The Sabon Garin Narabi Primary Health Centre (PHC) in Toro Local Government Area of Bauchi State is a one-block facility with three rooms, initially designed as primary health care dispensary with a reception, a store for vaccines and other materials, as well as an office.
Sabon Garin Narabi is a village that developed into a town with an estimated population of over 5,000 people, located in Toro Local Government at the boundary between Bauchi State and Plateau.
Despite its growing population, the town grapples with a deplorable primary health care centre without basic health facilities and equipment. The existing building of the clinic is swarmed with grasses with a local pit toilet, cracked walls within an unkept environment that exposes both staff and patients to health hazard, among other challenges
When our correspondent visited the facility recently, it was observed that a number of nursing mothers who brought their babies for routine immunisation sat on the floor on a queue for hours due to lack of space to accommodate them and their children.
A nursing mother who brought her newborn baby to the health centre, Khadija Abdullahi, told Weekend Trust that both mothers and their babies at Sabon Garin Narabi PHC were subjected to untold hardship during antenatal, postnatal and immunisation exercises, as well as other medical services for their children.
Khalid said, “The size of the PHC is too small to accommodate the number of mothers for any medical exercise because the building has only three rooms. And the immunisation section is very small. Even today, you can see for yourself that more than 150 mothers came for immunisations. We have to gather under a make-shift immunisation shade donated by the community.
“There are no benches or chairs at the health centre. The situation has compelled mothers who come with their babies for immunisation to either remain standing for hours or sit on the floor for hours to access the services. Apart from accommodation challenges, the worst problem is lack of drugs and other consumables.
“We are pleading with the government to liberate us from this untold hardship by providing benches or desks to sit on. There are two benches in the front row and you sit on a mat at the back row before reaching the front row. The reason we plead is that majority of the nursing mothers are still battling with complications of child delivery. And standing for hours might cause lots of other health problems.”
Khadija noted that the only thing that is free in the health centre was the routine immunisation and additional stipend of N1,000, saying that all other drugs, medical services, including diagnosis and other antenatal services, are paid for.
“I brought my newborn baby for immunisation and eye problem. After the immunisation, they examined the eyes and prescribed eye-drops for me to go and buy, unlike before when drugs were available for babies. In the past, for many years, when the government or partners provided the drugs, they gave us, but now, they are not available,” she added.
Another nursing mother seen at the PHC Mariya Saleh said the facility was not convenient for pregnant women and children because of the unnecessary stress and lack of other services needed for the wellbeing of the people.
“The only service attracting mothers to the health centre is immunisation because women are receiving N1,000. Secondly, it is the only government health facility in the entire Sabon Garin Narabi where you can access immunisation. Lack of space is discouraging women from antenatal and postnatal services, important drugs and other consumables,” Mariya said.
She appealed to the state government to intervene and rescue the situation by constructing additional rooms and fence the facility to secure critical equipment that are kept for the purpose of safeguarding the health of the people.
Sadiya Adamu, a mother of five children, lamented how the only government health facility could not provide basic services, forcing many patients to travel long distance outside the town to access medical services.
“Three months ago, before I gave birth to my fifth child, I was rushed to the health centre on the eve of delivery, but the personnel refused to attend to me; instead they referred me to the Tilden Fulani PHC, insisting that they didn’t have a labour room. On the way to Tilden Fulani, I almost gave birth in the vehicle due to traffic caused by a military checkpoint between Narabi and Tilden Fulani town,” she added.
A staff member at the Sabon Garin Narabi PHC who didn’t want her name mentioned confirmed the challenges at the facility, including lack of space to conveniently attend to patients, lack of labour room, no maternity section, non availability of drugs and consumables, no laboratory, as well as lack of test-strips and reagents. Even the few chairs were donated by the community.
She said, “We buy test-strips and reagents during antenatal services. We don’t admit patients due to the deplorable state and porous nature of the health centre; we refer critically ill patients to the neighbouring health centre at Tilden Fulani or Toro General Hospital. The ward has been turned to the main parlour where patients can wait and be attended to.
“You can see the large number of women and their babies who visited the facility today (Thursday) for immunisation sitting outside under a makeshift shade because the clinic doesn’t have a space to accommodate them. We have only three rooms – one is for the storage of the vaccines and the main reception for screening and administration and the only office used for consultation, which requires privacy. We also use the reception to run tests for antenatal patients because we don’t have a laboratory.
“We charge the pregnant woman N1,700 for antenatal care because we use our personal resources to buy the needed testing equipment. We also bought malaria drugs, which we combine with micronutrients and charge only N200 to give them during the period.
“We have a pit toilet that is in a bad condition. They partitioned it – one for members of staff and the other for our patients – but even our patients hardly use it due to its bad condition. The building is also cracking. It was one good-spirited individual in town that volunteered to fix the cracks in the walls,” she added
Another member of staff lamented that due to the porous nature of the facility they no longer kept sensitive and valuable materials there as there is no adequate. She said: “The only security guard manning the facility has since retired and no one is yet to be recruited, that is why we take our valuable things home. We only lock the main entrance door, leaving our records books and register behind because not long ago, the community fixed burglary on the windows.
“We attend to over 200 clients during immunisation; sometimes the number exceeds that figure. During antenatal we also have a high number of women – over 100 clients. Some women in the town prefer to go to the Tilden Fulani PHC, where they have all the needed facilities.
“Also, if pressed, patients use toilets in neighbouring houses, while others return home and come back when the need arises.
“We have five official members of staff under government’s payroll, including one Chew, one J-Chew, one community health officer, one environmental health officer and an environmental health technician, but we don’t have a nurse working in the clinic. The remaining four supporting members of staff are volunteers.”
She further disclosed that the number of patients was reducing due to lack of space, equipment and other services; and many prefer to go to private hospitals or travel to Tilden Fulani PHC where they can access full medical services.
She also noted, “We don’t admit patients in the clinic. The only time it witnesses a large number of women is during immunization, when we record above up to 150 people in a day.
“Due to lack of space, we attend to family planning patients at the reception; and other patients listen to our conversation. Unfortunately, our antenatal services are also carried out here in the reception due to lack of space. But we conduct the palpation of pregnant women in the store.
“Some women visit the health centre for various reasons, including family planning or counseling.
“The only commodity we get is the RDT for malaria and family planning. There are no drugs or consumables from either the government or development partners in this clinic. We refer to pregnant women with anemia, severe malaria or high blood pressure, and diabetic patients. We equally refer children with cough that has persisted for over two weeks, as well as sick children that present convulsion, and critically ill patients.”
When contacted, the secretary of the Village Development Committee (VDC), Sabon Garin Narabi, Umar Babaji, said the major challenge facing the health centre was lack of space to accommodate the number of patients patronising the facility. He said, “To be frank with you, the health centre is too small for the community, especially for health services involving pregnant women, nursing mothers and immunisation of our children. On a daily basis, over 100 women visit the clinic for various reasons.
“The Almighty Allah has blessed Sabon Garin Narabi and its surrounding villages with a large population of people. As I am talking to you, the town has over 5,000 people living in Sabon Garin Narabi, apart from other smaller villages behind the town. The health centre has qualified medical personnel working on a daily basis, but the building is too small to accommodate the number of people.
“The personnel are managing and trying to do their best despite difficult conditions and lack of space and equipment because they don’t have a labour room for pregnant women nor ward to admit patients. Although they upgraded the facility from a health care dispensary to a primary health care centre, the building is still for a dispensary.”
Babaji disclosed that the community, through the VDC, had written a letter of complaint to Toro Local Government, pleading for the upgrade of the health centre, but the committee was instructed to write a formal letter.
“It was as a result of the letter we wrote and stated our demand that they upgraded the clinic to a primary health care centre. They deployed more staff but the building was not upgraded. That’s the major predicament of the community.
“The community has demonstrated commitment to the development of the health centre by contributing money to construct the makeshift immunisation shade to alleviate the suffering of nursing mothers standing for hours in the sun waiting for the immunisation of their children. The community also donated benches for the women and chairs for staff to support the smooth running of the facility.
“We are appealing to both the state and local governments, as well as development partners, to come to our aid by expanding the structure of the facility since they have upgraded it to a primary health centre. We want the facility to become a standard health centre where patients can be admitted, pregnant women can safely deliver and other basic primary health care services rendered,” Babaji added.
Another member of the VDC and youth leader in Sabon Garin Narabi, Muhammad Sani Aliyu, said that the committee had made several efforts through elected representatives, right from the ward councilor, local government chairman, commissioner and other officials, to ensure that the health centre is upgraded to serve the community better because the population of the people is growing rapidly and the existing building and equipment cannot meet up with the number of people visiting the facility.
Aliyu said, “We have made several efforts and will continue to push and ensure that the clinic gets the needed attention. We are pleading with the government to reconstruct the PHC and provide equipment. We need a borehole to provide clean water in the PHC because we don’t have any source of water there. We have members of staff at the moment but the PHC has no laboratory, no labour room and maternity section. We need a fully reconstructed building for the primary health care centre in Sabon Garin Narabi.
“We are happy that the minister of health is from Bauchi State. We are also extending our plea to him. Let him know that the health centre requires total overhaul to serve hundreds of women and children in this community and environs. Sabon Garin Narabi is an integral part of Bauchi State. We are using this medium to pass our message to the minister to intervene and rescue the health centre.”
While the primary health centre remain in this state, it is worthy of note that only recently, the federal government didclosed plans to procure emergency care helicopters, develop a nationwide air ambulance system to enhance what it called rapid medical response.
The Coordinating Minister of Health and Social Welfare Prof. Muhammad Ali Pate, in a statement said President Bola Ahmed Tinubu, had approved the procurement of emergency care helicopter for handling healthcare emergencies.
When contacted, Executive Chairman Bauchi Primary Health Care Development Agency, Dr Rilwanu Mohammed, said that the Sabon Garin Narabi PHC isn’t meant to be a Primary Health Care Centre but a Primary Health Care Clinic designed for only 15 beds and not 25 beds.
Mohammed said, “Unless we upgrade that facility to a primary healthcare centre, increase the number of beds and offices to carry out laboratory and investigation services, increase places for drugs and immunisation, antenatal and delivery. We must have a staff quarters to provide accommodation for staff, that is, when the clinic can be upgraded to a full PHC centre.”
Responding to the lack of drugs in the facility, Mohammed said that the Narabi PHC is not a full one but a clinic and wasn’t registered for the State Drugs Revolving Fund due to the number of patients. “The governor has increased the funds to N500 million, and the number of PHCs has increased from 300 to 600 PHCs benefiting from the genuine drugs. We’re revolving these funds to help the people of the state. The state government has signed an MoU with nine pharmaceutical companies to supply these effective and genuine drugs to be dispensed at the PHCs.”
Mohammed added that the local governments select the PHCs based on criteria, but the government is planning to expand the scope to a thousand PHCs before the end of the year.