AMINU Yusuf was at the Federal Medical Centre Gusua, Zamfara State, in July 2018 to treat his wife, who suffered from bacteria infections during pregnancy.

The woman, Habiba, and her husband travelled from the state to the Usmanu Danfodiyo University in Sokoto State before running some tests that showed she had sepsis. The Gusau FMC did not have the equipment to run tests on her.

The couple returned to the FMC Gusau with the test result for Habiba’s treatment, covering the 213-kilometre Gusau-Sokoto Road.

That was the situation of the facility before it got the CACOVID Fund (otherwise known as the COVID-19 Intervention Fund) in 2020, which enabled it to procure some world-class equipment in its critical departments.

For instance, the hospital did not have a molecular laboratory to conduct specialised diagnoses. It referred patients and their relations, like Yusuf’s, to other states to do the procedures.

Some of the patients travelled as far as Maiduguri to run tests before getting results that revealed their conditions. But that has stopped.

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In February 2022, Danladi Mustapha and his wife, Mariam, were at the Gusau hospital to treat their five-year-old son, who had a viral infection.

Because the hospital already had all the equipment needed to run tests on the boy,  the family did not have to travel elsewhere like Yusuf’s family. 

Since 2021, the FMC Gusau has acquired more equipment, built a complete molecular laboratory, and upgraded its intensive care unit (ICU), among others, courtesy of the CACOVID Fund.

The ICIR reports that the CACOVID fund differs from the yearly capital releases by the Federal Government to the hospital, which are used for other purposes.

The facility now hosts hundreds of patients daily because it has expanded its services. Being the only tertiary health facility in the state, it enjoys higher patronage than ever.

Some of its patients are victims of insurgency and banditry who need emergency treatment, including transfusion, and whose relations often throng the hospital. 

Many primary and secondary healthcare facilities in the state have been inactive because of insecurity and other challenges, making most people in the state see the FMC as their most dependable institution for healthcare delivery.

The FMC’s medical director, Bello Muhammed, said the new equipment procured with the COVID-19 fund positioned the hospital to render services it could not previously offer, including those it had sought in Maiduguri and other places.

Because of the funding support, the hospital now has a molecular laboratory that carries out essential diagnoses.

The FMC has upgraded its five-bedded intensive care unit (ICU) to a ten-bedded ICU. All the ten beds are new and have accompanying gadgets for patient care in a modern ICU, courtesy of the fund.

Besides, the hospital has a remodelled isolation ward and a gas plant funded by the fund and a chemistry analyser and blood bank.

The reporter found out that services have been more effective at the hospital because the management enforces discipline, such as using an attendance register in every department to curb absenteeism and lateness to work.

Every worker logs their name and the time they arrive work in the workers’ register positioned at their office’s entrance. They also sign out when closing from work.

All workers interviewed said the medical director sets the example. The reporter saw the medical director moving around the facility at 8:30 a.m. on October 18 when he visited the hospital to check the equipment purchased with the COVID-19 money.

The visit followed similar verifications by the reporter at the Federal Medical Centres, Jalingo and Makurdi, Jos University Teaching Hospital (JUTH), the Modibbo Adama University Teaching Hospital Yola, Adamawa State, Gashua town, Yobe State and Federal Neuro-Psychiatric Hospital Kware, in Sokoto state. 

Muhammed told the reporter that he instilled discipline in his workforce to promote productivity and ensure every worker justifies their wage.

The COVID-19 Intervention Fund

The threat posed by the emergence of coronavirus globally in early 2020, and its accompanying high morbidities and fatalities, pushed  Nigerians and corporate organisations under the auspices of Coalition Against COVID-19 (CACOVID) to raise funds to strengthen the nation’s health system.

As of June 2020, 181 corporate organisations and individuals had contributed N30.2 billion to the fund.

At the end of the year, the government had spent N38.59 billion from the fund.

Nigeria recorded its first case of the disease on February 27 and locked down some states on March 30, as infections from the virus spiralled nationwide.

Among other measures, President Muhammadu Buhari constituted the Presidential Task Force on COVID-19 and approved emergency procurements of pharmaceutical and non-pharmaceutical measures to combat the pandemic.

The role of Bureau of Public Procurement in managing the fund

The Public Procurement Act 2007 recommends competitive and open bidding for public contracts. The Act, however, has a caveat for emergency procurement during a crisis such as the COVID-19 pandemic.

The Federal Government expected all the fund beneficiaries to log the details of their procurements in the Nigerian Open Contracting Portal (NOCOPO).

NOCOPO is a creation of the Bureau of Public Procurement (BPP) to foster the National Action Plan of the Open Government Partnership.

Some of the hospitals, ministries and agencies that recieved the COCAVID fund published details of what they got on the NOCOPO website. Others failed to do so.

Beneficiaries were to provide information on how they spent the money. The information includes project title, contractor, contract sum, completion period, project status and items they procured.

The ICIR reports that failure to upload the details, otherwise known as the procurement plan, is a contravention of the Bureau of Public Procurement (BPP) Act and undermines its transparency initiatives for governance.

While the Gusau hospital entered the details, it failed to name the items it bought with the money it got.

The FMC’s share of the CACOVID Fund

The hospital’s medical director, Bello Muhammed, said the FMC got N949 million (949,068,634.00), but the Accountant General’s Office figures showed the facility got N1.35 billion.

“It’s not up to over one billion. It was over 900 million. The money was not paid at once. There were releases. We had to do some of the projects in phases because we were given the first tranche. We were not expecting the second tranche until when we finished executing the first release. 

“Then, we heard about the second tranche. The money was released at different times for different purposes,” the medical director told The ICIR.

Contracts awarded with the fund

An Abuja-based firm specialising in medical equipment, DCL Laboratory Products Limited, got the contract for constructing and equipping a molecular laboratory at the sum of N345.8 million.

Another company, Sudabelt Medical Co. Ltd, dealing in medical equipment, got the contract to supply equipment for the hospital’s isolation ward at N99.8 million.

The firm got yet another two contracts, namely a contract for the supply of equipment for upgrading the ICU to 10-Bed capacity for N353.6 million and another contract to procure personal protective equipment (PPE) at N96.1 million.

COVID-19 fund, a blessing to Gusau FMC – MD

The medical director said the fund helped the facility purchase equipment it never thought it could buy. “You have seen the molecular laboratory, which is fully equipped. We did what we had done with the intervention. We infused essential equipment such as the chemistry analyser and blood bank in our general laboratory. 

“The blood bank here is among the best we have in Nigeria.

You can see the intensive care unit. Before, we had a five-bedded intensive care unit, but with this kind of intervention, we upgraded it to a 10-bedded intensive care unit.

“Previously, we had to go as far as Kaduna and Kano to get oxygen, which was not easy. With what is going on now, soon, we will start selling to outside neighbouring states.

We may only be able to consume some of what we have produced. All these are courtesy of COVID-19.”

He averred that the COVID-19 intervention provided equipment of world-class standards that encouraged the entire institution’s staff.

Muhammed said with the calibre of equipment on the ground; patients could easily have the investigative procedures and treatment they needed. 

“It has cut down a lot of expenses. Before now, some of these patients travelled far to get some of these services. Along the line, they also had an accident.

“The last time I saw a chemistry analyser of this capacity was in France in 2012. Now, here we are with the equipment.

We could only do some of these investigative procedures here before the COVID-19 intervention. You had to take your patients as far as Sokoto, Zaria and Kano, which are not less than 240 kilometres each.”

Hospital has 38 consultants and others to provide services

The medical director said the FMC had 38 consultants and other health professionals.

There were 45 consultants at the facility. Seven left within the past year. Gunmen killed one of the consultants in 2021 in his home in the state.

Muhammed said the state faced insecurity more than any other in the country. “The insecurity has impacted negatively on the performance of this hospital. Some of the specialists have fled outside the country. The brain drain is affecting the hospital in two ways.

“Some specialists leave this part of the country for the southern region. At the same time, some leave for outside the country. So, our brain drain is the worst in the country because it is in two ways.

“And the victims of banditry and insurgency are also brought to the hospital. The hospital is seriously overwhelmed.”

Some of the equipment bought with COVID-19 money at the FMC

Some of the equipment at the molecular lab are the bio-safety cabinet, PCR machine, automatic extraction machine, centrifuge for manual extraction, Glove box, -80 degree Centigrade, VITEK 2 Compact, 20KV inverter, pure-water making machine, heating block, autoclave.

Head of the Molecular Laboratory Department, Shaibu Baba, told The ICIR, that the hospital should have gotten the facilities long before COVID-19 but expressed delight that they were available despite the delay.

He stated that the hospital’s molecular laboratory was the only one in the state. 

“We hope the government will keep supporting molecular activities in the country because they make life easy and make things cheaper for people to access health.”

At the hospital’s ten-bedded unit are mechanical ventilators for supporting patients’ breathing, ECT machines used for diagnosing patients’ heart abnormalities, defibrillators, infusion pumps, and mobile mechanical ventilators, among others. 

The hospital’s isolation ward has different wards where persons with suspected and confirmed infection cases are kept. The hospital renovated the ward with the COVID-19 fund. 

Some of the equipment there are an autoclave, oxygen concentrator, suctioning machine, Ambu bag, manual suctioning machine, oxygen cylinders, infrared thermometers, and bed-side cupboard, among others. 

At the FMC’s general laboratory are a haematology analyser and blood bank refrigerator (which can preserve 200 pints of blood).

Assistant Director of the Haemotology Department, Hassan Olorunfemi, said power outages were a main challenge at the department.

Asked about the equipment’s usefulness after COVID-19 is no longer very active in the country, the hospital’s Head of Department, Community Medicine & Community Physician, Musa Yakubu, a doctor, said, “People still come with diseases. Even if there is no more COVID, we still have diseases that require isolation precautions. We have Monkeypox. We have people who come with Lassa Fever that must be isolated from the general medical and emergency wards.”

Well-policed hospital with sprawling buildings

Visitors to the hospital meet private guards at every point from the facility’s main gate.

Every department and ward has a guard manning it. Police and officers of the State Security Service (SSS) also complement security at the FMC.

Following the insecurity crisis in the state, visitors are not allowed to take pictures or loiter within the facility.

The hospital parades dozens of new buildings it built in the past few years. The mostly-bungalow structures are linked with concrete walkways.

Some defects observed 

The reporter discovered that the haematology analyser did not work because it had a faulty UPS.

There are many packs of hand sanitisers at the hospital’s store. They could expire if left unused.

At the time of the visit, there was a bush in front of the hospital, close to the hospital’s major solar panel. The grass could harbour reptiles that might harm people who walk through the long route between the main gate and the facility’s buildings.

The reporter observed that many of the devices procured for the hospital’s isolation unit are kept in the store because there is no space to put them to use.

Marcus FATUNMOLE

Marcus bears the light, and he beams it everywhere. He's a good governance and decent society advocate. He's The ICIR Reporter of the Year 2022 and has been the organisation's News Editor since September 2022. Contact him via email @ [email protected].