By Patrick Obia
Walking into the health care center in Abredang, the only health facility in the Community, and lifting eyes to the roof, one could imagine if you walked into traps made up of two-by-two planks keeping a fixed gaze as if ready to strike.
With 12 feet wide and 16 feet long measurements of the labor room size, there lies a two feet height bed women lay to deliver at least 3-12 times in a month. This labor room and other rooms in the health center collapsed 2 years ago shortly after Mrs. Alice Samuel Isu delivered her baby.
“That very day it was God that showed mercy and saved me and my baby including the nurse. As a woman, immediately you deliver a baby you will have no strength to stand up quickly, it was the nurse whom God used to save the baby. While I was still laying on the bed and immediately the nurse carried the baby out from the labor room, the roof collapsed in the exact position the baby was, I thank God I was not hurt since I was still in the room,” Mrs. Alice recounted her ugly experience while giving birth in the facility.
“Imagine after delivering successfully, then the building collapses and kills you and the baby, what a tragedy,” she added with shock.
Abredang Community is one of a few communities in Biase Local Government of Cross River State. The Community, apart from the bad roads, dilapidated educational facilities, and no access to potable water among other needs plaguing the dwellers, part of the only health facility in the community has collapsed.
This health center is said to receive 3-12 child deliveries a month and at least 1 in a week by ratio; pitiable condition with falling ceilings, no power supply, water, drugs, and an unconducive facility is a major challenge.
While there is no access to potable water in the community, frequent treatment of cholera is rising. Inadequate manpower to attend to routine child deliveries with only one nurse crying for help is equally a challenge.
“It will not be good for patients and women to be treated or give birth in an open place because of the fearful building. We are pleading with the government of Cross River State and Nigeria, NGOs, and spirited individuals to please come to our help because when you are in the building and facing up you will be praying some prayers that shouldn’t be prayed; at that point, your spirit can even leave you,” Alice pleaded.
Stella Ogban is the first mother to give birth in the facility on 13th January 2023. After exhaling, she said: “it is just because of the prayers, I don’t know what would have happened delivering in such a condition. I was totally afraid, the facility and the labor room are not looking nice at all; the government seriously needs to intervene because a place like this can discourage patients from stepping foot. If not for the nurse who keeps encouraging us, we would be going to town for health issues.”
While Alice and Stella expressed fears, Rosemary Egwu was not left out. She said her prayer was that the broken sharp plank directly on her during delivery should not yank off from its holding.
“As human beings fear gripped me when I was delivering in the facility. When you take a woman to such a place there will be fear. The government should as a matter of urgency beam their satellite to make it conducive for patients; even the Nurse working here is not comfortable.”
No Water, Drugs, Manpower, A Big Challenge
Nurse Glory Paul Ede, is the Community Health Extension Worker in the Abredang health center who has worked in the facility since 2021.
She said apart from the collapsed labor room which is a nightmare to her, basic medical needs such as drugs, bed, water, and among others are crippling her performance but she is not deterred.
“The labor room and others have been falling from time to time on its own but women are still delivering there. I just had to vacate the part that had collapsed into another part but still in the same room.
“When the building did not collapse, I used to take delivery actually but when it started collapsing I even take delivery more than when it did not collapse for the past two years. Sometimes I take delivery more than ten (10) times in a month.”
She, however, said despite the collapse, there has not been any loss of life. clinging to her faith, she said while they await urgent attention, she uses prayers to protect delivery mothers and patients who visit the facility.
“Most of our challenges are the bad roads and no water in the facility and the community. Lack of manpower is the greatest of all; I’m the only one in this health center, I work alone and cry every day especially when I want to carry out immunization; I will work from morning till late at night in this uniform and it brings problems between me and my husband. Sometimes, it seems I’m no more in this world because the stress is too, too much on me.”
While confirming a few numbers of cholera outbreaks in the community – 5 children and 3 adults due to inaccessibility to potable water, Mrs. Glory said she relies on sachet water to clean up patients, disclosing that accessing water in the community is about a six-kilometer trek or a journey to the next community of Abapia.
“Right now there is no water in the community and there was an outbreak of cholera, we use tears to flush the toilet, water is our major concern, there are some days I will not even bathe, people trek more than six kilometers to get water from one stream. I try to take care of the patients with sachets of water I buy or we travel to the next community Abapia to fetch water.
“We need test kits, beds for patients, and drugs, we don’t have them, “the brown-skinned nurse solicited.
This reporter took a walk around the community and witnessed rusting hand water pumps and water wells in most of the compounds but all dried up.
Health Facility Not Captured In BHCPF
Of the one hundred and ninth six (196) healthcare centers selected each from the 196 political wards in the 18 local government areas of the State for the Basic Health Care Provision Fund (BHCPF), the Abredang health facility is not among despite Biase Local Government having eleven (11) facilities in the program.
BHCPF was established under Section 11 of the National Health Act (2014) but President Muhammadu Buhari officially rolled it out in 2018. The Fund, sourced from one 1% of the Federal Government Consolidated Revenue and contributions from donor agencies, is aimed at providing basic healthcare for Nigerians who cannot afford it, especially at the local health centers.
It also seeks to fund the Basic Minimum Package of Health Services (BMPHS), increase the fiscal space for health, strengthen the national health system particularly at Primary Health Care (PHC) level by making provision for routine daily operation cost of PHCs, and ensure access to health care for all, particularly the poor, thus contributing to overall national productivity.
The National Primary Health Care Development Agency (NPHCDA) is one of the three implementing agencies, its funding consists of a programmatic fund for Decentralized Facility Funding (35%), which is made up of funding for essential drugs, vaccines, and consumables (20%) and maintenance of primary healthcare facilities, equipment, and transport (15%). The remaining 10% is for Human Resources for PHC interventions consisting of 5% for midwives’ and 5% for Community Health Influencers and Promoters Agents (CHIPS).
Nurse Glory said intervention of this nature that would have gone a long way in improving the condition of the health center has not been heard of.
“Nothing like the Basic Health Provision Fund support, nobody has come to ask us about our needs in the facility in that name,” she inferred.
We Have Been Tricked By Our Leaders, We Need To Vote Right – Community Chief
Elder Ukam Ulom, the Chief of Abredang community is woken up from his afternoon nap after coming back from the struggles of trying to get cash from one of the commercial banks in Akamkpa Local Government Area where they left him frustrated.
Bemoaning the current challenges plaguing the nation, he said he’s worried his community lacks basic amenities. The civil servant accused their representatives of neglecting the people who elected them into office.
“I’m worried and very concerned, there is no good road in this axis, no drinkable water, and no good hospital apart from what is there. It is the Community that rallied around to build this health care but the government has taken over. We are doing everything on our own, the government will come and go without fulfilling its promises. Our hand pumps are not working, our children trek 10 kilometers to go fetch water.
“I am begging the government to please come to our aid to renovate and equip the health center, if you go inside there are no chairs, no drugs, and the Nurse there is suffering; if not for the Nurse’s help and efforts, no single patient would have entered there. We are begging the government to help us.
“The people of Abredang are praying for a free and fair election, electing good leaders that will hear our cry, ” he prayed.
PHC Director-General Not Aware, Promise To Intervene
When contacted, the Director-General of the State Primary Healthcare Development Agency, Mrs. Abasioffiong Offiong, said she is just coming on board and is not aware of the collapse and has to make calls.
Offiong, recently appointed by Governor Ben Ayade to replace Dr. Janet Ekpenyong weeks ago assured that when the necessary inquiries are done, the next action will be taken to fix it.
A breakdown of childbirth in the facility since collapse. 2021 with 36 births. 2022 has 103 deliveries and in 2023, six (6) births were recorded when this reporter visited the health center bringing the total number of births from 2021, 2022, and 2023 to 145.
This story was supported by the Africa Data Hub Community Journalism Fellowship.