By Arinze Chijioke
THIS investigation by SOLACEBASE correspondent Arinze Chijioke looks at how communities in Jigawa State suffer due to lack of access to healthcare after government agencies awarded contracts, payments made and were not executed, while for those carried out, not in accordance with the specification.
The curious case of Bardo PHC
Tucked some miles away from residential buildings, along a lonely bushy path, is the only healthcare centre which serves Bardo, a predominantly farming community in Taura Local Government Area of Jigawa State.
The entrance to the healthcare centre is indicative of what has become of it, a structure that bears a semblance to a forgotten camp where rodents and reptiles live.
Inside the facility, brown stains are visible on the walls and ceilings, most of which are rotten and falling.
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Whenever it rains, rooms inside the facility are flooded. The walls are covered with cobwebs. The paint is peeling, while the doors and windows are broken.
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On one of the old and smelly hospital beds lay Ummi Ahmed, who was receiving treatment for Typhoid and Malaria. She was placed on a drip, but it was hung on the facility’s wall because there is no drip stand.
Ahmed is tired, but she cannot close her eyes for fear that sand particles from the ceiling might fall on her. Over a decade ago, when the facility was constructed, the Officer-in-Charge at the healthcare centre, Samin Usman, said that there was a steady influx of community residents and those outside the community.
“We handled all kinds of sicknesses. We also helped pregnant women deliver their babies because we had personnel who could attend to them,” said Usman, who has worked at the hospital for years.
Now, the facility has become a shadow of its old self, having been abandoned by the government. But with no other option, community members such as Ahmed still visit to get whatever treatment might be available, no matter how poor.
The project we do not know about
Under the 2021 Zonal Intervention Program (ZIP), the sum of ₦40 million naira was approved for the construction of Primary Healthcare Centres (PHCs) in Bardo by the Aminu Kano Teaching Hospital (AKTH)
However, a visit to the community in September 2022 showed that the project which was awarded to Hash Global Engineering and Technical Services Ltd was not executed. This is even after ₦28m out of the ₦40m budgeted for it was released.
When asked, the traditional ruler of the community, Alhassan Haruna, said that he was not aware of any primary healthcare project executed in the community. Other members of the community who spoke to SOLACEBASE also said that they had not heard of or seen the project anywhere in Bardo.
“We have not seen any contractor who came to Bardo to say he wants to build a primary healthcare centre,” Haruna said. “What we have been using is the old facility which is completely dilapidated.”
constituency projects…
Introduced in 1999 under the Obasanjo-led administration, Zonal Intervention Projects (ZIPs), otherwise known as constituency projects, are projects executed by the federal ministries, departments and agencies (MDAs) based on nominations by members of the national assembly, including senators and house of representative members.
However, the Executive Director of Civil Society Legislative Advocacy Centre (CISLAC), Auwal Musa Rafsanjani said that several reports have revealed that specific details on the ZIPs, including project type, cost, and target sector, have been kept secret in the past because Nigerian legislators typically pocket the cash meant for the projects.
“For many constituencies, there has never been transparency around which projects were budgeted or the estimated completion time for them,” said Rafsanjani. “This has continued to raise concerns among the citizens, who view massive public sector corruption as a daily phenomenon, while expected development continues to escape the primary beneficiaries.”
According to him, the provision of healthcare facilities which constitutes a major component of constituency project allocation and implementation is bedevilled by low maintenance culture, poor access and services, ill-equipped infrastructural services, and human resource gaps.
“Apart from this, out-of-pocket payments for primary health care by constituents constitute 40 per cent in Nigeria, while public government spending accounts for less than 50 per cent; exposing households to serious financial burden and inequality in healthcare services,” he explained.
Ruth Otori, programmes officer at the Socio-Economic Rights and Accountability Project (SERAP), said that the lack of awareness of how to hold public officials accountable on the part of the citizens is another factor that stunts the growth of accountability and transparency in the execution of ZIPs.
“Community members can hold those representing them to account by leveraging the freedom of information act that allows them to ask public officials questions and get answers about projects”.
She said there are cases where lawmakers nominate projects without conducting a needs assessment of the community and then funds are budgeted and released to them after which they go ahead to award the contracts to themselves.
More challenges
The Bardo healthcare centre also lacks water supply as the only water project serving the hospital has stopped working. The water project was carried out under the Water Supply and Sanitation Sector Reform Programme (WSSSRP) projects, implemented by UNICEF and funded by the European Commission for Humanitarian Aid.
The power supply is also a mess. On entry into the facility, it is common to see electricity cables hanging on the wood used to construct the roof of the building, thus constituting a hazard to patients and staff. The facility is accessible to anyone because it does not have a fence, and sometimes, people come into the centre’s vicinity to defecate and mess it up.
Apart from dilapidated structures and a complete lack of equipment, the health facility is poorly staffed, with Usman and two volunteers being the only personnel who work at the hospital. They are often overwhelmed because of the number of patients they attend to.
Because of these challenges, Usman and the volunteers work between 8 am to 2 pm daily. Whenever it rains, they don’t come to work as the road leading to the facility is often submerged in flood and impassable. Some of them come from Ajauro, another village which is some kilometres away from Bardo.
“If we are in the hospital and it starts raining, all we think about is what happens to our patients because we all get beaten by the rain. Everywhere is open. We are supposed to live in the facility to be able to work throughout the day, but we can’t”.
The health centre hardly gets supplies from the government. Some of the drug supplies at the facility are expired; hence, patients buy their own drugs.
AKTH refutes findings, claims contract has been executed
Assistant director of procurement at the AKTH, Mohammad Ali said that Hash Global was fully paid and that the project- which according to him, is in Bardo, a community in Jahun- had since been executed. He said that what is left is its commissioning.
He said that after the award, a site inspection was carried out and a location selected, after which the contractor was mobilised and paid the complete money to execute the job.
Contrary to the claims by the assistant director that Bardo is in Jahun LGA, findings showed that Bardo is in Taura. Google searches have also shown the same result.
While a search on the website of the Corporate Affairs Commission (CAC) did not show details of the company, further search on NG-Check showed that Hash Global Engineering And Technical Services Ltd was registered on December 23, 2016, in Kano with Registration Number 1382144 and its registered office address is situated at No. 302 Dausayi town, km14, Hadejia road.
When SOLACEBASE called Hassan Shehu Hussain, a director and shareholder in the company who supposedly is an aide to the former speaker of the House of Representatives, Yakubu Dogara, he hung up the call. Another number was used to call him several times to clarify the status of the project, but he didn’t pick up the calls. He did not also respond to a text message sent to him on October 18, 2022.
Taking their fate in their hands
In August 2020, after women in Bardo could no longer bear the pains of losing their lives due to the lack of a functional healthcare centre, some of them who benefitted from the federal government’s conditional cash transfer program of N5,000 contributed N1000 each for two months and bought a car that is now used to transport villagers to the hospital whenever the need arises.
Before then, pregnant women in the community had to be transported in wheelbarrows and motorbikes on untarred roads to Aujara, where they hired vehicles to take them further to Taura General Hospital.
“As a result, we lost many women and their babies,” Haruna told SOLACEBASE. “Apart from losing their lives, we had women who gave birth on their way to Jahun where we have a general hospital, while some ended up with complications which had serious implications for their future pregnancies.”
Although it is believed the vehicle has reduced the casualties’ rate during childbirth, some women still suffer complications given the distance between the community and the general hospital.
“If we have our own functional health centre, it will be easier for our women and other members of the community to access care. The government needs to step in and ensure that we have our own functional healthcare centre.”
Kila healthcare centre constructed without furniture
In 2021, the sum of ₦30m was approved and the entire money was released for constructing one block primary healthcare centre with furniture in Kila town, Gwaram Federal Constituency, Jigawa State, by the Border Community Development Agency, BCDA.
However, when SOLACEBASE visited the project site, it was discovered that the contractor Green Circle Continental Limited, only constructed one block of PHC without any furniture, even after the entire money had been paid. On the signboard, the project was captured as the construction of one block of primary healthcare.
The deputy-in-charge at the healthcare centre, Bello Ali, said that the project was sponsored by Hon. Yuguda Hassan Kila, a member representing Gwaram federal Constituency, who died after the implementation of the project commenced.
After Kila’s death, the project was taken over and completed early 2022 under the supervision of the newly elected Member representing Gwaram Federal Constituency, Yusuf Shitu Galambi.
“When it was opened for use after completion, we discovered that it did not have furniture, which was part of the project. This is making work difficult for us because patients often sit on the floor when they come to the facility.”
Ali said that he and other community members had tried several times to contact Galambi about the need to provide furniture as stipulated in the budget, but he kept saying he has completed the project.
Before the project was nominated, Kila town already had a healthcare centre which housed the outpatient department, a laboratory, a structure where routine immunisation was done, a labour room as well as the ante-natal care unit.
The goal was that most of the departments would be transferred to the new facility. But after it was discovered to be without furniture, the hospital management transferred some chairs, stretcher trolleys, hospital beds and bedside tables to the facility.
“We had to shift the routine immunisation, the labour room, as well as the ante-natal care unit to the new facility. Some ceiling fans also had to be taken to the new location”.
Because the beds and chairs are not enough, some patients who come to the hospital often sit on bare floors while they receive treatment. Apart from the lack of furniture, it was discovered that the ceilings were already failing, a clear sign that the rooftop was poorly done.
A laboratory attendant at the healthcare centre, Ali Dalhatu, said that health workers were happy when they saw the project thinking that it would further improve access to healthcare.
He said, “We are determined to work for the people, but we cannot work effectively when we don’t have everything we need at the PHC. We are calling on the individual that the project is fully implemented.”
Lawmaker requested borehole instead of furniture – Contractor
When SOLACEBASE contacted, the managing director of Green Circle Continental Limited, Bello Baba Habu, who confirmed that the entire money was released, said that the honourable, Yusuf Shitu Galambi wrote to the BCDA requesting to be allowed to construct a borehole at the health centre because, according to him, “furniture will dilapidate”.
“You will see an overhead tank which is not in the bill of quantity, and you will also see a borehole there. Galambi even added his personal money to the borehole project because the money for the furniture would not have been enough,” he said.
However, workers at the hospital who spoke to SOLACEBASE said that while it was important to provide water for the facility, their major need was furniture.
Reacting to this, CISLAC’s Auwal Musa Rafsanjani said that it was a complete violation of the procurement law for Galambi to interfere with the execution of the project because he is not the procuring entity.
“His action is part of the impunity and corruption that exists in the award and execution of projects. His job ends at the nomination of the project and he has no business in changing or redesigning the contract”.
What is the way out?
Ruth Otori of SERAP said that the way out would be for the Economic and Financial Crimes Commission, EFCC and other anti-graft agencies to investigate issues of corruption in the award and execution of ZIPs and make sure that those found culpable are prosecuted.
“The public can also partner with civil society organizations like SERAP to call out public officials who mismanage funds. We can help to co-write FOI requests, demanding information about projects and involve anti-graft agencies to prosecute when necessary.”
Rafsanjani added that there must be a legal framework guiding operations of the ZIPs with transparent and accountable execution or implementation monitored and audited.
“The government must clean up the public procurement process which remains one of its activities most vulnerable to corruption, mismanagement and wastage,” he told SOLACEBASE.
This report, republished from Solacebase is produced with support from the Wole Soyinka Centre for Investigative Journalism (WSCIJ) under the collaborative Media Engagement for Development, Inclusion and Accountability project (CMEDIA) funded by the MacArthur Foundation.