Massive resignation of doctors sickens Nasarawa
With high rate of illiteracy, and people pushed into extreme poverty, the inadequacy in the number of doctors at Nasarawa State has only added up to make a triangle of death for the 14-year-old state of 13 local government areas and 16 development areas. But the many scorecards of Governor Aliyu Akwe Doma, including the […]
With high rate of illiteracy, and people pushed into extreme poverty, the inadequacy in the number of doctors at Nasarawa State has only added up to make a triangle of death for the 14-year-old state of 13 local government areas and 16 development areas. But the many scorecards of Governor Aliyu Akwe Doma, including the ones on the many signposts adorning federal highways, as well as the Nasarawa State Council of Chiefs, the People’s Democratic Party (PDP) in the state, the forum of former local government office holders have all said the administration has performed well in all areas of development including healthcare. But the governor has acknowledged, when he received the former council officials, that “only a little has been achieved”.
The budgets for the collapsing health sector since the inception of the present administration have always promised well for the state. The current budget which the governor called “Budget of Reality” projects a health sector expenditure of N4.9 billion out of the N40,646,265,383.00 budgeted capital expenditure. A cardinal feature of the budget is the planned construction of a General Hospital in Lafia, the state capital at about N200 million, a sum which has become a recurrence in the budgets for the same purpose, although nothing is yet to be provided. There have not been explanations for the inability to implement the budget in this regard, except for the global financial crisis of last year.
Only recently, the World Bank scored Nasarawa State top on the charts of the in the implementation of the Health Systems Development Project (HSDP). The assessment was done by the joint mission of the representatives of the world financial institution and those of the Federal Ministry of Health have said. Upon this rating, the state will draw down additional funds to the tune of $3.5 million from the World Bank to complete the health sector projects which were awarded for execution upon the release of $1.5 million in the 2009. Director of Planning, Research and Statistics of the Federal Ministry of Health, Dr. Mohammed Leke who led the World Bank Task Team Leader in Nigeria, Mrs. Ann Okigbo, and other members of the mission to Lafia, told Governor Aliyu Akwe Doma the rating was the fall-out of the days of project assessment in the areas they were located.
But the state continues to remain sick in the hands of inexperienced and poorly paid doctors. The state chairman of the Nigerian Medical Association (NMA), Dr. Usman Abe had said about 70 doctors resigned their appointment in the last one year alone, resulting from alleged poor condition of service including poor remuneration, lack of space for doctors to consult, lack of functional ambulances, absence of official vehicles and residences and general decay. The NMA has pressed for improved conditions of service throughout the life of the present administration, without results.
Although the NMA gave about 70, inquiries from records have shown that more than that number – running into over 80 doctors, have left in the past one year. Most of them, according to our inquiries, resigned as soon as they resumed, as they discovered the conditions of service are anything but impressive compared to neighbouring states’. Records show that the state has continually appointed doctors to fill the vacuum, but the more these appointments are made, the higher the number that leaves to seek greener pastures elsewhere including in private hospitals, neighboring states and the Federal Medical Centre in Keffi, which has remained the saving grace for the state. The FMC in Keffi, a referral hospital, has served everybody from down the ladder to the top since the general hospitals are pale shadows of their former selves.
At the moment, the Nasarawa State Hospital Management Board (NSHMB), which had about 60 doctors in the early 2009, now has only 26 of them with four serving at the headquarters in Lafia as administrative staff, while 22 are managing the 18 general hospitals. While a few of these general hospitals including the one in Akwanga, have more than a doctor consulting, others have only one, working 24 hours a day – doing the ward rounds, consultation, operations and handling administrative matters. These doctors are mostly inexperienced as most of them just left the housemanship, are seeking a place to start.
Out of these 18 hospitals, only eleven of them have doctors – three, two or one, while seven of them have remained without doctors. Agbashi, Umashi and Arikye have not had a doctor in two years. Keana remained without a doctor for over six months before a new one was sent there. In Awe, a doctor whose name was given only as Doctor Uja, has remained the only doctor for over three years, same for Obi. The records show that within and about the last one year, 35 of them resigned with seven additional ones without trace.
The Dalhatu Arab Specialist Hospital is the biggest state government owned facility is run by a different board from NSHMB – which is the Specialist Hospital Management Board. It has, at the moment, 80 doctors, according to our inquiries, but half this number is scattered – with some doctors working as administrative staffs in the health ministry, parastatals, or undergoing further studies. Like the NSHMB, the specialist hospital too has a problem of retaining doctors as most of them have resigned in the last one year alone. Records show that 38 of them have resigned with six additional without trace.
These resignations are coming with the crisis in the two boards. The governor rose early last year to sack the two boards, which have remained for about a year now without new ones. There has not been any explanation for the sack, or the delay in reconstituting them. Meanwhile, officers now do as they wish, since there is no defined line of communication.
Coupled with these is the decaying state of the hospitals, the lack of space and ambulances. Our correspondent visited the Akwanga General Hospital which is staying in the decaying structure which housed the defunct National Republican Convention (NRC) in the local government during the military administration of General Ibrahim Babangida. The observation there revealed a decaying system sustained by lack of vision and commitment to the healthcare system in the state. Three doctors, all using the rickety Peugeot 505 pick-up van-turned ambulance as their official vehicle, have to make do with anything available to them including equipments, drugs, reagents and electricity. The equipments at the centre are obsolete and have not been replaced, as reagents and drugs are always unavailable, turning the hospital into a mere centre for consultation. The general Nigerian problem of epileptic power supply has had a serious effect on the hospital, as patients in critical conditions wait hours for when the old generator will kick-start or get diesel.
At the Garaku General Hospital, the situation is worse, sustained by the same lack of vision and commitment for the development of the health sector. The rickety Peugeot 505 announced the presence of the doctor as he uses it as his official vehicle. He just completed his NYSC programme in the state, and had resumed duty as the only doctor. He came in to fill the vacancy created by the resignation of the last doctor whose name was given only as Doctor Isah. He was seated in his consulting room, and had not the time to speak to our correspondent. But observation revealed a decaying structure comprising Paediatric, Female, Male and Maternity wards, nurses reporting lack of drugs or reagent to treat critical cases, toilets broken down and complaints from impatient patients seeking emergency they did not get because of the only one doctor.
The structure has received a recent painting, but the ceilings are almost falling, with some parts of it serving as haven for bats, roaches and rodents. The toilets have remained locked because they had long broken down. A youth corps member, Nwosu Obiageri had to provide a pit latrine to stop patients and staff from turning to the back of the hospital for excreta. The laboratory is the only section with modern equipment, but like the case at Akwanga, these were donated by a consortium of Non-Governmental Organizations.
Yet this hospital is supposed to serve the large population of Garaku and the entire local government area of Kokona. Patients spoken to say they resort to this hospital because of their poor condition. “Where is the money to seek treatment elsewhere? We have no choice, but it is unfortunate that government has continued to look the other way while we suffer”, said an elderly woman in Hausa. She refused to give her name.
At the Specialist Hospital in Lafia, space for doctors to consult has been a major problem while the government continues to carry on as though all is well. “A lady comes with strange ailment and leaves without disclosing it, because a small room is containing three doctors seeing different patients at the same time. This is no specialist hospital standard at all,” said a doctor who declined to disclose his identity.
At the Emergency Ward of the hospital is where much of the problem lies. It is chaotic with screams of pains while doctors carry on as if they are not bothered. “It is because of poor remuneration. The motivation is not there,” said another doctor.
But Nasarawa State government has said it has no idea how many doctors have left the services of state in the past one year, state commissioner for health, as Dr. Bawa Abimiku told Weekly Trust on phone. The commissioner said he is new in the office and cannot give figures at the moment. He however said “if these people left more than a year ago it means there must be something happening.”
He said he had already contacted the Hospital Management Board in the state to get him the figures, but added that “I don’t know how many have left.” He however did not deny that about 70 doctors have left the service of the state government in the last one year alone. The commissioner also made brief comment on the alleged lack of functional ambulances to enhance what the state chairman of the Nigerian Medical Association (NMA), Dr. Usman Abe called “referral system”. He said “I am even going round the hospitals to see what is on ground and what is not.” He did not deny the alleged poor condition of the state government owned ambulances. All this while the question hangs: How many more doctors are on their way out?