How banditry disrupts access to primary healthcare services in Niger communities

The persistent attacks by bandits on communities in Rafi, Munya, Shiroro and other local government areas of Niger State, north-central Nigeria, in the last five years have disrupted access to primary healthcare services in the affected communities.  Findings by Daily Trust revealed that while some primary healthcare centres were completely shut, others only rendered skeletal […]

The persistent attacks by bandits on communities in Rafi, Munya, Shiroro and other local government areas of Niger State, north-central Nigeria, in the last five years have disrupted access to primary healthcare services in the affected communities. 

Findings by Daily Trust revealed that while some primary healthcare centres were completely shut, others only rendered skeletal services amidst fear of invasion and attacks by bandits who invade communities at will. 

Residents and health officials in the affected communities told Daily Trust that the prevalent attacks had left permanent scars in their lives, as some healthcare officials kidnapped on duty were only released after payment of millions of naira as ransom. 

For instance, Daily Trust gathered that in December 2020, the head of the Primary Healthcare Centre, Garin-Gabas, Rafi Local Government Area, Hajiya Halima Isah, was kidnapped alongside her 18-year-old daughter and was released six days after a N3 million ransom was paid. 

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Hajiya Halima told our correspondent, who visited her healthcare centre, that she was tortured and that the days  spent in captivity were like years due to the severe torture and hunger they suffered. 

She said her abductors invaded her residence around 12am that fateful night just after she closed from work and took her and three of her children but they later released two of the children because they could not trek far. 

“We have no single security, even night watchmen guarding our primary healthcare facility despite persistent attacks on this community. When we come for night duty, we don’t have security support; we come here alone to attend to patients. It is a serious problem for us to come out at night to see patients,” she said.

She added that “I had to pay N3 million ransom before I was released. During that time, we had to shut down our primary healthcare centre. And since we reopened for services, we have stopped night duties. We only come to work during the day and we ask patients to go back home once night falls.” 

She said they received no fewer than 200 pregnant women who came for various healthcare services on a monthly basis, saying that with persistent attacks and her abduction, the inflow of patients had reduced. 

“We want the government to help us with security men because we operate here in fear without any security backing. We cannot come out at night to attend to patients, which is a problem. Before now, the attacks were almost every day but in the last two months, it has reduced,” she said.

Similarly, the Basic Primary Healthcare Centre, Yakila, in Rafi LGA was forced to shut down for two years due to persistent attacks on the community. Staff of the centre told our correspondent that bandits had attempted to invade the centre in broad daylight, but the staff were able to flee. 

The Head of the Yakila Basic Healthcare Centre, Hajiya Safiya Abdullahi, said “it is two years now since we shut the centre because of banditry. Within those two years, we were given a building inside town where we render skeletal services because our clinic is located on the outskirts of the town. We reopened on February 6, 2023 after it was closed for two years.” 

She added that “we don’t have any security arrangements on ground even as we reopen but we have told the community that we need at least vigilantes to provide security for us at least when we are at work. When we close, they should also go home. But up till now, we have not received any feedback.” 

She said the clinic received no fewer than 80 patients on a daily basis, especially pregnant women who came for healthcare services from various communities. She called on the state government to help provide permanent security stressing that “most of us working here are women and we are afraid of staying here without security support. If we have security guards, we will feel more comfortable doing our work.

“There was a time, bandits were already at the entrance of this clinic, just about to enter, when we fled through the backyard.” 

Checks in communities in Shiroro Local Government by Daily Trust also revealed the same situation. Residents said Primary Healthcare centres in eight wards out of the 15 in the LGA had been shut. They said most communities had been deserted as the residents have been displaced by bandits. 

The Director, Primary Healthcare, Shiroro LGA, Hajiya Maimunatu A. Gogo, said some primary healthcare officials had to be transferred out of the danger zones to safer places within the LGA. 

“Sometimes, primary healthcare officials use a ‘kick and run’ method whereby they meet patients as quickly as possible and leave. Sometimes, they had to follow them to IDP camps and render the needed services. Then, my staff were not able to go to work in their uniforms; they had to go to work in mufti because of bandits. 

“Recently, my staff went to Kuta IDP camp, where they discovered a woman with cancer. The nipple had already fallen off and she was carrying a two-month-old baby. It was not discovered early because there were no primary healthcare centres for them to visit. So, we had to take her to a doctor for proper care,” she said. 

Hajiya Gogo appealed to the state government to provide funds to recruit security for primary healthcare centres in Shiroro Local Government to protect staff and the healthcare facilities, lamenting that “we don’t even have a single watchman to guard our facilities.” 

Also speaking, Head of the Basic Primary Healthcare Centre, Gunu, Shiroro LGA, Kabiru Adamu, told Daily Trust, “actually, insecurity has affected us in different ways. First, even the staff we are working with are in constant fear of bandits.

“Also, even the patients and their relations are not always comfortable being in the healthcare facility. I recall, two weeks ago, there was an attack at Egwa, a community not too far from us, people from this community also fled.

“We had to disconnect the drips from our patients on beds and left the facility because we could not leave the patients behind in the facility. The vigilante office is close to us but they all fled. We are always scared.”

He said some of the skeletal services they were able to render were with support from non-governmental organisations, which provided the needed support to enable residents to access primary healthcare services. 

Consequently, Ahmed Adamu, the community leader in Gunu, said they contributed money to recruit security men in their community, adding that “Without support of the NGOs, we wouldn’t have survived these security challenges even for a day.

“NGOs have brought a lot of programmes that have helped us,” he said, and called for the supply of adequate drugs to meet the demands of the residents. 

Adamu said healthcare officials in the community don’t come out at night to attend to even emergencies because of fear, adding that “a lot of emergencies come up in the night. So, we need the government to deploy security men to our communities to give our healthcare officials the confidence and courage to stay and attend to patients,” he said. 

The Technical Officer, Partnership for Advocacy in Child and Family Health (PACFAH@Scale), Shehu Ahmed Baba, said the security assessment of primary healthcare facilities in the affected local government, conducted in partnership with the development Research and Project Centre (dRPC) through the Centre for Communication and Reproductive Health Services, Bida, Niger State, revealed lack of security support on the part of government thereby denying the residents access to primary healthcare services. 

“We have worked across all the security-affected communities in Niger State to support the Niger State Ministry of Health and State Primary Healthcare Development Agency to improve security support in the affected areas.

“We discovered that with the intermittent security challenges, the primary healthcare services, especially child and family healthcare, were at handicapped stage.

“We discovered that there was lack of security support in those areas and widespread lack of funding to continue with the services. So, the healthcare officials in those areas needed to be very well motivated to respond to their services. So, we saw gaps around security support and funding.” 

The Deputy Director, Health Facility, Niger State Primary Healthcare Development Agency, Alhassan Musa Kaboji, confirmed that security challenges had disrupted primary healthcare services in the banditry-infested communities.