Chinonye Onodugo clinches her three-year-old daughter—she sits on a wooden bench—waiting to be attended to by a community health worker under a mango tree. Her daughter has been feverish and needs to be attended to, but there is no other place to seek medical help than a dilapidated health centre in the community.
The mango tree, for the past two years, has served as the waiting, consulting and dispensing rooms for the only health centre at Ugbawka in Nkanu East Local Government Area of Enugu State. It serves three other communities: Amafor, Akpa and Umuizu.
There are four wooden benches, all unkempt and faded due to the impacts of rainfall and sun, and then a few plastic chairs and a table where health workers attend to patients.
Onodugu is one of the few villagers who still keep faith in the dilapidated Ugbawka Health Centre—many others have stopped consulting the centre since it now looks like a war-ravaged building with no roof and everything that makes a functional health care facility.
“We have no option,” Mrs Onodugo laments. “I gave birth to my daughter in this health centre. The labour room is like a home of mad people: no mattresses. The only mattress of the centre is brought during labour from a neighbouring house where it is hidden. The only cover during child delivery is a green curtain.
“If not for the hardship in the country, I wonder why anybody would come to this health centre to access health services.”
An Eyesore Called Health Centre
Ovuorie Health Centre, as it is called by locals, serves the densely populated community, believed to be over 4, 000. For two years, the facility has been abandoned, though there are workers still attending to a few people that come once in a while.
On that Tuesday, two community health workers (CHEW) were on ground to attend to Onodugu. They only work at the centre because they are passionate about the work and because, according to them, they are not owed salaries, but where they work is an eyesore.
“We beg whoever cares to come to our rescue,” one of the CHEW said while pleading not to be named. “This health centre has been dilapidated for years. It has no roof; in fact, there is nothing here.
“We, however, attend to patients on a daily basis. Health centres are still the cheapest place for health care services in Enugu State. We carry out immunisation and antenatal services. We also treat primary ailments, and make referrals as the case may be. Many patients access this centre. About four of us work here daily. One lives here to attend to emergencies.”
Locals and the health workers say the centre used to receive about 20 patients each day, but the number has since dropped as there are no facilities at the centre again. More worrisome, the only toilet in the centre now doubles as its store. It also serves as an emergency room, one of the workers at the centre revealed.
“We have qualified health workers, save for facilities,” said the senior health worker. “Our vaccines are stored at the solar-powered freezer located at Amuzam health centre. It is not very far from here. We have a store behind, which used to be a toilet anyway.
“Our other facilities are kept in nearby houses. We are ashamed because the owners of those houses have been asking us to remove those things, such as mattresses, bedspread, refrigerators, injection materials, among others.
“We are not owed salaries, but the basic thing is lacking. Health is a priority, so when we see the environment we treat sick people, we feel ashamed.”
The moribund facility has five rooms, including a waiting room, a consulting room, labour room, pharmacy and an office. However, none of them are functional. Disused iron beds, buckets, chairs, among others, dot every nook and cranny of the building.
One of the workers said, “In fact, many of what we had here were stolen by unknown people. Others were removed by scavengers. Gradually, everything went away. This hospital is just a skeleton of its own. We have cried enough.”
A native of the area, John Amuka, said, “We thought that hope had come when the incumbent council chairman began to re-roof the health centre. We praised him for the intervention because before him, no one ever did that.
“Unfortunately, the project has been abandoned for close to one year. Ordinarily, the reconstructing of the health centre should not take a reasonable and determined local government administration more than two weeks to complete,” Amuka added, apparently losing confidence in the local government chairman’s intervention.
On what happens when rains fall, a patient, Amaka Ukwueze, said, “We run to shops opposite this centre. Even the workers are not spared. It has become a norm. But traders laugh at us. They asked us to tell the government to repair the health centre.
“This place is also a home to mosquitoes and some poisonous rodents. We are at their mercy.”
Villagers now patronize private health care facilities, which are expensive and most times parade incompetent personnel.
Eucharia Okii, mother of one, said she had resorted to a private hospital since the community’s health centre became dilapidated. “I can’t go to where snakes can bite me and my baby while in search of good health.
“I want the government to repair that place. Many people around here can’t afford medical services at private hospitals. That is why rehabilitation of this health centre has become necessary.”
Ezekiel Eze, a tricycle rider, said, “I can’t go there again. I told my wife to be going to another health centre. At a time, the roof was even trying to fall. That was before the intervention of the council chairman. It is a deathtrap both in structure and facilities.”
A patient, who declined to give her name, still has confidence in the centre. She said, “Even though the facilities are in bad shape, some of us are happy because the workers are hard working.
“They do their best in the face of all these challenges. I also believe members of the community should contribute funds to fix the centre because it serves all of us one way or the other.”
The law establishing health centres in Enugu State shows that they are under the care of local governments, although the state ministry of health supervises them.
In 2020, the authorities of Nkanu East LGA attempted to rebuild the hospital. The council, under the leadership of Uche Nwobodo, only put woods on the building without roofing it. One year later, the woods were old and were giving in to the effects of rainfall and sun.
When contacted, the council chairman, Nwobodo, in a terse message, said, “I will complete it.”
But locals are doubtful as his tenure in the local government will end in 2022.
Despite its poor state, the health centre provides immunisation services every Friday while pregnant women come for antenatal services on Tuesdays.
Lawmaker Diverts Fund Meant For Rehabilitation
Succor would have come the way of the abandoned primary health care centre as it was captured in the 2021 Appropriation Act. In the document, the rehabilitation of the health centre is under Zonal Intervention Projects (ZIP).
According to the document released by the Budget Office, “N25million was budgeted in the 2021 FG budget under 2021/ZIP/1199 for the Rehabilitation Of Health Centre At Ugbawka In Nkanu West/East Federal Constituency. This project is to be executed by PRODA (Projects Development Institute).”
But findings revealed that Hon Nnolim Nnaji, a member of the House of Representatives, who is also a pharmacist, representing Nkanu East/Nkanu West Federal Constituency in the National Assembly, facilitated the budget allocation to the primary health care centre.
Checks by our correspondent, as contained in the Presidential Enabling Business Environment Council (PEBEC), show that code W302 is for the Rehabilitation of the Health Centre at Ugbawka in Nkanu East/West Federal Constituency of Enugu State.
Further findings revealed that there has been a 75 per cent mobilisation for the rehabilitation of the centre, but no work has been done and no one in the community was aware of the budgetary allocation.
When contacted to find out why the health centre has not received a facelift, the lawmaker, who those in the know said has diverted the fund into other purposes, said the fund was diverted to another important project that was incomplete. He also questioned the knowledge of the reporter about the operations of ZIP.
Quoting him, “Do you know about ZIP? Do you know if the contract has been awarded? Do you know how the project entered the budget? Can a contract (sic) execute a project without mobilization?”
He said ZIP is his money as a member of the House and he has used part of the money for another project which this newspaper found out to be an empowerment project.
“ZIP is my money as a Rep member and I decided to use part of it to complete the project started by Dame Rex Onyeabor and possibly other women of Ugbawka,” he said.
Nnaji, however, said the rehabilitation contract had been awarded to someone from the community who has not commenced work on the project: “It has been awarded to someone from Ugbawka to complete the building. He got the award letter a few days ago and is waiting for mobilisation. Let’s give him time.”
Community Leaders Plead For Intervention
Christian Chukwu, the traditional prime minister of the community, appealed for immediate rebuilding of the centre.
He said, “That health centre is covering our area, even though we have another one at Ishienu. I appeal to the government to come to our aid. Ovuorie is the centre of Ugbawka. People of Amafor, Akpa and Umuizu access that centre for their health needs. Our women go there for their antenatal care.
“Because of the situation at the centre, many people now do not go there. Some even resorted to not attending antenatal at all, which is dangerous. The officer in-charge of that place is known for her industry. But the look of that place has demoralised her. Patients that go there leave with dissatisfaction. She was hard working when she headed the health centre at Ishienu.
“I appeal to the government to roof that building even if nothing can be done there again. That is the heart of Ugbawka. That building existed before the war, and got dilapidated. It was rebuilt over 20 years ago by Fr Michael, who happens to be my brother.”
Ebuka Okoh, the president of the Nigerian Youth Council, Enugu State chapter, and a native of the community, said, “We have other health centres aside from the one at Ovuorie. It is located at Ogonogo Ohuno. They are the only two health centres in the entire Ugbawka. But they are in shambles.
“Health centres are essential in communities because they are cheaper and affordable to locals. I appeal to the concerned authorities to uplift that health centre. The environment itself is unkempt. The government should also post resident doctors, or at least visiting doctors to ensure quality health care.”
– This story was produced in partnership with Civic Media Lab under Grass-roots News Project