The Health Poverty of the Rural Poor

Nwachukwu Egbunike

Tunde is farmer in a village in Ijebu-Ode, South-West Nigeria. One day, he woke up in disbelieve to notice that his two legs were swollen. Tunde’s wife was convinced that her husband was a victim of envy from his colleagues who had smeared jazz (juju) on his foot wears and this has resulted in the engorged feet. The solution was to refer him to a spiritualist who will dispel the evil spell. After months of ‘treatment’ the sores neither healed nor disappeared. A village nurse was called in and upon further examination, declared Tunde to be diabetic.

That was the beginning of the dilemma; Tunde’s family could not afford the cost of treatment from the nurse – whose expertise was rather limited. They could neither seek proper medical attention from the General Hospital which was about 200 kilometres from their village. Tunde’s limbs lay precariously close to amputation. Paradoxically, in that same village, reproductive health counselling is ubiquitous. Yet the villagers are so steeped in poverty that they cannot afford basic health care for diabetes.

Tunde is quite ‘lucky’ since his ailment was diagnosed others are not so fortunate. I had the good fortune of hosting a long time friend, a doctor, who just completed his National Service in Igboho, a town in near Ibadan. As such we – joined by another doctor – went for a drink. The conversation was numbing. Chinedu glee of his fame in Igboha looked superficially vain – with children always happy whenever he laid his hands on them, like the Pope. However, it made sense, since in that town, majority of the women are delivered of their babies at home. Those that make it to the hospital only do so due to post-natal complications.

Ambrose’s tale was gorier, as he works in a hospital in the heart of Ibadan. He lamented that most paediatric fatalities could have been averted with a N200 ($1.15) worth of anti-malaria medicine. Their parents – usually bus conductors and kola nut hawkers – cannot just afford the cost of the prophylaxis and have to watch their children die.

Although poverty stands out clearly as the major factor in the cases narrated above, yet lack of access to information, corruption and inability of the government to provide for the common good, all have a fair share.

It is difficult to demur with Olaniyan and Bankole (2005)[i] that “the poverty situation is Nigeria …presents a paradox considering the vast human and physical resources that the country is endowed with. It is even more disturbing that despite the huge human and material resources that have been devoted to poverty reduction by successive governments, no noticeable success has been achieved in this direction.” To situate this in context, it is a shame that Nigeria is one of the poorest among the poor countries of the world, ranking 54th with respect to the human poverty index (HPI) – making it the 20th poorest country in the world.

Yet poverty cannot carry the blame alone. The mentality of public and non-governmental officials sitting in air-conditioned offices in Abuja and conjuring interventions for the rural poor is really pitiable. “This shows a certain attitude of policy makers and the media who set public agenda by talking for the people rather than talking with the people.[ii]

It is really a question of development. And this a great deal to do with communication, not so much about the usual jingles, but rather placing the needs of the people first. Or else, we have the situation outlined above lingering for a very long time. While we all seem satiated with information about HIV/AIDs, it seems that malaria and other diseases are creating more havoc. Communicating development issues need therefore to originate from those involved, not just going to them to implement ‘artificial’ policies.

Unfortunately this is the situation in many African countries, including Nigeria. Ojebode (2008) asserts that, this is one more manifestation of the deeply ingrained military culture in Nigeria. “The result is a government or an agency which decides what the citizens want and goes ahead to do just that, the way it understands it, using the means it is pleased with.[iii]” And by so doing, thinks that their wishes will become reality by divine or magical fiat.

While we all anticipate that government will one day wake up to its responsibilities, we all have the duty to save the Tunde’s of this world. Granting people access to health is a prime development agenda. Yet how will the needs of the rural poor be heard, if no one cares to listen to their voice?


[i] Olanrewaju Olaniyan and Abiodun S. Bankole (2005) “Human Capital, Capabilities and Poverty in Rural Nigeria.” (Retrieved, Ocotober17, 2010).

[ii] Nwachukwu Egbunike (in press) “New Media and Health Communication: Communication Strategies in Malaria Control in Nigeria” in Wachanga Ndirangu D (Ed), Cultural Identity and New Communication Technologies: Political, Ethnic and Ideological Implications. Hershey PA: IGI Global, USA.

[iii] Ayo Ojebode (2008). Low Patronage of Development Radio Programmes in Rural Nigeria: How to Get Beyond the Rhetoric of Participation. Journal of Multicultural Discourses, July, Vol. 3 Issue 2, p 135-145, 11p.


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