At the break of dawn in Ilaje, a coastal town in Ondo State, the fish market comes alive before the sun begins its climb. Wooden canoes dock at the muddy banks, and the air quickly fills with the sharp scent of smoked fish and salty waves. Women—dozens of them—unload baskets, negotiate prices, and haul goods across water-logged jetties with practiced efficiency. They are the economic engine of the waterways, yet they remain invisible when it comes to the most basic human rights: healthcare, finance, and hygiene.
I have walked among these women. I have seen their strength, their hustle, and the quiet pain behind their eyes. These are the women of the water—the fish traders, processors, and hawkers whose lives are shaped by tides and trade, but whose needs are often drowned in silence.
The River is Their Road, But Not Their Right
In many riverine communities across Nigeria’s Niger Delta, including Mahin, Igbokoda, Awoye, and Aiyetoro, women dominate the fisheries value chain. They process fish by drying, smoking, or salting it; they paddle canoes to distant markets; they serve as middle agents between fishermen and consumers. Without them, the aquatic economy would collapse.
Yet despite their central role, most of these women have no access to basic health services.
Take Mama Ebun, a 42-year-old fish processor in Ugbo-Nla. She begins her day at 5 a.m., standing for hours over a firewood smoker, inhaling dense smoke that clings to her lungs and eyes. She often coughs, feels dizzy, and suffers frequent chest pains. But she has never seen a doctor. The nearest primary health center is across a lagoon and a two-hour paddle away.
“We only go there when it’s life or death,” she says. “And even then, we may not find anyone on duty.”
This is a familiar refrain. For most of these women, routine checkups are a luxury. Maternal health services are inconsistent. Screening for cervical or breast cancer is unheard of. When menstruating, many have no access to sanitary pads or clean toilets. During pregnancy, they work until their due date and return to fish smoking within days of delivery, often without postnatal care.
The Hidden Price of Labour
Fish trading is hard labor. The work involves lifting heavy loads, walking long distances through slippery banks, and standing for hours in smoky sheds or under the sun. These activities take a toll on women’s musculoskeletal health, respiratory systems, and reproductive well-being. Many suffer miscarriages due to strenuous work during early pregnancy. Others deal with chronic back pain or arthritis by the time they turn 40.
Yet these health consequences are rarely captured in public health data.
“No one counts us,” says Mummy Bisi, a fish vendor in Igbokoda. “We are not in government books, not in hospitals, not in any of their plans.”
She is not wrong. Health programs in coastal Nigeria often focus on children, infectious diseases, or malnutrition. Little attention is paid to occupational hazards faced by women who trade in fish and other water-based livelihoods.
Even community health volunteers admit they receive no specific training to address women in the fisheries sector. Most interventions are short-term and donor-driven, without community consultation or long-term sustainability.
Water, But No Sanitation
Ironically, in these communities surrounded by water, hygiene is a daily struggle. At fish markets in Ilaje and Okitipupa, there are no gender-sensitive toilets. Women squat in the bushes, wash with river water, and clean fish under unhygienic conditions. The lack of sanitary facilities affects their dignity, health, and income.
“When I’m on my period, I use old wrappers,” confides a teenage apprentice. “There’s nowhere to change. No one to ask.”
The risks are not just physical but social. Menstruating women are often stigmatized in traditional fishing communities. Without access to menstrual hygiene products, many girls drop out of fish processing work or school. Others develop infections that go untreated.
During the COVID-19 pandemic, handwashing stations were installed in some markets, but most have since been abandoned or broken. No efforts were made to include local women in maintaining them.
Financial Disconnection
Healthcare is not the only unmet need. Most of these women operate outside formal financial systems. They save money in wooden boxes, borrow from informal cooperatives, and depend on unstable daily earnings.
Without health insurance, any illness becomes a financial emergency. Without bank accounts, they cannot access microloans or government support programs. Without digital access, they are cut off from online training, e-commerce, and mobile health solutions.
When I asked a group of fish traders if they had ever used a mobile banking app, they laughed. “Where is the network?” one asked. “Even when we charge our phones, it’s only to receive calls. We are not your city people.”
This digital exclusion deepens their vulnerability. During illness, they must sell their goods at lower prices or take loans with steep interest. A single health emergency can wipe out months of earnings.
Seeds of Hope
Despite the hardship, hope persists.
In Orioke-Iwamimo, a small collective of women recently partnered with a local NGO to establish a mobile clinic that visits the fish market twice a month. They now get blood pressure checks, pregnancy screening, and health talks on hygiene. It is not enough, but it is a start.
Another group in Aiyetoro has launched a savings cooperative, pooling funds to cover emergencies and contribute to a group insurance plan. They are also lobbying the local government to build a gender-friendly market shed with toilets and solar lighting.
These efforts show that solutions exist—when women are included in the conversation.
What Must Change
If we are serious about equity, then we must recognize that fish traders are not just economic actors. They are mothers, caregivers, and frontline workers of the blue economy. Their health is a matter of national concern.
- Targeted Health Outreach: Government and NGOs must tailor mobile health programs to address the specific needs of female fish traders. This includes cervical cancer screening, respiratory care, and reproductive health services.
- WASH Infrastructure: Markets must have gender-sensitive toilets, clean water access, and menstrual hygiene products. These are not luxuries—they are human rights.
- Financial Inclusion: Access to mobile money, cooperatives, and credit schemes can help women manage health emergencies and grow their businesses.
- Occupational Health Research: More data is needed on the long-term health effects of fish trading. Without evidence, there can be no policy change.
- Inclusive Policy Design: Women in water-based livelihoods must be involved in designing policies that affect them. Nothing for them without them.
Women of the Water, Pillars of Survival
In every ripple along the creeks of Ilaje, you will find a woman’s story—of labor, resilience, and quiet sacrifice. These are not victims. They are visionaries. But even visionaries need care.
When we talk about universal health coverage, let us remember the women who work where the roads do not reach. When we speak of climate resilience, let us include those who smoke fish through storms and sell at markets even after floods. When we imagine a healthier, fairer Nigeria, let us start by asking: what about the women of the water?
Their silence is not consent. Their survival is not a strategy. Their needs are not invisible. They are simply ignored.
But no more.
