THE Federal Neuro-Psychiatric Hospital, Kware, (FNPHK) Sokoto State, is set to provide general health services after procuring state-of-the-art equipment with the COVID-19 Intervention Fund.
The facility is one of the federal government’s hospitals that shared 35 billion COVID-19 intervention funds donated by private organisations and well-meaning individuals in Nigeria at the peak of the pandemic in 2020 to support the nation’s health system and make it better combat the virus.
The FNPHK started as a mental home in 1988. The Federal Government took over the facility in 1996 and converted it into a neuropsychiatric hospital.
The hospital has since specialised in providing services for mental-related conditions for patients in Nigeria, Niger and other neighbouring countries. In 2019, the hospital cared for nearly 90,000 patients.
The FNPHK is one of Nigeria’s eight federal neuropsychiatric hospitals, out of which three are in the North.
Photo credit: The ICIR/Marcus Fatunmole
Medical Director of the hospital, Shehu Sale, a doctor, said the equipment the hospital procured with the COVID-19 fund and other infrastructures it acquired with its budgets from the Federal Government in the past few years had positioned the institution to expand its services beyond psychiatric care.
The hospital’s services now include dialysis, accident and emergency, cardiology, maternity, eye care, dental, gynaecological and other general services.
The COVID-19 Intervention Fund
The world responded to the devastations accompanying COVID-19 in 2020 and 2021 with different measures. While morbidity and mortality from the disease soared globally, well-meaning Nigerians rose to support the nation’s health systems to combat the virus through the Coalition Against COVID-19 (CACOVID), otherwise known as the COVID-19 fund.
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 over N35 billion from the donation, distributing a large chunk of it to 37 federal hospitals.
Federal Neuropsychiatric Hospital, Kware’s share of the fund
A document obtained by The ICIR from the Accountant-General’s office in Abuja showed that the FNPHK got N1.078 billion from the CAVOVID money.
But the hospital’s medical director told this newspaper that the facility received less than a billion Naira.
Head of Procurement at the hospital, Ibrahim Nazir, also confirmed to The ICIR that the hospital got N948.1 million from the fund.
Role of the Bureau of Public Procurement in managing the CACOVID donations
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).
The NOCOPO is a creation of the Bureau of Public Procurement (BPP) to foster the National Action Plan of the Open Government Partnership.
Some hospitals, ministries and agencies that received the COCAVID fund published details of what they got on the NOCOPO website. Others failed to do so, including the FNPHK.
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.
Equipment purchased with the fund
The ICIR visited the hospital in October and met the newly-built molecular laboratory, intensive care unit (ICU) and isolation centre built with the CACOVID fund.
The ICIR’s visit to the hospital was part of its verification of the equipment purchased with the CACOVID fund by federal hospitals.
The visit followed similar verifications at the Federal Medical Centres, Jalingo and Makurdi, Jos University Teaching Hospital (JUTH), the Modibbo Adama University Teaching Hospital Yola, Adamawa State, and Gashua town, Yobe State, and other places.
Sale and his management team conducted The ICIR around the sections of the hospital housing the equipment bought with the CACOVID fund. They are the molecular laboratory, isolation ward and intensive care unit.
This reporter also saw the hospital’s newly-built Accident and Emergency (A&E) and the Regional Women and Children Drug-Dependent Treatment Centre all equipped.
Molecular Laboratory
Some of the devices at the molecular laboratory are: -86 C refrigerator, autoclave, blood box biosafety cabinet, extraction machines (manual and automated) including refrigerators for keeping reagents, minus 40-degree fridge, real-time PCR machine, life river (used for amplification), bio-safety cabinet and shaker. There is a big generator to supply power, and solar power panels and their batteries.
There are also VITEK 2 Compact (automated media machine), monitor, Number One Plus Two Automated Incubator, microscopes, Selectra, Skyla, mini vidas and centrifuge.
Others are: water purification system, refrigerator, UPS, analyzer, electrophoresis, automated coagulometer, microscopes, microhematocrit centrifuge, mixer, and blood bank refrigerator.
Idris Muhammed, a Visiting Pathologist, Simon Isezuo, a Professor of Medicine and Cardiology from Usman Danfodiyo University, the Head of the Department of Clinical Services in the hospital, Adebayo Adebisi, a psychiatric doctor, and Roseline Eruwa, Head of the facility’s Medical Microbiology were among the experts who lauded the CACOVID fund donors and the Federal Government for supporting the facility.
In addition to treating COVID-19, they said the hospital would use the equipment to manage other infectious diseases and for research and training.
Before the hospital got the equipment, patients and staff travelled to distant places such as Irrua in Edo State to test blood samples.
According to Isezuo, the hospital can now handle any cardiological-related ailment because of its equipment acquired with the CACOVID fund.
He spoke glowingly of the intervention, stressing that the fund helped the hospital have more buildings and equipment to compete with its contemporaries globally.
Isolation Ward
The hospital has two wards as its isolation—one for suspected cases and the other for confirmed cases.
Every bed has ancillary devices, including a C-PAC machine, a nebulizer (for patients with acute respiratory distress), defibrillators, ultrasound machines, oxygen concentrators, and autoclave machines, among other devices.
Ten-bedded ICU
There are ten beds, a generator, an intercom for communication, a digital x-ray machine, closed-circuit Television (CCCT) camera for monitoring patients at the ICU.
Every bed has a monitor and vertical bedhead. “There advantage of this vertical bedhead is that there is a computer system in the nursing station. The nurse doesn’t need to come to the bedside to monitor the patient’s blood pressure, other vital sounds, or respiratory rate. You have the patients on the bed, and all the equipment are connected to them, sending the information to the central system.
“Even if you have one nurse that is seated there, she’s monitoring ten patients at the same time. The nurse will immediately come to see the bedside whenever there is any red flag. What we have here is a fully digital ICU. That means you don’t need to go to the bedside and take vital signs. We monitor them remotely. Each bed has ancillary equipment comprising a ventilator, suction machine, ECG machine, and oxygen concentrator. There is also a syringe pump. The vertical bedhead has an oxygen pipe supplied to it. There are also ventilators in the ICU”, Idris Muhammed, a Visiting Pathologist from Usman Danfodiyo University, Sokoto, said.
The building has a ramp for patients’ easy movement into the facility.
The hospital can use the ramp to take patients from the isolation room to avoid contact with the other persons at the facility, and there are three entrances to the building.
COVID-19 equipment, a blessing to hospital – Medical Director
The medical director said only a few hospitals in Nigeria had the kind of equipment that now exist in the facility before the emergence of COVID-19.
“We thank the Federal Government. We thank President Muhammadu Buhari for this giant intervention. Though these were procured to fight COVID, they will be instrumental in tackling other conditions.
“With the COVID intervention and other equipment that we have purchased, we are set to provide eye services, dental care, gynaecological and general medical conditions.
“You can see that we’ve already completed the building and equipping of our state-of-the-art Accident and Emergency, which will make the hospital provide general care you can have in other hospitals. We have theatres and laboratories, with many beds for patients before they are moved to the general wards.
“So, the hospital is providing general care. It is no longer just a psychiatric hospital. By the time the services fully take off, psychiatric care will be just a branch of services in the hospital.”
Giving insight into why the hospital’s services expanded, Sale explained that the Usman Danfodiyo University Teaching Hospital in Sokoto was being overstretched, and more people were coming from Niger and other parts of Nigeria to seek care at the FNPHK.
He revealed that one-third of people getting care at the facility were from Niger Republic.
How brain drain hits hospital
The FNPHK has its share in the brain drain hitting the Nigerian health sector.
Several reports, including The ICIR’s, show how medical practitioners leave Nigeria in drove yearly.
Sale said the hospital recently lost two consultants, a couple of nurses and people from other professions to brain drain.
The hospital hires about 17 visiting consultants to fill the vacuum created by the brain drain.
“They are people from different specialities who come from different parts of the country.
“We also have visiting nurses with different expertise. We are pushing for the replacement of staff that have exited. Once we do that, the number of staff will increase. They will be able to cater for the teeming number of patients at the hospital.”
The contracts details
The hospital awarded the contract for procuring and installing ten-bedded intensive care unit equipment and reagents to Sudabelt Medical Co Ltd at 308,084,000,00. The procurement was to be delivered within 56 days.
Ceword Int’l Resource got the contract for procuring and installing the isolation centre’s equipment and reagent for 84,939,678.92. The procurement had 56 days delivery target.
The hospital awarded the contract for constructing an isolation centre and intensive care unit (ICU) to Akoon Multi Services Ltd for 59,999,956.48. They were to be completed within 180 days.
DCL Laboratory Ltd got the contract for procuring and installing molecular biology equipment, reagents and other molecular laboratory equipment for 300,848,654,00. The company was to deliver the equipment within 56 days.
The contract for the construction of the molecular laboratory was awarded to Horkey International Services Ltd for 44,794,083,63. The project had a delivery deadline of 100 days.
De Roox Precious Services Nigeria Ltd got the contract to procure personal protective equipment at 53,547,170,00.
Similarly, the contract for another tranche of procurement of personal protective was awarded to Health Matrix Nigeria Ltd for 95,982,250.00, with a delivery deadline fixed for 56 days.
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].