Investigation: In Offa, Kwara State, government clinics running without doctors, pharmacists, water

With an urgent haste, a middle-aged man, Olasunkanmi, was moved from a public health centre in Offa local government area of Kwara state to a private hospital at the Alubata area of the town. That was last year, but often such occurrence – referral from a public health centre to private centres – happens

Olasunkanmi, at the private hospital, was later diagnosed as having Typhoid, which was undetected at the public health centre. His condition had deteriorated, due to wrong diagnosis and mistreatment, before he was hastily moved.

“He would have been one of the casualties recorded in the year 2017 if the referral was delayed or not done,” said a nurse at the private clinic.

People in Offa prefer private clinics to the public. From our investigation, the reasons include inadequate facilities and drugs, compounded by a shocking shortage of human resources and an almost total funding cut.

Considerably, the public health service is perceived as only useful for routine immunisation services, which, though should be free, are being paid for by the residents.

“Asides immunisation (for her child), I don’t come here for treatment,” said Basirat Adeoye. “Whenever anything is wrong, I go to Alhaji Afelele, who owns his own hospital.”

Then, there is also a cost and value dimension. The cost of health service at the public health centre, according to residents, is almost the same as what is charged for a private service, whereas the latter is widely trusted to provide a more qualitative service.

Ishola Mufutau was one of the residents who shared this view.  The public healthcare service is so distrusted that people even prefer patronising nurses operating at home. “In my family, we use a nurse, who resides down the street. If the situation is beyond her, we go to Olanipekun private Clinic,” said Mr Mufutau.

No staff, no working tools, no funding

Our correspondent visited seven primary health centres in Offa LGA.

From interviews with community health officers-in-charge of the PHCs, it was gathered that most of the health centres lack alternative power supply facilities, access to good water, sufficient drugs, medical and laboratory equipment, conducive environment and good buildings.

All of the centres visited rely on the Drug Revolving Fund (DRF)  scheme for drug and vaccine supplies. The health officers in turn charge patients for the dispensation of these drugs.

DRF  is a product of contributions from the communities which are used to purchase an original stock of essential and commonly used medicines. These drugs are to be dispensed at prices sufficient to replenish the store.

One of the health officers at the Owode market Clinic, Sarah Omideyi, decried the terrible situation of the PHC without essential drugs, despite DRF, and with rickety beds, which prevents the facility from placing patients on observation or admit them when necessary.

Ms. Omideyi further said the clinic has only two small rooms, an inadequacy which impacts negatively on service delivery. For the past two years, the clinic has “not enjoyed” power supply.

Our investigation revealed that only two of the primary health centres visited can have access to a good source of water if the two faulty available borehole facilities are repaired.

Oyeleke Rachael, the community health officer-in-charge of PHC Abogunungun area of Offa, lamented that the pumping machine used in supplying water to the centre and the manual pumps are both faulty.

“There is no water in the toilet as you can see. We have to fetch outside.” she said.

Furthermore, many of the buildings of the PHCs are in dire need of renovation. Painting of some should be urgent while others require a total renovation of the entire infrastructure.

At Oluyemo, Hamzat Risikat, the officer-in-charge, said: “We cannot admit someone in this kind of condition. The last renovation was done by a politician during the 2014 general elections and was badly done. In fact, it worsened the situation.”

Worse still,  laboratory services can’t be fully rendered for the want human and technical resources. There are no laboratory kits and only three out of the seven PHCs visited have a laboratory technician.

When asked for the statistics of sputum tests conducted in the last three months, Mulikat Oyelola of Infant Welfare Centre explained they could not carry out such test due to the unavailability of adequate laboratory equipment.

It was also discovered that none of the health centres has an access to an ambulance for referral or emergency cases. So, families are urged to make an alternative plan for this.

“They will either make an arrangement for motorcycle or bus,” said Ms. Hamzat.

Shortage of manpower is also a problem. None of PHCs operate or attend to emergencies at night with the excuse of inadequate security officers and health officers. There is no PHC with a medical doctor and pharmacist in the local government.

UNPAID SALARIES OF WORKERS AND THE REACTION OF THE LOCAL GOVERNMENT OFFICIALS.

In a survey carried out by the PREMIUM TIMES CENTRE FOR INVESTIGATIVE JOURNALISM (PTCIJ) with a view to knowing if health workers are motivated to work effectively or not, it was discovered that Kwara state government owed local government workers, including those in the health sector, over 6 months’ salaries last year.

One of the health officers, Oyeleke Rachael, expressed her grievances over the non-payment of salaries. She noted that this, as a factor, is responsible for poor health care delivery in the area.

“How can someone who is owed be motivated to work?” she queried.

Many of the health officers no longer report for duties as they are unpaid.

Then with that backlog uncleared, the government paid January salary, which was allegedly deducted in controversial terms.

The deduction has been denied by the government. “The January Salary was paid in full and no one is making unauthorized deductions from the monthly entitlements of LG staff and pensioners in the state.,” said Muideen Akorede, the spokesperson for the Governor.

In an interview with the Head of the Department of health care services in Offa Local government, Mallam S.I Gidado, he explained that the hands of the local government are tied as regards attending to the urgent needs of the Primary health care centres.

“Normally, the Local government should be responsible for the payment of electricity bills and some other things but now the local government is in an abnormal state. There is no money,” he stated.

Mr. Gidado, who spoke in the company of the officer-in-charge of Environmental health and Health records in the LGA confirmed that his own salary was also deducted in that month.

“They initially removed 35 thousand naira from my salary. Later on, they credited me with 10 thousand naira. No one is happy with that.”

In response to the shortage of health officers in PHCs, the HOD clarified that nothing can be done to make provisions for that unless the Federal Government or State government recruits more staff.