Located at Ekporoden, after the Government’s Migrant and Technical College, the facility has no water within but solely depends on rain and a running stream over 2 kilometers away.
By Archibong Jeremiah
In this special report, Archibong Jeremiah of TheInvestigator chronicles how Agoi Ekpo Community in Yakurr LGA, Central Senatorial District of Cross River State effort to get quality, comprehensive, and affordable healthcare is thwarted by a lack of manpower, medications, and other amenities.
In 2007, the Tulsi Chanrai Foundation set up and commissioned the Akarukpat Primary Healthcare Centre (PHC) Agoi Ekpo, in the Yakurr local government area of Cross River State with three staff. After 13 years of operating from a temporary and unbefitting structure, the community decided to build a new and better facility and began operations in 2020.
Before moving to the new site, two health workers were transferred out, leaving Mr. Arong Owai. The community then provided a volunteer to support him, and for five years now, Mr. Arong has been the only Community Health Extension Worker (CHEW) running the facility.
To the community, four years after the new site of Akarukpat PHC began operations, having only one health worker and a bed, not having a doctor attached to do routine visits, pharmacy, medications, nursing station, consulting rooms, wards, potable water, fetal heart rate monitor, working fridge for vaccines, stretcher, oxygen gas for patients, and funding is defeating their aim of setting up the facility – to receive quality, comprehensive, and affordable healthcare.
Located at Ekporoden, after the Government’s Migrant and Technical College, the facility has no water within but solely depends on rain and a running stream over 2 kilometers away. Still, they have a geepee tank for storage.
The poor working conditions have left Mr. Arong crestfallen. Pouring out his dilemma to TheInvestigator, he recalled, “One day we had three deliveries, and because the facility has only one bed, there was no space for the other two women.”
On the lack of oxygen for patients, the soft-spoken man said: “When we have complicated labor that requires oxygen to resuscitate the child, we use a mouth-to-mouth process.”
The lack of manpower, pharmacy, medications, wards, beds, potable water, funding, and other basics needed by the Akarukpat Primary Healthcare Centre could have led the community residents to seek healthcare elsewhere or even traditionally.
Antenatal and immunization are two popular services known to be offered by a PHC. Still, in Agoi Ekpo, many pregnant women wait till the last trimester before going for antenatal, leading to delivery complications.
Mr. Arong revealed that many women in the community delay before registering for antenatal care, which is dangerous for both the mother and fetus.
Narrating an experience of over three years ago to TheInvestigator, he said: “We had a case where the child died in the womb of the mother, there was no equipment for one to do the evacuation, I referred her to the General Hospital Ugep and she was operated upon and she’s fine now.
“She came in with a history of offensive discharge and when I examined her I discovered the baby inside was not alive. I discovered that she registered for antenatal late and that is one of the practices of community women here, they will wait until 6-9 months before they come to register.”
Not being able to utilize his full potential due to a shortage of apparatus the Community Health Extension Worker (CHEW) 1 asserted that he is disheartened but is not deterred.
“In the absence of all those things, I look at it as limiting against the services we would have offered. I feel so discouraged and demoralized knowing too well that I would have been able to rescue or save that condition but the apparatus and the things needed are not present.” He maintained.
Mr. Arong further told TheInvestigator that the facility is run through Internally Generated Revenue (IGR) and that they make a paltry sum that doesn’t meet their need.
His revelation: “We fund the facility through the facility management concept (Internally Generated Revenue). Some months we gather up to N50,000 – N80,000 to use and run the facility.”
*Grace Eteng, a mother of two told TheInvestigator why she did not deliver her two daughters in the PHC but at a Traditional Birth Attendant (TBA) home.
She spoke in Yakurr “I’m not saying going to the PHC to deliver is bad but I consider many things. They don’t have a bed, drugs, or water, and most times the cost of everything is important too, I’m just a farmer, and my husband drives an Okada (motorcycle), the distance is another thing, my place is very far from and on a motorcycle with this rough road, I prefer home delivery.
“My mother, and three sisters all use the traditional method, which is cheaper. The herbs we use are found everywhere here, whereas I would have to send someone to Ugep to buy everything I need including drugs if I do the normal antenatal.”
She added with a smile on her face while picking dirt off her last daughter’s hair who clung to her the whole time, “Yes, a lot of people talk bad of the traditional birth system and that is why I don’t want my name mentioned so that even the woman who helps us doesn’t have a problem with the Government even though she is registered. Many people around me will register for antenatal but the same woman will be the one they will call to come or go for delivery, it is about choice.”
Joy Ofem, a grandmother of five shared her opinion with TheInvestigator, “All my three children were delivered at home, during our time it was normal but over time things changed. My daughters were delivered at the hospital, and in that PHC, in particular, my third grandson was delivered there without any challenge but seeing the stress the man goes through to help women is scary. What if blood is needed, what if an ambulance is needed? These thoughts ran through my mind the whole time.”
The area used as reception, waiting room, and nursing station.
She further stated “With the level of service they render there if there are three health workers and two volunteers, people will increase patronage. From my experience, it is the lack of more hands, beds, pharmacy, and drugs that make most people reluctant to go there, only when there is an emergency, but immunization even if you don’t go they go house to house most times.”
Government Should Massively Recruit For Those Facilities, Stakeholder Advise
Mr. Felix Ngwu, Founder of the Centre for Healthworks, Development, and Research Initiative (CHEDRES) when contacted for expert opinion sympathized with Akarukpat Primary Healthcare Centre and called on the Cross River State Government to conduct massive recruitment for the facility and others alike.
According to him, “The issue is that the State Government is supposed to be up and doing, many communities have tried to help themselves through self-help.”
He went on to reveal that “Our recent project, community life monitoring that we did in Obudu local government area revealed the fact that government presence is skeletal. The government should do massive recruitment to support those facilities. Recruit appropriate people to man those facilities.”
Mr. Felix, who has worked in the health development sector for over a decade, said the new administration of Sen. Bassey Edet Otu needs to go back to the drawing board.
He said, “The government has to sit back and look at the functionalities, PHC is the mainstay, and they need to look into these things.” Adding that, “Look, people are retiring in March and there is no replacement, all that technical capacity.”
On the importance of mentorship and the need for a mentorship program, Mr. Felix said “Nobody is mentoring anybody. If today you recruit people and they go to inject someone where they are not supposed to, that’s because nobody mentored them.”
He further suggested that, “Even those who have retired you can engage them as mentor mothers or so. Provide technical capacity, it’s not about recruitment alone but sound training.”
The Commissioner Has Requested Approval To Intervene – Official
The Office of the Commissioner for Health was contacted to know if they are aware of such facilities and others with challenges.
Mr. Kingsley Agim, the Ministry’s Information Officer, spoke to TheInvestigator over the phone.
He acknowledged that the Ministry is aware of facilities with challenges and the Commissioner, Dr. Henry Egbe Ayuk had visited some including those abandoned.
Mr. Agim who is also the State Chapter Nigeria Union of Journalists (NUJ) Assistant Secretary revealed that the Commissioner has sent a memo to the State Governor for approval to take major action.
Mr. Agim said, “The Commissioner has talked about those facilities with challenges, he has written to the Governor requesting for those facilities to be supported.”
He revealed that “He has been visiting facilities with challenges, he has been to Etomi where one is abandoned.”
Note: The name asterisked is to conceal the person’s identity because she requested it.
This story was produced for the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science. It was supported by the Africa Data Hub – Frontline Investigative Program.