From George Onyejiuwa (Owerri), David Onwuchekwa (Nnewi), Jeff Amechi Agbodo (Onitsha), Geoffrey Anyanwu (Awka), Emmanuel Uzor (Abakaliki) and Petrus Obi (Enugu)

One of the most sought-after social amenities by the people is healthcare. Its absence or neglect in any state affects the people negatively.

In the South-East, there are quite a good number of healthcare facilities. Some are owned by the Federal Government, some state-owned while many others are owned by the missionaries and private individuals. But because services in the government facilities are mostly subsidised, more people tend to patronise them.

However, some of these facilities, over the years, have been allowed to decay while those that are still functional do not have specialists.Most specialists would rather remain in private practice.

This investigation across four states of the South-East revealed that while some federal hospitals in some states were up and running, in some other states, their facilities are almost comatose.

Imo

In Imo State, health care services are yet to get to the standard the people want. 

Apart from the Federal Medical Centre, Owerri, with annex in Izombe in Oguta Local Government Area, there are 11 other general hospitals in the state. These include Ngor Okpala; Imo Specialist Hospital at Umuguma Owerri; Ogwa General Hospital,  Ikeduru; Aboh Mbaise; Arodiuzogu; Awo-Omama; Ohaji/Egbema; Oguta; Orlu; Okigwe; Mbieri and Ihitte Uboma. These are in addition to 650 primary health care centres scattered across the state.

The Rochas Okorocha-led administration has also commenced the construction of one new hospital in each of the 27 local government areas in the state, which he said would be specialist hospitals, with some of them nearing completion.

However, the state of the hospitals generally leaves much to be desired, as majority of the general hospitals in the state as well as the primary health centres, are almost comatose. Most of them lack funding, necessary equipment and manpower to deliver quality healthcare to the people.

The bid by the state government to reposition the general hospitals through concessioning was fiercely resisted by the union of health workers in the state. They argued that health delivery was a social service and part of the government’s responsibility to the people, insisting that it was not a profit-making venture.

The health workers’ union prevented the taking over of the management of the general hospitals by the private health providers appointed by the state government, as concessionaires, which had led to a clash between the two opposing camps.

The health workers’ union, which was stoutly backed by the Nigeria Labour Congres (NLC) in the state, had argued that for such concession agreement to be effective, the state government must pay the workers all arrears of salaries, allowances and retirement benefits owed them.

So, as the general hospitals in the state seemed to have become mere consulting centres, since most of the basic equipment are not in place, pressure has been put on the Federal Medical Centre, Owerri, which is the only functional medical institution in the state.

This necessitated the management of the federal medical facility to resuscitate its extension at Izombe in Oguta Local Government Area to accommodate the heavy outflow of patients from Ohaji/Egbema/Oguta/Oru-East/Oru-West Local Government Areas.

Speaking on the state of the government-owned hospitals, immediate past state Chairman of the Nigeria Medical Association, Dr. Hyacinth Emele, said that the major problem that had affected the efficiency of the general hospitals was lack of adequate funds required for the procurement of necessary medical equipment, as well as for training, re-training, and research.

Dr. Emele also pointed out that the state government seemed to view healthcare as a business venture instead of a social service to the people.

His words: “Government should increase its health budget for the training and re-training of the staff and not thinking of health services as business, instead of social service. Some ailments like tuberculosis, HIV/AIDS, leprosy and even immunisation of children are treated free of charge in government hospitals, and that is why majority of the poor, who could not afford the medical bills at the private hospitals patronise the government-owned facilities.

“Now, the specialist hospital has only three consultants, which is very bad. The hospital does not have any functional X-ray machine as well as ECG and other vital equipment. When a specialist hospital does not have a common X-ray machine, how would other general hospitals have? And so, how can the hospitals generate revenue?”

The situation, he said, had forced most qualified medical professionals out of the public health institutions to private hospitals in the state.

Similarly, Dr. Emele pointed out that none of the new 27 general hospitals being constructed by Okorocha had become functional, stressing that the NMA had advised the state government against the building of 27 general hospitals, but to instead establish one in each of the three senatorial zones, as a pilot scheme. He said the governor rejected the idea.

Speaking in the same vein, Dr. Wilson Onumo pointed out that the main reason government-owned health institutions had not performed efficiently was inadequate funding by the state government.

He maintained that in developed climes, it is usually in public health institutions that people get the best specialists in any field, as the hospitals are well funded.

“But it is not the case in Imo State and Nigeria, as most qualified medical personnel are not motivated enough to work in the government hospitals.

“The major problem is inadequate funding, and if you go round these general hospitals, you will discover the lack of basic equipment to work. You don’t expect the personnel to do their work with bare hands.

“It is the responsibility of the government to fund the general hospitals and the community health centres because it is only the less-privileged and the poor people that normally patronise them. The rich people have the money to pay the bills in private hospitals.

“It is because of the situation of the general hospitals in the state that the Federal Medical Centre is constantly under pressure because it is the only real functional hospital in the state,” Dr Onumo said.

At Ngor Okpala, for instance, most of the people no longer patronise the general hospital there because of lack of medical personnel. It was learnt that most of the medical staff posted to the hospital only come to work once in a week.

According to Nneji Acho, a youth leader, most patients who go to the general hospital to seek medical attention have nobody to attend to them.

He informed that the hospital was one of the centres where those suffering from HIV/ AIDS are supposed to get their drugs, bit sadly, the doctors are hardly there to attend to them.

He regretted that the state government had abandoned most of the primary health centres in the communities.

“We are still waiting for the completion of the new general hospitals, which we believe will be better,” he said.

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The situation is not different at the General Hospital, Umuelemai in Isiala Mbano. Those who needed medical services carry out their laboratory tests in private laboratories, as there are no functional medical laboratories in the hospital.

According to him: “We don’t have a hospital, because any hospital that cannot render effective service cannot be described as a hospital.”

He pointed out that most people who had serious ailments always go to the FMC, Owerri, to take treatment, revealing that some time ago, one of his relatives almost died because of lack of oxygen. He said the man had to be taken to a private hospital where he was stabilised before he was returned to the FMC.

“So, what we have as a general hospital is just an empty building, and even the new general hospital has been taken over by weeds.”

However, Governor Okorocha, who recently commissioned the Ikeduru General Hospital, said some people, especially health workers, had misunderstood his intentions of concessioning the general hospitals to private management, which he said was to ensure that the Imo people enjoyed quality health care.

“Today, we have a state-of-the-art diagnostic centre and the first of its kind in the entire South-East. And with the 27 new general hospitals also coming on stream, the healthcare of the people of the state would be greatly improved.

“The problem is not that the government has not been funding the existing general hospitals; it is the lackadaisical attitude of the health workers, who simply see it as government work and, therefore, are not dedicated to their duties.

“Last time I visited the General Hospital at Ogwa, there was an emergency. But the doctor was not there, except an elderly nurse. That is the problem, not that the government has not been funding the hospitals,” the governor said.

Anambra

In Anambra State, the Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, a federal health institution, has been unable to move to the permanent site situated at the confluence of Nnewi, Ozubulu and Oraifite axis. The construction started years ago, but it has been stalled due to paucity of funds.

Nearly all the equipment at the hospital requires regular electricity supply, but getting regular power has not been easy.

Chief Medical Director of NAUTH, Prof Anthony Igwegbe, said the irregular and epileptic power supply at the institution has forced the management to depend on generators with the attendant natural increase in the cost of running the health institution.

As the general and primary hospitals in the state are not functioning, those who would have used them end up at the teaching hospitals, thereby putting pressure on the available resources.

Prof Igwegbe said accommodation problem at the NAUTH remained one of the major headaches of the hospital, since the temporary site had been overcrowded and stretched to its limit.

He said about N3 billion was needed to be injected into the permanent site to get it ready.

“But relocation to the site is not expected soon because of the on-going economic recession, despite the fact that many structures have been put in place there,” he said.

Prof Igwegbe explained that apart from the challenges earlier mentioned, some of the life-saving equipment that are obsolete needed to be changed, but regretted that the spare parts could not even be easily sourced.

As this persists, the host community is wondering why the Federal Government cannot expedite action to get the permanent site ready to alleviate the sufferings of the patients.

Some of the patients interviewed also called on the Federal Government to do something urgent to address the congestion issue and the high cost of medical treatment. In their view, as a federal institution, hospital bills should be highly subsidised.

Also, some of the people in the rural area complained that some of the general hospitals had no resident doctors, with only fresh doctors on national service attending to patients.

Mrs. Okoye said: “The problem we have in most of the rural areas is poor patronage of the hospitals and health centres, and with that, you see that there are no resident doctors, but only youth corps doctors, and in some cases, only nurses. That is why majority of our people prefer to patronise the private clinics despite their high bills.”

Officials of state Ministry of Health could not speak on the issues. They insisted that only the Commissioner for Health could talk on such official matters.

However, a staff in one of the general hospitals disclosed that the wife of the state governor, Chief (Mrs.) Ebelechukwu Obiano, had, through some of her programmes, been encouraging the rural people, especially women, to patronise the government health facilities.

The staff noted: “Mrs. Obiano has been visiting primary healthcare centres, where she distributes maternal delivery kits to pregnant women. This gesture has increased the registration of pregnant women for antenatal in the government facilities.”

Another woman, who pleaded anonymity complained that the government hospitals, most often, lack drugs and usually have no power supply for night duties.

A visit to the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, showed that the hospital has become busy, as people trooped in and out to access medical attention.

Also in the Onitsha axis and its environs, public health facilities were being neglected, though the previous administration in the state did a lot in establishing health centres and mission hospitals, which the present administration has continued to maintain and renovate.

The general hospital at Awka Road, Onitsha, is the only major public hospital in the area, which has the capacity to handle most of the medical cases from the patients.

The hospital is one of the largest general hospitals in the state with vast land.

The doctor in charge of the hospital, Dr. (Mrs.) Ebelechukwu Anugu, told the reporter that she needed approval from the state Commissioner for Health before she could talk.

•To be continued