In a remote part of the Federal Capital Territory, (FCT), Abuja is Wassa, a community not far from Waru in Apo district of the Abuja Municipal Area Council (AMAC).
The community houses some Abuja residents living in dilapidated structures, rusted zinc houses and accommodation unbefitting humans. Among those in these scant shelters lacking electricity and clean water are the Gbagyis, often described as the original inhabitants of the FCT.
There is also a large population of Internally Displaced Persons (IDPs) in Wassa Refuge Camp of the FCT. They are persons displaced from Borno, Taraba and Adamawa states as a result of the insurgency in their states, which forced them to leave their homes unplanned.
The Wassa Refugee Camp now provides the IDPs respite from attacks. For many of the inmates, who are now orphans, widows, and widowers, indecent accommodation and poor healthcare are some of the challenges they grapple with. The only health centre available to the residents is housed in a container, the community’s makeshift Primary Healthcare Centre, servicing a large population of the community, who cannot afford to patronise private health facilities.
Of note, however, was that at a point, the PHC provided the much needed first aid to the IDPs. While some residents including IDPs at some points in the past stopped visiting the health centre for care, some others who continued to use the facility were forced to discontinue visiting because whenever they visited, there were no drugs and other supplies. Thereafter, the health centre was closed, denying residents any access to public healthcare.
As a result, all the residents are left with the option of visiting private health facilities that are several kilometres away from Wassa.
Sharing her experience, one of the IDPs, Aisha Ali, a mother, has lost two of her children consecutively after each birth due to lack of health facility within the community. She, however, said it is share luck that the baby she is nursing is alive.
She said with no Primary Healthcare Centre (PHC) in the community to attend to residents, and the inability to pay for healthcare in a private hospital during pregnancy, delivery and after delivery have left many women in dire situations, especially pregnant women and newborns.
“I really cannot count the number of pregnant women, who have lost their lives and or their babies, because of lack of access to healthcare facility.”
Meanwhile, of the N579.69b allocated for the running of the FCT in the 2023 national budget, N36.9b was earmarked for the health sector, N52b for education, N11b for the environment and N8.9b for water sector among other allocations.
While the breakdown of the health budget for the area councils were not available, efforts to reach the FCT health secretary yielded little result as the reporter was told to write a letter to the FCT administration before the information is made public.
Speaking on the deplorable state of some health facilities in FCT, especially the hard to reach areas like Kwali and Kuje area councils, State Program Officer of the Civil Society in Malaria Control, Immunization and Nutrition, FCT, Samuel Simon, said as far as the FCT is concerned, access to healthcare is a work in progress, because PHCs in the FCT fall short in delivery to the people, especially for consumables such as drugs, and medical equipment.
Acknowledging women as the key population seeking services in PHCs, he said: “There are some facilities you walk into; there are no health personnel to attend to patients. Hence, it is important to advocate for more health personnel in such facilities. There are still facilities with poor infrastructure,” he said.
He added that some facilities grapple with insecurity, which obstructs their operations, noting that a community with a good public health facility, but due to insecurity, the centre only operates for few hours. He cited Dafa, Pai and Yangoji communities in Kwali Council Area.
“Some primary health facilities are threatened by the insecurity in the country. It could be a very good facility but you cannot stay longer than a particular time in that community otherwise you stand to be kidnapped.
Another insecure place in Kwali is Pai. Pai is a community some kilometers off the road. That place is also not safe.
“In places like Kuje, there is a community called Dahara, where the health facility is dilapidated. The ceiling of the Out Patient Department (OPD) has partially pulled off and could fall on a visiting pregnant woman.
“If you go to places like Kuchigoro along airport road, the facility is good and well positioned, but battling with shortage of space for the large number of patients visiting. They have ample health personnel, but need more space to accommodate the number of people visiting.”
Simon added that the health facility in Jikwoyi, Nyaya axis is in a sorry state as the facility’s soak-away has collapse aside it is very close to the community’s refuse dump, which constantly emit foul smell.
In Kuchibuyi PHC of Sabongari, Bwari Area Council, Mrs. Mercy Amos, who is six months pregnant, sat on one of the many long benches for expectant women on antenatal visit alongside others on similar mission.
In a brief exchange with the reporter, Amos disclosed that the centre is the major public health facility for residents of Sabongari, Tudun Fulani, Old Soldier’s quarters, Pwoyi, Guto, and Kuchibuyi villages among others.
She noted that the personnel available at the centre are not doing badly, but there are usually no personnel to attend to patients at night, including pregnant mothers. “Bwari General Hospital is the option to this PHC, but it is too far for me and many others,” she said.
The reporter arrived the primary health centre some few minutes to 10:00 to join pregnant women on antenatal visits. The exercise did not start until about 10:30am.
But unlike the abandoned container used as PHC in Wassa, the facility in Sabongari, Bwari, is bigger, cleaner and much livelier even though it is located in a hard to reach area, accessed mainly by motorbikes dropping off patients.
The facility has a medium size patient waiting area, consulting room, injection room, laboratory room, and two toilets.
Recalling similar visit to the Dei-dei PHC, large number of women on antenatal visits were seen seated with only two nurses attending to them. The exercise lasted till late hours with the nurses looking tired and at some point snapping at the pregnant women.
One of the nurses, who spoke under anonymity, said the centre is short staffed; aside it is in dire need of expansion.
The Dei-dei health centre is located along the ever-busy Kubwa-Zuba expressway, a densely populated area littered with dirt, patches of green algae water and a busy market generating huge waste.
The Guardian once reported incident of deaths in the facility following Cholera outbreak.
Funding remains a challenge
The President of the Nigerian Academy of Medicine, (NAMed), Professor Samuel Ohaegbulum, once said: “It will be futile trying to improve primary healthcare, mother and child care or mental health, if funding is poor.”
He said the major barrier to Nigeria boosting access to affordable healthcare is poor funding. “We keep calling on the government to increase budget allocation and to at least fulfill the 2001 Abuja Declaration that recommended 15 percent of national budget going to the health sector.”
Commenting, Project Director, PACFaH@Scale, Mustapha Jumare, said the primary healthcare system in Nigeria requires a lot more work in terms of meeting basic standards and budgetary provisions.
“It will be difficult for the country to meet the target date of the Universal Health Coverage for some many reasons. The health budget is not being captured well, let alone the primary health care budget.”
Sharing her experience of helping women in her community deliver babies in the absence of health facility and personnel, Wassa IDP Camp Women Leader, Hafsat Haman, said: “I have helped deliver countless babies, because we cannot stand by, watch fellow women and their babies die due to the lack of health facility, personnel and money to go to private hospitals.
“We are therefore appealing to the AMAC authorities to send us another doctor because the available doctor left after a disagreement over medical supplies with the youth. Even the nurse has since left,” she said.
Pointing out the importance of gender accountability, inclusivity in governance the Gender Strategy Advancement International, (GSAI), in partnership with Open Society Initiative for West Africa, (OSIWA), said advocacy is key ensuring gender accountability, advancing women’s rights and holding government accountable for its actions.
While calling for greater transparency, accountability and inclusivity towards advancing the right of women and People Living with Disability, (PWDs), the Executive Director, GSAI, Adora Sydney-Jack, underscored the importance of promoting advocacy for gender friendly policies that amplify the voices of women and women with disabilities.
