Unpaid salary, poor facilities affect health centres
Primary healthcare is suffering serious neglect in Enugu State. Investigations by The Guardian revealed that health workers in the local councils have not been paid for some time. While the immediate past elected council chairmen were said to have left four months salary arrears between September last year and January 4, this year when their tenure elapsed, those who were appointed after them were said to have not paid salaries. The development has crippled the primary healthcare centres as majority of the workers no longer go to work. Those who attempt to go at all have done so without commitment.
A visit to some of the health centres in the State showed that weeds have taken over the premises. Some of the buildings also have their roofs blown off. Doctors attached to the centres have absconded since last year.
At the Ikerike Health Centre in Enugu South, although the facility was commissioned on December 23, 2009 by the immediate past governor, Sullivan Chime, several parts of the building have become weather-beaten. Some roofs have been blown off resulting in the flooding of the wards. No patient was found there.
Of the 11 workers working at the centre, only two community health officers were on duty. It was disclosed that the only doctor working there absconded last year, while others no longer come to work because of non-payment of salary.
It was gathered that immunisation is the only thing that takes place at the centre presently. One of the workers, who spoke on condition of anonymity said they don’t have access to drugs, adding that except for a few women that come there for immunisation on Mondays, nothing else takes place here.
She said: “We still come to work because you cannot close the health centre. You cannot ask somebody whose salary has not been paid for months to continue to work for you. Since the present Transition Council chairman came into office, he has only paid salary once. We heard there was bailout fund from the federal government sometime, which Enugu state benefitted, but that money did not come to us because our salary has not been paid regularly.”
At Obeagu-Amechi healthcare centre, also built in 2009, the situation was the same. The unfenced premises is surrounded by thick forest. The only access road to the centre has been taken over by weeds and erosion. The building, though still new, is empty and gives no sense of a health centre.
The only female staff who sat on a small chair and table at the balcony of the building said: “ I am the only person here out of the eight of us. Our people have refused to come to work. I can’t go inside because any dangerous animal can move in here without my knowledge. You can see the bush here. There are no facilities here. We don’t have drugs, and we don’t attend to any emergency. There is no doctor here. It was very difficult for us to get malaria drugs from the Ministry of Health, so since then, nobody cared to go back there.”
When asked the number of patients they record daily, she said: “If you have a sick relative, will you agree to bring him or her to a place like this? We can have two or three on immunization days, but outside that, nobody comes here for anything. There is nothing that should bring anybody here in the first place. The surrounding is enough to scare anybody. So I don’t believe that we should be blamed but the authorities should be held liable. Let them come and make this place conducive for habitation”.
Another healthcare centre, Obeagu Cottage hospital, was under lock and key and surrounded also by over-grown weeds.
A native, Mrs Jane Ugwu, told The Guardian that they open once in a while, adding that the workers have not shown any commitment to work.
Asked whether she had visited the place for medication before now, she said: “ I don’t think they have anything doing. You can imagine a centre of this nature without doctors and facilities that can handle emergency. I think it is sad and something that should be looked into. If doctors are here, why will people not visit the centre and why will it continue to be under lock and key?
At Ngene Evo, the centre had been deserted for some time. Residents said the place was doing well until they started lacking drugs and their staff abandoned work.
State Commissioner for Health, Dr Simeon Ngwu, told The Guardian that the problem was being addressed by the State government adding that though primary healthcare was the responsibility of the local councils, the State government will not fold its arms.
“These are some of the problems the present government met on ground and they are being attended to.”
Also speaking, State Chairman of Association of Local Government Of Nigeria (ALGON), Cornelius Nnaji, said that paucity of funds had hindered the payment of salary to council workers. He, added, however that efforts were being made to address the issue.
ADAMAWA: Poor Bed Space, Absence Of Health Personnel Ground Farai Health Centre
Farai town is the traditional cultural centre of the Bachama kingdom located along Yola -Gombe road near Demsa the headquarters of Demsa council area of Adamawa State. Every April of each year, Farai plays host to both local and international tourists during the festival that is organised by the Bachama traditional ruler. The state government has been making millions of Naira from the Farai tourist festival every year as guest within and outside the country visit the place.
The pitiable condition of the only primary health centre in Farai is a confirmation that the Adamawa State government is only interested in making huge money from the town with a population of over 3000 native inhabitants who are poor farmers.
When The Guardian visited the health centre, it was nearly mistaken the place for an abandoned cemetery. The building, which is of the match-box size and built with local blocks, was more like a 17 year-old century graveyard.
When the reporter was directed back by a lady, he waited for close to an hour before a middle-aged woman, dark in complexion and wearing torn-clothes appeared with a dead broom and started sweeping the premises, which has the capacity to generate other killer diseases due to its filthy nature.
Mrs Helen Joshua, a health worker at the centre told The Guardian that there is no visiting medical doctor and pharmacist at the centre. According to her, they are only three health workers with one bed for admission of patients that are in critical condition, especially women who are in labour.
The centre, which has only one bed-space and two plastic chairs, has no drugs. There is are no equipment for either testing blood pressure or mini-laboratory for diagnosis.
She said that due to lack of space only two workers sat inside, while one sat outside because the space cannot contain three chairs at the same time.
“As you can see we have to carry one chair and put on top of another chair when we are closing, but if all of us are here one chair is kept outside for one of us and two inside. We have three bed-spaces, the space takes only one bed, so we keep the other two with mattresses in a private house until when the centre is expanded,”she said.
She said that patients do not come everyday because there are no drugs.
“They go to either Numan which is 15 kilometers away from Farai or those with serious cases go to Yola the state capital which is 50 kilometers away from Farai.”
The Guardian investigations revealed that this year six women in labour died in Farai before reaching Yola for medical attention. Cases of children dying as a result of either malaria or typhoid fever are rampant considering the fact that there is no private medicine store close to Farai for patients to buy prescribed drugs.
It was also gathered through the centre’s records that the last time a patient visited the place was in February this year. The records are indicative that patients in the area see the centre as a death trap for anyone that visits for treatment.
A community leader in Farai, Mr. Aruba Hayatu, who lamented the poor condition of the centre, disclosed that the little structure housing the centre was built more than 20 years ago through communal efforts, but till today government has not done anything to improve the standard of the centre.
“As for us people of this community we know there is no government in Adamawa State. They said that health is wealth, but the Adamawa government doesn’t want the people of Farai town to be wealthy people. That is why government refused to give us a good health centre that can take care of us,” he said.
Further investigations revealed that traditional medicine practitioners are making brisk business, as majority of the people that cannot afford to travel to Yola seek medical care from them.
The big question that Adamawa lawmakers especially Numan /Demsa constituencies need to ask government is what happened to the budget of Ministry of Health for the past 16 years?
What about the recent one billion Naira Governor Muhammed Jibrilla Bindow released to the 25 Adamawa State lawmakers for constituency projects. These questions if properly answered, would open a new chapter for the health sector in State.
Non-Payment Of Workers’ Salary Hampers Operation In Kogi
From John Akubo, Lokoja
Primary Health Care (PHC) being a local government sponsored medical service in Kogi State, has been at the receiving end since 2013 when the workers at that level have been receiving only 30 per cent of their salaries.
With the downturn in the economy the local councils have been having a herculean task meeting up with their obligation to their workforce.
A staff of one of the one of the health centres who spoke to The Guardian on condition of anonymity, said that since 2013 they have been receiving as low as 30 per cent salaries and in some cases lower.
However, he pointed out that with the emergence of Governor Yaya Bello in January this year they received 35 per cent in January and 30 per cent in February.
“Since then we have not received any other money for the past three months.”
Again the fact that services at the health centre such as family planning, ante-natal Care (ANC) malaria treatment, HIV screening and so on are mostly free, the provision of the necessary drugs has not been very regular and adequate.
When The Guardian visited the Child Welfare Health Centre in Ward B, the place was the shadow of what it used to be as turnout of patients was very poor, making the staff to idle away.
The fact that they rely on electricity without any alternative source of power was another snag because, for most part of the day, there was no electricity to carry out some simple tests.
The officer in charge, Kasim Ismaila said: “We carry out growth monitoring, family planning, ANC services and delivery.
According to him, in recent times, NYSC doctors were being posted to the centre but for sometime now they don’t have any doctor.
He identified the challenges facing the centre as shortage of staff. He said the centre needs renovation, adding that there are no enough drugs and clinical equipment.
Ismaila said there is a medical laboratory, but inadequate reagents for some other major tests apart from the Rapid Response Test, Malaria, HIV screening and ANC laboratory services.
He disclosed that treatment of typhoid fever is also free of charge at the centre.
The officer said they have an average of five to six patients daily because of its proximity to other health service providers.
The centre boasts of four nurses and one laboratory scientist with no pharmacist.
There is a cancer-screening laboratory, but there is not qualified staff to operate it.
One of the patients at the centre, Salamatu Ibrahim, who came for family planning, said she has been visiting the centre because of the fact that they don’t delay in attending to her children, adding that she was satisfied with their services.
At the New Layout Ward A Primary Health Care Centre there is very low turn out of patients. The workers lacked adequate motivation because they are being owed salaries for several months.
The officer in charge, Aisha Haruna, said the centre offers free ANC, family planning and routine immunisation for children, adding that they also treat out-patients.
For child delivery, she said it has been difficult at the centre because most women deliver in the night and they don’t run night shifts. She said the pregnant mothers come to the centre for antenatal, and at 36 weeks of pregnancy, they refer them to FMC or Specialist Hospital with their cards for delivery.
She said the centre has no laboratory but has one nurse, three community Health Extension workers, three junior workers and one medical recorder.
According to her there is a major drought in patient influx due to the availability of other health facilities unlike in the 90s when it was the only health facility within the vicinity.
‘If you ask them to pay the N100 they would say they don’t even have because they have not collected their salary for some months.”