INVESTIGATION: Simari’s hope for a PHC, easy access to healthcare dashed over poor execution of constituency project

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BY ABDULAZIZ BUBA, DECEMBER 09, 2023 | 11:18 AM


Background

Imagine a seven-month pregnant woman walking under the sun for more than 7km to access basic antenatal care! Or a terribly sick child led by his comprehensively aged father trekking across that distance to receive lifesaving malaria treatment. That had been the situation for residents of Simari, a ward in Mafa Local Government of Borno, until a primary healthcare was ‘built’ in the community.

Before now, those who could not trek because of their health conditions had to pay for transport, which according to their earnings as rural dwellers is huge and thus ‘eats up’ what would have bought them drugs or pay their medical bills. 'Let me tell you one funny story. My transport to Maiduguri Specialist Hospital where I used to go for my antenatal was N800. But I used to trek for some distance to cut costs so that it would be affordable to me,' a Simari resident, Aisha, 40, recounted.

'To go to a hospital was costing me over N500. Simari Primary Healthcare is a big relief to me and my family. I do not need to pay for transport now. I have a hospital close to me,' Sara said.

Of course, for locals in rural communities, access to basic healthcare is one of their primary concerns. It is often what contributes to the high mortality rate among them, especially at the point of birth.

Glimpse of hope

For the people of the community, who never thought healthcare could ever come close to them, the sight of a new healthcare facility right under their nose was a thoroughly cheerful news.

Aisha said their regular struggle and sufferings came to an end with the ‘completion’ of the project by the federal government in 2022.

'I had my last antenatal appointment at the primary health care here, and it was very easy because it is very close to my house,' she added.

Hadiza Abubakar, a mother of two, who sells perishable goods at the community said they are hugely grateful to 'the person who built the hospital because we never thought Simari would ever have a medical facility in our lifetime.'

The real story

Simari Primary Health Care Center was a constituency project facilitated by Hon. Ibrahim Muhammed Bukar, the federal lawmaker representing Dikwa, Mafa Konduga Federal Constituency. It was executed at the cost of N113m by Abalam Service Nigeria Limited under the supervision of University of Maiduguri Teaching Hospital, UMTH, as an agency of the federal ministry of health.


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In a visit to the facility in July, several people had thronged to the facility waiting for their turn to see a doctor. Their health demands were varied, some needed professional advice, others needed drugs but those with severe cases would need close monitoring and would thus require as much as admission.

The facility had about ten staff at the time of the visit, led by Mrs. Sarah. They were all lost in their job, catering for the people. Uncompleted project

But despite the obvious importance of the PHC in the community, our reporter learned that it was not yet completed.

The contractor, Abalam Service Nigeria Limited, did not complete the project, though available records indicate that he was fully paid. A payment history on the Nigerian Open Treasury Portal showed that payment was made to Abalam.

The company was expected to both build and equip the center, which it did not.

Our investigation reveals that the building is not only substandard but it was also not equipped, three years after award of the contract.

Facility uncompleted, yet occupied and used by another PHC

It also seems that the joy of the residents would not last long, as the facility did not even yet have its own staff. Unknown to them, Mrs. Sarah and her team belong to another facility and were only in Simari temporarily.

Mrs. Sarah said her original facility was Gwozari Healthcare Facility, which was under rehabilitation.

'Our permanent site is at Gwozari, a few kilometers away from here. The Gwozari facility is under rehabilitation. As you can see we are here temporarily. We could not put our stickers on the walls. We are also warned not to temper with anything here,' Mrs Sara said.

The shock of Simari community

This revelation was a big surprise to the residents of Simari who are now imagining how life will be for them the day the temporary facility relocates to its permanent site.

Mal. Bulama Modu, a traditional title holder and a leader of the community, appealed to the contractor to ‘please come and complete the project before this people will leave.’

He said his people have already suffered enough and cannot afford to endure the same suffering again.

Again, poor project execution and contravention of procurement laws

An assessment of the facility by our reporters showed that the supposedly new building had already begun to develop cracks on the walls, which indicates that it is not properly built.


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Similarly, the equipment have not been provided yet. The ones available belong to the visiting Gwozari PHC.

Painted ash and white, the building, which is tucked under one roof, has two rooms, a reception, a toilet with a corridor that divides the reception and the two rooms. There are two beds in one of the rooms while the other was being used as an office.

But that does not meet the basic standard for a PHC.

The Nigerian Federal Ministry of Health said a minimum standard for PHC structure must include the following:

Color: Cream

Minimum land area: 1, 200 square meters,

Two rooms with cross ventilation

Availability of a clean water source: motorized borehole

Walls and roof must be in good condition with functional doors and netted windows

A sanitary waste collection point

A waste disposal site

Be clearly signposted – visible from both entry and exit points

(See floor plan).

Others include a separate and functional toilet for male and female, constant source of water supply and electricity (connected to the national grid).

YEN NG could not ascertain exactly what equipment and furniture Abalam was contracted to provide for the facility, but there is an established standard.

Basically, a PHC should be furnished with 'two benches, two chairs, two cupboards, one examination couch.’

Others are a ‘screen, a stove, a wash hand basin, a writing table and two dressing forceps. Similarly, a PHC should also have one fetoscope, two Geo Style Vaccine Carrier (GSVC), four ice packs per GSVC, one injection safety box and two kidney dishes.

‘A set of ORT Demonstration Equipment (cup, jug, washbasin, towel, bucket, standard beer or/and soft drink bottles), two scissors, one solar refrigerator 1, two sphygmomanometer, two stethoscope, a tape rule, a thermometer and a weighing scale.'

None of these equipment appear to have been in place, except for those of Gwozari PHC, which will be evacuated immediately upon their relocation.

Mrs. Sara who is an expert in public health, also condemned the facility for lacking basic necessities of a primary healthcare.

She said: 'as far as I am concerned, this building does not attain the standard of primary healthcare center.

'Because a PHC must have an immunization site, labor site, family planning site, ante and post natal sites and admission site. These are all necessary,' Mrs Sara said.

'Even for us as visitors, we need additional toilet, at least two for staff, two for the patient. And as you can see, the fence of the clinic is also not suitable for the safety of both staff and patients,' she added.

No comment from contractor, supervising agency

YEN NG could not reach the contractor for comments. The company’s filings on Corporate Affairs Commission’s online portal showed that it was registered in 2009, with registration number RC 801363. Its directors are given as Bashir Gana Abatcha, Mallam Gana Abatcha and Mustapha Abatcha. The company’s office address was also given as: Shop 1 along Bama Road, Maiduguri, Borno State.

But when this reporter tried to locate the office on the address, it was not available. This paper could not also find the company’s email address and/or telephone number to send inquiries.

What UMTH say

The UMTH, which supervises the project is yet to respond to our inquiry. The teaching hospital’s director of engineering works said the project was executed before his appointment into the office and thus he would have to visit the facility before responding. The time it took has now exceeded our editorial waiting time of three weeks.

Conclusion:

Simiari needs a PHC, otherwise the people will continue to die because of basic health problems. As things stand now, they have a building that props up as a PHC, but it is yet to have one, thanks to the contractor’s refusal to complete the work and failure of the supervising agency to ensure that public procurement laws are adhered to.


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