TheCable

BY ABUBAKAR ABDULRASHEED

To enter the only Primary Healthcare Centre (PHC) at Zabeyidna, an agrarian community in the Gurara Local Government Area (LGA) of Niger state, you will need a torch to navigate your way around the dimly-lit bungalow.

The health centre was said to have been built through a communal effort to address the medical needs of its over 1,000 residents and five other nearby settlements. The small building has two rooms with two bed spaces serving all patients for all kinds of medical services, while one health worker attends to all of them. The centre relies on water from the stream, which serves the villagers too.

There is no medical equipment inside the PHC; patients and staff rush to a nearby bush to defecate when nature calls.

The old health centre

It was a bad experience for Muhammed Shagaya, a contractor who was awarded the project to construct a new PHC for Zabeyidna community. He had a deep cut on his hand while working and he started bleeding. He visited the old PHC, but there was practically nothing inside the building to stop a bleeding hand and treat the cut.

With a piece of cloth, he tied the affected part of his hands to stop the bleeding, while he was rushed to a clinic in another LGA.

“After I got the treatment, I had to buy syringes and other materials worth over N85 000 for the old health centre in the community, while we continued with the construction of a new one.  I was concerned that they were just there without adequate medical support from the government,” Shagaya said.

Dauda John, the only health worker at the old clinic, sighed deeply before he began his lamentations about the deplorable state of the health centre.

“The PHC is not well-equipped with medical tools. This is the only health centre in the community, and neighbouring communities also rely on it to manage their health challenges. Our register shows that the centre welcomes over 150 patients every month,” John said.

“Sometimes, we have to refer patients who need emergency attention to a hospital in Sabon Wuse in Tafa LGA, which is about an hour journey. Most times, before they got there, their situation becomes more critical.”

A NEW PHC TO THE RESCUE

The new health centre

In 2020, Mohammed Musa, lawmaker representing Niger East senatorial district, facilitated a project for the construction of a health centre at Gawu in Gurara LGA. Musa later relocated the project to Zabeyidna, claiming that Gawu already had a state-owned health centre.

“The choice of the new PHC is for the benefit of nearby communities in Gurara LGA that don’t have a health facility. If Gawu has one, why should other villages without a PHC not get one? I did the needful by reallocating the project,” Musa said via text message.

The National Primary HealthCare Development Agency (NPHCDA) awarded the project to build the new PHC at Zabeyidna to Kayroy Nigeria Limited at the cost of N88 million, under the close supervision of the federal ministry of health.

Constructed in 2020, the project brought pure joy to the residents of Zabeyidna, as it appeared as the biggest government intervention they’ve ever received in the community. The new facility raised the hope of the agrarian community, but their hope soon disappeared when the project remained inaccessible two years after its completion.

On a visit, the centre was under lock and overgrown with grass. The faded paint and collapse of the PVC ceiling at the entrance of the building showed the project had long been completed but abandoned. But the community members won’t let the facility degrade while they do nothing. Residents cut the grasses as soon as the entrance is blocked. The backyard of the centre has been converted into a maize farm.

The maize farm behind the health centre

Inside the building are the client observation area, consulting room, delivery room, injection room, lying-in ward, pharmacy, laboratories, record section, store, toilet and many rooms to accommodate patients; however, the facility has not been equipped. All rooms were dust-ridden and dotted with cobwebs. Solar street lights were also installed by the Rural Electrification Agency (REA).

HELPLESS COMMUNITY LAMENTS

Speaking with members of the community, they commended the lawmaker for facilitating the project but decried the long abandonment of the health centre.

John, the healthcare worker in the community, said the residents have made several calls for the centre to be opened for use, but there has been no fruitful resolution to commission the completed facility.

He said soon after the building was completed, he met with the director of the Primary Health Center of Gurara LGA, who assigned his team to visit the project to assess whether it complied with the criteria to receive medical equipment.

A few months after the team visited the facility, medical equipment and other materials were supplied, but they were kept in the village’s head residence because the NPHCDA wouldn’t permit them to set it up, and the old PHC didn’t have space to accommodate them.

“Assuming this place (new PHC) has been commissioned, we would have moved into it and there would be enough space to set up the equipment given to us,” John said.

But John didn’t give up on his efforts; he kept reminding the director on behalf of the community to assist in the commissioning of the project, but the response he kept getting was to “exercise patience.”

“I don’t know what has stopped them from commissioning it. Maybe they are not in the position to commission it; but they told us that with time, it will be commissioned,” John stated.

Yakubu Zakariyau, the village head, expressed worries over the abandoned project, which he described as an answered prayer. He said the new PHC will go a long way in giving the community quality healthcare, but it remains inaccessible and they have to keep relying on the old and small centre.

“For two years now, we have been taking care of the place because we know its value. But we’ve given up. Nothing has been done up till now,” Zakariyau said.

“That is the reason why you see these grasses everywhere and the inside is now dusty because it has been up to four months since we did a general cleaning.”

PHC DIRECTOR: WE HAVE NO APPROVAL TO SET UP EQUIPMENT

Shagaya of Kayroy Nigeria Limited, the contractor, said he stopped the project when the money released to him was exhausted.

Shagaya said he only received N48 million awarded for the first phase of the project, which consists of the construction of the perimeter fence and the PHC building, both completed and delivered.

“I wish to bring the whole project to completion, including the staff quarter, but they (agency) said there is no money to complete it. If they give me money today, I’ll go and construct the staff quarters,” the contractor said.

“For phase 1, they didn’t ask me to construct the gatehouse and generator house, and the borehole, but I did them because I know the centre should have them. Though they later paid for them, not for the borehole.

In a telephone interview with Idris Abdulkadir, the director of Primary Health Center, Gurara LGA, he said the equipment for the new PHC was supplied in 2021 and it was enough to kick off medical services at the centre. He added that there was no approval to set up the equipment, so they were kept with the village head.

“We have delivered equipment to them. As I’m speaking to you, there are more than 10-bed spaces with mattresses and other necessary equipment that will enable them to start using the new PHC.”

“I forwarded a request to the chairman of the LGA that he should liaise with the facilitator (Musa) if we can be given the right, or delegate his aides or the chairman himself to commission the place so that we can set up that equipment, but I didn’t hear anything from them.”

When contacted, Musa, who was evasive in his response, said all inquiries should be directed to the agency that awarded the contract.

“I think you can direct your questions to the National Primary Health Care Development Agency for answers,” the lawmaker said.

THE BACK AND FORTH, WHILE COMMUNITY SUFFERS

When contacted, Mallam Yanda, the NPHCDA assistant public relations officer, claimed the agency is not aware of the project. He directed this reporter to forward his inquiries to the state division, Niger State Primary Health Care Development Agency (NSPHCDA).

An official of the NSPHCDA, who said he should be addressed as the state’s director of health facility, told this reporter on the phone that the agency was not officially contacted by the NPHCDA to take charge of the project and do the commissioning.

The director said the NPHCDA sent them some ongoing and completed primary healthcare centres to assess, but the new one at Zabeyidna wasn’t included.

“There was a project indicated in the letter, but the community where it is located was not specified,” the director said.

He, however, said he will meet with his executive director and relate the situation to him, and follow it up with the national agency.

Speaking with Abubakar Umar, the procurement officer of the NPHCDA, he confirmed that the project has been completed but has to be commissioned first before use.

“The project has been completed and you know it’s a constituency project. Ideally, it should have been handed over by the lawmaker. But I will remind our department of special duties about the commissioning and handing over. They are the one that has the responsibility of handing over and commissioning the project.”

While the back and forth over the inauguration of the project continues, the community members keep travelling for several hours to neighbouring communities to get adequate and accessible healthcare.