Daily Trust (Abuja)
Theophilus Abbah
16 November 2008
(Page 2 of 4)
A resident of Rikadawa, Alhaji Bello Musa, captured the plight of the people thus: "We are facing serious difficulties as far as health care service is concerned. We don't have even a single health facility in our area, not to talk of a hospital. We are calling on government to come to our aid by completing this project."
In Kogi State, the primary health care centre built in Ugbamaka in Olamaboro Local Government Area brought hope and excitement to the people, but it was gathered that six months after the structure was put up, nothing has been heard from the authorities. The building has been overtaken with weed, while some equipment said to have been supplied were kept at the residence of one politician. As a result of the non-commissioning of the hospital, some of the drugs supplied began to expire, forcing the health authorities to take them away.
The story of the primary health care centre in Dikko village, Gurara Local Government Area of Niger State is similar to that in several other states. While it is indicated on MDGs office documents that the project has been completed, a visit proved that it was not, as at mid-October, 2008. The structure is yet to be roofed. Here the only medical facility is a dispensary established by missionaries, and there are two medical doctors and a couple of nurses. With the growing population, the dispensary can no longer meet the health requirements of the community. A resident, Mrs Maimuna Bahago summed up the expectations of the people from the health centre, saying, "The establishment of a state-owned dispensary in Dikko will go a long way in augmenting the good work of the missionaries. We hope the centre will soon be completed so that our people can benefit from it."
In Nasarawa State, several primary health care centres have been rehabilitated and new ones built, but, as usual, they were not without complaints. For instance, at Adogi, a rural community, the primary health care centre was 'upgraded' with the use of the debt relief money. All that was done were the repainting of the structure and the construction of a new fence. There was no new equipment or facilities supplied. The beddings are in a very bad shape, looking old and worn out. Though our reporter could not ascertain how much was spent on the rehabilitation, it was gathered that the upgrading ought to have included the provision of new equipment at the health centre.
The story is the same at a primary healthcare centre in Dome Road, in Lafia, the federal capital, which has been painted and covered with new roofing materials. When our reporter visited the health centre, he found a crowd of about a hundred women, who were being attended to by only one nurse. There were no midwives or qualified doctors. Gidan Waya, a village, has had its primary health care clinic upgraded. It has been fully built, but the beddings and other furniture spoke of old age. There is a new laboratory there but other equipments were conspicuously missing. This health centre caters for peasants in four villages of Gidan, Ehim, Mashiri, and Angwar Sabon. It boasts of one midwife, one nurse and a laboratory.
Other health centres visited included Abogini South and Adudu villages, where the traditional ruler, Mohammed Abba, remarked that, as far as he was concerned, where the projects were executed, it "starts and ends with fencing and painting. No medicine or equipment is supplied." He complained further that at the clinic in his rural settlement, the company to which the contract for the construction was awarded had abandoned the project six months earlier, and nothing had been done about it. On his own, Dr. Kabir Musa Ibrahim, the chief of Azara in Awe LGA complained that the villagers could not access some of the primary health care centres because of bad roads.
There are a few issues that are not clear about the award of contracts for primary health care centres across the country. First, the contract sums are exorbitant. Some of the structures being built for N19 million, could be successfully prosecuted with about six million Naira. Secondly, some of the health centres are sited in communities that would rather prefer other amenities. For instance, the people of Abbare in Lau local government of Taraba State complained that they did not need a primary health care centre. A ward head told Sunday Trust that, "The people of Abbare are in dire need of clean water due to the prevalence of water borne diseases. Prevention, they say, is better than cure. If we prevent ourselves from water borne diseases by consuming clean water, we will not be sick, hence the need for boreholes instead of clinics." The people of Zangon Kombi community in Ardo-Kola Local Government Area, raised the same complaint, saying they preferred boreholes to the health centre built for them, because they could access the hospital in Jalingo, the state capital, when faced with serious health crisis.
On their part, the people of Yakoko village in Zing Local Government Area, Taraba State said although the medical facilities in the primary health care centre were impressive, they would not patronise the clinic because they had more confidence in the missionary hospital, which has qualified doctors. The health centre in Yakoko does not have a qualified doctor. Abigail Musa, a resident of Yakoko explained thus, "We are more comfortable with the missionary hospital where we have been receiving qualitative medical care over the years."
Where projects are executed, there are evidence of poor finishing and the use of substandard facilities. At Kwachiri health centre in Kano State, the floor of the hospital, which was constructed only six months before this investigation, has been scrapped off, so that dust has begun to issue out of the supposedly concrete floor. Complaining about this abnormality, the officer-in-charge of the centre, MallamYusuf Lawan said, "The issue is that the actual construction was not concrete, therefore, it started breaking off not long after the project was commissioned. We called the attention of the contractor who sent one of his boys to come and address the issue. On coming here, he directed the labourers to scrap the floor in order to allow them cast another foundation. Six months after, nothing has been done. In September, the wife of Kano State Governor, Hajiya Halima Shekarau visited the centre and promised to reconstruct the floor, but no contractor has turned up to carry out the repairs."
In places where the projects have been completed, there is the lack of water and electricity. What the MDGs office does is to provide solar energy to provide electricity, but in some cases, the communities have to source their water and electricity. In Kwachiri village in Kano, the relatives of patients, especially, those who put to bed in the health centre, are asked to purchase water from vendors for the hospital to use. Also, patients are asked to contribute money for the purchase of fuel for the standby generator at the centre. Mallam Yusuf said, "we are not happy doing that, but the problem is beyond our control and, therefore, we are left with no option than to operate that way."
An official of the Monitoring and Evaluation team at the MDGs office in Abuja confirmed that the department was aware that some of the jobs were poorly done, and that the office was not going to be quiet about it. But he did not outline measures being put in place to ensure a redress.
To buttress what the official said, a report by the Monitoring and Evaluation team, obtained by our reporter has this to say: "Many PHCs were completed but could not be commissioned either because electricity and/or water supply had not been provided by the LGAs, or healthcare staff had not been provided by the State/LGA. This situation would greatly limit the usefulness of the completed centres, and seriously dampen confidence on the programme by host communities..."
In another section the M&E report says, "There was a recurring problem of PHC equipment and drugs being supplied with no place to keep them because construction of the PHC itself was uncompleted. Equipment and drugs have therefore been kept with the local chiefs, at the LG offices, in other health centres or in the uncompleted facilities where the security and safety of the supplied equipment were invariably jeopardised."
On the supervision of the project, the team has this to say: "There was also substandard quality of work and the use of substandard materials on the projects across the zones, which suggests inadequate supervision and management by the Consultants commissioned to carry out that aspect. Problems range from poor quality building materials, poor workmanship with some buildings collapsing before completion, lack of adherence to contract specifications (e.g casting 3" DPC instead of 6", lack of use of BRC, using inferior wood for roofs, etc.) This will shorten the lifespan of the structures and affected sites will soon be in need of rehabilitation. In many cases, the quality of supplied equipment was unsatisfactory, and in some cases some supplied equipment were rejected by the Zonal Technical Officers. This programme, even though nationwide, also shows differing levels of success for different locations in the country.
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