With temperatures ranging from the low to mid 40s in Maiduguri, just about everyone – especially during the holy fasting month of Ramadan – is suffering from dehydration but most at risk are pregnant and breastfeeding mothers.

Extreme heat increases the likelihood of hospitalisation during pregnancy and hypertension during childbirth. For infants, the risks include dehydration at birth and being hospitalised in the first year of life.

Black mothers are especially vulnerable, according to a working paper from the National Bureau of Economic Research, titled What to Expect When It Gets Hotter: The Impacts of Prenatal Exposure to Extreme Heat on Maternal and Infant Health.

Symptoms of overheating or heat exhaustion include a cool, moist skin with goose bumps when in the heat, headache, dizziness, faintness, fatigue, weak/rapid pulse, low blood pressure upon standing, muscle cramps and nausea, according to the Centers for Disease Control and Prevention. Pregnant women whose body temperature is above 39°C are at greater risk of heat stroke, heat exhaustion and dehydration.

Climate change and global warming, especially in the Lake Chad region, as well as other parts of sub-Sahara Africa are expected to cause more frequent and severe extreme heat events, which could lead to dehydration and renal (kidney) failure in pregnant women.

Dehydration early in pregnancy can affect the baby’s growth and, later, can cause pre-term birth.

In Maiduguri, the temperatures have been hovering between 40°C and 45°C, putting pregnant women, especially during Ramadan when they are fasting, at risk. During pregnancy, the body has to work harder to cool down both the woman’s body and that of the foetus.

Although exempt, many pregnant women partake in the fast during the daylight hours during Ramadan.

Pregnant women and breastfeeding mothers told RNI how they were coping with the blazing heat, coupled with fasting.

Halima Ali said: “We thank God for this Ramadan, the only problem is the extreme heat. Sometimes, you have to stop the fasting because of the scorching sun and lack of electricity. The Islamic religion permits pregnant women to stop fasting but most of us try to fast unless we encounter difficulties.

“When I struggle, I usually go to hospital for a check-up and proper treatment. The doctors usually advise me to eat nutritious food and continue to take prescribed drugs or medicines.”

“Honestly, it’s not easy for pregnant women to fast and work, cooking and keeping the house clean, when it is so hot. I often ask my younger sister to help me to do the housework because I can’t. Even women who aren’t pregnant and other people struggle in this heat,” Amina Goni Mohammed said.

“Whenever we go to a hospital, the doctors advise us to stay at home and tell us we shouldn’t work under this hot sun. The doctors tell us to adhere to their advice because the heat could affect our health and that of the unborn child.”

Hajja Yana Alhaji Modu, the head of Maiduguri’s Yerwa Clinic, told RNI that pregnant women and breastfeeding mothers should visit hospital regularly, stick to medical tips and suspend all kind of work or things that will harm them in this extreme weather, especially during Ramadan.

“Fasting in this harsh heat without electricity is a challenge for all people, not only pregnant women or breastfeeding mothers. That’s why I encourage them not to fast if they don’t have the strength. Islam allows people who are ill not to fast. In this heat, it can harm pregnant and breastfeeding women.

“If these women want to fast, they should always be careful and protect themselves by staying indoors and not exposing themselves to the scorching sun. They should always eat nutritious food and drink a lot of water. This will help to keep their bodies strong and healthy, including their infants and unborn child.

“Going to hospital for regular medical check-ups is very important, because it will help to identify hypertension, malaria and other diseases. If found, they will receive proper treatment that will protect them, their little babies and their unborn child.”

Modu said some pregnant women and breastfeeding mothers were risking their lives by collecting alms, such as rice and sugar. Others were forced to beg on the streets because of poverty.

“Unfortunately, I know of two women who collapsed and died doing these activities. Many women who are poor rush to get things that are free. They go out into the hot sun to get alms without realising they could harm themselves, their unborn child, as well as their infants.

“Sometimes women struggle because they are neglected by their husbands. Men need to support their wives, not shun or neglect them.”

She said mothers should use mosquito nets – insecticide-treated nets (ITNs) – to protect themselves and their children from mosquito bites that causes malaria.

“Most hospitals provide mosquito nets for pregnant women and breastfeeding mothers. But the problem is that some of them sell the nets for ₦400 or ₦500, without realising their importance. I urge all pregnant women and mothers to use the nets, especially during this hot weather when they often sleep outside because of the excessive heat. This will protect them and their babies.”

• Maternal health refers to the wellbeing of women during pregnancy, childbirth and the postpartum period. The major causes of maternal morbidity and mortality include haemorrhage, infection, high blood pressure, unsafe abortions and obstructed labour, according to the World Health Organisation (WHO).

In Africa, climate change is likely to expand the range of malaria high-risk zones, according to a report by the Netherlands-based Global Centre on Adaptation. Even though malaria mortality has decreased from 840,000 deaths in 2000 to 602,000 deaths in 2020, it remains a major health challenge on the continent.

The effects of climate change are likely to slow the progress against hunger, with an additional 78 million people in Africa facing chronic hunger by 2050, said the WHO.

The United Nation Children’s Fund (UNICEF) says Nigeria’s 40 million women of childbearing age – between 15 and 49 years of age – suffer from a disproportionally high level of health issues. While the country represents 2.4% of the world’s population, it accounts for 10% of global deaths of pregnant mothers.

Figures show a maternal mortality rate of 576 per 100,000 live births, the fourth-highest in the world. Each year about 262,000 babies die at birth, the world’s second-highest national total.

Infant mortality stands at 69 per 1,000 live births; deaths for under-fives are 128 per 1,000. More than half of the under-five deaths – 64% – result from malaria, pneumonia or diarrhoea. Investment in this sector has been high in recent years although the proportion of patients able to access appropriate treatment remains low.

 SHETTIMA LAWAN MONGUNO