AFTER witnessing killings, losing family members and property to Boko Haram insurgency, Internally Displaced Persons (IDPs) at Wassa camp in the Federal Capital Territory FCT are facing challenges of access to proper healthcare and facilities; the ICIR’s Mustapha Usman reports.
In Wassa IDP camp, Abuja, access to proper healthcare has been a major challenge for its residents, who are mainly people displaced from the insurgency plaguing the northeastern region of Nigeria for over a decade.
The Wassa IDP, which is supposed to be a temporary refuge till their homes are safe to return to, has over 896 households, 200 Units of houses and over 5000 numbers of displaced persons, mostly from Borno, Adamawa and Yobe.
As of December 2020, Nigeria has over 2.7 million Internally Displaced Persons (IDPs), the third largest in Sub-Saharan Africa, behind Congo Dem. Republic and Somalia. In 2020, Conflict and violence led to 169,000 new displacements.
In 2021, the government signed a revised edition of the National Policy on IDPs. The policy states that all wounded, infirm, and IDPs with a disability shall receive medical care to the extent practicable, which shall include psychological and social services whenever necessary. This policy was first introduced in 2012 before it was reviewed last year.
However, until 2020, most of the displaced persons at the Wassa camp could access care at the Wuse and Asokoro General hospitals as a special intervention by the Federal Government (FG).
The camp chairman, Geoffrey Bitrus, stated that in the past, a displaced person gets a letter and identification from Federal Emergency Management Agency (FEMA) and National Commission For Refugees Migrants And Internally Displaced Persons (NCFR), which they take to the designated hospitals and then access care. However, this is no longer functional.
Early this year, a resident of the Wassa camp Emmanuel Marcus lost his first son, Jacob.
Emmanuel believes his son may still be alive if he had access to healthcare. He said he made several attempts to get the letter from the camp leader, who is the liaison with two agencies in FEMA and NCFR, but was told they no longer issue it.
As such, he went to a ‘chemist’ as he could not afford hospital bills.
The camp has a mobile clinic, but Marcus did not go there as there are no drugs or health workers at night.
Ruth Jacob lost her child two weeks after giving birth to him at her residence in Wassa, she also said she could not access healthcare for herself or the newborn, and the mobile clinic just around her house was not useful.
Jacob and many other residents interviewed said they do not use the clinic.
Many factors can cause child mortality, especially in an IDP camp it could be government neglect, poor access to water, sanitation, hygiene or malnutrition.
Barely a few months after he fled from Borno with his relative to the Wassa IDP camp, Abuja, Ibrahim Umar, 21, had an accident that led to an injury in his leg and hand while coming back from work at Apo primary.
Ibrahim was a commercial motorcyclist.
Umar could not afford hospital bills, and because of the unavailability of the identification letter, he was taken back to his residence in IDP Wassa camp instead of to a hospital.
He said he had to do whatever drugs were available at the mobile clinic. Then eventually, he was taken to outskirts communities in the FCT where he could get healthcare at a cheaper rate, this means resulting to traditional and herbal treatments.
‘My hand is not working. I can’t raise it. I can’t move it at all. I could only hide it beneath my long sleeve or pocket. Had it been I have money, or we have a provision that caters for us here in IDP, my hand wouldn’t have turned like this. If I had gotten treatment at General hospital, I would still be able to ride motorcycle because I love riding and more also it brought me more profit than the phone charging business I am into now,” Umar said, panting.
He now earns a living by charging mobile phones for a fee.
Meanwhile, the Head of Medical Records at Wuse General Hospital, Adio S.O confirmed that the IDPs stopped coming in 2020.
“We can’t turn them back if they come with identification. I think they stopped coming since the inception of COVID-19 in 2020. So, I don’t think we still have them.
“Before they can have access to treatment here, they must have an identification to present; then we would now register them free,” she told The ICIR.
Like Umar, Patrick Bitrus, a 10-year-old, fell from a mango tree and fractured his hand and leg in February.
“We didn’t even bother going [Wuse and Asokoro General hospitals] because we heard they stopped giving it out two years ago”, Patrick’s guardian told The ICIR when asked why he wasn’t taken to the designated hospitals.
When they eventually did, at the Wuse General Hospital, they were billed N270,000, which they couldn’t afford, his guardian said.
Unlike what the law says, these sets of people are battling it out themselves.
The ‘‘National Policy on Internally Displaced Persons (IDPs) in Nigeria’’ dreams of a Nation where the rights of all internally displaced persons are met. It also acknowledges that “Persons affected by displacement situations experience a wide variety of needs in the short, medium and long term. These include water, food, security, psychological well-being and access to healthcare.
This national policy further grants in Chapter 3. 1.1 (e) Vulnerable IDPs shall have a right to receive protection and assistance required by their condition or special needs. Such vulnerable IDPs shall include children accompanied, unaccompanied and orphans, women including nursing and expectant mothers and female heads of households, persons with disabilities, and the elderly.
But this, according to the IDPs in Wassa, falls far short on implementation.
Measles outbreak in the camp
The camp had experienced a measles outbreak which affected many families. Hadiza Ibrahim’s family, who fled from Borno, was one of the affected.
Her three-year-old son had measles, which she could not treat due to cost, resulting in self-help.
For Aisha Shuaibu, four of her five children were affected. She initially thought of taking them to the mobile clinic but realised that the medical staff didn’t work on Thursday.
Shuaibu said, “ The clinic is mostly closed on Thursday, and most times, they hardly have drugs.”
On how she was able to fund the drug purchase, she said the expenses were taken care of by her husband, who is a farmer.
Bukola Mohammed’s family was also affected. She said, “My son is two years old and has been suffering from measles for almost a week now. He has been on medication that costs around N3,500.”
.According to the secretary of the Wassa IDPs, John Samaila, scores of people had also been reported affected by the outbreak, and he also said the mobile clinic was not fulfilling its function due to a lack of drugs.
The Abuja Municipal Area Council (AMAC) Deputy Director and Disease Control officer of IDPs, Abdulkareem Mustapha, said it’s the council’s responsibility to provide basic health needs for the IDPs, such as drugs to the clinic.
He stated that at one point, the drugs were supplied through an intervention by the wife of the Inspector General of Police (IGP).
“The wife of the IGP donated N500,000 worth of drugs to them last year, but they forcefully distributed it amongst themselves instead of putting it in the mobile clinic,” he told The ICIR.
According to him, AMAC always provides them with the support they need whenever there’s a disease outbreak.
“When they reported an outbreak years back, we were there. I could remember we were there for three weeks treating the outbreak of measles two to three years back,” he said.
The mobile clinic…
The IDP clinic, donated by a former speaker of the House of Representatives in 2017, showed that the building has three rooms, the largest room, which happened to be the Ward has two functioning beds.
The ICIR also gathered that the mobile clinic only has one Public health practitioner and a volunteer.
This two shoulder the responsibility of more than 5000 IDPs in Wassa. Findings reveal the mobile clinic often lacks drugs. On a few occasions, they get donations from philanthropic organisations; other times, the community contribute to restock the supply.
“Anytime the drug is finished in the store; I will write a prescription for them to go and get it in a chemist shop”, Tanimi Osu, the Public health officer told The ICIR.
NCFR, FEMA debunk looking away
Even though the AMAC officer in charge of IDPs, Abdulkareem Mustapha, didn’t deny the allegations levelled at FEMA and NCFR by the IDPs in Wassa, he, however, said he had in the past followed the IDPs to get referral letters from FEMA until about two years ago when the Agency told them that they were overwhelmed with hospital debts and bills.
In Contrast, FEMA Director of Relief and Rehabilitation, Abdulrahman Muhammed, insisted that the welfare of IDPs is put in place in these hospitals.
Some of the issues raised, he said, are due to ignorance, lack of contentment and as well as lack of funding.
He told The ICIR that FEMA didn’t stop identifying the IDPs for the hospitals to take care of them. However, he said the number of letters they issued had reduced as they put modalities in place to check and curb false claims.
“Fema didn’t stop giving IDPs letters, the medical bills of IDPs were taxed towards Asokoro and Wuse hospitals at a time. If you go there on your own without us telling them that this person is an IDP, they wouldn’t attend to you,” Muhammed said.
In case of emergencies, Muhammed noted that the hospitals have emergency medical services, and according to him, IDPs are also enrolled.
“If you go to Wuse and Asokoro hospitals, there’s emergency medical service which IDPs also fall under the emergency medical service. They will attend to them. I don’t know what their leaders are doing; they need to be proactive and ask questions about what’s happening now,” he said.
Although the Deputy Director IDP of the National Commission for Refugee Migrants and IDPs, Musa M.K., agreed with the findings that the commission has stopped catering for IDPs who are facing serious health issues but however disagreed that it’s been up to two years.
He said in 2021, the commission stopped giving out referral letters to IDPs because the 2021 appropriation budget did not capture the hospital expenses. The commission owes the hospital a huge sum of money.
“For years, we have had an agreement with the National hospital. We used to give referral letters to IDPs to go on treatment. Unfortunately, we owe them a huge sum of money. I believe you know as an FG Agency, we work with appropriation. We work with the budget, so we exhausted our budget, and we are owing a huge sum of money, so we decided to put that on hold until we settle the National hospital. So if that’s what they are referring to, this is the reason why we stopped giving referrals until we settle all the bills. We stopped giving referrals just a year ago.”
“What we intend to do in 2022 when they release the money, we are going to start exiting camps. It’s not rational for us to keep on keeping people that were displaced in 2014 eight years later as IDPs.”.
Usman Mustapha is a solution journalist with International Centre for Investigative Reporting. You can easily reach him via: umustapha@icirnigeria.com. He tweets @UsmanMustapha_M