Pregnant women forced to travel long distances for medical care, risking complications.
By Violet Ikong
Abenyo, is one of the communities that make up Calabar Municipality, Cross River State. Though located in the state’s capital, the community suffers from government neglect, which is evident even in its primary healthcare. Like many communities across Nigeria, Abenyo has a Primary Healthcare Centre (PHC) that is in a sorry state and deprives residents, especially women, of access to antenatal, delivery, and post-natal services.
The community’s only healthcare centre, identified by residents as Health Centre Abenyon Ward 10, is located about five kilometres from the heart of the state capital.
On a visit to the facility, the first challenge that one is bound to face is the deplorable and inaccessible road that leads there. Besides being untarred, the road can only be accessed using motorbikes.
Another problem is the deplorable state of the facilities at the health centre. Although the Abenyo Health Centre was established in 2007, it has not undergone any renovation since then. The facility’s building bears an old and outdated look with worn-out paint, and some parts of the building are damaged.
Although Nigeria has over 35,000 primary health centres, only 20% of them are fully functional.
‘No Water, Bed, or Drugs’ In The Health Centre
When the Abenyo Health Centre was commissioned in 2007 by then Governor Liyel Imoke, locals were excited at being able to access basic healthcare which they had been deprived of for a long time. But 17 years later, they still cannot access basic healthcare services.
“We can not get medical help here. Nothing is working,” an elderly man from the community who is in his late 70s said, in frustration. The village head of Abenyo, Chief Okon Akpan, decried his sadness and fears at the health risk that his community members, particularly pregnant women, and mothers, face due to the abandonment of their primary healthcare centre by the government.
The Water and Sanitation Hygiene (WASH) facilities in the health centre including toilets and boreholes, are no longer functional.
According to the Centers for Disease Control and Prevention (CDC), without appropriate WASH infrastructure and services, patients, healthcare workers, and communities are at increased risk of disease. However, in the case of Abenyo, some of the pipes holding WASH facilities have been broken and laid on the ground. Staff at the facility explore difficult options to get water and use the convenience when they need to. Also, the facility, just like many others across the country, does not have drugs or other consumables.
According to Check Isho, a health practitioner and director of Shape African Health, “Through functional Primary Healthcare services, women can learn from skilled health personnel about healthy behaviours during pregnancy, better understand warning signs during pregnancy and childbirth, and receive social, emotional and psychological support at this critical time in their lives.
“They can also access micronutrient supplementation, treatment for hypertension to prevent eclampsia, as well as immunization against tetanus and HIV testing. In areas where malaria is endemic, health personnel can provide pregnant women with medications and insecticide-treated mosquito nets to help prevent this debilitating and sometimes deadly disease. Primary Health Centres have a great impact on the health of pregnant women, nursing mothers, and the general population at large,” he said.
Sorry State Of The Facility And Human Resources Twists Abenyo’s Expectation
The infrastructure in the health facility is another problem. The door behind the health facility has been eaten off by termites and has yet to be replaced. The facility also has damaged hospital beds, an absence of clean water, and no source of electricity. A shortage of well-trained and qualified healthcare staff is another challenge for the Abenyo Healthcare Centre as only one community health extension worker is assigned to the facility.
When TheInvestigator visited the facility, it was discovered that the community health extension worker visits the community from the heart of the state capital, and he only goes to work once or twice weekly due to transportation challenges and the working environment. There are also times when the worker doesn’t visit the facility at all.
These problems with the facility make it unfit for pregnant women. The women in the community during pregnancy and antenatal are left to themselves without due medical attention, and many face high risks during the process of antenatal and childbirth due to damaged and non-available healthcare equipment. As a result, many women in the community register for antenatal care at facilities located at the heart of the state capital, and they also go there to deliver their babies.
But driving a pregnant woman from Abenyo to the heart of town for medical attention is capable of severe health complications due to the state of the access road.
Some of the locals shared their experiences with TheInvestigator about the conditions they go through.
“I have not used this facility before, and I can’t remember when last I saw a doctor or a nurse around here. We need beds, repairs to the doors, and other things that will help the facility function,” said Janet Inyang, a native of the community who is in her 20s.
The vice president of Abenyo Youths, Ezekiel Akpan, said, “Since this health center was built, we have not had access to standard water here. Even our pregnant women do not have nurses to take care of them, not to mention a doctor,” he said. “We often take patients to the urban centers because we cannot access medical care here. Nobody gives birth here, we rush them out to the urban center during labour,” he added.
When contacted, the village head of the community registered his displeasure about the state of the health facility in his community.
“There is no accessible road into this community and then there is no water. There is also no power supply in there; in fact, there is nothing in and around that healthcare facility,” the chief, Akpan, said. Whenever somebody falls sick, we get to get them to the urban area for treatment because we cannot get help here, and it’s the same for pregnant women,” he added.
Despite calls and pleas to the past government of the state, no intervention has been carried out at the health facility.
“We have not written to this present state government yet; we only cried to the last government that has passed, but what we are saying to this present government is that they should give us a road, renovate, and equip our primary school and health centre. We also need water, the chief said.
Even Old Women Aren’t Spared
An old woman in her 70s, Agnes Effiong, said she has no need of the facility, as her expectations were quashed long ago. “I do not have any dislike for the facility, but how do I use it when there is no doctor, nurse, drugs, or water? The facility is not helping us in the community,” she said.
The situation at Abenyo is similar to many PHCs in Nigeria as the country has failed to invest in its primary healthcare system. “The nation has failed to reach its pledge to devote at least 15% of the overall budget to health over the last 20 years. The amount of money currently allotted to health (5.75% of the total budget) is the largest in the nation’s history, but it is glaringly inadequate to address the problems facing the health sector,” Isho said.
‘We Are Not Aware,’ Ministry of Health
In an attempt to inquire from the Cross River State Ministry of Health about the condition of the facility, the State Commissioner for Health, Dr. Henry Ayuk, opted to send his team to the facility immediately for assessment.
“There are 1,445 facilities in the state; I may not picture the facility you are referring to; just text the details to me, and I’ll send my team there immediately for assessment.”
The commissioner hung up immediately afterward, refusing to take further questions.
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.