If there is anywhere that epitomizes the parlous state of healthcare facilities in Nigeria, it is the South East geo-political zone. In the region made up five states – Abia, Anambra, Ebonyi, Enugu and Imo, it’s a nightmare for citizens to access healthcare as most healthcare projects exist on paper or at best abandoned. The Daily Times investigation also found that drugs in most healthcare centres in most state in the South East are expired. Here are snippets…
Obollo Ile and Ofiambela…as home of ‘ghost projects’
After asking at least 10 different people at Obollo Afor, the headquarters of Udenu Local Government Area, about the location of Obollo Ile, there was still no clue. Everyone claimed there was only Obollo Eke and Obollo Etiti communities in the local council but records of uncompleted primary healthcare centres across Nigeria obtained from by our correspondent from the National Primary Health Care Development Agency (NPHCDA) mentioned a certain Obollo Ile.
“Oga, na Obollo Eke you dey go,” said the driver who convinced our correspondent to board his bus from Obollo Afor market. “We no get anywhere wey be Obollo Ile here, na Obollo Eke and I go carry you reach there.”
So, all of them insisted the place is Obollo Eke village. Therefore, the journey in a bus returning from the market to the village was inevitable.
All signposts by the roadside say Obollo Eke; could it be a typographical error in the record that says Obollo Ile? Maybe. But the village is not the subject of the ultimate search, rather an uncompleted primary healthcare facility awarded in 2005 by the Federal Government. And, according to information made available by NPHCDA, the project is located at Obollo Ile, Udenu Local Government in Enugu State. It was awarded to Abduk Nigeria Limited at the sum of N19.1 million. But 12 years after the contract award, there is still no trace of the project.
After another 20 minutes’ trek from the main road through erosion-ravaged road that leads to Obollo Eke Market Square, there stands in the bush a signpost that reads: ‘Early Child Bed Clinic’ — an old healthcare centre with pre-independence buildings looking recently painted but almost taken over by weeds.
No water, no light in Udenu Local Council health centre
“This clinic was built before independence,” according to a very courteous Ogbonna Bibiana, the officer in-charge of the clinic, while responding to a question on whether it is the one awarded by Federal Government in 2005.
“And this place is Obollo Eke, not Obollo Ile; in fact, there is no village like that here,” she quips, leading her guest to one of the empty hospital wards with scanty beds.
Bibiana could not have been wrong; there is nothing at the health centre to suggest it was constructed about 12 years ago. The facility does not have the look of a model primary healthcare centre. It has no source of water.
“We rely on rain and stream water here because we don’t have well or a borehole,” she says, and there is no electricity; kerosene lantern and torch are what they use at night even if there are women in labour to attend to.
What looks like a toilet project in the premises of the clinic is an abandoned pit said to have been started and abandoned by UNICEF.
The only latrine there is a filled pit at the health centre which also serves as placenta pit.
“UNICEF said they were constructing toilets and providing water,” she said. “They just dug and left more than a month ago.”
In a community with a high number of local birth attendants, the clinic is not a choice for many pregnant women despite the risks involved. There is no doctor at the government healthcare facility, the real reason most men in the village discourage their pregnant wives from seeking care at the centre.
“Pregnant women don’t even patronise the centre due to a lack of facilities and manpower. We have no doctor; we are only community extension workers,” according to Bibiana, who is a Principal Health Extension Worker.
Showing apparent neglect by the local authority, the Early Child Clinic itself is a source of diseases, with offensive odour oozing from two filled pit latrines.
“We don’t have placenta pit; the latrines also serve as placenta pits,” she revealed. When both the workers and patients want to defecate, we make use of the bush.”
And just behind the hospital building were disposed syringes and needles and other wastes from the centre, in a small carton. The beds are broken down and covered by dust, while the compound has been overtaken by cassava and maize farm owned by Bibiana’s family.
Despite all these, some villagers still patronise the healthcare centre, albeit with reservations. Mamah Everestus, a community leader, who brought his daughter for malaria treatment that morning, lamented the condition of the centre.
“Government is supposed to fund the health centre well; no water, no generator, no toilet, no placenta pit, no drugs,” he fumed. “They are supposed to see what the people in the community are suffering and all of them are eating in Abuja. Look at grasses in a health centre, no worker to cut the grasses.”
But where is Obollo Ile? She suggested it might be the new health centre at Obollo Ishielu or a village called Amutenyi. “It may be at Amutenyi because that is where they have a new health centre.”
A ride on a bike from Obollo Eke market square to Obollo Ishielu revealed another health centre, newly built but under lock and key even at 10am. It was constructed in 2015 under the Millennium Development Goals (MDGs) projects.
There was no one around. Residents, including Bibiana, claim that the centre was giving free drugs to villagers when it was newly opened, which was one major reason pregnant women chose it over the Early Childhood Clinic. However, it does not open until 10am.
With Ekwueme Silas, Head of the Department of Health, away in Enugu attending a workshop, no one was willing to speak. Others claimed they had no permission to talk. Those who volunteered to speak anonymously said there was no village as Obollo Ile.
But when Silas spoke through a telephone conversation, he said there might be a mistake in the spelling of the name of the community. Though he added there have been rumours about an abandoned healthcare project in the local area council.
“…People used to say there is an abandoned project somewhere,” he said. “But I have not come across such a project since 2016 when I assumed office.
“I have not been able to understand the particular community…Obollo and then gini? Yes, there is Obollo Eke, Obollo Etiti and Obollo Ishielu, probably because you may have gotten the name wrong but we have Obollo-Oye. It’s like Obollo-Oye you want to call.”
When he was told that what is in the record of NPHCDA is Obollo-Ile, Silas replied, “There is no place like that.”
Could it be that the Federal Government awarded a N19 million ghost project? So it seems.
Udenu Local Government in Enugu State is not the only place where a funded Model Primary Healthcare project is untraceable in South East Nigeria. Elsewhere in Ukwa West Local Government, Abia State, another N16 million Model Primary Healthcare project awarded in 2004 to Emjec Nigeria Limited could not be found.
According to a record of uncompleted primary healthcare centres across the country obtained by the Public and Private Development Centre (PPDC), a non-governmental organisation, from NPHCDA, and made available to The Daily Times, the project is located at Ofiambela in Ukwa East Local Government, Abia State.
After more than two hours searching through Obeaku Village, Ohambelle (the supposed Ofiambella) and back to Ukwa West Local Government secretariat, it became clear that there is nowhere known as Ofiambella, and this is just as there is no uncompleted model primary healthcare centre in the village. Did the Federal Government again award a ghost project in a ghost community?
An existing health centre on the main road of Ohambelle, constructed by Adolphus Wabara, a former Senate President, during his second tenure as the local government chairman of Ukwa West in 1998, is begging for repair.
“We don’t have a Federal Government constructed primary healthcare here in Ohambelle,” says Florence Ekeke, who works at Ohambelle Health Centre.
Ngozi Emeka, Head of Health Department at the local council secretariat, confirmed the non-existence of such a project, stressing: “We have 33 healthcare centres in this local government but we don’t have any project in Ohambelle that is under construction or that is uncompleted. Even the one in that community is dilapidated. To the best of my knowledge, there is none like what you are looking for.”
Like Obollo-Ile, Ofiambella, from all indications, appears to be a ghost village with a ghost primary healthcare project that had been reported awarded by the government.
Expired drugs, leaking roofs… the dilapidated Amabokwu Health centre
Despite a fairly large turnout of nursing mothers, pregnant women and elderly citizens at the health centre that Wednesday morning, Okpe Martina, Principal Community Health Extension worker who heads Amaboku Healthcare Centre, Igbo Etiti Local Government in Enugu State, said it is hard to give up on attending to the health needs of the people, just that the tools to work with are decaying.
Ozor Raphael, a retired school teacher, was of the view that the entire community would be seen to have failed should the health centre be closed down despite its precarious situation.
It has 14 bed spaces, though all are dusty. Amabokwu Health Centre, awarded in 2004 at the cost of N16, 540,331.49 has fallen in standard both in infrastructure and personnel. Showing apparent signs of neglect by the relevant authorities, the health centre is an example of failure of government to treat primary healthcare as the cornerstone of a stronger and resilient public health system.
The laboratory at the centre does not work because of lack of manpower to manage it; a doctor comes from Nsukka twice a week and any other time else there is an emergency.
There ought to be resident doctors at the clinic but the residential apartment constructed for that purpose in 2013 under MDGs project is still uncompleted. Four years after, the building remains without windows and doors — an example of disconnect between government policymaking and implementation.
With falling ceiling, leaking roofs, expired drugs, power outage, Amaboku Primary Healthcare Centre needs rehabilitation. Disconnected by the electricity distribution company for the past eight years, the local authorities could not raise N30, 000 said to be the centre’s debt.
“If we have money, we buy fuel to power the generator, but if we don’t have, we use lantern at night,” she reveals.
Despite an application to the local government authority by Martina in May 2017 requesting for renovation of the only public health institution in the village, nothing has been. Due to the leaking roofs, the centre is flooded each time it rains. Even the room that serves as drug store ends up waterlogged.
“We need help for this place, you are seeing water because it is rainy season. Once it is dry season, we don’t have water; we buy water to flush toilets or go into the bush,” says Martina.
The local government health secretary could not be reached; she was also in Enugu attending a week-long workshop.
Expired drugs on the shelves at the centre.
Covered in the dust were drugs that have already expired…their manufacture and expiry dates read 2005 to 2008. Next to drug shelves is a microscope with obsolete lens. Martina says the drugs were already expired at the time of supply just as the microscope has never worked since it was supplied.
Why are the drugs still being kept on the shelves? Martina said only personnel of National Agency for Foods, Drugs, Administration and Control (NAFDAC) is empowered to remove the drugs and dispose of them.
Evidently, the Federal Government, through the NPHCDA, does not follow through many of the contracts awarded for the construction of the healthcare centres.
The solar panel installed to provide alternative energy for the centre since its commission has never worked. It was abandoned in a corner under the cover of darkness and taken over by dust and cobwebs.
The same goes for the water reservoir, which was not well constructed, according to workers at the facility. Thus, it leaks and cannot hold water. Toilets are filled with unflushed defecation. Workers and visitors at the centre rush into the bush when nature calls. The hospital windows are without mosquito nets.
This is despite the first global healthcare ranking report that placed Nigeria at 140th position with 51 points on Healthcare Access and Quality Index. The ranking is based on a quantification of personal access and quality for 195 countries and territories from 1990 to 2015.
According to the study, published in the May 18, 2017 edition of the medical journal, the Lancet, Nigeria lagged far behind other leading African nations in a new global healthcare report. Nigeria couldn’t have fared better with all these indices.
The United Nations Children Fund (UNICEF) says, “Every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world.”
With health centres like Amaboku’s, child and maternal mortality would no doubt be on the rise in the country.
Abandoned Eititi Oma Nkporo health centre
The people of Etiti Oma Nkporo, in Ohafia Local Government of Abia State, are still waiting for mother luck to smile on them so that they may enjoy the dividends of democracy. They are yet to feel the real presence of both the federal and state governments – there are no good roads to the community and there are no good healthcare facilities.
Despite being the community of Ude Oko Chukwu, the current Deputy Governor of the state, Etiti Oma Nkporo, the largest of the eight communities in the locality, has been struggling to see the completion of an abandoned primary healthcare centre awarded more than 10 years ago. They are still hoping for an intervention from the Federal Government, after the contractor, Masta Services Nigeria Limited, abandoned the project.
Awarded at the cost of N17million by the Federal Government to Masta Services Limited in 2004 when 120 of such were approved for construction nationwide, what is supposed to be a model primary health centre at the village is now home to lunatics, drug addicts and urchins who have also turned it to their toilet. Sitting on an expansive plot of land and looking over the palatial house of the Deputy Governor, the building is roofed but has no windows and doors.
“For over 10 years, that project has been abandoned … and that has taken us back. We have lost the use of drugs. We have over a million naira worth of drugs sent to the community. Parts of the equipment are spoilt already,” says the Egwugwo of Amudu, Eze Innocent Ume.
“We don’t have road, we have worried the Federal Government to give us just a road. Our people say two legs are not good to be bad, but now we have five legs, none is good. We have five outlets leading outside, none is good. If somebody is sick before you carry him to Ohafia, at times you take Ikem to Igbere before you go to Ohafia. The other health centre does not have anything; no doctor, no laboratory. There is nothing there and we have been reporting to the local government authority.”
Has the community folded its arms over the abandoned projects and the health needs of the people? “No”, the monarch, said. The community development union has met with Senator Mao Ohuabunwa, the senator representing Abia North Senatorial District at the National Assembly, on the fate of the facility.
“About two weeks ago, our people, led by the chairman of Nkporo Development Union (NDU), went to Senator Mao to ask about the project. He told them that about N50million has been approved for the completion. He told the Chairman of Nkporo Development Union that the sum of N50million had been approved,” he said.
Ohuabunwa is also member of Senate Committee on Primary Health Care and Communicable Diseases.
The monarch confirmed that the lawmaker sponsored the project when he was a member of the House of Representatives between 1999 and 2007. But he doesn’t know the contractor handling the project.
Further findings by our correspondent, however, show that Masta Services Limited, the company handling the abandoned project, was registered with the Corporate Affairs Commission (CAC) in 1992, with one Ugo Ohuabunwa as its Managing Director and Chief Executive Officer. If Ugo Ohuabunwa is a relative of the Senator, it is a clear violation of the 2007 Procurement Act.
The lawmaker was unavailable for comments. Calls to his constituency telephone number were unanswered, while messages sent to the same number were not replied at press time.
Elsewhere in Okposi Umuoghara, Ezza North Local Government, in Ebonyi State, it is a tale of lamentation for parents who, after taking their sick children to the only healthcare centre in the area, cannot get them treated.
The malaria infected kids at Okposi Umuoghara health centre as well as their parents are usually disappointed at the centre, each time they go there for medical attention.
It is known as Comprehensive Health Centre, but nothing is as depleted and “uncomprehensive” as the facility. At 9am, no one is at the centre. But as soon as a lady steps down from a motorbike and unlocks the main entrance to what appears a town hall, parents with their kids come in droves. By 9:29am when a fat woman who would later turn out to be the officer in-charge of the centre climbs down from another bike, there are more than 10 children in the hall awaiting treatment.
On the day, seven children test positive to malaria. Their fate hangs in the balance, as there is no drug to treat them, except injection which, according to Peace Ohike, the officer in-charge of the centre, is the last resort.
Okoposi is ravaged by malaria; the centre records more than 40 cases daily. Yet, there are no drugs to treat them.
Nwane Virgilus, a father of four, was lately at the former development centre, now designated Pilot Model Health Centre by the state government with two of his children who are down with malaria. Victory Nwane, three years old, and Shedrach Nwane, five years old, looked pale and weak. Both, like Nweze Kosarachi (six) and Nweze Ifesinachi (five), rest on the wooden benches at the centre.
“Malaria is reigning here. It is a major challenge here. Many people burnt their mosquito nets when they were given during the governorship tenure of Elechi Martins, thinking it was a political gift. Now, we don’t have enough nets,” Ohike reluctantly said as she took the blood sample of a sick kid.
When women go into labour at night, lantern and torch come to the rescue as the centre was long disconnected from the power source due to an undisclosed amount of debt. The labour room that has no light is also where women for family planning insertion are attended to.
But while parents and their wards struggle to get healthcare at the former development centre, now Pilot Primary Centre in Okposi Umuoghara, the N21.9 million National Primary Healthcare Centre that ought to bring relief to people of the area wastes away under lock and key near Nwuomah Primary School.
Abandoned Okposi Umuoghara Health care centre project
It was awarded in 2014 and handled by Stephanie Michael Nigeria Limited. Overtaken by weeds, the well-painted and fenced facility from appearance could be ready for use. But the reason it has remained locked is not known. The contractor, Stephanie Michael Nigeria Limited, is apparently not registered, as it has no records with the CAC.
In a clear case of disconnect between politicians and their constituents, residents of Okposi Umuoghara do not even know that the facility is meant to serve them.
Even where the abandoned healthcare centre is located, nobody knows that it is meant to serve them. The construction signpost that should provide information about it was on the ground, taken over by weeds and used as food by termites feed on it.
Victoria Chinedu, a pregnant housewife whose house is adjacent the facility, does not know what the building is meant for. But for her antenatal care, she pays N50 for a tricycle ride to the development centre. “We go to the development centre for antenatal and immunisation,” she said.
According to her, she does not even know that the building almost opposite her house is meant to be a health centre.
After his kids were given injection instead of malaria drugs, a disappointed Virgilus said that many people in the community thought the abandoned primary healthcare centre was a political project sponsored by Peter Edeh, a former member of House Representatives representing Ezza North and Ishielu Federal Constituency. Yes, it is actually a constituency project. However, since he lost his re-election bid, the project has been neglected.
“We don’t know that place is a primary health centre,” he says. “We only know that Honourable Peter is the one behind it.
Like Okposi, like Nkalaha
At Nkalaha, Ishielu Local Government, Ebonyi State, nursing mothers such as Ada Ugochukwu prefer to take their babies or themselves to Amofun Community in distant Enugu State. Holding her sick son to her chest and trying to maneuver her way round the bad road, Ugochukwu said she was taking her son to Amofun for treatment because the health centre at Nkalaha has no doctor or qualified nurse.
Ugochukwu noted the bad road to Nkalaha health centre and non-availability of a doctor are the reasons she prefers hospital in Amofun, Enugu State.
They have enough reasons. From Gedegede village to Nkaleha, it is easier for a horse to pass the eye of a needle than for human beings to navigate the road to the village. It is deplorable. Then, a newly constructed model primary healthcare is also under lock and keys. It has been taken over by bushes.
The only primary healthcare centre serving the whole community exists just in name. It has no doctor; instead, it relies on stream water for treatment of patients. Pregnant women in the village make use of birth attendants when in labour rather than the centre, even if they had sought antenatal care there.
Ebe Rosemary, who heads the centre, said there is no visiting or resident doctor at the centre. The shelves are filled with expired drugs.
Speaking on why the centre has not been opened for public use, the contractor, Status Global Services Limited, who handled the N21.9 million project awarded in 2014, claims he used his personal money to undertake the project.
Daily Times News