SINCE August 2022, the General Hospital in Sabon-Tasha, Chikun Local Government Area (LGA) of Kaduna State has been operating without electricity. In this report, The ICIR’s Nurudeen Akewushola chronicles how the hospital was thrown off the national grid, thereby crippling healthcare services in the facility.
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It was around 7 p.m. on a Friday. The premises of the General Hospital, Sabon-Tasha, appeared quiet, unlike the busy atmosphere of a typical general hospital. The disposition of both patients and their caregivers mirrored their dissatisfaction, as some had to abandon the wards to sit at the entrance to escape the suffocating heat. In an attempt to find relief, a number of caregivers and patients resorted to the use of placards to wave off the heat.
It all began in August 2022 when the transformer supplying the hospital developed a fault. Though the transformer was later fixed, a year later, the facility, located in the heart of Kaduna Metropolis, remains unconnected to the national grid, thus crippling efficient health care service in the hospital.
Since then, the hospital has relied on a generator as its power source. But this comes at a cost. The patients have no alternative but to bear the cost. The generator is fuelled by the fees charged clients for medical and laboratory services.
Nurses rely on phone torches for ward round check
Faith Isaac looks tired and frustrated. Her child was admitted to the hospital due to malaria and that has kept her within the hospital walls for three days and throughout this time, she could not have access to electricity.
“It’s frustrating because there’s not been light for the past three days that we have been here and the mosquitoes are everywhere,” Faith lamented. “When the nurse wants to go around to check the children at night, she will have to use her phone. Sometimes I have to borrow her my power bank to charge her phone.”
She recalled an incident where she was nearly stung by a scorpion in the darkness but was saved by her torchlight.
“Thank God I was using my torchlight, the scorpion would have stung me. The experience has been very bad,” Faith recalled.
During a visit, The ICIR confirmed the absence of potable water either for drinking or domestic use. Though strange, findings showed that health workers, especially nurses, often go outside the hospital to get water at a cost. Relatives of the patients also do the same in some cases, due to the same challenge.
Though the hospital has a borehole, the absence of electricity makes it impossible for the hospital to pump water for its basic needs.
Kezia Amos, a caregiver from Angwan Gimbiya community lamented the persistent darkness at the hospital in the evening. She said there was no power during his four-day stay, forcing health workers to rely on lamps and phones for tasks due to the absence of power supply.
Garba Makama, a resident of Anwan Baro community, recalled a fateful day he brought his daughter to the hospital in the night, only to find out that the doctors were absent from their seats. The nurse he met was preparing to leave and they had to sit down in the dimly lit reception area.
Suddenly, another patient emerged who was in need of emergency attention. The health workers wanted to attend to him but were all holding feeble torchlights amid darkness. This made it hard for them to locate the patient’s vein and inject him accordingly.
“Because they were using torchlight, they were looking for his vein and when they saw it, they wanted to put the syringe in it but they couldn’t get it right and that’s how they ‘punched’ the patient like more than 10 times and the patient later collapsed and fainted,” Garba recalled.
*Usman, a civil servant, has been admitted for five days and since then, he has witnessed the departure of three persons which according to him is due to lack of quality healthcare delivery in the hospital.
He believes the hospital is lagging behind its counterparts. He said the problem extends to the surgical unit but once it is time for surgery, the hospital’s management would swiftly power the generator.
“I have been here for the past five days and it has been a horrible experience,” *Usman lamented.
“On this light issue, I think this hospital has been neglected. I have never experienced light since I came here. The only place that I experienced light was in the theatre. They powered the generator to operate on people. But at the wards, everybody has to use their phones or rechargeable lanterns.”
Mirabel Esau, a resident of Sabon Tasha, decried the lack of electricity and water at the hospital, highlighting how these challenges impact patients’ comfort. According to her, washing the patients’ clothes and other necessary cleaning tasks have become a difficult assignment due to lack of water.
“I am here to care for a patient, but the major challenge we face is the absence of both light and water within the hospital premises. This has made it impossible for us to remain within the ward due to the heat. We had to sit outside to get fresh air,” said Mirabel.
Struggles of health workers
The hospital’s health workers interviewed by The ICIR shared their experiences of using cellphone touch lights and rechargeable lamps to provide healthcare for patients due to the absence of electricity.
They also expressed their concern over the frustration of patients in the pediatric ward where they constantly battle heat and mosquito bites.
“The work is frustrating,” said a nurse in the hospital who was met using his broken phone to write medical prescriptions on paper.
Etched on her face was a feeling of discomfort and concern over the lingering problem.
“To get the right prescription written on the administered drugs for patients is also a challenge. This is because at times, the drugs are tiny, and one will have to strain her eyes to write the drugs,” she added.
She lamented how the lack of basic amenities especially electricity hamper their productivity and healthcare delivery in the hospital.
According to her, the health workers have to go outside the hospital to power their gadgets and get water for their various needs.
“Both the patients and the medical workers are not comfortable but we have to make these sacrifices because of our patients.”
A medical doctor in the hospital’s maternity, who also cannot be named, expressed frustration over the inaction of the state government and how the absence of light has made his job very challenging.
According to him, doctors and nurses need to wear torchlights on their foreheads in order to take care of pregnant women in the maternity.
“People are really fed up with government hospitals because of lack of facilities and this place is in the metropolis of the state that the government needs to look into. It’s not primary healthcare, it’s a secondary facility the government needs to put into consideration the lives of the people which is very important that those are the things that people should benefit from for free for the benefit of the society,”the doctor lamented.
The bigger picture
The Nigerian healthcare system has long grappled with significant challenges that have impeded its ability to provide quality and accessible medical services to its citizens. One of the foremost contributors to these struggles is government negligence, which has led to a plethora of issues affecting patient care, healthcare infrastructure, and overall public health.
The chronic underfunding of healthcare and insufficient financial support cripples hospitals’ ability to afford basic amenities and provide a conducive environment for both its workers and users.
As a result, patients often receive substandard care, leading to delayed diagnosis, inadequate treatment, and sometimes even preventable deaths. The challenge also exposes health workers to risk. This manifested in the tragic death of a medical doctor at Odan General Hospital, Lagos Island, who was crushed to death in a lift on July 26, 2023.
The lack of a conducive environment in public hospitals such as General Hospital Sabon-Tasha has been attributed to the high rate of “brain drain,” where qualified healthcare professionals seek employment opportunities abroad and incessant industrial action by resident doctors which have further depleted the nation’s healthcare.
Ensuring healthy lives and promoting well-being for all at all ages through affordable and prompt healthcare delivery is one of the commitments of the United Nations’ Sustainable Development Goals (SDGs).
This commitment encompasses various targets, such as reducing the global maternal mortality rate to below 70 per 100,000 live births by 2030 and putting an end to avoidable deaths among newborns and children under 5 years old. Every nation is striving to decrease neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births by the year 2030.
Additionally, the goal includes eradicating the epidemics of diseases like AIDS, tuberculosis, malaria, and neglected tropical diseases, while also combating illnesses such as hepatitis, water-borne diseases, and other communicable diseases by the same deadline.
However, the realization of this crucial and admirable objective has become a distant prospect in Nigerian government health facilities.
Nigeria accounts for the second-highest number of maternal and child deaths globally according to World Health Organisation. Nigeria’s former health minister, Osagie Ehanire, attributed the high maternal, infant and under-five mortality in the country to a lack of access to quality healthcare services which experts have said is partly due to poor investment in healthcare infrastructures such as General Hospital, Sabon-Tasha which has been in darkness for close to a year.
According to the 2021 Multiple Indicator Cluster Survey by the National Bureau of Statistics, the under-five mortality rate in Kaduna State increased from 82 per 1,000 births in 2017 to 127 per 1,000 births in 2021 while the child mortality rate increased from 18 per 1,000 births to 58 per 1,000 showing the alarming situation of the state’s healthcare.
Management bemoans low patronage, drop in IGR
A top official in the hospital who spoke under the condition of anonymity explained that the problem of power outage in the hospital lies in the hands of the state government which fails to pay the electricity bills of the hospital to Kaduna Electric Distribution Company.
According to him, the problem has led to the disconnection of the hospital from the national grid and made it rely solely on generator for more than eleven months.
He noted that the challenge is taking a toll on the internally generated revenue of the health facility as they now spend more on fuel especially now the price of PMS has risen.
“The power is not there and so we generate little, not as much as we should because of that and now, we even spend more on power. The Internally Generated Revenue has dropped because of that and even patients’ influx is down,” he lamented.
He urged the state government to offset the electricity bills of the hospital or give an order to the distribution company to restore electricity in the hospital pending when they are going to settle them ultimately.
Power companies trade blames
When contacted, the Head of Corporate Communication, Kaduna Electric Distribution Company, AbdulAzeez Abdullahi, explained that power has not been restored to the hospital due to the failure of Kaduna Power Supply Company(KAPSCO) to pay the electricity bills of the hospital.
The Kaduna Power Supply Company is the official body charged with increasing Kaduna’s electricity access. It is responsible for powering off-grid communities, executing independent power projects, maintaining streetlights, and providing power to public buildings such as government health facilities.
Abdullahi said, “The issue now is with KAPSCO. They are the ones who will explain to you how much they owe and why are they not paying their debt. The hospital is not even among the list of government agencies that KAPSCO is paying us for every month.”
He, however, clarified that KAPSCO has fixed the transformer of the hospital and they are also responsible for connecting the hospital back to the grid.
The ICIR contacted the Kaduna Power Supply to verify what led to the hospital’s disconnection from the national grid but the company only responded with one sentence that reads :
“We wish to inform you that KAPSCO does not disconnect national grid electricity customers, only the distribution companies do so. You should please direct your letter inquiries to them.”
Further clarifications sought after the response were not answered by the company as of the time of filing this report.
NMA calls for enabling environment for health workers
Speaking with The ICIR, the President of Nigeria Medical Association, NMA, Kaduna State Chapter, Madaki Sheyin, noted that the absence of electricity in the hospital would greatly impact the welfare of doctors and the quality of healthcare delivery in the hospital.
“Without a conducive environment, doctors cannot function optimally no matter how good they are. For instance, in a situation like this where there is no light, the doctors won’t be able to operate properly, especially at night. It will impact how they handle emergencies among others.
“Productivity will definitely be reduced, there’s no two ways about that. That’s why we have always encouraged and agitated for the government to ensure that these things are put in place,” he said.
Madaki noted that the poor working conditions and lack of an enabling working environment would also prevent the state from attracting doctors.
He pointed out that the previous administration invested heavily in primary healthcare facilities but a lesser attention is given to secondary healthcare facilities such as General Hospital, Sabo despite the fact that it’s within the metropolis.
He charged the state government to address the challenge in order to ensure optimum productivity and curb the exit of doctors from Nigeria to countries with a better working environment.
“We are dealing with ‘Brain drain’ issue which is one of the issues that we have always been hammering on. The Government needs to address those push factors. We cannot really do much about the pull factors that are actually making the doctors leave the country or state.
“The government should ensure that these lingering issues are addressed quickly and with all political will. I think if we do that, a lot of doctors I know are willing to stay back and work for their state and country at large,” he concluded.
State govt. faults El-Rufai’s administration
Meanwhile, the Kaduna State governor, Uba Sani, in several of his campaign promises pledged to improve public healthcare in the state and make it more accessible to the people.
A few weeks after he assumed office, he signed into law the Public Health Bill. The law is aimed at improving the public safety of the people of Kaduna State from health threats, preventing diseases and striving for a healthy population.
The purpose of the law is to improve the public safety of the people of Kaduna State from health threats, prevent diseases and strive for a healthy population.
The ICIR contacted the Governor’s Chief Press Secretary, Muhammad Shehu Molash, to ask about the government’s efforts to address the challenge and he forwarded the enquiries to the Permanent Secretary of the Ministry of Health, Adamu Mansur.
According to Mansur, the problem is due to the failure of the Committee on Billing of Government institutions of the last administration to capture the hospital for electricity bill payment.
“We have been engaging KAPSCO on the matter. There was an error by the last administration for not capturing the hospital bill centrally by the Committee on Billing of Government institutions,” he said.
He promised to follow up with Kaduna Power Supply Company to ensure that the issue was resolved and electricity is restored in the hospital.
Nurudeen Akewushola is an investigative reporter and fact-checker with The ICIR. He believes courageous in-depth investigative reporting is the key to social justice, accountability and good governance in society. You can reach him via nyahaya@icirnigeria.org and @NurudeenAkewus1 on Twitter.