Birth Control

By Engr. Khalilah Yahya Aliyu 

September was the month dedicated to raising awareness of various medical conditions, among them hydrocephalus, which is commemorated in the United States on the 20th. This article was meant to have been published as my contribution to this course, but you will have to forgive me. The pen became too heavy for me to write as it required revisiting emotional wounds and acknowledging future fears.

I am a mum to a vibrant two-year-old blessed with this little-known condition–Hydrocephalus. Or so I thought, until I had him and realised hydrocephalus has quietly existed around us all along. During my final ultrasound before delivery, I curiously read the note from my OB-GYN: “mild ventricular dilatation.” At the time, “dilatation” only meant one thing to me, which was that my body was preparing to bring my baby into the world. What caught my attention, though, was how different this report was from the one I received during my first pregnancy.

As soon as I got home, I turned to Google: “What is mild ventricular dilatation in a foetus?” I learned it’s also called ventriculomegaly. It is a condition characterised by enlarged ventricles (fluid-filled spaces in the brain). The diagnosis was mild, and I read that it might normalise. I was still advised to watch for signs like visible veins on the scalp, projectile vomiting, and a rapid increase in head size.

Let me take you back a bit. Hydrocephalus, in direct translation from Greek, means ‘hydro’ (water) and ‘cephalus’ (head). Literally speaking, “water in the head”. But it’s not just any water. It’s cerebrospinal fluid (CSF). While CSF is essential, an excess of it leads to hydrocephalus.

Although some cases are congenital, it is critical to note that hydrocephalus can be acquired either due to old age or blunt trauma to the head. The case that scared me to my bones was when we were researching for a registered Medtronic vendor to purchase Ja’far’s shunt. We heard about a ten-year-old whose head accidentally hit a wall. The trauma distorted the flow of CSF, and he was not diagnosed on time till he nearly lost his mobility and sight. The shunt surgery restored his health.

I gave birth via emergency C-section after a prolonged labour. The first thing I checked when I held my baby was his head. It looked normal, covered in a full mass of hair. I couldn’t even see his scalp. Due to the labour complications, we stayed in the hospital longer. On the second day, neonatal jaundice set in, and my baby was admitted to the Intensive Care Baby Unit (ICBU). By the third day, I noticed something unusual. He vomited after every feed, and not just regular spit-up. It was forceful, the typical definition of projectile vomiting. I informed the paediatrician, who advised smaller, more frequent feeds. I followed the advice, but the vomiting persisted. Luckily for us, he had a voracious appetite, and after each episode, he’d eagerly refill his tummy.

We were discharged after 10 days. Grandma gave him his first haircut, and that’s when we noticed the intricate network of veins on his scalp. Visitors had all sorts of suggestions, from saffron oil to headache “ciwon kai” remedies. But deep down, I knew what it was. I anxiously waited for the final symptom to appear. Within days, his head began to enlarge, and his fontanelle (Madiga) wasn’t pulsating as it should. The vomiting continued. I turned to my husband and said solemnly, “Baby Ja’far needs urgent medical attention.” Grandma agreed. I trusted my instincts, and kudos to my husband, family, and friends for providing me with the strength to keep hope alive. They left no stone unturned to make this trial bearable.

At precisely one month old, we took him to Aminu Kano Teaching Hospital. We first saw a paediatrician at the GOPD, who ordered a scan, and my fears were confirmed. He has Dandy Walker Syndrome (DWS), which has led to excess fluid buildup in his head. I cried. Yes, I did. But I was also hopeful because I had read that early intervention could improve his chances of living an everyday life. We were given a medicine, Acetazolamide, that must be compounded to suit a child’s dosage. The medication is to reduce cerebrospinal fluid (CSF) production and help manage intracranial pressure. We were then transferred to the Neurosurgical Department, where we met the neurosurgeons on their clinic day, a Wednesday. A strike by resident doctors worked in our favour, allowing Ja’far to be seen directly by a consultant neurosurgeon. 

I mentioned how warm his head felt, and the consultant reassured me it wasn’t related to hydrocephalus. “He’s like any other baby,” he said. “He can have a fever”. That was the beginning of our journey. I was frantic. I just wanted him treated quickly to relieve the cranial pressure. He needed brain surgery to insert a shunt that would regulate the CSF flow. Delays could cause irreversible damage. The medical team was dedicated and compassionate, particularly the doctors. He had the surgery successfully at two months old, and we watched him ace his developmental milestones. We celebrated his second shunt anniversary on June 19, 2025.

After Ja’far’s diagnosis, my curiosity deepened. I consumed every piece of literature I could find related to hydrocephalus. Wednesdays became my learning days, not just from the doctors but from fellow patients and caregivers. I remember overhearing a professor of neurosurgery advising a mother of another shunted warrior: “You and your partner should properly plan subsequent pregnancies. Gone are the days of ‘just taking in'”. He emphasised starting folic acid six months before conception, staying healthy, and avoiding harmful practices. And of course, make prayer your closest ally as you follow the healthiest regimen possible. Take your child to the hospital because even with limited resources, our healthcare workers continue to perform wonders, saving lives every day. They are our true heroes. 

It is pertinent to add, though solemn, that a shunt is a foreign body and can be prone to infection, blockage or malfunction. You must be alert; should you observe the slightest recurrence of any of the pre-surgery symptoms, hasten to the hospital for proper diagnosis. The doctors often reassure us that milestones might be delayed for our warriors. Still, with the appropriate care, they accomplish them over time. Seeing the scars where the shunt is placed, be it the catheter or the pump, and knowing that it is going to be there for life, can be heartbreaking. But I have learned to overcome this feeling by viewing it as a lifesaver because without it, you might not even be able to hold your bundle of joy. Brace up, not everyone’s journey is the same, but be ready for bumps. They can come in the form of incessant headaches, seizures or double incontinence.

I cannot conclude without a strong plea to the government. Congenital diseases are rare. Ja’far’s DWS, for example, ranges from 1 in 10,000 to 35,000 live births. Setting aside funds that low-income parents can access to cover medical expenses will go a long way toward improving our warriors’ quality of life. Make the health sector more robust. Map out a lasting plan to eradicate strikes. It might have worked in our favour, but it has also stalled the needed intervention for some of our warriors, leading to irreversible brain damage. Mandatory, accessible antenatal care, overseen by qualified medical practitioners, will help preserve the rarity of these conditions.

To all my fellow hydro mums, be grateful to the Almighty for the gift and celebrate your little warriors. Whether it’s an inch or a milestone, every step is worth celebrating. Also, you are not alone. We have a community, and we’re here to support one another, always. To everyone who stood by us throughout this journey, I want to say thank you. Where could we have found the strength to carry on without you?

Engr. Khalilah Yahya Aliyu wrote via khalilah20@gmail.com.

By Maryam Ahmad

An Indonesian province is offering cash rewards to men who undergo vasectomy procedures, in a bold effort to slow the country’s rapid population growth, The Star reports.

As part of a government-backed family planning campaign, local health authorities say the initiative aims to promote shared responsibility in reproductive health. Men who voluntarily get the procedure will receive a financial incentive, though the exact amount has not been publicly disclosed.

“We want to raise awareness that family planning is not just a woman’s burden,” a provincial health official told The Star. “Men also have a role to play in managing population growth.”

With over 270 million people, Indonesia is the fourth most populous country in the world. Officials warn that continued population growth could strain resources, from healthcare to education and employment.

While some have praised the initiative as progressive, others have raised concerns about potential social pressure and the need for proper counselling to ensure informed consent. Authorities say all participants will receive thorough medical guidance before proceeding.

The program is currently being rolled out in selected areas and could expand if deemed effective.

By Zakari Abubakar

It is evident that whenever there is an upsurge in criminal activities in parts of northern Nigeria, a perennial debate usually rears its head among those interested in the root causes of the problem. This is understandable. Without identifying the cause of a problem, its solution may not be in the offing. Like virtually every year, this debate is also gaining traction in this early part of 2022.

Admittedly, this view adds to the existing number of discussions on this topic. Those who are following the debates are not unaware that there are a group of people who link the rise in criminal activities in the north and the rate of excruciating poverty among its people, mainly to the large number of children born in virtually every family in the region. This group of people base their argument SOLELY on the superficial and generalised assumption that people with a large number of children, more often, engage in irresponsible parenting.

Another reason why this group of people see an individual with a large number of children as a potential source of criminality and economic stagnation is that Nigerian authorities have for long been finding it difficult to provide social services such as education, electricity and other life essentials to these growing number of citizens which leads to more people becoming poor. This is where I find their argument too simplistic. Because the same authorities are providing these services to themselves, their families or their cronies.

Going back to their first argument, it is glaringly verifiable that for every individual with many children who fail to cater for them, hundreds, if not thousands, bore many children and saw to their responsible upbringing. This example is on the level of individuals. There are many more such examples on the societal level. For instance, several countries and regions of the world have nearly the same population as northern Nigeria or are more populous but are not facing the same challenges.

Those societies have considered such a phenomenon as a gift and therefore utilise it positively. To buttress this point, the five most populous countries in 2021, according to sources, are China, India, the United States, Indonesia, and Pakistan. Although these countries may be facing their security and economic challenges, the standard of living in those societies is by far more robust than what is obtainable in northern Nigeria.

To cite a specific example: about 90% of China’s population is Han Chinese. They are over a billion people, yet, there is no accusation from the rest of the population in that country or the Hans themselves that the Hans are a potential source of poverty or criminality. Similarly, the most populous state in India is Uttar Pradesh, with over 200 million inhabitants. But go to India. How does Uttar Pradesh fare compared to the rest of Indian territories in terms of economic prosperity?

No one is disputing that northern Nigeria is recently replete with a high rate of criminality occasioned by poverty among its growing population. But to solely link this problem with the region’s birth rate is to accord the topic attention that is less than it badly desires. For example, what about the other seemingly systemic problems that have to do with governance and political leadership?

One may say, why do people resort to adding problems for themselves by producing more children since the government failed to sustain their needs? Then I would say, instead of blaming those who fail to provide those essentials (though they are providing them for themselves and their families), we resort to blaming the poor, despite his effort to always get himself out of the effects of poor/bad political leadership?

Elsewhere, other regions of the world are complaining of a decline in their population. Thus, they outsource other remedies for their problems, like encouraging men and women to engage in economic activities. Therefore, no matter how small, we should demand accountability from our political leaders and seek other possible options that are more viable than resorting to birth control, which has its implication on man’s overall health.

Zakari Abubakar is with the Department of Physical and Health Education, Aminu Saleh College of Education, Azare. He can be contacted via zakariabubakarnng@gmail.com.