“This is a secondary healthcare centre, unfortunately, the facility has deteriorated to a level that some primary healthcare centres are better. If you check this place you will confirm that there is no standard. We are just doing our jobs because human life is involved” – Medical Personnel at Cottage Hospital
By Shadrach Okon
The time was 10:30a.m. on Tuesday, 24th December, in Akwa Ibom State, when this reporter arrived Cottage hospital, Ikot Ekpaw, an agrarian community in Mkpat Enin local government area, Akwa Ibom State, on a visit.
Apart from the chirpings of bird, there was grave silence, the hospital which used to receive scores of patients daily during its glory days, was deserted.
A small signpost hoisted at the entrance pointing people to the hospital which sits on a large expanse of land is rusty.The facility is old, dilapidated, decrepit and abandoned.
The premises is bare without a perimeter fence and security guards.
A decrepit bungalow which serves as the first point of contact to visitors captures a glaring lack of maintenance of the facility. It has windows with missing louvres which allow feeble streams of daylight to infiltrate the dim interior of the offices within the block. Dust motes danced lazily in the air, caught in the rays of light as they filtered through the tattered curtains that hung askew in the offices within the building.
Within the bungalow is a doctor’s office. Inside the office is a wooden rectangular table which serves as examination couch with a white linen carelessly thrown on it. A brown wooden office chair was found facing a 6 cubic feet refrigerator propped by a broken wooden table; beside it was a rusty cart case with piles of files. Broken ceilings, rumpled papers, chips of wood destroyed by termites and sand debris strewed the dirty floor– the whole office was in shambles
Another abandoned block in the hospital which is in a terrible state of decay is the female ward. The building is old and grey in appearance. The roofs long bereft of any maintenance, sagged in resignation, weighed down by the heavy burden of neglect and raindrops. Sunlight streamed through the countless gaps, casting erratic patterns of light and shadow on the over 250 abandoned hospital beds. Rain has damaged more than half of the roofing in the hospital female ward.
A female nurse sitting in an office in a dilapidated public health block was apprehensive. She grabbed her small handbag, her eyes were dilated, showing apprehension, when she saw this reporter. Young male patients don’t visit the hospital often, so, she thought the reporter was probably a thief. Her fears were doused when the reporter introduced himself.
At the hospital’s theatre is one old operating couch with once-gleaming sterile surface now marred by time and lack of proper care. The life-saving medical equipment is now a guardian of empty hope.
The visit puts the The Guide newspaper face-to-face with the gory state of infrastructure and other incidental challenges like understaffing, lack of medical equipment and supplies, and how these have affected rural access to healthcare amidst rising concerns of infectious disease like Mpox, maternal and infant mortality rates.
■ Infrastructural decay
Termites had built beautiful mud tubes on the walls of the public healthcare department, infested the ceiling, causing it to buckle. There were deposits of rodent’s faeces on the floor in one of the abandoned wards.
All the wards except the male’s which is now the general ward are completely dilapidated. The children and female wards have been sealed from use. There are no offices to keep patients’ records, no pharmacy and no store for drugs. Drugs are kept under the doctor’s examination couch.
Mr. Emmanuel Udoh (not real name), a medical personnel in the hospital said two out of five blocks are functional.
“There are only two structures that are working in that place. The structure that houses the admin block, the other structure is the residential quarter, those are the only two blocks that are still in use in the whole hospital”.
“The Out Patient Department (OPD) houses very important units in the hospital. Within the OPD, we are supposed to have at least two doctors’ offices. The records unit is supposed to be there, the pharmacy is supposed to be there, and that is where we have the cool chain for immunization. But here there is no OPD here in this hospital, if you check under the Doctor’s examination couch, that is where we are keeping drugs.”
The hospital also lacks basic health support equipments like ambulance and power supply.
■ Staffing
The hospital has only one medical doctor who was on leave when this reporter visited the facility in December.
Enobong Essien, a nurse on duty said, formerly, the hospital ran 24 hours services, but now opens between 8a.m. and 6p.m. due to security concerns.
“When I resumed duty here some years ago, we used to sleep here, but now we only come in the morning and leave in the evening because the place is not secured. Even the patients coming to seek medical attention here do not like to stay here at night.”
“We are willing to revert to 24 hours services, but the facility doesn’t support such.”
In February 2022, a senior medical officer, Dr Felix Ekpo, was kidnapped at the hospital while on duty. More than two years after the incident, the state government has not provided security for staffers at the facility.
Mr Emmanuel Udoh spoke about staffing in the hospital.
“We have one medical doctor. We have seven nurses, two of them are retired but retained on contract. You cannot push a whole lot of work on those retirees. So, actively, we have five nurses covering the hospital. Two of them are community health workers covering the immunization unit.”
“We have written to the state government on many occasions on the state of this facility, the security of the environment and the need to send more staff, but that has not been treated.”
■ Budgetary Allocation between 2015 -2024
In the last 10 years, the state government has budgeted N60,000,000 for recurrent expenditure in the hospital. Records from the Ministry of Finance show that N6million is budgeted annually for the hospital.
Often, there is a wide gap between approved budget and implementation. For instance in 2019, the hospital received N160,000 only from the N6million budgeted, according to the audited financial statement of the State.
The state government budgeted N48 million for renovation of the hospital in 2016 and N10 million for perimeter fencing. Renovation work allegedly awarded to stakeholders of the ruling party in the area was abandoned shortly after it commenced.
■ Call for government intervention
Mr Udoh called on the government to intervene by reconstructing the dilapidated blocks in the hospital, providing perimeter fence around the hospital, recruiting security, and more medical personnel to the hospital.
“Where do we want government to come in? Government should come in by providing perimeter fencing around the facility an equally sending security men to secure the facility. Government should come in by reconstructing the block that is housing the theatre, nurses section and the matron’s office, the lab and the public health and the whole block that is dilapidated.
Government should also intervene by reconstructing the OPD itself.”
“Within the OPD, we are supposed to have at least two doctors’ offices there. The records unit is supposed to be there, the pharmacy is supposed to be there and that is where we have the cold chain for immunization. I believe if they intervene in those areas, the fortunes of that place will turn around.”
The Permanent Secretary Hospitals Management Board Dr. Abraham Inyangudoh when contacted to speak on the state of the hospital said he was not in good position to speak on the issue. According to him, the Commissioner for Health in Akwa Ibom State was the right person to comment on the state of the hospital. Meanwhile, as at the time of filing this report, Governor Umo Eno had dissolved the State Executive Council and was yet to appoint new commissioners.
P.S: Emmanuel Udoh and Enobong Essien are not the real names of the sources; they spoke on condition of anonymity due to civil service rules which does not permit a civil servant to speak to press.
