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PHC tracking: In Kwara, health workers walk miles to fetch water for clinics

Nurat, drenched, came into the old building hosting the Ajoko-Oja primary health centre, visibly exhausted. “I just returned from where I went to get water,” she told the probing journalist at the centre. “It’s miles from here.”

For any purpose, the Ajoko-Oja health centre does not have water supply facility. So, a health worker, like Nurat, has to combine the tiring task of covering a long distance to get water for use in the facility with her routine healthcare duties.

Ajoko-Oja Health Centre

“There are no toilets here,” she continued as water dripped from her clothing. “The two rooms available are not in a good condition not to talk of a toilet. Patients make use of the bushes around.”

By the minimum requirements of a basic health centre set by the National Primary Health Care Development Agency (NPHCDA) in 2017, the Ajoko-Oja centre is a mockery of a primary health centre. The agency specifies that a primary health centre should have water should have water and toilets facilities within its vicinity.

Ajoko-Oja Health Centre

Apart from Ajoko-Oja, other primary health centres in Oyun LGA of Kwara State from Ipee to Ojoku and even those in Offa LGA are pathetic excuses for a health centre, illustrating the limited access of poor Nigerians to an important component of human capability enhancement services.

At Ipee, the only available toilets are dry pit latrines. The WC in the facility is broken-down and there is even no water to flush. Like Nurat at Ajoko-Oja, the health workers at Ipee also take pains to go search for water for use in the facility, especially during dry season when the well dug by the LGA is dry, lamented  Janet Eegunfemi, the community health officer (CHO) in-charge.

Pit toilets at Ipee Basic Health Centre
Pit toilets at Ipee Basic Health Centre
Pit toilets at Ipee Basic Health Centre
Pit toilets at Ipee Basic Health Centre

Even for clinical use, the facility uses water from a near-by stream.

For clinics without services as basic as toilet and water, it does not come as a surprise that they have adequate laboratory service. According Mrs Ajibade, a nurse in Ipee PHC, most of the blood and urine samples collected for tests are taken to the laboratory unit of the general hospitals.

“We don’t carry out sputum tests, urine or blood tests because we don’t have enough laboratory officers and equipment. All we do is just Malaria Parasite tests,” Ajibade said.

Besides, like every other state and local government staff in Kwara state, salaries of health workers in Oyun local government are not regularly paid. People who have to take extra duties fetching water to serve patients don’t get paid as and when due.

Opeyemi Bankole, 39, a support staff in charge environment and waste management at Igosun primary health centre, told our correspondent how he stopped working after months of unpaid salaries.

Primary Health Centre Igosun

“I was being paid 5,000 Naira every month initially,” he said. “It was later reduced to 2,000 Naira and eventually, they stopped paying.”

Bankole, who heads a family of four, left the government service to be a commercial motorcycle rider.

“When they stopped paying us, the casual staff and the salaries of the permanent ones are not being paid regularly, I resorted to okada riding in order to fend for the family,” he explained further.

The facilities do not have security guards. The implication is that, for safety reasons, the staff close between 2 p.m. and 4 p.m. and emergency situations after these hours would have to be managed elsewhere.

“There are no guards in the health centre. We close by 2pm,” said Nurat at Ajoko-Oja, adding that two officers at the clinic don’t report regularly.

“The road to this place is bad, which doesn’t make it motorable. Only motorcycles can ply the road. Because of that, the two senior officers alternate their attendance. One has a motorcycle and the other spends 1,000 naira on each visit.”

Also, in Ojoku, three out of the six health workers, living outside the village, rely on the vehicle of the community health officer (CHO) in-charge, Rebecca Alabi, for mobility most times.

One of the officers, Miss Opeyemi, who referred to the CHO as ‘mummy’ said “Most times, mummy helps us with the transportation from Ojoku to Offa, where we reside. At times when she’s not available, I don’t come to work because of the exorbitant transportation charges.”

“Government rarely pay us these days. You know,” she buttressed.

The Director Speaks

Head of the health department in Oyun Local Government, Solomon Olaegun, expressed displeasure as regards the state of primary health centres in the local government.

He said: “Most of the security guards have retired and no replacement. The same with nurses.

“I am the only local government medical doctor in the whole local government and I will soon retire. We used to be three but the other two retired two years ago. By this time next year, I’m out of office.” He added.

On the irregular payment of salaries, Mr Olaegun said, “There is no money in the local government. Maybe when local governments are autonomous, we’ll be able to do some things.”

Speaking on facilities, he said, “We dug a well for them but during dry seasons like this, the well will dry up. Even the solar borehole in Ijagbo is faulty at present.

“I know the state of things in these centres. Ordinary baby weighing scale and thermometer, some of them don’t have.”

New renovated clinic in Ojoku

Ojoku has a newly renovated primary health centre, just commissioned in April, over one year after the health minister, Isaac Adewole, announced it was a part of the 109 clinics to renovated across the country.

The Renovated Ojoku Health Centre
The Renovated Ojoku Health Centre
The Renovated Ojoku Health Centre
The Renovated Ojoku Health Centre

However, the health officer, Rebecca Alabi, complained: “The water coming out of the borehole is not good neither is it safe for use, which is an indication that it was badly dug.

“I had to pay the electrician, who came to fix the cables that were distorted as a result of the renovation, with my personal money.”

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