The recent reports of the new governor of Sokoto State paying an unscheduled visit to the general hospital in the state and discovering that they operated with torchlight put similar hospitals across the country in the spotlight.
Findings by Daily Trust Saturday revealed that hospitals of similar status in many states of the federation are facing a myriad of challenges, ranging from dilapidated facilities to shortage of human resources and poor funding.
General hospitals are majorly state government-owned health facilities established with the objective of offering affordable treatment to citizens and help improve health delivery that could not be accessed at primary health care centres (PHCs).
It is from such hospitals that patients are referred to federal medical centres and university teaching hospitals when the need arises.
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Over the years, some state governments across the country have established at least one general hospital in each local government area (especially old LGAs) and more in the state capital or local government areas with higher population, but most of such facilities are now in pitiful condition.
Patients that have the means rather go to private hospitals or federal facilities to access medical care.
This is because the deplorable condition and obsolete equipment in some of the state-owned hospitals remain a big challenge.
Our correspondents across the country sampled the terrible condition of such facilities with patients calling for action by authorities.
Billiri General Hospital on verge of collapse
In Gombe State, the General Hospital in Billiri Local Government Area of the state was renovated and commissioned in 2006 by former President Olusegun Obasanjo during the administration of former Governor Muhammad Danjuma Goje.
The hospital has an administrative block, General Out-Patient Department (GOPD), accident and emergency unit, nursing and pharmacy units, laboratories, surgical and medical wards for both male and female patients, paediatric ward, among others.
But over the years, due to lack of proper maintenance, the fortune of the 17-year-old hospital had decayed and some of its basic equipment collapsed.
A resident of the community told Daily Trust Saturday that the facility had decayed so much that its beddings stinks, a situation that forces some in-patients and their relatives to sometimes sleep on bare floors to avoid contracting other diseases.
It was learnt that non-availability of essential drugs and other basic items also became frequent, forcing people to stay away from the hospital.
Decayed infrastructure, paucity of medical equipment, lack of drugs and inadequate qualified personnel to man the facility have almost turned the once vibrant hospital to a mere consulting clinic, with few people now patronising it.
When our correspondent visited the hospital, the GOPD, which is the first point of call to new patients, was totally deserted.
The Accident and Emergency Unit was also empty. It was gathered that in the case of any emergency, patients have to buy basic things such as cotton wool and syringe before they could be attended to.
Also, only a handful of in-patients were on admission in the hospital at the time of the visit, with only a few health workers sitting idle in poorly ventilated offices and other wards of the hospital.
To compound the already worrisome situation at the hospital, at the onset of the rainy season last year, a heavy windstorm destroyed the roof of the female medical and surgical wards, forcing the hospital management to move female patients to the male ward.
“It is a very weird situation because there is no privacy as both female patients and their relatives now share toilets, bathrooms and other facilities with the male,” a staff member of the hospital lamented.
The staff, who craved anonymity, said that apart from the decayed equipment and infrastructure, shortage of manpower was another problem affecting the smooth running of the hospital.
“We have less than 20 nurses, with 17 community health extension workers and 11 environmentalists. These are the only permanent staff members that literally man the hospital,” he said.
He added that the hospital heavily relied on casual workers who run shifts.
A teacher and resident of Billiri, David Mela, said that most of the time, they would prefer to attend private health care centres or patronise over-the-counter medicine stores for their medications.
“There was a time I took my neighbour’s wife to the hospital for delivery, when we reached, I was asked to buy simple items like hand gloves and cotton wool before they could attend to her,” he alleged.
When contacted, Ismaila Uba Misilli, the Director-General of Press Affairs to Governor Muhammadu Inuwa Yahaya, said the poor condition of the hospital was part of the rots inherited from past administrations in the state.
He said the administration of Governor Yahaya had already commenced renovation and reconstruction of three general hospitals in Bajoga, Kaltungo and Kumo respectively across the three senatorial districts of the state.
“There is an ongoing reconstruction of three hospitals in each of the three senatorial districts of the state. The Kumo General Hospital in Akko Local Government Area in Gombe central is undergoing reconstruction while renovation is ongoing at the Bajoga General Hospital in Funakaye Local Government for Gombe North.
“At the same time, the Kaltungo General Hospital in Kaltungo Local Government for Gombe South is also undergoing renovation. All will soon be completed,” Misilli said.
Patients use backyard as restrooms in Sokoto
Malama Aisha, who was looking after her sick sister at the female medical ward of the Specialist Hospital, Sokoto, said many patients and their relatives resorted to backyard as restrooms.
The facility is the second largest reference hospital in the state beside Usmanu Danfodiyo University Teaching Hospital.
Many residents, particularly in the state’s metropolis and from the 23 local government areas patronise the hospital because of its affordability; hence it is overstretched.
Another caregiver, Fatima, who has been with her sister in the hospital for days now, cited many instances where patients’ relatives have to contribute money to buy detergent and wash the place.
“The place is not conducive for admission at all because of its deplorable condition.
“The toilet is even worse, it is unhygienic. It requires a strong mind to use it. This is why some of us go to the backyard when over pressed,” she said.
Our correspondent, who was at the male surgical ward, observed that one of its sections was being used by workers for keeping their motorcycles due to its level of dilapidation.
One of the nursing staff who spoke on condition of anonymity said he could not remember when the place was renovated.
“You can see how bad the place is. You can’t use the patients’ toilet unless it is necessary. This is why some of the patients and their relatives defecate at the backyard. You can smell it.
“We really need government’s intervention. The place needs a holistic rehabilitation.
“We also need additional toilet facilities, adequate water and electricity supply,” he said.
At the children ward, our correspondent observed mothers fanning their children on admission with locally fabricated hand fans because of heat.
It would be recalled that Governor Ahmed Aliyu had, in the early hours of Monday, paid a surprise visit to the hospital on tricycle.
Briefing newsmen on the visit, he said it was in response to public outcry on the condition of the hospital.
He said the unscheduled visit, which lasted for over an hour, offered him the opportunity to see things for himself.
Nurses told the governor that the hospital had been in darkness for the last 9 months and had no option than to use torchlight to attend to patients.
The immediate past chief medical director of the hospital, Dr Hamza Maishanu, who was at the hospital during the visit, attributed the darkness to the failure of the previous administration to pay their cash allocation for the past 9 months.
However, when our correspondent revisited the hospital days after the governor’s visit, some engineers were seen working to restore water supply in the hospital.
Doctors drop from 18 to 6 in Minna hospital
Findings by Daily Trust Saturday revealed that general hospitals in Niger State are also faced with the challenges of inadequate staff and lack of state-of-art facilities to facilitate effective service delivery.
Some nurses at the Jummai Babangida Maternal and Neonatal Wing of the Minna General Hospital, told our correspondent on condition of anonymity that lack of adequate staff was affecting service delivery.
The hospital, with only six medical doctors, reportedly receives hundreds of pregnant women on antenatal visits on a daily basis.
One of the nurses confided in Daily Trust Saturday that the hospital, which initially had 18 doctors, could only boast of six now, and two are consultants.
She said staff members of the hospital were overworked, adding, “The big structure you see has nothing inside, in terms of adequate personnel and modern facilities.”
Challenges of inadequate staff and lack of functional facilities were also reported at Lapai, Mokwa, Bida, Kontagora general hospitals, among others.
The chief press secretary to the Niger State governor, Bologi Ibrahim, said Governor Mohammed Umaru Bago, who took over recently, was committed towards providing state-of-the-art health facilities in the state.
He said the governor had restated this when he went on a facility tour of the Nigerian National Petroleum Company (NNPC) Medical Services in Abuja, recently.
He said the state government intended to replicate the facility he saw in Minna or Suleja.
Corps members to the rescue in Kano
The challenges in Kano general hospitals are largely associated with inadequate manpower – mostly non-availability of doctors to take care of patients.
The Murtala Muhammad Specialist Hospital is a case in point as patients complained that it takes longer hours to be attended to because the medical personnel were overstretched.
In Nasarawa hospital, also in Kano metropolis, the most pronounced situation is lack of water as it always struggles to fend for itself in terms of meeting its water needs.
According to health officials at the hospital, they buy at least 10 tanks every day.
Another challenge bedevilling the aforementioned hospitals includes lack of adequate facilities at the accident and emergency unit.
Beside these two most visited hospitals within the metropolis, Kano State has general hospitals across local government areas with upgraded ones situated at its emirates.
A visit to Karaye Local Government General Hospital, which was upgraded by the Ganduje administration, showed that the facility has no resident doctor.
Also, during a visit to Gwarzo Local Government Area General Hospital, it was discovered that the situation is the same with that of Karaye.
According to findings by our correspondent, the hospital is being managed by corps members posted on request from the National Youth Service Corps (NYSC) secretariat in the state.
“For years, we have not had a resident doctor here. We manage corps members, and when their time elapses, we request for another one or two.
“We only see doctors when it is necessary, then we call. Even at that, we need to have many similar cases and book them on appointment before calling the doctor,” one of the staff who asked not to be mentioned revealed.
Multiple fact-findings in Kebbi, no action
A number of the over 28 hospitals in Kebbi State are in a sorry state given the dilapidated nature of their structures and facilities. There were efforts by the immediate past administration of Governor Abubakar Atiku Bagudu to fix the dilapidated structures and facilities in the state general hospitals but not much success was recorded on that before the expiration of the tenure of the administration.
Some patients who visited the hospitals in recent times have one complaint or another on the failure of medical equipment, decline in efficient services, decaying infrastructure and poor sanitary condition of its wards, toilets and mortuary.
About three years ago, the state government sent a team of engineers from the state Ministry of Works to inspect and advise on how to renovate and expand the hospitals because the structures and facilities can no longer meet the needs and demands of today’s general hospitals.
A senior medical personnel at the Sir Yahaya General Hospital in Birnin Kebbi told our correspondent under condition of anonymity that they had written to the state government on the need to fix the dilapidated structures at the hospital.
“The government sent their engineers here and we went round with them. We put heads together and we came up with a gradual plan so that the hospital can be renovated without disrupting its activities, but as we speak, nothing was done till the expiration of the tenure of the last administration.
“Casual workers are given a meagre amount to keep general hospitals, such as Sir Yahaya with over a 250-bed capacity clean. Another challenge is that some of the patients instead of using the toilets prefer to just go somewhere beside it to defecate or urinate.
“Unfortunately, only one or two persons take care of a ward of 30 persons. The government has to do more in employing the necessary personnel. It is not only the doctors and nurses that are important in the hospital. Government is aware of the challenges we are facing here,” he said.
A senior official of the state Ministry of Health, who does not want his name in print, told our correspondent that the present administration under Governor Nasiru Idris had taken measures to fix the deplorable situations of many of the state general hospitals.
“The present administration is aware of the dilapidated structures and facilities in the hospitals. They will be addressed soon. The governor has promised to give health a priority and to make our hospitals functional,” he said.
Thumbs up in Akwa Ibom, Benue, Oyo
In Akwa Ibom, the immediate past governor, Udom Emmanuel, prioritised the development of the health sector, especially the rehabilitation and renovation of secondary health facilities across the state.
Aside the employment of more doctors and health professionals in the state, the government renovated and refurbished all the general hospitals in the 10 federal constituencies in the state.
A patient, Ndifreke Effiong, said that although there are rooms for improvement, the government deserves accolades because it has taken health delivery to the door steps of the people.
In Benue State, it is a mixed grill because with the intervention of the Central Bank of Nigeria (CBN) through loan facilities obtained by the immediate past administration of Governor Samuel Ortom, some of the general hospitals seem to have witnessed an appreciable facelift.
Shortly before leaving office, Ortom said N900million was taken out of the loan allocated to various general hospitals in the state to upgrade medical facilities to enhance health care service delivery for the people.
Our correspondent reports that there was evidence of comprehensive renovation of the Gbajimba General Hospital in Guma Local Government Area and its doctors’ quarters and other hospitals (including the state owned teaching hospital).
Ortom had said that N1.2billion was spent to upgrade hospitals in parts of the state.
But a visit to Makurdi General Hospital, located in the North Bank suburb, which before now appeared to have shortage of virtually everything, including ordinary booklets for proper medical records of patients, had gained some form of assistance from individuals and government even though it is far from the ideal.
The facility, situated in a densely populated environment, often gets huge patronage, but most of the patients had complained of lack of basic equipment to attend to their needs.
Zuzu, who frequents the North Bank General Hospital, told our correspondent that there was significant improvement, though he still paid for nearly every little thing, including buying hand gloves, which the medical personnel used in attending to him.
Some patients said common drugs were lacking in the hospital and they had to purchase most of their prescriptions outside the facility.
A nurse complained that they had only one ramshackle table inside the theatre of the hospital, stressing that the facility lacked necessary equipment.
The narrative was the same with the Otukpo General Hospital before the facility was recently taken over by the federal government and upgraded to a teaching hospital for the use of the Federal University of Health Sciences, Otukpo.
Like the Makurdi facility, patients said the Gboko General Hospital and Gbajimgba General Hospital in Guma Local Government Area needed more than just renovation to offer the required services to people of the environs.
Meanwhile, a staff at the Makurdi General Gospital told our correspondent that despite some level of improvement, the structures in the facility still remained choked up because of population constrained by available space.
In Oyo State, despite the challenges faced in terms of shortage of manpower, infrastructure and equipment, health service delivery is experiencing a gradual turnaround in recent times.
This is majorly because there have been remarkable improvements in the services rendered by general hospitals across the state, as attested by patients and medical officers.
Under the Oyo State Hospital Management, there are 37 general hospitals, one of which is the Adeoyo Maternity Hospital, which has been upgraded in terms of infrastructure.
The hospital has been accredited for fellowship training in obstetrics and gynaecology by the Nigerian Postgraduate Medical College of Nigeria, the same thing for Jericho Specialist Hospital, which has been accredited for postgraduate training for family physicians by the same college.
An Ibadan resident; Mrs Olawale Khadijat, who resides at the Olodo area of the town and patronises Adeoyo Maternity Hospital, confirmed that the facility upgrade experienced by the hospital has translated into positives in terms of health care delivery.
At the Ring Road State Hospital, new services and equipment like CT scan, mammography, ultrasound, a dialysis centre and a functional high dependency unit (HDU) are some of the latest investments in the hospital.
According to Dr Gbola Adetunji, the chairman, Oyo State Hospital Management Board, the right of the patient is that they should get care from the health facilities, but they have to understand that these facilities are overwhelmed.
We know that we are still short of staff; and we are trying to cope with the migration of nurses and doctors. The situation has been extended to medical laboratory staff.
“They should understand that in a general hospital setting, there will be more patients than doctors. So they have to learn to be patient. Since they did not drive them away they should just wait for their turn, and they will be seen.
“When patients come to the hospital, the more critical ones are treated first and the other people can wait, but they don’t want to understand,” he said.
Haruna Gimba Yaya (Gombe), Hope Abah Emmanuel (Makurdi), Iniabasi Umo (Uyo), Abubakar Auwal (Sokoto), Abubakar Akote (Minna), Salim Umar Ibrahim (Kano), Adenike Kaffi (Ibadan) & Ismail Adebayo (Birnin Kebbi)
