Dr Michael Boroditsky had a unique, challenging and rewarding experience when he volunteered in northern Nigeria for 6 weeks this past spring. He worked under the auspices of Doctors without Borders, also known as Medecins Sans Frontieres-MSF. MSF works in over 71 countries worldwide, over 30,000 employed, with roughly 10% international staff. In 2017 just under 200 Canadians worked with MSF. Most of the work is done in sub-Sahara Africa, Southeast Asia and Haiti. Boroditsky worked as a “staff surgeon in Obstetrics at Jahun Maternity Hospital, Jigawa State, Nigeria.

Boroditsky was housed in a secure compound with other ex-patriots of MSF. He reports, he was “ not able to move freely in the area, due to risk of kidnapping and violence. I was provided a driver to and from the hospital.”

Boroditsky admits, Jahun is “a male dominated Muslim society. Women were marginalized and without basic health or maternity care. The consent for any surgery was provided by the male head of the family”.

“Many of the women were married as teenagers and did not complete formal education. This resulted in a very high teenage pregnancy rate” Boroditsky noted.

Maternal morbidity and mortality were very high.  Boroditsky indicated “ this was largely due to the limited health care infrastructure for preventative or antenatal care. In addition, there were severe cases of malnutrition resulting in significant anemia, cardiovascular and respiratory disease. These complications made for significant volume and acuity of obstetrical complications.”

Nigeria has the third higher maternal mortality rate in the world at roughly 900/100000 pregnancies. Compared to Canada which is only 8/100000. Boroditsky described “Weekly having maternal deaths, not uncommon for them to be young teenagers” One of the worst days, was when two young women died and were both 15-year-old. The same age, at the time, as my youngest daughter”

Additionally, Jahun Maternity Hospital, Boroditsky explained, provided no fetal surveillance while a mother was in labor. No intervention was provided for a sick fetus. Resources and the local reality of what was available, did not permit. This along with multiple other factors resulted in a term Stillbirth rate as high as 15%. At Jahun Hospital there are roughly 9000 deliveries each year, thus approximately 1200 are still born. Three to four times per day a mother will have a full grown fetus die in utero.” Compare this to Manitoba, where the Term still birth rate is 1-2/1000.

Jahun Hospital was staffed and partially funded by MSF. The staff were primarily Nationals from Nigeria, and only a small contingent of Ex- pats. Most from Europe  and neighboring African countries such as Ethiopia, Kenya and Ivory Coast. The hospital conditions were quite minimal. “No linen, food, clothing was provided for the patients, who were frequently 2-3 per bed.” Accordingly, to Boroditsky, families would provide food and clothing while living outside the hospital in the courtyards.

Boroditsky remembers one of the biggest challenges was the weather. Sub-Sahara Africa is very dry and hot. Daily the temperature would be between 40-45’ Celsius. “ The first week I was there I must have drank 10 liters of water per day. Showering 4-5 times just to try and cool off.” While working in the OR, he recalls, routinely his glasses would fog up and require wet linen placed around his neck to complete the surgery.

Boroditsky felt his experience working with MSF was very positive. The people of Nigeria were very warm and welcoming. The MSF team was first rate and provided a valued service to a community in great need and to women whose very lives depended on it.

Boroditsky has volunteered before overseas. He worked in  Dhunche, Nepal for the International Red Cross after the Nepal Earthquake in 2015.