At the Okaka Primary Health Center, Ineresimei Odor, a 27-year-old nursing mother, voiced concern about “the potency of the polio vaccine health officers provided on our children.”
I always worry that it will injure my baby, I say.
Because there isn’t a refrigerator at the PHC and the officers always carry the vaccines from the Secretariat of the local government, I just have a bad feeling about the polio vaccine. Some of us are worried about how it is being stored,” she stated.
Mrs Faith, a volunteer at the Okaka PHC corroborated Odor’s views over her fears about the status of the polio vaccines being administered.
“One of the major problems we have here is that the refrigerators to store vaccines. On immunisation days which are usually on a Wednesday, we bring the vaccines from the local government headquarters and when we are through, we return the ones left, until the next immunisation day. The fears over the storage of the vaccine are very genuine”.
Our correspondent found her dread after a visit to the Kpansia Primary Health Center (PHC) in Kpansia, Yenagoa Local Government Area of Bayelsa State, to confirm the account of Odor among many others.
It was a Thursday at 1pm, and the center’s doors were tightly closed. Around the center, no health officer could be seen. The Doctor was present in the morning, but had closed and left, according to a woman who introduced herself as Mrs. Helen and whose house is directly across from the Center.
When asked if this was how the Doctor typically left the PHC, she replied in the yes and added, “He is the only one here. On occasion, if he works in the morning beginning at about 9am, once the once the crowd thins out by 12pm- 1pm, he closes and goes home.”
The pathetic situation at the Kpansia Primary Health Centre is replicated across the eight local government areas of Bayelsa State namely, Yenagoa, Ekeremor, Nembe, Brass, Ogbia, Southern Ijaw, Sagbama and Kolokuma/Opokuma.
Shortage of manpower, corruption, lack of electricity, absence of security, lack of water, low staff morale, nepotism, political considerations, lack of capacity and poor facilities have been identified as some of the problems militating against the optimal efficiency of PHCs in Bayelsa State.
In 2018, the then governor of Bayelsa State, Mr Henry Seriake Dickson had during the Maternal and Infant Mortality Summit and Launch of Safe Motherhood provided a cheque of N1.2 to the Bayelsa State Ministry of Health and the Primary Healthcare Board out of the N3 Billion earmarked for the construction of healthcare facilities in each of the 105 political wards in the state. He also directed that the building of the health centres be completed by December that year.
A year after the deadline set by Mr Dickson, the State Commissioner for Health, Dr Paraba Newton Igwelle announced that 83 of the health centres have been completed while the remaining 22 were 80 per cent completed. Investigations revealed that the PHCs have since been completed.
However the completion of the PHCs across the state has not been able to improve health care delivery in the state owing to the problems bedevilling it. For instance one of the noticeable problems with the PHCs is the absence of security to safeguard the staff and property of the PHCs. The high level of insecurity in some parts of the state makes it mandatory to close early leaving patients at the mercy of patent medicine stores. In some of the PHCs especially in coastal communities, most of the equipment procured have been looted.
At the Amarata community PHC, the wheelbarrow used by a water seller welcomes guests to the centre. A middle-aged woman lay on the bed using a newspaper as a hand fan due to lack of electricity. The Community Health Officer (CHO) who identified herself as Ms Sorbei listed lack of security, lack of water, electricity and space as problems of the centre.
She said, “As you can see with the Mairuwa( water seller) that we don’t have water here and depend on water sellers. Also there is no electricity and there is no generator to light up the centre. Lack of security is also a major problem. Hoodlums around this area usually harass patients and most times dispossess them of valuables. It is a terrible situation we are in here this has discouraged nursing mothers from bringing their children for Polio immunization.”
Dr Caleb (not real name for fear of being victimised) who works in the Bayelsa State Ministry of Health and has been involved in designing operational plans for PHC in the state identified corruption, shortage of staff and inexperience as the drawback for PHCs in the state.
“For me the problems of PHC in Bayelsa State include corruption, shortage of staff and inexperience. Those appointed to head were not on merit but on political grounds. They lacked experience and capacity. PHC only engages people on casual jobs. We have graduates of College of Health Technology trained to fill the gap of manpower. They trained them but would not employ them. There was money allocated for employment but they refused to employ. Money was released but was diverted. In most PHCs, you have just a staff. How can one person work as malaria focal person, HIV focal person, Tuberculosis focal person, NTD focal person, Measles focal person, Cholera focal person?
According to Dr Caleb, the broken system in PHCs in Bayelsa has affected advocacy in the area of vaccinations.
“PHC were supposed to be involved in advocating and creating awareness for vaccination to be effective. But they lack manpower to do it. They went to Public Health to ask for assistance especially Neglected Tropical Diseases (NTDs) to help with advocacy with households. But in the end they could not even provide logistics. So in that vein how can people accept what they do not know? In our society before people take vaccinations they should have been properly briefed. So how can people accept what they don’t know? Even when you explain to people, they are still reluctant to take it not to talk when there is no awareness. So in order to siphon money they did not engage those to help with advocacy as it has greatly affected vaccinations,” he added.
Mr Amabawei (not real name for fear of being victimised) also a staff of the Ministry of Health who has worked with the World Health Organisation ( WHO) and United Nations International Children’s Funds( UNICEF) said though the office of the deputy-governor, Mr Lawrence Ewhrudjakpo recently “approved 200 community health workers on temporary basis and posted to various PHC”. This he regrettably said “has not addressed the shortage of manpower.”
He lamented that in Ofoni, Agbere and Edebebiri communities all in Sagbama Local Government Area, PHCs have been turned to residential and community meeting venues. Aside, he drew attention to the lack of stocking taking of drugs which leaves more for racketeering of drugs and vaccines.
“I have been to several PHCs, but most times they are not around even when we tell them they are coming. There should be somebody in charge of stock- taking; those drugs donated by partners should be accounted for. Vaccines are not properly kept. Racketeering of vaccines and drugs thrives. PHC are supposed to be open 24 hours but in Bayelsa by 1pm, most of them have closed,” Amabawei said.
A former member of the Bayelsa State Primary Healthcare Board, who craved anonymity, as he is still a serving civil servant, blamed the government for the sorry state of PHCs in the state.
“The State government is not giving PHC the proper attention it deserves. To be sincere with you, it is being used as conduit to siphon funds. As a result of that, people were taking advantage of the situation to divert funds. The state government is not sincere with PHCs. It is not sincere in terms of financing, management of funds and prioritising the interest of the people.
“Because of the mismanagement of funds, there is a shortage of staff. PHCs lack manpower. Some of the PHCs built have been locked up like the one in Aduku community, Sagbama Local Government Area. The state government is only interested in media headlines. The core of what is expected of them has been left undone. Most staff of PHCs are not at their place of work. But you can’t blame them because there are no incentives. The same way government hospitals are being run is the same way PHCs are being run, most of the revenue generated goes into private pockets.”
During an investigative hearing conducted by the Bayelsa State House of Assembly Joint Committee on Health, Local Government, Chieftaincy and Community Development in November 2021, stakeholders bemoaned what they described as the “moribund state of primary health care” across the eight local government areas pointing out “shortage of equipment, medical and health personnel.”
A lawmaker, Mrs Ebiuwou Koku- Obiyai said “Over 80 per cent of primary health care facilities are not functional because we have not drawn from the pool of available manpower, thereby avoiding brain-drain”
In early 2022, the Bayelsa State Government partnered with a leading commercial bank, Sterling Bank, Zipline, a global leader in instant logistics, Drugstoc and Health Spaces to revolutionise the state healthcare system through Health Supply Chain Consortium.
The Memorandum of Understanding ( MoU) which the State Governor, Mr Douye Diri personally signed and which PHCs were to be the ultimate beneficiaries involves Zipline establishing a distribution hub in Bayelsa State for the introduction, operation and maintenance of a just-in-time instant logistics solution to ensure that essential drugs, blood and a selection of other life-saving medical supplies are available to the state health facilities in Bayelsa State.
“We envisage that this partnership will remain one of the most significant ways of removing the access barriers that mitigates easy delivery of medical commodities to our health facilities,” Mr Diri had said on the occasion. However 11 months after the signing of the MoU, nothing significant has been achieved and the people are still at the receiving end of the poor state of the PHCs.
The State Commissioner for Health, Dr Pabara Igwelle has assured that the state government is committed to revamp the PHC in the state. According to him, the state government is deploying drones to help in drug distribution in remote areas of the state. Part of the government effort, he insisted, was the provision of N12.526 billion in the 2023 Appropriation Law.
Bayelsans are weary and no longer interested in yapping; they now look towards the sky and hope for quality healthcare through PHCs.
