Northern Nigerian Breaking News

Despite multi-million-naira releases for PHC renovation, primary health care still in shambles, projects remain unexecuted, uncompleted in Plateau State

By Ekemini Simon

Stepping a foot into the vicinity of Gumshir Ward primary healthcare centre (PHC), Dengi Constituency, Kanam local government area (LGA) gives a glimpse of the rot enveloping the entire healthcare centre. The cracks on the walls of the clinic, its broken windows, tables, chairs and doors are obvious signs of the poor state of the health facility.

Mary Moses, a patient this reporter met at the clinic in October said the deplorable ambience and lack of facilities at the clinic does not give any indication that the facility can provide quality and effective care.

“Visiting this clinic is like visiting a shrine. You can see the cracked walls and broken floor. The environment alone aggravates our sickness. We only come here because there is no other place to go,” she said.

outside of PHC Gumsher Dengi
Outside of PHC Gumsher, Dengi
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Yet the condition at this government owned facility should never have persisted as the Plateau State 2021 Report of the Accountant General and Financial Statements showed that Plateau State Primary Health Care Development Agency (PSPHCDA) spent N5 million for the “Renovation and Purchase of Hospital Clinic Equipment at Gumshir Ward, Dengi Constituency” at Kanam LGA.

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A visit to the facility by SOLACEBASE in late October, showed that the project was not executed despite the urgency needed to change the dilapidated condition of the facility. The Officer-in-Charge (OIC) of the facility, Micah Adamu, told this reporter that no renovation works or supply of medical equipment was carried out since 2021 till date. This was also confirmed by the Councillor representing the Ward, Hon. Dalhatu Garba.

Adamu disclosed to SOLACEBASE that the few equipment in the facility are old and faulty hence the need for an overhaul of the entire facility. Adamu said the facility can only admit two patients at a time because there are only two old mattresses despite having some bed spaces.

PHC Gumsher Dengi Constituency 1
PHC Gumsher, Dengi Constituency

“If a male patient and a female patient come, we keep them in the same place. There is no privacy, we are managing what we have but for how long?” Adamu queried.

Hon. Garba decried the poor condition of the facility adding that not having a functional health facility in the community is causing a lot of hardship to patients.

“There is no place to even admit the patients when they come. They are discharged immediately because they cannot sleep there due to lack of space,” he said.

Although the renovation and purchase of hospital clinic equipment was not carried out, this newspaper observed a building left at lintel level in the clinic’s premises. Staff of the facility and community members said the project started in early 2022 and have been abandoned. They noted that for over six months, no effort has been made towards the project’s completion. Surprisingly, SOLACEBASE did not see any information about the contractor or the project in the vicinity as it’s general practice.

Structure found at lintel level at PHC Gumsher Dengi
Structure found at lintel level at PHC Gumsher, Dengi

When SOLACEBASE contacted the State Assembly member representing the constituency, Hon. Seleh Yipmong who nominated the project, he insisted that the project has been executed and completed. When asked further if he is sure that the facility was renovated and furnished with necessary equipment as described in approved budget, he asked this reporter to visit the Plateau State Primary Healthcare Development Agency for explanation.

“Since you didn’t see renovation, and didn’t see a new building there I insist you need to get information from the ministry, not me.”

Hon. Yipmong refused to comment on the year the building project was awarded as staff of the hospital and community members noted that the project commenced in 2022 whereas the funds investigated was reported in the financial statement to have been spent in 2021.

Multimillion naira project unexecuted despite

There are other instances where projects were unexecuted despite financial provisions and releases. Just like residents of Dengi constituency, the people of Naraguta (B) ward (NEPA), Jos North Central at Jos North LGA, Plateau State are also victims.

The member representing Jos North/North Constituency at the State House of Assembly, Ibrahim Baba Hassan lobbied for the furnishing of the primary healthcare centre at Naraguta ward to be included in his constituency project in 2021. That same year, the state government through the PSPHCDA awarded contracts for the furnishing of the health facility to the tune of N6 million. Findings showed that N5.9m out of the N6m budgeted was released for the project.

However, when SOLACEBASE visited the facility in late October 2022, the project had not been executed and there was no indication that the contractor mobilised to site.

The Officer-in-Charge (OIC) of the facility, Mrs. Theresa Gyang told SOLACEBASE that she has been working at the facility for two years and in that period no furnishing work was carried out in the facility.

The unexecuted project has impacted the health centre adversely. Findings showed that patients’ trust in the effectiveness of service at the healthcare centre has nosedived. This is evidenced in the fact that the number of patients who visit the healthcare centre has reduced significantly, residents of the area said.

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Gyang admitted to SOLACEBASE that the clinic was in gross lack of furniture and other important medical equipment.

“When I came, we were not having patients here maybe due to the condition of the place but we have tried to mobilise and the people understand us. But we are appealing to the government to properly equip the clinic, so that we can serve the people better.

“Some of the challenges we are faced with in this facility include no access to clean water, and working tools. In the labour room, we don’t have a delivery bed, the one there is bad. A woman almost fell off the delivery bed recently. We need forceps in the labour room, couches in the consulting room because you need to examine a patient before you start treatment but we don’t have a couch in the consulting room,” she said.

Attempts to reach Member representing Jos North/North Constituency, Ibrahim Baba Hassan  for comments was unsuccessful as he did not respond to calls and messages sent to his known phone number during the course of this investigation. The message sent to him, specifically requested to know why the project he nominated was not executed despite the release of funds and what he has done to ensure the execution of the project.

Extra-budgetary spending and how the people of Ibrahim Kastina Ward were short-changed

Ibrahim Katsina Ward PHC popularly known by its alias, Dogon Agogo is among the Primary Healthcare centres rotting away in Plateau State.

The facility lacks room space, medical equipment among other essential amenities needed to provide quality and effective care. The OIC of the facility, Mrs. Hannatu Gyang complained that due to the shortage of room space, the facility is forced to keep patients outside for treatment.

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“Even in the rainy season, we keep our patients outside and treat them. There is no waiting room for patients to sit, no space even for equipment. We are choked up in this place,” she said.

Nevertheless, these challenges should have ceased since 2021 if the funds disbursed for the construction and furnishing of the clinic was judiciously used.

Captured in the budget of primary healthcare development agency as “Construction of PHC Clinic, Dogon Agogo, Jos North” with N10 million, the financial statement of 2021 showed that N9.9m was paid for the execution of a new primary healthcare centre at this facility.

When SOLACEBASE visited the facility in late October 2022, the project was not completed, 10 months after the end of the 2021 fiscal year. Work was still ongoing at the site, and entire structure of the building was at the roofing level. Some workers seen at the site, declined to comment on the reason for the slow pace of work.

work ongoing at PHC Dogon AgogoIbrahim Katsina Ward despite spending made in 2021
Work ongoing at PHC Dogon Agogo(Ibrahim Katsina Ward) despite spending made in 2021

Speaking on the slow pace of work, Youth Leader and member of the Ward Development Committee, WDC, Babawo Abdullahi said the slow pace of work has caused untold hardship to patients and staff of the clinic.

He said: “The project in this clinic is not moving well. We are not happy about it because we have a large population here and the place is too small. We need help, and we want all constituency projects on health in our area to be completed because the officers in charge of these facilities are suffering. Health projects in this area should be given the seriousness it deserves so that good services can be given to the people.”

The Ibrahim Katsina Ward PHC is known by two names. The facility’s formal name is Ibrahim Katsina Ward (Dhilima) while its alias is called Dogon Agogo. Findings showed that the Primary Healthcare Agency (PSPHCDA), used the two names to access and disburse funds.  First, they awarded contract for the construction of the facility to the tune of N9.9m through the alias nomenclature (Dogo Agogo) of the facility and later used the formal name of the facility (Ibrahim Kastina Ward, Dhilima) to award another contract for the furnishing of the facility to the tune of N4m.

According to findings, the furnishing contract was not approved in the budget implying that the PSPHCDA spent N4m without recourse to the budget. Even with this supposed spending as recorded in the financial statement, the furnishing project was still not executed.

Sarkin Jengre PHC Clinic remains uncompleted despite full release of contract sum

The Speaker of the Plateau State House of Assembly, Yakubu Sanda in 2021 nominated the completion of Sarkin Jengre Ward PHC at Bassa LGA. The project was awarded at the sum of N6 million in 2021 with a total of N5.99m paid by the state government. The Sarkin Jengre PHC project was yet to be completed three years after it was started. Hon. Sanda’s nomination of the project was supposed to complete the project and make access to health care better in the community but when our reporter visited the project site in October 2022, the clinic was at the roofing level, without doors, windows and plastering of the wall.

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SOLACEBASE also observed that no staff was on ground at the clinic. A resident of the community, Nagari Sauri said community members rely on primary healthcare centres in other communities anytime the fall ill.

“The non-completion of our clinic is a big problem for us in the community. We are calling on the government and people of goodwill to come to our aid. All the health workers have been transferred out of the community. We have no one here to attend to even our basic health needs.

“I believe if the clinic is put in order and the staff brought back, the cost and stress of going to Jengre and other places for our healthcare needs would be reduced.” Efforts to speak with the Speaker were futile. The Speaker failed to respond to questions on efforts he has made to ensure the project is completed. He did not respond to our calls, text and WhatsApp messages as at the time of filing this report.

Farin Lamba Mista-Ali PHC

According to community members, the Mista Ali PHC was originally facilitated by the immediate past member of Pengana State Constituency, Bassa LGA, Late Hon. Ezekiel Afon. Three years after, the facility’s four bedroom apartment has remained uncompleted.

The OIC of the facility, Mrs. Felicia Baling said the facility is presently undergoing decay because it has been abandoned at the roofing state since 2019.

However, instead of completing the project and furnishing it, the Speaker of the Plateau State House of Assembly, Yakubu Sanda nominated a fresh construction of the facility in 2021.

Awarded at the sum of N10 million by the Plateau State Primary Health Care Development Agency, finding showed that N9.9m was released for the project. SOLACEBASE discovered that although a new four bedroom has been constructed and joined together with the abandoned building, the new building is yet to be completed as windows and painting of the building are yet to be carried out.

Community leaders said they will not allow the project to be handed over to them if the new four rooms joined to the old building are not completed. The community members insist that the Speaker nominated a fresh building without recourse to the community because he wants to show off that it was his dispensation that a new facility was built.

Baling insists that what the facility really require is the completion and renovation of the four-bedroom staff quarters earlier built but uncompleted and not a fresh project.

She added “I have talked with the Speaker; the work is under the care of a contractor and what is left is the painting and fixing of windows.”

The community members are unhappy over the lack of value of the project since it was awarded in 2021. A community leader, Geoffrey Ishaya blamed the slow pace of work on politicians “playing politics with everything.”

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He said: “When we lost the former member, some people felt the wife would be asked to take over the seat and complete the husband’s tenure. She commenced the renovation of the project maybe because she knew about the plans but since it did not work out for her to stand for the bye-election and get the seat, another person came on board from the same political party.  But now, look at how the project is been handled.

“If the work is not harmonized and completed, I wonder how it will be commissioned. Will they commission the four rooms and leave the other four rooms untouched? That would be very interesting.”

Baling noted that the unavailability of staff quarters has made the facility convert one of the wards to staff quarters.

“We are not supposed to use the ward as staff quarters because we have hindered patients from being admitted there. However, most of us are not living close to the clinic, so if we must serve well, we need the staff quarters. If the project had been completed long ago, this won’t happen.

“Recently, we had students who came for clinical experience here. There was nowhere to keep them so we had to open the uncompleted apartment for them to stay without the windows and it was even during the rainy season.  The boys had to use the corridors while the girls stayed in the rooms. It was very uncomfortable for them.”

Construction of PHC Kerang Ward A Ghost Project

The Member representing Mangu South Constituency, Hon Bala Fwangje in 2021 nominated as his constituency project the “Construction of Clinic Kerang Ward, Mangu South” at Mangu LGA. The project was approved in the budget and later awarded to the tune of N8.5 million. The budget did not specific the exact location of the project in Kerang ward. Meanwhile, findings showed that the entire funds meant for the project was released.

Read Also:How women, children suffer from poor primary health care, dilapidated facilities at Unilorin Teaching Hospital

Sadly, a year after, the project is yet to be executed. When SOLACEBASE visited the four Primary Healthcare Centres in Kerang Ward; PHC Fumulam, PHC Dikibin, PHC Fwangkwak and PHC Kerang in October, it was discovered that there was no trace of a new facility being built.

At Fumulam PHC in Kerang, the facility is an eyesore. The structure is dilapidated with broken floors, no ceiling and leaky roofs. The OIC, Mrs. Lami Langkwap said the poor condition of the health centre makes treatment of patients very stressful.

Outside of PHC Fumulam Kerang ward
Outside of PHC Fumulam, Kerang ward

“Both patients and staff are just managing here. During the rainy season, everywhere will be leaking and it floods the room. Yet, we still take delivery of babies here at the clinic. You can imagine the threat to mother and child in such a condition. We are just two staff and two voluntary workers; we need more hands to run the clinic,” she said.

Interior of PHC Fumulam in Kerang Ward
Interior of PHC Fumulam in Kerang Ward

The situation at Fwangkwak Healthcare Centre is heart wrenching.  The mud building with five rooms housing the clinic is already threatened by termites. No construction work was noticed when a visit was paid to the clinic. A community member who resides close to the facility, Charity Dakhling said community members look forward to the government giving urgent intervention.

PHC Fwangkwak

PHC Fwangkwak

The story is not different at the healthcare centre in Dikibin. At Kerang PHC, there was no newly constructed structure credited to the Plateau State Primary Healthcare Development Agency. However, the OIC who identified herself as Mrs. Gonet Only a labour room which the Officer in Charge of the facility, Mrs. Gonet told our reporter that the newest structure is a labour room and it was built through the Basic Health Care Provision Fund (BHCPF) awarded by the National Primary Health Care Development Agency (NPHCDA), an agency of the Federal Government.

PHC Kerang Kerang Ward.
PHC Kerang, Kerang Ward.

When contacted, Hon. Fwangje said even though there is an urgent need for the construction of the facility which he nominated, he is disturbed that a year after, the project has not been executed.

While accusing the State government of playing politics with constituency projects nominated by lawmakers of the opposition party in the state, Fwangje said no constituency project nominated by a PDP lawmaker has been awarded.

“In 2021, we had a crisis in the State House of Assembly and our constituency projects were not awarded because we did not follow the dictates of the state government in place,” he said.

When told that the funds were released for the project according to the Plateau State 2021 Financial Statements, the lawmaker expressed shock on why the project would not be executed despite the funds provided. He assured that he will find out and ensure what is due his people is given back to his people.

Projects missing on Public Procurement Portal

Checks by SOLACEBASE have revealed that contract information on the Primary Healthcare projects investigated are not published by the Plateau State Bureau of Public Procurement. Since February 1, 2016 when assent to the Public Procurement bill was given, Plateau State government is expected publish contract information it awards. This information includes contract name/ information, contract reference number, selection method, names of all bidders that participated, all bid prices as read at bid opening, all bid prices as evaluated, name of successful bidder, contract price, date of award and contract duration.

Although SOLACEBASE sighted some information on other projects awarded in 2021, information on projects awarded by the Primary Healthcare Development Agency was not published.

Meanwhile, according to the Bureau of Public Procurement Law 2018, the Bureau must undertake procurement and contract performance audit. When SOLACEBASE reached the Director General of Plateau State Bureau of Public Procurement, Peter Dogo for comment whether his Bureau has undertaken contract performance audit on the primary healthcare projects investigated, he promised to get back to this reporter but he didn’t. Reminders sent to him was not acknowledged nor replied.

Plateau State Government keeps Mum over Discoveries

Besides not responding to the Freedom of Information request for key documents and information required for this investigation, the government of Plateau State has kept silent over the discoveries in this investigation.

The FOI request by SOLACEBASE to the Plateau State Primary Health Care Development Agency which was responsible for the projects in question specifically requested to know the cost of each of the projects, list of bidders, contract approval letters, total amount spent from commencement of each of the projects to October 2022, approved budget and amount spent in 2021, approved budget and amount spent in 2022, and stage of work implementation in 2021.

Other requests made include evidence of payments made to the contractors from commencement of each project to October 2022 and the precise location of each of the projects.

SOLACEBASE‘s attempts to get comments from the Executive Secretary of Plateau State Primary Health Care Development Agency, Livinus Miapkwap were unsuccessful. He did not respond to several calls, text messages and delivered WhatsApp messages sent to his known phone number as at the time of filing this report.

The messages sent to him bothered on the identity of the contractors for each of the projects, and reasons for delay in project execution despite release of funds.

House of Assembly to commence investigation

The Plateau State House of Assembly has assured that it will commence investigation into how funds was released for unexecuted and uncompleted primary healthcare projects in the State.

Contacted, the Chairman Plateau State House of Assembly Committee on Health, Hon. Daniel Nanbol said its committee had undertaken oversight work on the projects investigated by SOLACEBASE and observed that “the PHC projects awarded are yet to be completed in most of the local government areas.”

When asked what the House has done specifically after its observation, Nanbol said: “The truth is that some of these monies were not released to contractors as stated. Some of the Honourable Members drew my attention that there is an NGO that asked them similar questions. We shall investigate more”.

This SOLACEBASE publication 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.

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