. Dr. Oyefeso contrasts this with systems abroad, where children can receive critical services like open-heart surgery without their parents paying a single dollar.
To reform the system, both doctors underscore the necessity of establishing basic, solid primary healthcare centers across the country, complete with 24/7 staff coverage, necessary medication, and functional transportation services, including ambulances. The dire consequences of systemic failure are evident even in urban areas, such as Makoko in Lagos, where a recent visit by Dr. Oyefeso revealed "deplorable" conditions, filthy water contaminated with feces, and a clinic where four women who had just delivered were detained for owing a combined total of only 70,000 naira for their care.
The problem is compounded by a massive brain drain, driven by a lack of incentives for doctors to stay and serve underserved areas. Dr. Oyefeso strongly agrees with the sentiment that if public officials were compelled to use the same public hospitals as the populace, the quality of care would drastically improve, arguing that talent flows where it is rewarded.
In conclusion, while the challenge is immense, the collaboration between organizations like For Breath for Life and dedicated medical professionals like Dr. Aproko TV and Dr. Oyefeso aims to drive change. Dr. Oyefeso's ultimate sentiment remains hopeful, but emphasizes that hope must be intentional, requiring enough compassionate people to speak the truth, demand accountability, and actively work to shift a culture where actions do not reflect a verbal commitment to valuing life.
