By Rauf Oyewole, WikkiTimes
Adamu Yusuf Misau became a widower on August 5, 2020, at the age of 43 when his wife died during childbirth in Bauchi metropolis. His wife, Zaliha Yahaya Muhammad, was taken to the State Low-Cost Primary Health Centre where she had a stillbirth and died of complications afterwards, he said.
Adamu who works with the State’s Radio Corporation (BRC) got a call from his neighbour who informed him of his wife’s condition at the PHC. He met his wife in a pitiable condition –bleeding.
Zaliha had her antenatal at the PHC but when her condition became worse, they referred her to the Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) where she was attended to. A surgical operation was done at the Tertiary Hospital and they informed Adamu that Zaliha needed to be placed on a dialysis machine.
“They told us that their machine was not functioning at the time but referred us to the Bauchi State Specialist Hospital. This happened on the morning of the 4th of August but sadly, they did not release her to go for dialysis at Specialist Hospital until 11 pm. They delayed us for about 12 hours –a distance of about 2 kilometres.
“When they finally released her to us, one of the doctors at ATBU torn a sheet of paper without letterhead of the Hospital (ATBUTH), when she wrote to the receiving (Specialist) hospital, saying: ‘Sir, to whom it may concern, please, kindly help and suture the site that I forgot to suture. I have already dressed the site by the time I saw the suture which,’ she signed.”
Adamu narrated to WikkiTimes that a lady, one of the staff of the dialysis unit of the ATBUTH, asked him to pay N14,000 cash to put his wife on the patient’s dress. He then demanded evidence of payment which the lady declined but told him that payment of cash is a routine in the unit.
He told WikkiTimes that after taking his wife to Specialist Hospital, the head of the unit went on Sallah break. They reached out to one of her subordinates via phone who said that the staff who was in the custody of the key did not respond to calls put across, sadly he switched off the phone.
“We were not attended to till about 2:00 am before returning back to ATBUTH. While we were there, we narrated our experience but nothing was done to help my wife. Painfully, my wife died about two hours after,” he said.
Adamu has filed a case against the ATBUTH at the Federal High Court, Bauchi. But the Hospital management vowed to investigate the issues raised by Adamu.
Ayuba Ibrahim who lived in room 1, Sahaja Suite, Yelwa Makaranta, Bauchi died in May 2020 of kidney-related disease. He worked with the Bauchi State Universal Basic Education Board where he slumped and was rushed to the Specialist Hospital for treatment but his younger brother narrated that they were told that the specialist doctor at the Specialist Hospital travelled to Egypt for Sallah break. He was asked to return when the doctor was expected to come back from the trip.
Worried about his condition, Ayuba returned to a private hospital that his family did not want to reveal. “They kept on passing water on him. I think they didn’t ask him nor conduct an examination before giving medications. His two legs and stomach were swollen. We did not know his condition until he died.” His brother, Auwal Ibrahim told WikkiTimes in an interview.
For Bilyamin Al-Amin who lives at Nasarawa Jahun whose left hand got broken when he fell down from a Jincheng motorcycle on September 15, 2021, the bottleneck and the waiting hours of seeing doctors discouraged him from seeking medical attention. Preferably, he resorted to a pharmacy where he got some drugs to treat himself.
“I fell from an Achaba (motorcycle) and my left arm broke. I don’t like how people sit down for long to wait for doctors. I got treated by a pharmacist but the injury kept swelling. It was bringing out black irritating water. I told my friends to help me cut it off for me to be at peace because the pain was severe.
“My friends were the ones who discouraged me from doing self-amputation because of the consequences. Umar and Abubakar brought me here to see the doctor at the Specialist Hospital,” Al-Amin said.
Governor’s 30 Months Unfilled Promises
Governor Bala Mohammed on 29th May 2019 in his inaugural address said that “The primary healthcare level will be strengthened to provide the majority of the services required in our communities. We commit to making pregnancy and childhood safe for all citizens wherever they live. At present 1 in 115 live births result in a mother dying from preventable causes related to limited access to either basic midwifery or emergency care.
“To improve access to quality midwifery care, the government will strengthen and expand the Midwifery schools, but beyond training more midwives. We would work to retain frontline health workers, too. To address the acute shortage of health workers and the health crisis in Bauchi State as a whole, I would convene a Health Sector Multi-Stakeholder Roundtable Conference which will explore avenues for enhancing the capacity of the workforce in terms of numbers, quality and equitable distribution across the 20 LGAs.”
Last year, on September 23rd, 2020, he told the leadership of the Nigerian Medical Association(NMA) that the state’s health sector has deteriorated to the level that he has to call for an emergency. “We are left with no equipment to deliver, the ratio of doctors to the patient is over 1000 and the demographics are making us have more population and we have barely 100 doctors for eight million citizens.
“In some hospitals, we don’t have doctors, and at the primary health care centres forget about it because even auxiliary workers we don’t have. The doctors are jumping bonds because of the cluelessness of the previous administration to invoke the conditions and we are left in despondency and disillusion,” he said.
The situation has gone worse; no new employment has been made and the hospitals across the states are still terribly understaffed. The Governor ordered the State’s ministry of health to employ 100 doctors, but they were yet to be employed. 26 doctors have been interviewed according to the health commissioner, but WikkiTimes’ findings reveal that they were yet to be engaged even after a shortlist was conducted.
The 100 doctors to be engaged cannot address half of Bauchi’s health problems. Despite repeated promises, the governor has yet to keep his words.
Poor Govt Policies, Motivation Our Major Undoing—Doctors
Doctors who work at the general hospitals in the State are in the dilemma of relocating to greener pastures over the inclement environment and lack of motivation. “Government policies have rendered the health sector obsolete in Bauchi,” a medical doctor said.
He described the situation as “ugly” as he pleaded anonymity. “The problems are myriad. From little or no equipment, medical supplies, to insufficient staff and high patient loads. You will imagine that in some local government areas only one doctor is manning the general hospital. Most of the doctors are leaving because the government is owing them salary or they have not been upgraded to the supposed salary cadre. I could go on and on telling you the unending problems of health care in the state. Summarily, I will say, the situation is unpleasant.”
At the General Hospitals, Darazo and Misau, there are two doctors each. WikkiTimes observed that a doctor attends to over 100 patients daily. The insufficient medical personnel take care of in-patients at paediatric, maternity and adult in-patient departments.
Doctors Facing Administrative Bottleneck
Dr. Samaila Dahuwa, the Commissioner of Health, agreed with his colleague but assured that the government was aware of the situation and that the present administration inherited a “literally collapsed health care system”. The current government, according to him, is retooling the sector by restricting the employment of irrelevant health workers.
“We have a lot of doctors in the state including those that are working at the Specialist Hospital and in almost all the (26) general hospitals but the number is not very good. We are trying to make it at least two doctors per general hospital –especially in hard-to-reach areas.
“We have 26 general hospitals in the state, considering this and our lean resources I think the number (of doctors) is not that bad.
“What the doctors said about the administrative bottleneck in promotion and posting is very true. When I came as commissioner, I noticed so many administrative bottlenecks. There were so many allegations made against things moving the way they shouldn’t have. Although, we have sprung up to action. They have valid reasons to complain but I can assure them serious action is being taken to assuage the problems.”
The state government had in June 2019 declared a state of emergency in the health and education sectors. State officials say the government has “constructed, renovated over 323 centres of excellence across the 323 wards of the state”, in partnership with development partners but none of them has a doctor. A large percentage of the residents of the state seek medical attention at the PHCs, especially the hard to reach villages and are attended to by unqualified health professionals.
One of the doctors who confided in the reporter alleged that there are job bottlenecks and racketeering in posting doctors to their duty posts. He said that “with all due respect to the government, the declaration of a state of emergency is a political statement, not a true statement backed with experiential action. The situation in general hospitals across the state says so much about the supposed declaration of the state of emergency.
The doctor on the field said there has not been any change. The hospitals across the state have been the same way they are with no medical supplies, equipment and personnel.
“The government to sanitise the health system, starting with those in the Ministry of Health and Hospital Management Board. The level of impunity and corruption in these two places is unimaginable. To upgrade workers to their true salary level cadre, those in the Ministry of Health will tell you, if you don’t bribe them, they will delay it, and I am talking about nothing less than 6 months. For the Hospital Management Board to post doctors will take them months. The bad eggs in these places need to go and good people who will work should be brought on board.”
According to 2018 data from the National Primary Health Care Development Agency (NPHCDA), there are no doctors in the PHCs in Bauchi State. Also, checks revealed that a state embargo on employment has prevented personnel into the health sector. Many of the general hospitals in the state are manned by two or three doctors while others are having the National Youth Service Corps members as supporting physicians.
In Misau General Hospital, there are only three doctors and a corps member who attend to 263,487 estimated population, this is against 1:600 WHO recommended doctor-patient ratio. Similarly, in Toro, one of the largest LGA in Nigeria, there are only two medical doctors attending to 350,404 estimated population. There are two doctors in Gamawa LGA, two in Jama’are, two in Darazo and while the case is similar to other LGAs.
The PHCs Director in Misau, Mr Jibril Inuwa said, “there are no doctors in any of the PCs but the only hospital with a medical doctor is the General Hospital, Misau. I know they are three with a corner –making four.”
The Chairman of the National Association of Resident Doctors (NARD), Bauchi, Dr. Nur Igarzali said that the condition of service of the doctors in many states of Nigeria is frustrating, therefore, making them seek greener pastures abroad.
“We have some of our members who work with state governments who are supposed to earn about N200,000 but end up going home with N90,000 or N100,000. Though, the situation differs in some states. All these things with the workload. A doctor, by the standard, should attend to 600 patients. But the situation is not like that today, coupled with the treatment of the practitioners,” Nur explained.
Volunteers Saving Bauchi’s PHCs From Personnel Shortage
There are 5,021 volunteers in the state health sector according to the Bauchi State Union Volunteers and Temporary Health Workers. These people have been trained in different public health courses across colleges of health and varieties –apart from medical doctors.
Yusuf Aliyu Fada is the leader of the Union and has been working voluntarily at different PHCs for seven years. He works presently at the Fada facility as a clinician alongside a government clinician in the area.
There are 24 personnel at the Fada PHC —with 12 of them working voluntarily with no take home. The rest are under the government payroll but leave the buck of the duties to the temporary workers.
Yusuf and 11 other workers are volunteers at the facility. He works as a clinician, sometimes he covers the day and night shifts. “I also manned the consultation unit with a colleague who is a permanent staff member. I assist in taking the child delivery.
Mrs Helen Kyauta, who graduated from school over 17 years ago, had joined volunteer work with different PHCs in Bauchi metropolis 10 years ago. She was seen at the family planning unit of Yelwa Domiciliary.
She said that “There are 40 volunteers in this facility. All of us are not getting paid. We do this hoping to be employed by the government as it has been repeatedly promised over the years. This is my tenth year in this voluntary work.”
Situation Worries State Assembly
On August 3rd, on the floor of the Bauchi State House of Assembly, Hon. Tukur Ibrahim who represents Toro/Jama’a Constituency moved a motion calling on the State Government to upgrade Primary Health Care, Nabordo to General Hospital from its current state to save more people from going to an early grave.
Pained by what his constituents are experiencing, he led the debate on the motion, Ibrahim said that the Nabardo Modern Primary Health Care, established 20 years ago to serve over 200 catchment areas in Toro and Tafawa Balewa Local Government Areas.
The lawmaker believes that the lack of required equipment and personnel to discharge its responsibility to the populace has forced patients to be referred to General Hospital, Toro –a-43-kilometer (34minutes journey). “And this causes some patients to die while some lose their pregnancies” on the way, according to Hon. Ibrahim.
He further told the legislative arm of the government his people are suffering because “there is no health personnel to take care of even minor cases, most of the healthcare clinics in the area are not manned by trained personnel.”
The State Ministry of Health budgets N6.3bn, while its Agency, Primary Health Care budgets 6,044,045,655 in 2021 –totalling over N12 billion in a fiscal year document tagged budget of consolidation.
The state voted 11.4 percent of its N213.9 billion budget on the health sector. Although, this is below the Abuja Declaration by African leaders in line with the World Health Organisation 15 per cent standard of the total budget.
We Are Employing 100 Additional Doctors –Govt. Reacts
On doctors’ accommodation, according to him, the government has built over 15 three-bedroom apartments in different local government areas. Samaila said that the government has embarked on massive renovation and upgrading of the facilities.
The Commissioner expressed dissatisfaction about the state government scheme that sponsors medical students outside the state with the aim of serving their state. “Over the period of 20 years, we have sponsored about 400 of them to student medicine, but sadly only 24 of them are working in the state hospitals. We can’t continue to use people’s money to invest in them and they end up taking jobs in Saudi Arabia and others.
Fraud In Volunteers’ List
Dr. Rilwanu Mohammed, the Executive Chairman of Primary Health Care Development Agency is also the Chairman of a committee on health workers employment said that his panel had screened the 5,600 volunteers in the health sector. But he discovered that the majority of them are not volunteers, they are the daughters of Councilors, chairmen of local government.
“The Governor asked me and the Commissioner (of health) to get the list of the volunteers in Bauchi State when we went to get the volunteers we discovered that the majority of them are not volunteers, they are the daughters of Councilors, chairmen of local government, they didn’t give us the real volunteers. Now, we are getting the real list of the volunteers who are working in our hospitals,” he told WikkiTimes.
This story was published with support from Civic Media Lab.
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