If it were not for the timely intervention of the elderly Islamic cleric at Kizara Village in Tsafe Local Government Area of Zamfara State, Garba Umar would have ended his 15-year-old marriage to his wife, Halima.
Her offence was allowing a male doctor attend to her in the labour room.
Saturday PUNCH learnt that when efforts by other women in the compound failed to help when she went into labour, she was rushed to the Tsafe General Hospital following noticeable complications that often accompany childbirth.
On getting to the hospital, there were no female doctors or nurses on the ground to attend to her. Thus, they were constrained to allow a male doctor on duty attend to her, at which time her health seemed to be failing.
Reluctant to embrace the option, the women said they had no choice but to allow the doctor (names withheld for security reasons) attend to her.
After three days of being in a coma, Halima survived, but she lost the baby. However, her family and friends were consoled that she made it out alive.
But unknown to the distraught mother, the consequences of allowing a male doctor attend to her awaited her at home. Her husband, it was learnt, had become livid, hurled insults at her and even threatened a divorce for allowing a male doctor to attend to her.
Those privy to the drama said Halima was on her way out of the marriage, but for the swift intervention of the cleric, who counselled and cautioned her husband against such a move.
“The cleric told him it wasn’t prohibitive in Islam for a male doctor to attend to a female patient in the absence of female medical personnel,” one of the witnesses told Saturday PUNCH.
Sadly, such an experience is not new, neither is it exclusive to Halima.
The same fate befell Hafsat, a resident of Talata Mafara in Zamfara State, in which case her husband warned that on no account should she seek medical attention from a male doctor in his absence, no matter the gravity of the ailment.
The vicissitudes of life would, however, compel Hafsat to flout the instruction. Like Hafisat, she was delivered of a baby girl by a male doctor when the husband was unavailable. It took the intervention of family and friends that the marriage didn’t end in a divorce.
Double loss for Mukhtar
Unlike Halima and Hafsat, who were both lucky to have their marriages intact despite flouting the ‘golden rule’ set by their husbands, a 14-year-old mother in Zango Local Government Area of Katsina State, Aminat Mukhtar, wasn’t as lucky. Hers ended in a divorce despite aborting her education because of the marriage.
She said her husband divorced her for allowing a male doctor attend to her when she had complications during childbirth. Sadly, she had a stillbirth. Thus, she lost the baby and her marriage.
Mukhtar, who was a JSS 3 student at a government secondary school in 2022, said she was out of school for a year due to the development, noting that her suitor pressured her for the marriage, a situation that made her drop out of school for one year before the outcome of the short-lived marriage compelled her to return to school.
According to her, the school principal, Fatima Muhammed, was impressed with her courage and allowed her to return to the school. However, she could only return to JSS 3 instead of SS1 as her former classmates were already ahead of her academically.
Mukhtar revealed that her ambition in life was to become a school teacher.
She told one of our correspondents in an interview, “I am 14 years old and the eldest in my family. We are three in the family. The other two are a boy and a girl. I am in JSS3.
“‘I was initially attending school here (Government Girls Secondary School, Baure) when I met a man who said he wanted to marry me. He promised me several things and lured me to drop out of school. After I left school, I kept on seeing my schoolmates, and they told me that some programmes were being implemented at the school to assist students who were from poor homes like me. I made inquiries and confirmed that it was true.
“I subsequently called off the marriage proposal, and I returned to the school. Our school principal assisted me a lot, and up till now, she keeps on encouraging me. I have no regrets for my decision to return to school. My ambition is to become a schoolteacher and contribute to the development of my community.”
As heartbreaking as these are, such cases are prevalent in some northern states like Katsina, Kano, Sokoto, Bauchi, Zamfara, Kebbi, Jigawa, and others.
In some of the states, male doctors are reluctant to attend to female patients, especially in public hospitals, without their husbands present, for their own safety or the possible consequences for the woman.
A staff nurse at the Federal Medical Centre, Gusau, Zamfara State, Mohammed Sani, who spoke to Saturday PUNCH said male doctors had stopped attending to female patients, except with the permission of the husband or the guardian, as the case might be.
Sani told one of our correspondents that over the years, there had been marital quarrels, which often led to separation or outright divorce over the issue of male doctors attending to female patients, especially pregnant women.
He stated, “We (male medical personnel) are no longer attending to pregnant women in labour unless we get the written agreement from their husbands or relations. There are so many incidents where pregnant women who are in labour were attended to by male doctors and the issue became unpleasant in the end.
“You know that we have shortage of female doctors, as such, male doctors must be assigned to attend to female patients, especially those in labour.”
On the religious implication, a renowned Islamic scholar, Sheikh Liman Musa-Kura, told Saturday PUNCH that in Islam, male doctors are not allowed to see the anatomy of a married woman except with the consent of her husband or blood relatives.
Kura warned that male doctors should stay off from attending to a woman during labour unless it became absolutely necessary.
The cleric stressed that in the absence of female medical personnel, it was only if the female patient was in grave danger that a male doctor could be called upon to save her life.
Musa-Kura stated, “In Islam, everything is fully explained. It is forbidden for a man to see a female private parts if he is neither her husband nor her blood relation.
“So, in case there is no female doctor around, a male doctor could be assigned to treat a woman in the presence of either her husband or her relatives.”
Meanwhile, Kura lamented the shortage of female doctors in the state, urging the authorities to do something in order to avert the “ugly trend”. He cited the Kingdom of Saudi Arabia “where only female health personnel can treat their fellow women.”
Interestingly, the opinion of the District Head of Gagi community in Sokoto State, Alhaji Sani Umar Jabbi, was different.
According to him, it was unconstitutional to ask housewives not to seek medical attention from male medical doctors, adding that it had nothing to do with religion.
He described as “heartless” the attitude of some men in the northern part of the country, who punish their wives or deny them the right to seek medical attention from the hospital because they do not want them to be attended to by male doctors.
As a way out, the monarch called for more protection for women, especially housewives whom he said deserved the same protection as the men in the society.
He stressed the need to invest in girl-child education, noting that “the consequence of not investing in girl-child education by our people in this part of the country is what causes men to dominate every strategic part, including the health sector.”
Umar Jabbi noted, “The problem with our men in the North is that they have conservative mindset for not supporting women’s education, and unless we provide the opportunity for girl-child education and their empowerment, we will continue to have a gap.
“We must henceforth realise that education of the female children too is part of human rights and should be given priority. The issue of health care is also a guaranteed right of everyone, irrespective of their gender or status.
“I pray we change our perspectives so that in future we can have more human resources to take care of those areas, such as nurses, doctors, gynaecologists, among others, so as to meet our demands.”
Indeed, like Umar Jabbi noted, while it is inexcusable for men to deprive their wives of medical care because of the absence of female doctors and nurses, the menace also highlights the consequences of depriving female children of education, a danger more common in northern Nigeria.
According to the United Nations Educational, Scientific and Cultural Organisation in 2022, Nigeria had about 20 million out-of-school children, especially those aged between six and 18. Even though the Universal Basic Education Commission believed the real figure was about 10 million, Nigeria is said to have one of the highest figure in the world.
According to UBEC, the out-of-school children mainly comprise of the girl-child in northern Nigeria, boy-child in the South-South and South-East geopolitical zones, internally-displaced children, and the Almajiri Qur’anic and itinerant children “who are predominantly found in Northern Nigeria”.
The Department of Special Programmes at UBEC was however mandated to coordinate and implement all special interventions to address the out-of-school children challenge.
Equally contributory to the travails of the girl child, especially in northern Nigeria, is the issue of child marriage. The United Nations Population Fund revealed late last year that no fewer than 20,000 girls were saved from child marriage.
The United Nations Children’s Fund also revealed in a 2021 report that 40 per cent of girls in the country were married before they clocked 18 years. The report said the act of forcing girls into marriage with creditors to offset a loan contributed to the rate of child marriage.
Also emphasising the importance of girl-child education, the Country Representative of UNFPA, Ms Ulla Mueller, said in 2022 at an event, “Education is crucial in realising the potential of women and children. As such, we must ensure that every girl has access to quality education that equips her with knowledge and skills.
“Quality education will also enable girls to have the confidence to pursue their ambitions. When women have equal access to education, they are better able to enhance their own lives and contribute to the growth of their communities. Achieving gender equality is not only essential for its social and economic benefits but also because it is the right thing to do.”
Thus, like Jabbi noted, there cannot be female doctors, nurses and other healthcare professionals to treat pregnant women, much to the desire of some men in northern Nigeria, when the girl-child is deprived of education.
The poor access to healthcare underscores Nigeria’s high rate of maternal mortality, which is said to be the second-highest in the world. India is said to have the highest. A report by the World Health Organisation revealed that in 2020 alone, 540 women and children died per thousand in Nigeria, while the country accounted for 12 per cent of global maternal and neonatal deaths and stillbirths in the world.
Findings revealed that apart from the low access to proper healthcare, practices like this deprive women of the medical care that could have saved their lives.
Narrating his subjects’ ordeal, the community leader narrated, “Sometimes here in Sokoto, there was this housewife who was about to go into labour and her mother-in-law prevented her from visiting the hospital.
“We did all kinds of advocacy, but the woman refused to allow her go to the hospital. We later took the expectant mother to the hospital after being in labour for about three weeks. After her delivery, unfortunately she needed blood transfusion and the same woman placed a curse on her son if he donated blood to his wife.
“It took several interventions, and it was not until we told her that if she (the pregnant woman) died, she would be held responsible before she allowed her son to donate blood to the wife. We have so many stories related to this but the most important thing is to continue to create awareness to our people on the importance of education to our girl-child.”
On the religious beliefs attached to this, the community leader noted that ignorance and not religion was responsible for the belief that only a female doctor should attend to women in need of medical attention.
He stated, “It is unfortunate that some ignorant persons among our people link their actions to teachings of Islam, which is a lie. Allah never told us to deny our wives what can make them happy or well.
“The ultimate goal of religion is to save lives. Every aspect of human endeavour is there in the Holy Quran, even that of women, from delivery up to adulthood, and how they should be treated. You cannot deny women the right to quality health. It is there in the Holy Quran. People should ask what they don’t know.”
Practice no longer new – Ex-NMA chair
Meanwhile, a consultant haematologist with the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Dr Sani Abubakar, explained that harassment of male doctors by men when it concerns their wives was almost a daily occurrence, especially in northern Nigeria.
Abubakar, a former chairman of the Nigerian Medical Association in Sokoto State, described the actions of such men as overprotective and lacking in proper orientation and exposure.
He stated, “It is a natural thing for every man to protect their wives and children but we should realise that while protecting them, there ought to be a limit to what we do so as not to cause more harm than good to them.
“It is a known fact that all over the world, we have more of male doctors when compared with their female counterparts, even in a field like gynaecology, which deals with women, you still realise that more men are involved than even women.
“It is almost compulsory for a male doctor to attend to female patients. We should know that in the health sector, there is no gender limitation as to who can attend to who.”
The top medic dismissed attempts to link such behaviour to religion or culture, saying lack of proper education was responsible for such behaviour.
Abubakar added, “Even though people link the attitude of some men who went to the extent of attacking a health worker or their wives to religion or culture, I think it is more of a lack of education.
“When you look around here in the northern part of the country, you will find out that most people that are educated and exposed hardly do such a thing. Most times, it is the illiterates among us that do that, most of whom really don’t know what the religion said about such an issue.”
Sharing his personal experience with a patient’s husband, Abubakar stated, “There was a day a woman came for examination and while I was attending to her, I think when the husband was informed that she had gone to the hospital, he quickly rushed to the hospital and was asking about his wife at the ward. When they told him she was inside with the doctor, he forced his way in.
“Upon entering the consultation room, he met his wife lying down on the examination bed but fortunately for me, he met a female nurse standing by her while I was on the screen asking questions. That was what made him relax, otherwise he would have done something silly.”
Abubakar called on his colleagues to always be guided by the rules of the profession, adding, “It is wrong for a doctor to ask the husband to excuse them while attending to the wife. It is also part of our ethics for a doctor to have a chaperone or a third party. Such a person can be a relative of the patient or even a nurse, which would help to give more confidence to the patient or her family.
He said further, “On insinuations that male doctors take delivery of women in the labour room, we should note that the job of doctors in the labour room is limited unless there is a complication. That is why we always have midwives whose duty is to take delivery, and it is a female dominated profession.”
The haematologist, while condemning the action of men who went to the extent of divorcing their wives for allowing male doctors to attend them, observed that most of them only use that as an excuse as there might have been an underlying issue.
He also called on parents to allow their girl-child go to school so as to minimise the barrier, while reminding them not to deny anyone, especially their wives, health care which he said remained their constitutional rights.
In Katsina State, findings by Saturday PUNCH indicate that all eyes are on the state government for the implementation of the Child Protection Law, which aims to, among others, protect children in the state against all forms of abuse, including hawking, rape, denial of education and early marriage.
It was signed on December 29, 2020 by the immediate past governor, Aminu Masari, after its passage by the state House of Assembly on November 25, 2020.
Some individuals, members of civil society organisations in the state as well as international organisations, especially the Save the Children International, have engaged in extensive consultation and advocacy before the law came into being in the state.
Despite the passage of the law a middle-aged man, identified as Samaila, was arrested in Katsina following the discovery that he locked his two wives, Fatima Salisu and Hadiza Musa, in a room in his house, chained them and subjected them to inhuman treatment for 10 months.
Fatima is from MarkeMagaji Garin village while Hadiza is from Kalyarubandaba village, both in Katsina State. Both women were aged 20 years at the time and did not have children for Samaila.
Samaila, who was living with the two wives at Yannadabaiyye village in the Rimi Local Government Area of the state, was picked up by the police from the Rimi divisional police headquarters before he was transferred to the State Criminal Investigation and Intelligence Department at the Katsina police headquarters for further interrogation.
Reprieve came for the two women when Hadiza’s mother paid her a surprise visit in the village.
It was learnt that the old woman pleaded with Samaila to allow her go away with a sewing machine she bought for Hadiza since she (Hadiza) was not using it there.
Samaila, it was learnt, refused to release the machine. Instead, he allegedly assaulted her physically.
The woman reported the incident at the Rimi divisional police headquarters, which prompted policemen to visit Samaila’s house, where the two women were found under terrible conditions.
Fatima and Hadiza, who spoke in Hausa, alleged that Samaila locked the two of them inside a room, shaved their pubic hair and cut their fingernails.
They alleged further that he prepared a concoction with the items and forced them to drink.
Hadiza further alleged, “Samaila never allowed us to leave the room. We did everything in the room; we bathed there; we answered the call of nature there. He chained us and only removed the chains whenever he wanted to have sex with us, and he would have sex with us inside the room and in the presence of the other person.”
Hadiza also showed one of our correspondents her back, which was riddled with scars, sores and injuries sustained from the beatings she allegedly received from Samaila whom he alleged, used to flog her and Fatima with cable.
Although their offences were not exactly stated, Fatima disclosed that she was the first to be locked in the room 10 months ago before he married Hadiza and also locked her up in the room 10 weeks after.
Fatima alleged that Samaila threatened to kill any of them found menstruating or with blood stains.
None of the two women could say what Samaila’s job or business was, although they said he always came home with wads of N500 notes.
A Katsina-based non-governmental organisation, Gender Associates and Social Inclusion, showed interest in the plight of the two women and ensured that Samaila faced the wrath of the law.
The spokesperson for the organisation, Hajiya Rabi Muhammed, told Saturday PUNCH that the association took the women to a hospital for medical checkup and bought some foodstuffs for them before they were returned to their respective villages.
She added, “We took the two women to a hospital in Katsina, we counselled them and worked on their badly damaged psyche. We also gave them some foodstuffs. Those were the interim arrangements we made for them pending the time the police would complete their investigation on Samaila. We shall definitely empower them to help them pick up again.”
While the NGO says it awaits the conclusion of police investigations, there are strong indications that the governors, concerned government officials, community leaders, traditional rulers, religious leaders, civil society organisations and well-meaning individuals, especially in northern Nigeria, would have to do more to put an end to the discrimination against women and children, not only to save their lives but accord them their constitutionally-guaranteed rights to life, dignity, education and others.