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Grateful thanks are given to those Nigerians who took part in the writing of this article, either by giving interviews or reviewing the final text.
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Nigerians in Ireland speak frequently of the negative prejudice they receive based on their nationality. Nigerians are the largest African group in Ireland (approx. 20,000) reflecting to some extent the populous nature of Nigeria itself. The reasons for migration are varied. Many have applied for residency on the grounds of having an Irish born child. In these cases Nigerians will usually state that their aim is to improve their lives and in particular their children's lives. Howevere, many other Nigerians have applied to stay in Ireland under the asylum seeking process because they are fleeing genuine persecution that they have suffered in the ongoing unrest in Nigeria. However, all Nigerians seem to suffer from equal prejudice and many negative stories are circulated without regard for the fact that generalisations towards `Nigerians' disregards ethnic differences, and negates individual stories and experiences. Even in the health care setting this can lead to a lack of understanding and regard for individual life histories and personal needs. The following information should be used as a guide towards opening a dialogue with each Nigerian client rather than taken it as applicable to all Nigerians.
Nigeria is located on the West Coast of Africa, along the Gulf of Guinea. It is the most populous nation in Africa with over 120 million people. The country is a federal republic consisting of 37 states - 12 of which practice the strict Muslim law of Sharia. Nigeria was established as a nation at the time of its colonial occupation by Britain but its borders were set by colonial administrative rationale rather than on more appropriate ethnic divisions. As a result national unity has never prevailed over ethnic rivalries. Its geographical borders encompasses over 250 ethnic groups speaking many different languages and dialects. Unfortunately, hostility between many of these groups is widespread.
There are three main divisions in Nigeria - the north is dominated by the Hausas (21%) and Fulanis (9%) who are predominantly Muslim; the west is dominated by the Yorubas (21%) and the east by the Igbos, Calabar or Efik speaking people (18%). While members of each ethnic group are typically concentrated in one area many have migrated to urban areas, thus producing modern cities composed of mixed ethnic groups.
While Nigeria has experienced short periods of economic stability, relative peace and attempts at democracy, civil war, military rule, political insecurity and economic exploitation have dominated its chequered history. Currently, Nigeria has returned to civilian rule but inter-ethnic conflicts, repressive social controls and economic difficulties continue to plague the country.
The divisions between the rich and poor and correspondingly between the educated and illiterate in Nigeria is very pronounced. Privileged Nigerians receive excellent education up to third level while a vast number of Nigerians only receive basic primary school education and up to 32% have never attended school. As a result illiteracy rates are very high. The division between educated and inadequately educated Nigerians prevails in Nigerian communities abroad. Educated Nigerians are likely to have abandoned most traditional beliefs with regard to religion and health and will adapt more easily to Western medical systems. This will not be the case for most illiterate or inadequately educated Nigerians who still continue to adhere strongly to their traditional beliefs.
Although English is the official language, there are over 250 different languages spoken in Nigeria and the English spoken is often a pidgin form of English popularly called 'broken English'. The most widely spoken languages are Hausa, Yoruba, Ibo (Igbo) and Fulani. The use of voice tones is an integral aspect of communication for Nigerians. Therefore, high voice tones, while used during arguments do not necessarily equate with anger. High voice tones will also be used to discipline children. Nigerians will also use eye contact to discipline a child - winking is often used to convey a disciplinary message. It is customary for young Nigerians to bow (males) or kneel (females) as signs of respect before greeting elders. Eye to eye contact between young people and elders is considered to be disrespectful.
When interacting with the Irish, Nigerians usually are soft-spoken. However, in contrast to many other African cultures, there is a tendency among some Nigerians to be insistent about receiving services to which they feel entitled. This is because they are used to competing for limited services in Nigeria. They are usually extremely thankful for any service they subsequently receive.
Items should always be accepted and given with the right hand as extending the left hand is considered rude. Gifts can be accepted with both hands.
There is no state religion in Nigeria. About 50% of Nigerians are Muslims and 40% are Christians. Many other Nigerians practice the African Traditional Religion. Nigerians are often very strict about their religious practice and beliefs but the range of commitment, belief, and practice varies in each religion. While most people practice Islam or Christianity, many will still also engage in practices derived from indigenous (traditional) religions. These practices will usually include spirit and ancestor worship and will be based on tribal affiliations.
Despite promotion of contraception and family planning from the Nigerian government, natural and traditional methods of contraception are still preferred over barrier or artificial means. Contraceptive methods that are most commonly known about are the pill, the male condom and injectibles. 66% of men and 45% of women know that condoms can prevent AIDS/HIV infection. Strict adherence to religious guidelines and a high value that is placed on large families limit the more general use of contraceptives (8% of married women use modern contraceptives in Nigeria). However, contraception will usually be availed of by Nigerians in Ireland, with exceptions for those who do not believe they should ever use it (such as strict Catholics) or those who are not motivated to be concerned about unplanned pregnancies.
There is no official policy on abortions in Nigeria. Private abortions can be obtained and unsafe abortions are also prevalent. In Ireland, where abortion is not available, it will be more usual for Nigerian women to resort to drug taking and other practices to induce an abortion rather than to seek to have an abortion abroad.
Although Nigerians usually experience sex at a young age they may not have a similar education on anatomy as Irish women so it is important for health professionals to ensure that their patients understand about reproduction, basic anatomy and the mechanisms by which different contraceptives prevent conception, as well as STD transmission.
Mothers will usually avail of prenatal services (63%) at local health clinics in Nigeria but seldom within their first trimester. One of the aspects that Nigerian women find unusual in Ireland is the prohibition against the use of medication in pregnancy. It is not unusual that pregnant women in Nigeria would be allowed to take mild medications although strong medicines and antibiotics would beavoided. Nigerians in Ireland are invited to take a HIV test during pregnancy. Most expectant mothers welcome this intervention as it reassures them that their baby will be safe from the disease.
In Nigeria the majority of women in urban areas (75%) give birth in the hospital. However those in rural areas and less educated women tend to use traditional birthing methods or hospitals that are sub-standard while others give birth at home, usually with a birth attendant present, or with family members. Infant mortality rate is high (100 per 1,000 live births for the 1999-2003 period rising to 201 per 1,000 for infant mortality under 5 years of age). Nigerians who give birth in Ireland find the time of birth difficult, despite the reassurances of increased health care as they also miss their family and community support. The placenta is traditionally buried after birth in Nigeria so it is important for Health Service Providers to offer to return the placenta to Nigerian mothers. Caesarean births are seen to be unnatural and equate with failure on the part of the mother so there is strong aversion to the procedure but with careful explanations where it is needed it would usually be consented to. In some Nigerian communities mothers will eat very spicy `hot' foods after giving birth and will bathe in hot water immediately after the birth to prevent postnatal complications.
About 40% of women who give birth in Nigeria choose to receive postnatal care within two days of the birth of their child with about 60% receiving no postnatal care at all. Therefore, Nigerian mothers who have had no postnatal treatment in the past should not be expected to know the importance of postnatal care or the need to see a public health nurse for the heel prick test. Therefore all these should be explained in detail. Nigerian mothers may also often find the frequent visits from the public health nurse invasive and unnecessary.
Naming a child is an important aspect of Nigerian life. Nigerian children may receive different names from each of their extended relatives. Their full name will include all these acquired names followed by a Christian or Muslim name and lastly by their family/surname. The name subsequently used will be determined by the parents. This could be their traditional name or their Muslim/Christian name. Babies normally undergo the naming ceremony on the 7th or 8th day. As a practice of showing respect it is inappropriate to address someone by their first name unless they are your age equal or younger than you. If the person being addressed is elder or superior to you then their surname should be used.
Male children are circumcised at a very young age, preferably within the first 8 days after birth. This is usually combined with the naming ceremony. This can be a major problem in Ireland where the waiting time for a circumcision can be several months. Under these circumstances Nigerians may prefer to visit a traditional Nigerian expert in circumcision living in Ireland so that the circumcision can take place at the culturally appropriate time.
Approximately 20% of Nigerian women have undergone female genital cutting/circumcision (FGC) during infancy. However this figure belies the fact that 61% of Yorubas are circumcised and 45% of Igbos are circumcised. The practice of FGC in Nigeria is decreasing especially among urban women but in some areas it is still practiced enthusiastically despite attempts to eradicate it. These practices are maintained primarily by the women rather than men, 66% of whom believe that the practice should be stopped. The way in which patients and health care providers approach the practice of FGC can differ dramatically and may be a cause of misunderstanding and perceived cultural insensitivity. Many women view their circumcision as normal, and in fact, are initially surprised to discover that it is not performed in other parts of the world. Because they consider it normal and in some cases have no complaints - medical, psychological, or otherwise - these women find it irrelevant to have undue attention drawn to their circumcision. They also find it shocking to see that it is considered a crime. On the other hand 47% of Nigerian women have never experienced or perhaps heard of FGC and it can come as some surprise to them to be questioned about it by health service providers when they come to Ireland.
Breastfeeding for at least one year is the preferred practice for Nigerians (97%). However, many Nigerian mothers will not begin breastfeeding until at least 24 hours after the birth in the belief that colostrum is not good for the baby. Furthermore it is very common for Nigerian mothers to supplement breastfeeding with bottle feeding water after just 2-3 weeks. New mothers are supported by family and friends to take sufficient rest to enable her breastfeed successfully.
Nigerian children will usually be introduced to a traditional Nigerian diet that is high in fats. More traditionally minded persons view obesity as positive. Common staples include rice, yam and cassava. Meat, fish and vegetable stews are also popular. Pork is not eaten by Muslims.
About 33% of Nigerian children aged 12-23 months are fully vaccinated against BCG, measles, DPT and polio. 50% of infants are vaccinated against Polio. These are the lowest vaccination rates among African countries in which surveys have been conducted since 1998. Nigerian children who come to Ireland need to be assessed for vaccination treatment.
The entire community is expected to take part in a Nigerian child's upbringing. It is usual for any member of the adult community to discipline a child. Instilling respect for parents and other adults is very important. Keeping strong control over children is thought to be vital. It is the responsibility of mothers to bring up their children to be good. Therefore mothers are blamed when children misbehave or are bold or disrespectful. Many Nigerians view Irish childrearing practices as being too lax. Corporal punishment is considered to be an acceptable means of disciplining a child. It is usual for Nigerian children to stay with their parents or extended family and under their discipline until they are well into their twenties. Pre-marital sex for young daughters is disapproved of but evidence shows that pre-marital sex is becoming more widespread. Children are expected to take on family responsibilities as they grow up, such as caring for their younger siblings. Family responsibility also extends beyond the nuclear family to the extended family. For example, a mother's sister will take on extra responsibilities towards her nieces and nephews if she is in a position to do so. Parents sometimes choose spouses for their children when they come to a marriageable age but in most cases couples will choose one another .
In Nigeria, significant numbers of children do not get the opportunity to go beyond elementary school but at least 65% do receive some secondary education and the adult literacy rate in Nigeria is currently 68%. As a result of limited educational opportunities in the past there are a number of Nigerians in Ireland who have literacy problems. However, education is highly prized by Nigerians who live in Ireland as is taking part in sporting activities and young Nigerians and children of Nigerians study hard.
The elderly are traditionally cared for by their children and extended families. Nursing homes are rare and only serve elderly people who do not have families.
The death of an infant is treated differently to other deaths. Parents are prohibited from being involved in preparing the child for the funeral. They will, however, instruct extended family members about what they would like them to do. Migrants living away from family members can find this time extra traumatic.
Other death rites are determined largely by the person's religious and ethnic background. For example, the Igbo will not traditionally bury a person on the day they die unless the death has been caused by an accident. Muslims, however, will expect the person to be buried before nightfall on the day of their death.
A programme of events will be planned for each death and this will change according to the status of the deceased and availability of mourners. This will include where the burial will take place, where the wake will be held, what rites will be used and how long the mourning period will be. Pregnant women would normally not attend a wake or burial.
Suicide is seen as being unacceptable and a source of great shame for family members. Christians consider it to be a sin.
Rituals surrounding death can be very elaborate, especially for those who practice Traditional religions.
Gender relations in Nigeria have gone through vast changes in the recent past which has raised a number of social and family issues. Women in Nigeria have become increasingly vocal and active in asserting their rights in work, in business and in the home. 56% of married women are currently employed. There have also been changes to traditional marriage patterns, to practices such as FGC and to domestic arrangements. Divorce is becoming increasingly common especially in urban areas. These changes have met with some resistance from men and in particular from fathers and husbands.
Traditionally marriage often occurs at an early age (at least for females) and childbearing can also begin at an early age. Marriages involve all members of the two families. A brideprice is paid, and there are elaborate religious ceremonies. Polygamy is legal and practiced throughout Nigeria, but this practice is gradually decreasing. Wealthy and/or powerful men often have as many as six or seven wives (which exceeds the limit of four imposed by Islam). In urban areas, more and more people select their own partners and marriages across ethnic groups are becoming more common. The age of marriage is increasing amongst the more educated population, with most marriages occurring between the ages of 20 and 28.
Children are very important to Nigerian families. In Nigeria, families tend to live together in one village or area of a town. Extended families are very important in the lives of Nigerian people. Mothers are the primary care givers in the family, both to children and elderly parents, but they receive significant help and support from the extended family. Mothers-in-law often play an important role in family life. This traditional family structure is disrupted as a result of families moving from rural to urban areas. The absence of supportive extended families in Ireland can be a major cause of stress to most Nigerians. In most Nigerian families men are dominant and make most of the decisions. The typical Nigerian husband does not do household duties. However, it is becoming more common for wives to go into paid employment and decisions concerning the family and home are increasingly being made by both husband and wife together although usually the male will have the final say.
Wife beating is a practice that is common in Nigeria and is prevalent in Nigerian families in Ireland. 50% of women in Nigeria have suffered abuse at the hands of their husbands or fathers. There is only one refuge centre in Nigeria for women fleeing rape and violence. The state views violence as a domestic private matter rather than a human rights crime and wife beating of a non injurious nature is enshrined in Nigerian law. Violence against women is therefore considered normal in Nigerian communities. A survey in Nigeria shows that 60% of both men and women believe that there are occasions when it is justified for men to beat their wives. These justifications include the neglecting of children or going out without permission.
In Ireland it is more usual for Nigerian women to retain their maiden names after marriage but this is not the case in Nigeria. In Nigeria, women are typically addressed by their own chosen first name together with reference to their relationship to either their husband or their child (i.e. 'Joshua's mum')
Traditional cures are popular in Nigeria and many Nigerians will follow prescribed rituals to deal with illnesses. Witchcraft, voodoo or juju, and consultation with oracles are still very much practiced. Illness is often believed to be the result of breaking a taboo. Spirits are often believed to have caused an illness and the presence of a disease or an illness may be seen as a warning sign that there is an imbalance with either the natural or the spirit world. Traditional healers in Nigeria (sometimes called "surgeons") focus on maintaining a balance between the invisible world of the deities, ancestral spirits of good or evil, and beings inhabiting the "other" world.
Traditional (magic or spirit-oriented) healers are thought by some Nigerians to belong to a special species of human beings with mystical powers and attributes, including the ability to commune with the spirit world and seeing through walls. Traditional medicine is often preferred over modern health-care practices especially for culture-bound disorders such as "Ode Ori" (a disorder that includes a variety of somatic complaints, as well as symptoms of depression and anxiety). Many traditional remedies are preserved and passed on by families.
There also is widespread use of medicinal plants to treat illness in Nigeria. Studies of such plants, including those used for peptic ulcer, asthma, pain, and other problems show significant degrees of efficacy for many treatments. Other treatments, e.g., inducing vomiting or giving cow urine to treat upper respiratory infections, are harmful.
Modern-health care facilities are often sought only as a secondary source of care, when traditional methods of healing have failed by those who have strong beliefs in traditional medicine.
Among Nigerians in the West, these traditional beliefs seem to be less of an issue. Illness and health are seen as biomedical issues and treatment in clinics and hospitals is readily sought. However, some beliefs may remain; for example, one common belief among Nigerians is that epilepsy is a communicable disease, so persons with epilepsy are usually avoided. More dangerously, many poorly educated Nigerians believe that HIV/AIDS is transmitted by witchcraft or mosquito bites or by sharing food so care must be taken to make sure that those Nigerians are made aware of the facts.
Hospital appointments are not usually necessary in Nigeria. Queuing - and queue hopping - are the norm. Health clinics and hospitals in Nigeria are under resourced and have limited facilities. While consultations are free, hospital beds and medication are not. Nigerians who can afford it will go to private clinics for better care. Nigerians have reported that barriers to accessing health in Nigeria includes the inability to pay for treatment, the distance from the health service and in 10% of cases the inability to gain permission to receive treatment from husbands. Similar fears that might prevent access to treatment in Ireland need to be allayed.
Medication is used widely in Nigeria and Nigerians in Ireland find it strange when they are not offered medication as part of their treatment, especially while pregnant.
Hausa-Fulani: Found predominantly in the northern states of Sokoto, Katsina, Kano, Bauchi, and Kaduna. Most are Muslim with their culture being greatly influenced by their religion. Adult Hausa women will be secluded following Islamic law and Hausa men may have several wives. Children on the other hand enjoy considerable freedom and young girls will go to the market to sell goods because their mothers are not allowed to do so, thus exposing them to early responsibility and social pressure - including sexual pressure. Age-long Hausa traditions of testing manhood and the giving away young girls for marriage is still observed. Marriage as young as 12 or 13 for girls is common. The husbands may often be considerably older. It is normal for Hausa to marry 3-4 times over their lifetime as divorce is common.
Open sexuality and sexual exploration - usually termed sex-play - was traditional amongst pre-pubescent Hausa children but full pre-marital sex was emphatically discouraged. However, it did sometimes take place. In contrast to this open attitude to sexual practice there was often a taboo against discussing sexuality especially between parents and children. In the most severe cases of non-communication taboos a mother could not even acknowledge her own child and the child would be raised by their stepmothers. These practices are all now changing.
Muslim Hausa children have their heads shaved on the eighth day before undergoing a naming ceremony.
Yoruba: Found in southwestern Nigeria and most live in the states of Lagos, Ogun, Oyo, Ekiti, Ondo, Osun, Kwara, and part of Edo. Many are highly urbanized, but retain strong kinship bonds.
Traditionally, Yoruba children are named on the eighth day and this name should not be revealed to anyone until then. This is an important fact for maternity hospital staff to be aware of.
Mothers in Yoruba tradition are given special care for 30-40 days after giving birth and continuing support for a further 3 months.
Numbers are extremely symbolic for Yoruba.
Igbo (Ibo): Found in the southeast states of Anambra, Imo, Abia, part of Delta, and part of Cross River. The Igbo are known for their hard work and resourcefulness. Traditionally farmers, today a significant number of them have become traders. They are known to have a relaxed attitude toward their young children who are given plenty of free play time.
Edo: This group is found in Benin (Edo) state.
Ijaw: (also known as Zons): Found in the riverine areas of Ondo, Delta, and Rivers states. They are basically fishers with their home made on stilts over the water.
Ibibio: Found principally in mainland Akwa Ibom.
Kanuri: This group is found in Borno state. They have a long history and tradition as old as the Fulanis, but are found at the opposite end of the country.
Jukun: This group is known for being war-like and live primarily in Gongola and Benue states.
Nupes: Most live in the Niger State.
Note: There are many other smaller groups who are identified with either their tribal marks (scarring) or their mode of dressing. With modernization and intertribal marriage, many traditional ties and practices are changing or being lost.
This is a very good American site that describes traditional health seeking practices as well as giving useful facts (i.e. outlining prevalent diseases amongst the target community). It specifically looks at refugee populations and includes excellent links to other sections that give more detail on issues such as women and health, refugee experiences and health, infectious diseases etc. Recommended. ۞ ۞ ۞ ۞ ۞
This excellent report from Nigeria (available in PDF format given above) gives a helpful picture of the health status of Nigerians in 2003. It looks particularly at the health of women and children. ۞۞۞ ۞
This very readable Canadian site gives a short account of the county's geography, history, sports, arts, work, family and health. It is socially orientated rather than health focussed, as it is designed to initiate communication and integration between habitual Canadian residents and newly arrived immigrants. It will therefore not explain aspects of culture to a depth that some health care providers would need. However, it does offer avenues and ideas that could be used to open up a productive communication process between health care providers and clients that would lead to relevant information being exchanged. ۞ ۞ ۞
This reliable UNICEF site gives background information and health related statistics that could prove especially useful for health care providers who need to determine the health and social history of their clients. Some cultural information can also be deduced relatively easily from the statistical detail. There is an emphasis on children's and women's health due to UNICEF's focus on children. ۞ ۞
This site from the US Library of Congress presents an extensive volume on the country, but it is no longer up to date especially where statistical data is sought. However, it is easy to find sections on health and social topics which are very comprehensive. It gives the major diseases that affect the people and it outlines the classical medical services that are available. Although the volume is easy to navigate the writing is not very approachable. It is heavy on fact but gives no information on traditional medicine and cultural issues that could affect access to health. Use as a last resort and be aware that major changes will have taken place in the last two decades ۞
This BBC site will give you a brief overview of the current political situation in each country. This may help you to know what political situation your client may have left behind and what their relations are currently living with. It also gives a brief overview of statistics - population, religions, languages, life expectancy and exports. ۞
This site gives you basic facts and a map of each country. It gives basic demographic details that include religion, ethnicities, health risks, mortality rates etc. which may be useful, especially if comparative material is required. A short synopsis of the political situation in the country is included. ۞
In 2002 Access Ireland produced a directory aimed at assisting those who are working with refugees and asylum seekers. The directory opens with a comprehensive and valuable account aimed at improving cultural competency, especially in relation to health. Topics include: Intercultural communication; Developing inclusive, intercultural policies and service provision: Refugees health and well being. Also included are 5 cultural profiles relating to refugee communities in Ireland (Angola, DRC, Nigeria, Roma, and Romania) Unfortunately they are not available on their website but the directory can be obtained from the above address. ۞ ۞ ۞۞
This is an excellent thesis on Nigerian childrearing practices that would help the more serious researcher to look further into the situation for Nigerians in Ireland, in particular mothers and children. ۞ ۞ ۞
SPIRASI does not necessarily agree with the facts and opinions presented in this guide or any linked websites.
This Cultural Profiles web-site was designed to be fully compliant with modern standards for web publication (as specified by the W3C). The pages will be accessible and readable on any display using any web browser, old or new.