Makoko demolition is taking a devastating toll on displaced pregnant women, many of whom now sleep in canoes, battle hunger and anaemia, and face an increased risk of preterm birth. Several of those who shared their frustrations with PUNCH Healthwise said they are already suffering from hypertension, a leading cause of maternal death, yet have no access to antenatal care. With clinics lying in ruins and delivery dates fast approaching, these expectant mothers, gripped by fear over the fate of their pregnancies, are confronted daily with a haunting question: where will they lay their babies’ heads after delivery? Janet Ogundepo reports
Seven months pregnant, Theresa lay down on the neatly arranged, polished wood, which was placed to fit the edges of the canoe that had become her home for four weeks now.
The mother of three was among the affected families whose homes were demolished because they were situated close to the power line that runs through the waterfront community of Makoko, in the Yaba Local Council Development Area of Lagos State.
Sunday was when she eventually found temporary shelter on a piece of land at Tomaro, a riverine community and island in the Amuwo Odofin Local Government Area of Lagos State, away from the ruins of Makoko. But her worries are far from over.
What Theresa now calls home is a boat moored along the lagoon bank at Tomaro, where wooden stakes mark the cramped space she shares with her belongings. Blue and black tarpaulins are stretched over makeshift frames, sagging under their own weight and fastened with ropes or strips of fabric. They serve as both roof and walls, offering little protection from the rain or harsh sun.
Theresa, a fish vendor at Makoko, told PUNCH Healthwise, “I was one of the first set of people whose houses were demolished because my house was close to the 30 metres mark of the power line. I had nowhere to go and had to stay on my canoe on the water for three weeks. I couldn’t sleep well, and I have been having headaches and a fever. I came here (Tomaro) on Sunday. I haven’t got a place to lay my head because I am still sleeping on the canoe.”
At Makoko, the mother of three had registered for antenatal care at a clinic on the water, but since it was demolished along with her house, she has been unable to continue her antenatal visits.
“I got here (Tomaro) a few days ago, and I haven’t located a health centre around here. I will have to go back to Makoko in a few days’ time to look for a clinic. I am still feeling feverish. I only managed to eat with the little savings I had,” she said.
Whilst Theresa says she still has her routine antenatal medications, she looks lost as to what to do when they are exhausted since the clinic she knew is now in ruins.
Hopeless, little food, many children
Theresa is without her delivery pack and baby items in her new location, and with her savings, which she spends on food, she is yet to purchase them.
Her hope for a safe delivery, she says, “is in God’s hands” as she has no prospect of getting medical assistance when her time comes.
Her female relatives with whom she lives, she says, have no knowledge of childbirth, leaving her surrounded by unskilled and untrained birth attendants who would most likely attend to her when her time to deliver comes.
“I haven’t found a place in this new location where I can rebuild my house. This little piece of land, where we place our canoe and sleep, we pay for it because it belongs to another person. I have no place to lay my baby after I give birth,” the expectant mother lamented.
The middle-aged woman, who has been a fish vendor all her life, has lost her means of livelihood. Her condition makes it difficult for her to immediately return to her trade, leaving her at the mercy of her little dwindling savings and relatives who are also saddled with their own problems.
Nine months gone, no hope
Adeline Zosu, a nine-month pregnant woman, tied a wrapper around her chest as she sat under the mango tree outside the new place she now calls home.
Home is a square-like structure built with zinc roofing sheets on the quiet island of the Agala community in the Apapa Local Government Area of Lagos State.
Zosu is one of the displaced residents affected by the ongoing demolition of the waterfront community in Makoko. After spending several days sleeping on the canoe without proper sleep and rest, the mother of two, together with her family, sought refuge in other fishing communities, this time, several kilometres away from the rubble of her home.
But the new place is bereft of electricity, a thriving market, potable water and a proper clinic.
Zosu says she is nine months pregnant and over 40 weeks gone, but she is unsure of where to place her baby after delivery.
The former food vendor at Makoko says she has yet to complete her delivery pack and baby items.
The mini clinic on the island run by a midwife in the Agala community, Nurse Matilda, is her only hope for medical assistance when her delivery time comes.
“My pregnancy has gone beyond 40 weeks, and I have yet to give birth. I believe babies come at different times, so this would come when ready. I feel the baby’s movement, so I am not disturbed,” Zosu told PUNCH Healthwise.
The food vendor, who is also a mother of two, worries that her newborn will be placed in their new house, already overcrowded with family members.
“I have no savings, and we currently eat with the help of our new neighbours and the little money we brought. I only have about three items of clothing for my baby and would manage that for the baby,” Zosu said.
Five hours on water, no clinics in sight
During a previous visit to the Makoko waterfront community, PUNCH Healthwise had reported on babies with missed immunisation schedules and families surviving on soaked cassava flakes, popularly known as garri.
Our correspondent gathered that many displaced pregnant women have relocated to other waterfront and island settlements, including areas and communities along the Badagry Creek and Apapa Quay.
On Wednesday, PUNCH Healthwise visited four communities, Agala, Tomaro, Sagbokoji and Oyingbo waterfront, to observe and speak with pregnant women about their access to health facilities, skilled health workers and trained birth attendants, potable water, and shelter for themselves and their babies.
These locations lack basic health facilities, potable water and electricity. Sagbokoji and Agala are under the Apapa Local Government, whilst Tomaro falls under the Amuwo Odofin Local Government.
During a five-hour boat tour of the area along the Apapa Quay, our correspondent observed that most of the settlements had no clinics, potable water, electricity and a few hard-to-reach schools.
The only available health facility was a small clinic run by Nurse Maltida, which is grossly inadequate for the growing population, especially for pregnant women requiring antenatal and delivery care.
Matilda, a displaced resident of Ogogor community in Eti Osa Local Government Area who has been living in the Agala community for over a year, says she was trained as a midwife in the Benin Republic and has taken the delivery of over 30 babies in the community and environs.
The middle-aged woman told PUNCH Healthwise that many displaced pregnant women from Makoko recently came to her clinic for a health check. The stories were not too good.
Pregnant women with hypertension
Matilda said, “Two women who came to the community last week visited my clinic. Their blood pressures were high because they had been sleeping in their canoes for many days before they eventually came here. I monitored them and gave them medications, and this morning (Wednesday), when I checked their BPs, they were normalised. One read 110/80, and she said she was going back to Makoko to bring her remaining belongings.”
The midwife said many of the women, whom PUNCH Healthwise learnt were in their third trimester, do not eat well because they have limited money to get good food.
On how she gets hospital consumables and drugs, Matilda says she goes to the Idumota market to restock her clinic.
Whilst Matilda’s efforts have been able to provide immediate local help to the pregnant women within and in nearby communities, those with complications and in need of more expert attention and emergency caesarean sections would have to travel several kilometres by boat to secondary or tertiary hospitals around Apapa.
The delay in accessing the much-needed healthcare services might be costly.
Delays are a major cause of death from obstetric complications, accounting for 41 to 51 per cent of deaths.
Already, Nigeria accounts for 34 per cent of global maternal deaths, with about 75,000 women dying every year from causes related to pregnancy and childbirth.
Although the National Primary Health Care Development Agency reports a 22.5 per cent increase in antenatal care visits between the second and third quarters of 2025, about 58.1 per cent of pregnant women give birth at home.
According to the 2023–24 Nigeria Demographic and Health Survey, the neonatal mortality rate in Nigeria is 41 deaths per 1,000 live births, with the under-five mortality rate being 102 deaths per 1,000 live births.
The displaced pregnant women who spoke to PUNCH Healthwise are in their third trimester. During this time, gynaecologists and health organisations recommend that pregnant women attend antenatal care twice a month to closely monitor the baby’s growth and position, and check for signs of high blood pressure, among other complications.
But since Theresa’s house and clinic were demolished and Zosu and other pregnant women are living several kilometres away from the life they had known, in the past four weeks, they have been unable to attend antenatal appointments and routine checkups.
Cold exposure threatens newborns’ survival
A Professor of Paediatrics, Ben Onankpa, warned that extremely low temperatures pose a serious threat to both mothers and newborn babies.
He explained that babies die quickly from hypothermia when exposed to extremely cold environments, adding that such conditions also affect their immune system and increase the risk of illness.
“When you expose babies to an extreme cold environment, apart from hypothermia, it also affects their immune system and poses a risk for illness. Extreme cold can cause frostbite for newborn babies. Babies have a high body surface to mass ratio, resulting in rapid loss of body heat. It will cause skin damage and poor immune buildup, making them easily susceptible to infection and risk for illness,” Onankpa stated.
The professor warned that such exposure can lead to systemic failure, including heart failure, and sometimes death.
He identified signs of cold exposure in babies to include cold skin and unusual quietness or lethargy.
The child health expert stressed the urgent need to provide shelter for displaced families with newborns, noting that current weather conditions make exposure dire.
The professor further explained that babies need proper sleeping environments to grow, as growth hormones are released, especially at night during sleep.
“Babies grow when they are sleeping. They add weight, their cells multiply and they grow when they sleep, because the growth hormone is released, especially at night, when they sleep. So they need a good environment,” he stated.
Onankpa outlined the requirements for a proper sleeping environment for babies, including their own bed space, a room that is warm when the weather is cold and cool when the weather is hot, nice clothes appropriate to the temperature, and a quiet, dark room.
On delivery conditions, the paediatrician noted that whilst some mothers prefer home deliveries due to cost implications, proper hygienic conditions are essential.
“The room should be warm, because delivery should certainly be in a warm environment. The baby is coming from a warm environment, so you can’t deliver in a cold area. Heat loss occurs through evaporation, radiation, and condensation. If the baby is delivered in a cold room, the mother and baby will suffer,” Onankpa explained.
He warned that newborns delivered in cold environments face immediate danger from rapid heat loss, urging that adequate warmth be provided during and after delivery.
A Public Health Physician, Dr Rotimi Adesanya, stated that the exposure of babies to the cold, damp and polluted air areas increases their risk of having pneumonia.
He also noted that since many of the residents have lost their means of livelihood and are unable to eat well, the risk of malnutrition was higher, which would further increase the onset of pneumonia, especially in children under five, whose immunity is not yet as developed as adults.
Hypertension, fever may increase MMR, experts warn
A gynaecologist, Dr Joseph Akinde, said hypertension has a well-documented negative impact on pregnancy outcomes and is one of the leading causes of maternal deaths in Nigeria, second only to haemorrhage.
He explained that stress, including that caused by sudden displacement, could worsen hypertension in pregnancy and increase the risk of poor outcomes for both mother and baby.
“If pregnant women are developing hypertension as a result of stress from displacement, it will adversely affect pregnancy outcomes,” he said, adding that such risks are medically recognised.
The gynaecologist further noted that living in such remote settlements puts pregnant women at risk, particularly when labour or pregnancy complications arise.
Akinde advised expectant mothers close to delivery to temporarily relocate to areas with access to healthcare facilities.
“A pregnant woman who is due should go somewhere she can access a hospital or clinic, deliver safely, and then return to her livelihood afterwards,” he said.
He further advised that women experiencing pregnancy complications should prioritise their health and survival.
The gynaecologist encouraged displaced women to seek temporary shelter with relatives or friends on the mainland or in areas with functioning health facilities.
He stressed that relocation does not have to be permanent but should be long enough to address immediate health risks, especially during pregnancy.
“They didn’t fall from heaven. They must have relatives or friends somewhere. They should stay with them temporarily, access healthcare, and return when the situation is stabilised,” Akinde stated.
However, the gynaecologist maintained that whilst the demolition of residences along the power line was lawful, he argued that individuals who violate regulations should not shift blame to the government when enforcement occurs, noting that laws are impartial and apply equally to all.
In an earlier interview with PUNCH Healthwise, a Professor of Obstetrics and Gynaecology, Prof Ernest Orji, said fever is not a normal condition during pregnancy and should never be ignored.
He explained that fever in pregnancy is often a sign of an underlying illness, with malaria being the most common cause in Nigeria.
“The commonest cause of fever in pregnancy in our environment is malaria. Pregnant women are not exempt from malaria,” Orji said.
He added that other causes of fever in pregnancy include urinary tract infections, respiratory infections such as pneumonia, hepatitis and, less commonly, viral infections. He stressed that proper testing is essential to identify the exact cause.
“When a pregnant woman presents with fever, the first thing we do is to test for malaria parasites in the blood. We also test the urine to check for infection because malaria and urinary tract infections can coexist,” he explained.
The gynaecologist warned that fever in pregnancy can have serious consequences for both the mother and the baby.
He noted that high fever could trigger premature contractions, leading to preterm birth, miscarriage, or low birth weight.
According to him, severe or untreated fever can also cause anaemia in pregnant women, as repeated vomiting and poor appetite may lead to poor nutrition and weight loss.
“In severe cases, fever can affect the growth of the baby, leading to low birth weight. Malaria parasites can even cross the placenta, causing the baby to be born with malaria,” Orji said.
On prevention, Orji emphasised the importance of intermittent preventive treatment for malaria in pregnancy. He explained that pregnant women are expected to receive at least three doses of antimalarial preventive drugs during pregnancy, starting after the first trimester.
“For women with sickle cell disease, daily malaria preventive medication is recommended because they are at higher risk,” he added.
The professor warned that the consequences of untreated malaria in pregnancy can be severe.
“For the mother, severe malaria can lead to severe anaemia and other life-threatening complications. It is the severity of the illness that determines how fatal it can be,” Orji said.
He advised pregnant women to seek prompt medical attention whenever they experience fever, stressing that early diagnosis and treatment are critical to preventing complications and reducing maternal mortality.
Lagos defends demolition
The PUNCH earlier reported that the Lagos State Government on Tuesday defended the ongoing demolition exercise in Makoko.
The Permanent Secretary, Office of Urban Development, Mr Gbolahan Oki, said those opposing the exercise were residents who refused to vacate areas marked for demolition.
“What the law says is 100 metres from the power line,” he said.
Oki noted the government had acted in the interest of public safety, warning that residents would hold the state responsible if a power line fell into the water.
On whether the government was adhering to the agreed 100 metre setback from power lines, Oki said the actual safety requirement was wider.
“It is even 250 metres, so giving them 100 metres is free for all,” he said.
He explained that the demolition formed part of the government’s urban regeneration programme aimed at achieving megacity status.
Copyright PUNCH
All rights reserved. This material, and other digital content on this website, may not be reproduced, published, broadcast, rewritten or redistributed in whole or in part without prior express written permission from PUNCH.
Contact: health_wise@punchng.
