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Special Report | Inside Kano PHCs where continuous neglect creates hardship in communities

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It was late in the night when Ms Jemila Garba’s water broke, and labour set in. She was in excruciating pains, and all she wanted was to give birth to her child.

Zara Primary healthcare facility (PHC), only a few meters away from her house, was the best place to deliver her baby. However, unfortunately, Zara PHC was and is still a complete disaster.

Zara PHC is a grass-root facility meant to address the main health problems in the community by providing preventive, curative and rehabilitative services.

Being the first level of contact for individuals, the family, and the community, Zara PHC is regrettably far from what a primary healthcare facility should look like.

Although her child is close to 3 years, Ms Jemila is concerned about the devastating state of Zara PHC. She fears women who might have birth complications and not get appropriate assistance because Zara PHC is nothing but “a deadwood”.

That night, Ms Jemila’s brother-in-law had to scout for a vehicle that conveyed her to Abdullahi Wase Specialist Hospital, about 14 kilometres away from her Zara community.

Jemila Garba and her child in Zara PHC. Photo: Stephen Enoch

“I am married with five children, and I gave birth to two of my children at home because of the deplorable state of this facility. You have seen the facility. This facility is non-functional because there are no drugs and equipment. There isn’t even a single presence of security, the staff here are trying their best, but nothing happens here because of how bad the place is.

“I can recall a time when a little boy came here for medical care, and a plank of wood fell off the tattered ceiling and landed on the little boy’s head. He came for medical care but went back with a bigger injury. Later on, the community head and some staff use their funds to repair part of the shabby celling.” Ms Jemila narrated.

Out of pocket spending among residents of Zara community

Ms Jemila expressed her displeasure at the way people in the community now have to spend more to get drugs which initially should have been provided by Zara PHC.

“When we come here for drugs, the workers give us prescriptions, and we purchase the drugs from a pharmacy within the neighbourhood because there are no drugs here. This is why we don’t come here for anything serious. Most residents prefer private hospitals and clinics now.” She said.

Ms Suwaiba Yakubu is another melancholic resident because she constantly had to spend money on drug purchases at pharmacies.

When she spoke to Daily News24, she had a minor injury in her face, and she said that pharmacies were her only option if she had to treat her injury because Zara PHC is always out of stock of medicines.

“When women are in labour and about to deliver their babies, they have to go elsewhere, and, sadly, we have a facility that doesn’t work. We want the government to help renovate this facility so we can stop visiting other places for care. When I was about to give birth to my child, my husband struggled to get a vehicle to take me to a hospital town to deliver my child. She pleaded.

Both staff and patients are put in a precarious situation whenever it gets too windy or rains. Photo: Stephen Enoch

For Rijanatu Abubakar, it pains her that even though the PHC is just a stone’s throw from her house, she still has to spend much money on transportation to give birth in other facilities and that she has to spend additional money to buy drugs. She currently has six children, and most of them were birthed elsewhere.

“There are no tangible drugs in this facility, and the response some of us get on approaching the facility for drugs is that ‘there are no medicines’. We are begging the government to come to our aid because even conveying people to other facilities to give birth costs money, and not everyone can afford it.

“I can recall the time I wanted to give birth to my child. It was late in the night, and before a vehicle was gotten to convey me to the hospital, we went through a lot of stress. I was in agonizing pain, to the extent that I didn’t know the world I was in and for five days, I was unconscious before delivering my child.” She said

Giving birth at home

Like the Zara community, residents of the Watari and Dambare community in Kumbotso LGA share the pain of having a healthcare facility close to their houses. Still, they have to give birth to their babies in their homes.

Dan Jirima health post is Watari community’s only healthcare facility. Daily News24 learnt that their roof was recently fixed with the funds of the staff and community after it was blown away by the wind and was neglected by the government, despite their plea for the renovation of the facility.

Giving birth to children at home is now the norm in Watari because the facility no longer carry out the delivery of babies.

The road which links the community to the major road is terrible, and rather than risk passing through the appalling terrain, which could cause further complications or pains, delivering at home is just their best option.

Zainab Usman, a 29-year-old mother of six, who stopped birthing her babies in Dan Jirima facility, told Daily News24 that the poor quality of the health post made her and other women in the Watari community start giving birth to their babies at home.

Dan Jirima health post lacks a sanitation facility. It also doesn’t have any source of water supply and doesn’t have any perimeter fencing. Photo: Stephen Enoch

“Whenever pregnant women come here for delivery, they are always turned back because of the poor state of the facility. When I was in labour and about to give birth to my baby Ummal-khairi, it was about 8 am in morning. I put a call through to the staff of this facility to help me out, they came to my house, and I successfully gave birth to my child at home. She said.

20-year-old Aisha Dahir has three children, and her most recent baby was born at home. She said the delivery of her baby at home was smooth without any hitch.

“My plea to the authorities is that they renovate this facility so that other women can start giving birth to their babies here. The staff of this facility have been helpful to us, and we are grateful to them for their support.” She said.

A source explained that even though the facility was cluttered, they still receive patients from neighbouring communities. The source said they only attend to cases that were in their power.

The additional shocking situation of Zara PHC and Dambare health clinic

Some astonishing discoveries were made when Daily News24 visited Zara PHC and Dambare health clinic during the Resource Center for Human Rights and Civic Education’s (CHRICED) PHC tracking exercise.

The precarious situation in Dan Jirima health post isn’t different from that of Dambare health clinic. The clinic has been in existence for the past 30 years, the community members and staff of the facility have been the ones renovating and maintaining the facility. Because the facility serves other neighbouring local government areas, the community members contributed funds and expanded the clinic, but sadly, Dambare health clinic is in shambles.

In Dambare health clinic, women are examined when they come for antenatal care. This is also where emergency births are carried out. Photo: Stephen Enoch

A source in this clinic told Daily News24 that the facility no longer accepts delivery of babies because of how messy it has become. However, emergencies usually arise in which they have no other option than to attend to the emergency delivery in the facility.

Dambare’s community head, Awaisu Kasim Hawan Dawaki, noted that the staff of Dambare health clinic had tried their best in seeing the facility serves the community. He said that calls had been made to relevant government authorities to renovate the facility, but all their efforts had been fruitless.

“They keep making promises of renovating the clinic, which has not been fulfilled. I am calling on the relevant authorities to come to our aid.” He said.

In Zara PHC, this reporter discovered that the facility’s toilet had been out of use for the past five years. A source revealed that whenever the staff of the PHC want to ease themselves, they have to plead with residents close to the facility to use their toilets.

“For the past five years, this toilet has been out of use. We have no choice but to plead with the neighbouring houses to use their toilets. Even after making our complaints known repeatedly, we are still in the same situation, as you can see for yourself. Please don’t go close to the toilet because of the smell, and it could be dangerous, the source told this reporter.”

Zara PHC’s toilets. It has been out of use for the past five years. Photo: Stephen Enoch

A significant part of Zara PHC’s roofing has been ruined due to wear and tear, and sadly, it has remained in that manner for more than two years. As a result of this, patients are discouraged from visiting the facility. A source revealed that before the facility’s community head and staff used their funds to fix part of the ceiling, they had to cope with that terrible condition even in the rainy season.

The source also said that the facility had recorded a continuous drastic decline in the number of patients who visit the facility due to the continued degradation of the PHC without any hope in sight.

The government’s usual head-in-the-sand response has continued to degrade the quality of services in Zara facility. Residents prefer to go outside to seek medical care with their money, rather than visiting Zara PHC.” The source said.

The antenatal care services / postnatal care examination room, which served as the place for delivery, is a shadow of itself. Covered with dust from a leaking partly open area in the ceiling, rays of sunlight shines directly in the room. The hazy wind that blows from outside can be felt inside the room, making it unhabitable for any activity. Instead, it has become an abode for spiders, as a pile of cobwebs has taken over the ANC / postnatal care examination room.

Zara PHC’s antenatal/postnatal room is covered in dust. Photo: Stephen Enoch

Forty-year-old mother of six, Ms Majidda Umar, gave birth to some of her children at home because she had no other choice, and Zara PHC wasn’t a second or third option.

“When I wanted to give birth to one of my children, there were staff in this facility, but I couldn’t think of using it. They had to bring some materials from this PHC to assist with my birth at home.

“I was around when some government officials came to this facility last year and promised to renovate it, but till date, nothing has been done about the condition of this PHC. For the past five years, residents of Zara community have been enduring this hardship, and almost all of us in this community prefer to go elsewhere for medical attention than using Zara PHC. We are pleading to the government to fulfil their promise and renovate this facility,” Ms Majidda said.

While speaking to this reporter, human rights activist Mrs Zuwaira Omar said CHRICED visited the Zara facility about a year ago when the facility was appalling. She describes the facility as a place where no woman will willingly give birth to her child because it looked like an abandoned building.

“After discoveries of the first tracking was made public, the local government chairman said the facility will be renovated, they sent a surveyor to examine the place, and I thought that by now, the promise would have been fulfilled, but till date, it is surprising that nothing has been done.

“It is disheartening that a community like Zara does not have a functional PHC because the pressure on Mariri PHC will be much as residents from Zara and others will add to the pressure of Marri PHC. I am calling on the local and state governments to respond to the needs of the facilities which need intervention.” She said.

Zara, Watari and Dambare communities are suffering from similar problems. They all have no access to water. If only a solar-enabled borehole can be erected, it will ultimately help ease their concerns, thus achieving sanitation. Additionally, if they could be provided with mobile toilets, it would also relieve them from pleading with community households to use their toilets whenever they feel the need to answer the call of nature.

Security is also an aspect where the facilities are lagging. If the relevant authorities could employ community members as security guards for the facilities in the community in which they live.

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