Primary health centres in the country are on the verge of extinction with many of them not functioning, while others are dilapidated due to neglect by the state and local governments.
The PUNCH’s investigations in the six geopolitical zones across the country showed that the PHCs were bedevilled by a shortage of medical personnel, lack of drugs and poor environments.
Findings also revealed that many Nigerians indulged in self-medication by patronising neighbourhood patent medicine stores, herb sellers and alternative (traditional) medical practitioners who were poorly regulated. Others, our investigations revealed, patronised religious houses for faith healing. Due to these, many Nigerians die unnecessary deaths.
23 doctors manning over 800 PHCs in Oyo
In Oyo State for instance, investigations showed that because of an acute shortage of qualified health personnel, accessing health care in the over 800 PHCs in the state was increasingly becoming difficult.
It was gathered that there were only 23 medical doctors manning the PHCs in the 33 local governments and 35 local council development authorities of the state.
One of our correspondents, who monitored the development in Ibadan, the state capital, observed that a sizeable number of people opted for herbal medicine.
An officer in one of the PHCs in the city, who confided in one of our correspondents, said, “Ad hoc staff or auxiliary nurses are now in charge of many of our PHCs, due to the acute shortage of trained personnel in the state.”
This, he said, was because the last major recruitment for the PHCs was carried out during the late Bola Ige administration in the Second Republic.
The officer said many of such personnel had retired, while the few remaining ones would soon leave.
He stated, “The Egbeda Local Government here in Ibadan is among the councils without a single doctor in all its existing PHCs.”
The Executive Secretary, Oyo State PHC Board, Dr Lanre Abass, who confirmed the acute shortage of trained personnel, called for sustainable ways of providing drugs for the people.
He said, “In many places, the buildings need renovation because there are no electricity, water supply and even generators. We need to provide alternative sources of power like inverters and generators.
“As I speak with you, we are still closing down many of the existing 800 PHCs, in addition to the fact that many of the newly-created LCDAs have taken over health centres for administrative purposes.”
Abass attributed the increase in the patronage of traditional medical centres or herb sellers to cultural beliefs and the bad economy.
Ogun PHCs, dying of neglect and personnel shortage
In Ogun State, many of the PHCs at Itori, Egbado, Papalanto, Awowo, Obada-Oko, Igbin Ojo, Elere, Ibafo, Onigbedu, Asa-Yobo, Ajanbata, Wasinmi, Arigbajo, Ajegunle, and Olorunda, visited by one of our correspondents were in poor conditions.
A resident of Abule-Olomore, Jamiu Safiriyu, told The PUNCH that the health centre in the area had been closed down.
He added that a PHC at the Olomore Housing Estate in Abeokuta had been abandoned.
An indigene of Obada-Oko, a village on the outskirts of Abeokuta, Tunde Adesina, said, “I am not even sure if the centre has any doctor. The chief matron performs a doctor’s role. When you get to the health centre, you will be asked to go and buy drugs outside.”
But Governor Dapo Abiodun of the state said his administration would rehabilitate all the PHCs in 236 wards of the state .
He said his administration was planning to provide easy access to health.
Abiodun, who spoke through his Chief Press Secretary, Mr Kunle Somorin, said, “The governor will unfold how he will rehabilitate the PHCs in each of the 236 wards of the state using the local manpower.”
When asked how trado-medicine was being regulated in the state, the president of the state traditional healers association, Samson Soyoye, said, “We are being guided by the Ogun State Government Edit No 2 of 1990 under the supervision of state Ministry of Health.”
Enugu PHCs taken over by bush, snakes
In Enugu State, the PHCs visited by The PUNCH included the Ikirike Health Centre in the Enugu South LGA, Ogui New Layout Health Centre in the Enugu North LGA, the Amoji Nike Health Centre in the Enugu East LGA, the Abakpa Nike Health Centre in the Enugu East LGA and the Adama Health in Ikem Umu-Aram Community in the Isi-Uzo LGA.
One of our correspondents in Enugu State noticed that Ikirike, Amoji Nike and Adama health centres were in poor conditions.
It was discovered that those of Adama and Amoji Nike had been completely abandoned.
It was gathered that on several occasions, there were snake scares at the Ikiriki PHC. A worker, who confided in The PUNCH, said this often disturbed the personnel of the health centre.
Sources told The PUNCH that hoodlums had turned the centre to their hideout. It observed that the roof of one of the storey buildings in the health centre had been blown off by wind.
A member of staff, who spoke on condition of anonymity, said eight workers were posted to the centre, but only three of them had been coming to work regularly.
The PUNCH also observed that the Amoji Health Centre, which was built 18 years ago, had been abandoned.
Women patronise traditional birth attendants
A resident, Mrs Ogechukwu Oji, told one of our correspondents that due to the lack of a health centre in the community, pregnant women in the area resorted to the use of traditional birth attendants for child delivery.
According to her, politicians always come to the area during electioneering with a promise to complete the centre. She, however, lamented that the promise had not been fulfilled.
“Amoji women have been working tirelessly to complete the centre. You see the windows and doors have been fixed, thanks to the women of this community,” she said.
The traditional ruler of Ikem Umu-Aram autonomous community, Igwe Francis Okwor, told The PUNCH that lack of a functional health centre in Adama was affecting the community, adding that pregnant women and nursing mothers trekked over 20 to 30 kilometres to access medical care.
At the Ogui Health Centre, it was gathered that the PHC had one nurse, a midwife and two corper doctors and one night security guard.
A member of staff, who spoke to one of our correspondents on condition of anonymity, said the centre’s major challenge was lack of a refrigerator for keeping vaccines and drugs.
The Executive Secretary, Enugu State Primary Health Care Development Agency, Dr Hillary Ugwu-Agbo, declined comment on the challenges when contacted.
Agbo said, “This is not a issue we can discuss on the phone. You should write to my office your observations and you will give me time to get clearance from the state governor before I can discuss this matter with you.”
No water, no light, at Alausa, Lagos PHC
In Lagos State, one of our correspondents, who disguised as a patient at the Alausa PHC, was told he had to get a N100 registration card before he could be attended to by health personnel.
The correspondent, after getting the card, was asked to pay N2,500 for medical tests.
Throughout the over two hours duration the reporter spent in the hospital, there was no light and when he requested to use the toilet he was told to go outside the hospital because there was no water.
At the Aguda PHC, one of the workers, on condition of anonymity, said no doctor was assigned to the centre.
According to him, when a patient needs a doctor, he will be referred to the nearest hospital.
When contacted on the phone, the Permanent Secretary, Lagos State Primary Health Care Board, Dr Tayo Lawal, said he was not going to answer until he discussed with Governor Babajide Sanwo-Olu.
However, a resident of Ogba, Lagos, Isioma Victor, said he had given up on the PHCs in Lagos, saying he had opted for herbs sellers for treatment.
He said, “In Lagos and Nigeria as a whole, nothing is free. You pay for a card. You pay for tests and before you can be attended to, you will have to spend practically all your day there. So, why should I waste my time going to a hospital when I can easily go to a trusted herb seller?”
A 29-year-old resident of Ijaiye, Lagos, Tope Salami, said nurses’ attitude and lack of doctors in the PHCs were the reasons he resorted to traditional herb sellers.
No drug supplied to Jos North PHC in the last two years
In Plateau State, many residents of the state’s 17 LGAs are fast abandoning the PHCs in their communities because of poor services, an acute shortage of staff and lack of drugs.
Investigations showed that no drugs had been supplied to a PHC located at the Utan Community in the Jos North LGA in the past two years
A worker at the centre, who did not want her name mentioned, said, “The community members don’t come here because they know we don’t have drugs. The last time government supplied drugs to us was about two years ago. We also need more personnel because the ones available are few.”
Further findings revealed that the situation was not different at the Nanmua Junction Community PHC in the Jos South LGA.
A member of staff of the centre, who confided in The PUNCH, said, “There are about 30 or 31 PHCs in the Jos North LGA and the number is almost the same in the Jos South and other LGAs of the state, but how many of them can boast of drugs, adequate staff, quality services?”
Also, a resident of Heipang community in the Barkin Ladi LGA, Mathew Tok, said he preferred going to traditional medicine practitioners to the PHCs because of his experience.
He stated, “The attitude of the health worker is a problem. There was a day I almost lost a relative who was taken to the place around 11am. The workers told us that the person that would attend to her had not resumed work at 11am. Can you imagine that? I had to take her to another place.”
We are doing something—Plateau Govt
However, the Permanent Secretary of the state Ministry of Health, Dr Martins Azzuwut, when contacted, said, “ We are doing something.”
The Director of the state PHCs board, Dr Livinus Miapkwap, said the management of primary health care in the state would be brought under one structure so as to tackle the identified challenges.
In Sokoto State, The PUNCH correspondent observed that dust and cobwebs had taken over the male ward of the Dange Shuni PHC, a sign that the facility had not been in use.
When the correspondent contacted Dange Shuni LGA’s PHC Director, Bala Horo, he declined to speak about the health centre.
Bala said, “I cannot reveal any of our secrets to any journalist except, I get a directive from higher authorities.”
But a discreet investigation by The PUNCH revealed that only three of 16 health workers were on duty on Friday.
When one of our correspondents got to the PHC in Barangada in the Bauchi LGA of Bauchi State at about 2pm on Friday, there was no worker on duty. Two residents of the area were seen sleeping in the health centre.
When one of our correspondents woke them up, they said the support staff had gone to a mosque, while the only doctor in the centre had gone to Bauchi.
Bauchi PHC has three bed spaces for 6,000 residents
It was observed that although the structure of the hospital looked new, inside it, there were signs that it needed renovation because some of the ceilings had fallen off.
It was also noticed that there were only three beds in the entire hospital to cater for almost 6, 000 residents of the community and the surrounding six villages.
It was also observed that the two pit toilets in the PHC were in terrible conditions.
The PUNCH noticed that the toilets had not been washed for months, although they seemed to be in use considering the smell.
A member of staff, who later spoke with one of our correspondents on condition of anonymity, said, “There are no drugs in this hospital because it is the doctor himself that brings the drugs in a small quantity.”
He also said the centre had no maternity and a pharmacy, adding, “We don’t have anything in the laboratory. We only have a consulting room and a store where our drugs are kept. Our people are really suffering. We have about six catchment areas and all of them come to access medical care here. When women fall into labour in the middle of the night, they can die before they can get to the Bayara General Hospital.”
He pointed out that the workers were always overwhelmed by the high number of patients on immunisation days.
A resident of Barangada, Idris Adamu, lamented the state of the hospital, saying the PHC needed more doctors to attend to the about 6, 000 people living in the community.
13 doctors, 135 nurses in Ekiti’s 300 PHCs
Although in terms of physical appearance, the PHCs in Ekiti State are in good conditions, a shortage of personnel is a challenge facing the centres.
Investigations showed that there were only 13 medical doctors, 135 nurses and about 65 pharmacy technicians in the over 300 PHCs in the 16 LGAs of the state.
This implies that there are some PHCs without nurses and LGAs without doctors.
But the Chairman of the state PHC board, Mrs Monisola Oloro, said the Dr Kayode Fayemi administration would soon employ more workers.
Nigerians prefer alternative medicine because of failed PHCs, poverty – Ogun NMA
Commenting on the rot in the PHCs, the chairman of the Ogun State chapter of the Nigerian Medical Association, , Dr Ismail Lawal, said Nigerians embraced traditional medicine because of failed health care centres and poverty.
Lawal said, “Majority of citizens access traditional medicine not only because of the failed PHCs, but because they are poor. The way out is health insurance that is affordable and of global standard. I am worried, we are worried.”