In mid-July, the Federal Government announced plans to revamp 10,000 primary healthcare centres across the country to provide quality health service delivery, particularly to rural dwellers. Three months after, Yekeen Akinwale embarks on a fact-finding tour of some contracts awarded for primary healthcare centres in four southeast states: Enugu, Imo, Ebonyi and Abia. He presents his findings in this disheartening report.
‘Oga, na here you go come down,’ the driver announces in Pidgin English. After about 20 minutes’ drive from Obollo Afor, he pulls over his rickety bus to the side of the road for the journalist) to disembark. He zooms off immediately and once the smoke from his bus settles, the search continues – the search for Obollo Ile community.
Obollo Ile and Ofiambela… Home of ‘Ghost project’?
After asking at least 10 different people at Obollo Afor, the headquarters of Udenu Local Government, about the location of Obollo Ile, there is still no clue. Everyone claims there are only Obollo Eke and Obollo Etiti communities in the local government but records of uncompleted primary health care centres across Nigeria obtained from National Primary Health Care Development Agency (NPHCDA) mention a certain Obollo Ile.
“Oga, na Obollo Eke you dey go,” says the driver who convinces his passenger to board his bus from Obollo Afor market. “We no get anywhere wey be Obollo Ile here, na Obollo Eke and I go carry you reach there.”
So, all of them insist the place is Obollo Eke village. Therefore, the journey in a bus returning from the market to the village is inevitable.
All signposts by the roadside say Obollo Eke; could it be a typographical error in the record that says Obollo Ile? Maybe. But the village is not the subject of the ultimate search, rather an uncompleted primary healthcare facility awarded in 2005 by the Federal Government. And, according to information made available by NPHCDA, the project is located at Obollo Ile, Udenu Local Government, Enugu State. It was awarded to Abduk Nigeria Limited at the sum of N19.1million. But 12 years after the contract award, there is no trace of the project.
After another 20 minutes’ trek from the main road through erosion-ravaged road that leads to Obollo Eke Market Square, there stands in the bush a signpost reading: ‘Early Child Bed Clinic’ – an old healthcare centre with pre-independence buildings looking recently painted but almost taken over by weeds.
No water, no light in Udenu LG’s oldest health centre
“This clinic was built before independence,” says a very courteous Ogbonna Bibiana, the officer in charge of the clinic while responding to a question on whether it is the one awarded by FG in 2005.
“And this place is Obollo Eke, not Obollo Ile; in fact, there is no village like that here,” she quips, leading her guest to one of the empty hospital wards with scanty beds.
Bibiana could not have been wrong; there is nothing at the health centre to suggest it was constructed about 12 years ago. The facility does not have the look of a model primary healthcare centre. It has no source of water.
“We rely on rain and stream water here because we don’t have well or a borehole,” she says, and there is no electricity; kerosene lantern and torch are what they use at night even if there are women in labour to attend to.
What looks like a toilet project in the premises of the clinic is an abandoned pit said to have been started and abandoned by UNICEF.
“UNICEF said they were constructing toilets and providing water,” she says. “They just dug and left more than a month ago.”
In a community with a high number of local birth attendants, the clinic is not a choice for many pregnant women despite the risks involved. There is no doctor at the government healthcare facility, the real reason most men in the village discourage their pregnant wives from seeking care at the centre.
“Pregnant women don’t even patronise the centre due to a lack of facilities and manpower. We have no doctor; we are only community extension workers,” says Bibiana, a Principal Health Extension Worker.
Showing apparent neglect by the local authority, the Early Child Clinic itself is a source of diseases, with offensive odour oozing from two filled pit latrines.
“We don’t have placenta pit; the latrines also serve as placenta pits,” she reveals. When both the workers and patients want to defecate, we make use of the bush.”
And just behind the hospital building are disposed syringes and needles and other wastes from the centre, in a small carton. The beds are broken down and covered by dust, while the compound has been overtaken by cassava and maize farm owned by Bibiana’s family.
Despite all these, some villagers still patronise the healthcare centre, albeit with reservations. Mamah Everestus, a community leader who brought his daughter for malaria treatment that morning, laments the condition of the centre.
“Government is supposed to fund the health centre well; no water, no generator, no toilet, no placenta pit, no drugs,” he fumes. “They are supposed to see what the people in the community are suffering and all of them are eating in Abuja. Look at grasses in a health centre, no worker to cut the grasses.”
But where is Obollo Ile? She suggests it might be the new health centre at Obollo Ishielu or a village called Amutenyi. “It may be at Amutenyi because that is where they have a new health center.”
A ride on a bike from Obollo Eke market square to Obollo Ishielu revealed another health centre, newly built but under lock and key even at 10am. It was constructed in 2015 under the Millennium Development Goals (MDGs) projects. There was no one around. Residents, including Bibiana, claim that the centre was giving free drugs to villagers when it was newly opened, which was one major reason pregnant women chose it over the Early Childhood Clinic. However, it does not open until 10am.
With Ekwueme Silas, Head of the Department of Health, away in Enugu attending a workshop, no one is willing to speak. Others claim they have no permission to talk. Those who volunteer to speak anonymously say there is no village as Obollo Ile.
But when Silas speaks through telephone conversation, he says there might be a mistake in the spelling of the name of the community. Though he says there have been rumours about an abandoned healthcare project in the local government.
“…people used to say there is an abandoned project somewhere,” he says. “But I have not come across such a project since 2016 when I assumed office.
“I have not been able to understand the particular community…Obollo and then gini? Yes, there is Obollo Eke, Obollo Etiti and Obollo Ishielu, probably because you may have gotten the name wrong but we have Obollo-Oye. It’s like Obollo-Oye you want to call.”
When he was told that what is in the record of NPHCDA is Obollo-Ile, Silas replies, “there is no place like that.”
Could it be that the Federal Government awarded a N19million ghost project? So it seems.
Udenu Local Government in Enugu State is not the only place where a funded Model Primary Healthcare project is untraceable. Elsewhere in Ukwa West Local Government, Abia State, another N16million Model Primary Healthcare project awarded in 2004 to Emjec Nigeria Limited could not be found.
According to a record of uncompleted primary healthcare centres across the country obtained by the Public and Private Development Centre (PPDC) from NPHCDA, the project is located at Ofiambela in Ukwa East Local Government, Abia State.
After more than two hours searching through Obeaku Village, Ohambelle (the supposed Ofiambella) and back to Ukwa West Local Government secretariat, it becomes clear that there is nowhere known as Ofiambella, just as there is no uncompleted model primary healthcare centre in the village. Did the Federal Government again award a ghost project in a ghost community?
An existing health centre on the main road of Ohambelle, constructed by Adolphus Wabara, a former Senate President, during his second tenure as the local government chairman of Ukwa West in 1998, is begging for repair.
“We don’t have a federal government constructed primary healthcare here in Ohambelle,” says Florence Ekeke, who works at Ohambelle Health Centre.
Ngozi Emeka, Head of Health Department at the local government secretariat, confirms the non-existence of such a project, saying: “We have 33 healthcare centres in this local government but we don’t have any project in Ohambelle that is under construction or that is uncompleted. Even the one in that community is dilapidated. To the best of my knowledge, there is none like what you are looking for.”
Like Obollo-Ile, Ofiambella, from all indications, appears to be a ghost village with a ghost primary healthcare project.
Expired drugs, leaking roofs…The dilapidated Amaboku health centre
Despite a fairly large turnout of nursing mothers, pregnant women and elderly citizens at the health centre that Wednesday morning, Okpe Martina, Principal Community Health Extension Worker who heads Amaboku Healthcare Centre, Igbo Etiti Local Government in Enugu State, says it is hard to give up on attending to the health needs of the people. Just that the tools to work with are decaying.
Ozor Raphael, a retired school teacher, says the entire community would be seen to have failed were the health centre closed down despite its precarious situation.
It has 14 bed spaces, though all are dusty. Amaboku Health Centre, awarded in 2004 at the cost of N16,540,331.49 has fallen in standard both in infrastructure and personnel. Showing apparent signs of neglect by the relevant authorities, the health centre is an example of failure of government to treat primary healthcare as the cornerstone of a stronger and resilient public health system.
The laboratory at the centre does not work because of lack of manpower to manage it; a doctor comes from Nsukka twice a week and anytime else there is an emergency.
There ought to be resident doctors at the clinic but the residential apartment constructed for that purpose in 2013 under MDGs project is still uncompleted. Four years after, the building remains without windows and doors – an example of disconnect between government policymaking and implementation.
With falling ceiling, leaking roofs, expired drugs, power outage, Amaboku Primary Healthcare Centre needs rehabilitation. Disconnected by the electricity distribution company for the past eight years, the local authorities could not raise N30, 000 said to be the centre’s debt.
“If we have money, we buy fuel to power the generator, but if we don’t have we use lantern at night,” she reveals.
Despite an application to the local government authority by Martina in May 2017 requesting for renovation of the only public health institution in the village, nothing has been. Due to the leaking roofs, the centre is flooded each time it rains. Even the room that serves as drug store ends up waterlogged.
“We need help for this place, you are seeing water because it is rainy season. Once it is dry season, we don’t have water; we buy water to flush toilets or go into the bush,” says Martina.
The local government health secretary could not be reached; she was also in Enugu attending a week-long workshop.
Covered in the dust are drugs that have already expired…their manufacture and expiry dates read 2005 to 2008. Next to drug shelves is a microscope with obsolete lens. She says the drugs were already expired at the time of supply just as the microscope has never worked since it was supplied.
Why are the drugs still being kept on the shelves? Martina says only personnel of National Agency for Foods, Drugs, Administration and Control (NAFDAC) are empowered to remove the drugs and dispose them.
Evidently, the Federal Government, through the NPHCDA, does not follow through many of the contracts awarded for the construction of the healthcare centres.
The solar panel installed to provide alternative energy for the centre since its commission has never worked. It was abandoned in a corner under the cover of darkness and taken over by dust and cobwebs.
The same goes for the water reservoir, which was not well constructed, according to workers at the facility. Thus, it leaks and cannot hold water. Toilets are filled with unflushed defecation. Workers and visitors at the centre rush into the bush when nature calls. The hospital windows are without mosquito nets.
This is despite the first global healthcare ranking report that placed Nigeria at 140th position with 51 points on Healthcare Access and Quality Index. The ranking is based on a quantification of personal access and quality for 195 countries and territories from 1990 to 2015.
According to the study, published in the May 18, 2017 edition of the medical journal, the Lancet, Nigeria lagged far behind other leading African nations in a new global healthcare report. Nigeria couldn’t have fared better with all these indices.
The United Nations Children Fund (UNICEF) says; “Every single day, Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes the country the second largest contributor to the under-five and maternal mortality rate in the world.”
With health centres like Amaboku’s, child and maternal mortality would no doubt be on the rise in the country.
The people are frustrated
The people of Etitioma Nkporo, in Ohafia Local Government, Abia State, are still waiting for mother luck to smile on them so that they may enjoy the dividends of democracy. They are yet to feel the real presence of both the federal and state governments – there are no good roads to the community and there are no good healthcare facilities.
Despite being the community of Ude Oko Chukwu, the current Deputy Governor of the state, Etitioma Nkporo, the largest of the eight communities in the locality, has been struggling to see the completion of an abandoned primary healthcare centre awarded more than 10 years ago. They are still hoping for an intervention from the Federal Government, after the contractor, Masta Services Nigeria Limited, abandoned the project.
Awarded at the cost of N17million by the Federal Government to Masta Services Limited in 2004 when 120 of such were approved for construction nationwide, what is supposed to be a model primary health centre at the village is now home to lunatics, drug addicts and urchins who have also turned it to their toilet. Sitting on an expansive plot of land and looking over the palatial house of the Deputy Governor, the building is roofed but has no windows and doors.
“For over 10 years, that project has been abandoned … and that has taken us back. We have lost the use of drugs. We have over a million naira worth of drugs sent to the community. Parts of the equipment are spoilt already,” says the Egwugwo of Amudu, Eze Innocent Ume.
“We don’t have road, we have worried the federal government to give us just a road. Our people say two legs are not good to be bad, but now we have five legs, none is good. We have five outlets leading outside, none is good. If somebody is sick before you carry him to Ohafia, at times you take Ikem to Igbere before you go to Ohafia. The other health center does not have anything; no doctor, no laboratory. There is nothing there and we have been reporting to the local government authority.”
Has the community folded its arms over the abandoned projects and the health needs of the people? No, says the monarch. The community development union has met with Mau Ohuabunwa, the senator representing Abia North Senatorial District at the National Assembly, on the fate of the facility.
“About two weeks ago, our people, led by the chairman of Nkporo Development Union (NDU), went to Mau to ask about the project. He told them that about N50million has been approved for the completion. He told the Chairman of Nkporo Development Union that the sum of N50million had been approved,” he says.
The monarch confirms that the lawmaker sponsored the project when he was a member of the House of Representatives between 1999 and 2007. But he doesn’t know the contractor handling the project.
Further findings by the ICIR, however, show that Masta Services Limited, the company handling the abandoned project, was registered with the Corporate Affairs Commission (CAC) in 1992, with one Ugo Ohuabunwa as its Managing Director and Chief Executive Officer. If Ugo Ohuabunwa is a relative of the Senator, it is a clear violation of the 2007 Procurement Act.
The lawmaker was unavailable for comments. Calls to his constituency telephone number were unanswered, while messages sent to the same number went un-replied.
To be continued next week
This investigation is supported by the John D. and Catherine T. MacArthur Foundation and the International Centre for Investigative Reporting.