How poor power supply cripples Abuja primary healthcare centres

The reception area at the Abaji Central
The reception area at the Abaji Central

Abaji is a major satellite town of the Federal Capital Territory and the headquarters of a council by that name. The New Township Primary Healthcare Centre is located by the roadside in the heart of the town and is thus very accessible. But lack of steady power supply has affected services and discouraged attendance by patients.

The centre is understaffed and poorly financed. Although it is relatively well-equipped, housing the vaccines cold-chain store for the area and a laboratory, and officially running 24-hour services, workers said lack of regular electricity at the PHC is the main problem stopping them from providing round the clock healthcare services to the community.

Lukman Adamu, a laboratory technician at the centre, lamented that the laboratory was unable to carry out most tests required by patients because electricity supply is irregular and limited, although the PHC is connected to the national grid.

According to the technician, the PHC enjoys a maximum of four hours of electricity per day, “on days when we have light.” He said there are times the facility goes “weeks without power supply.”

As at the time the reporter visited, there was no light at the facility. The staff at the laboratory and the main centre said they had not had light in a week.

Mr Adamu said for a laboratory to function efficiently, it needs regular power supply.

“This is because we need light to operate some of our equipment such as the microscope and the fridge where we keep samples, unfortunately we cannot do this. We most times refer patients who need urgent attention to Abaji General Hospital which is quite far from here,” he said.

The PHC has a generator, but it is rarely put to use for lack of funds to purchase fuel. The workers said they often depend on rechargeable lights and torchlights to discharge their duties.

Mr Adamu, the laboratory technician, was running a urine analysis test when PREMIUM TIMES visited. He was working under the light of a rechargeable lantern hooked to the wall.

The laboratory which has equipment such as microscope, centrifuge among others can only conduct tests which does not require electricity to do and which they do during the day.

“A test that is not supposed to last more than five minutes will last 30 minutes. We don’t collect samples to keep because we are not sure of power supply to keep them in the fridge. We do simple investigations such as malaria, widal test, blood count, urine analysis, pregnancy test, HIV and Hepatitis B.

“The reagents that need to be kept at cold temperatures, we keep them in the cold chain section,” Mr Adamu said

Mr Adamu said they can do more, ”but the light has been affecting our output.”

“For example if I want to run a microscopy test and there is no light, that means I have to wait and I won’t be able do so. There has been no light for days now. They said something got spoilt somewhere. When we run the generator, we do so for four hours, due to lack of fuel.”

Mr Adamu said regular power supply would boost patients’ attendance.

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“We have almost all the equipment a small PHC needs to function effectively. Before the establishment of this place, there was no PHC nearby, people had to go to the General Hospital which is quite a distance away.

“We have many women who patronise this place but we still refer some to the general hospital because we do not have light to run their tests,” he lamented.

The story at the reception was not different. Despite it being afternoon when the reporter visited, the PHC’s confines were dark; sunrays from the open doors illuminated the reception area.

There were about eight staff on duty, most of them Community Health Extension Workers, (CHEWs), Junior Community Health Extension Workers (JCHEWs) and student extension workers on internship.

“When we don’t have light, this is how this place is usually dark. We put on rechargeable light at night. All of us have torchlights we bring to work. It is what we use to attend to patients at night, even for delivery,” Ogechi Idike, one of the CHEWs, said.

Ms Idike said the generator was not often on. “We put it on on Fridays when we want to do ultrasound scans. We don’t have an allocation to power the generator. Sometimes, we pull funds together to switch it on because we use it to pump water into the drum from the borehole.

”The water is used strictly for the hospital, we do not allow people to fetch because we cannot guarantee when we might will pump again,” she said.

Ms Idike, however, spoke of other challenges facing the health facility but quickly added that they do not reject any patient despite the challenges.

“We do not reject anybody unless cases which we cannot handle here and we refer to the General Hospital. We provide services as much as we can, though the government is not supplying us with equipment and drugs.

“We lack staff, most of us are volunteers and we are paid N5, 000 monthly. We sometimes use our money to buy drugs and resell to patients. That is how we generate funds to run the clinic,” she said.

Ms Idike lamented that most times, the patients could not pay for drugs, ”not to talk of going to a secondary health facility for treatment.”

“Most of the tests that we would have conducted here in our laboratory cannot be done due to lack of electricity. This delays treatment for patients and makes us refer them to secondary health facilities. For example, most of the tests done in the laboratory are stripe-tests and not microscopy. Meanwhile the have the equipment,” she lamented.

Ms Idike however said they do not have a problem with immunisation and vaccines because the facility houses the cold store which distributes vaccines to other primary health care centres in the area.

“We don’t have problem with immunisation, we have a cold chain store which is powered by solar, and this helps improve the immunisation activities. We collect vaccines on immunisation days and return the ones we did not use to them. This has taken care of the issues with cold chain,” she explained.

Abaji Central Primary Health Clinic

Abaji Central Primary Health Clinic is located about 50 metres from the New Township PHC and also has electricity supply problem.

The health workers on duty had their heads on the table when the reporter got to the facility. No patient was around for the about 40 minutes the reporter spent at the facility.

Zuliaihatie Al-Hassan, the CHEW on duty, said they always have patients only on ante-natal or routine immunisation days.

“Only few patients visit here, they go to the Township Centre because we do not have a laboratory and other equipment here. We are on the national grid, the electricity bill is paid by Abaji Local Government Council but we do not usually have light. Even when we do, we don’t usually have much to do with it.

“We do not store vaccines here. We collect our vaccines from the Township (PHC) on immunisation days and when we go on routine immunisation campaigns. We also return the ones we do not use to them. That is how we have been operating,” she said.

Ms Al-Hassan said the arrangement has made immunisation process ‘easy’ for them in the centre.

She said they also take deliveries when presented, ”with torchlights when there is no light.”

“We have a generator, but we do not switch it on most times because of fuel. We use our phones or kerosene lanterns. We pull money together to buy the kerosene. We only run one shift because of shortage of staff. We admit from morning till 8 p.m,” the health worker said.

Dakwa: Light In The Darkness

Dakwa Primary Healthcare Centre, however, is a slightly different story. The PHCis not on the national grid but has 24-hour power supply, the workers said.

But it was not always like that. For two years, the PHC located off the Deidei-Zuba Expressway had no light, until solar panels were installed at the facility by a Nigerian company, VAYA Energy, as its Corporate Social Responsibility act.

Speaking with PREMIUM TIMES during a visit of the Energy Audit/Experience Team to PHCs (involving journalists and Civil Society Organisations), Martha Zdikko, the CHEW in charge of the facility, said steady power supply has improved service delivery at the centre, especially as regards “routine immunisation, child delivery and running of essential tests needed for treatment.

“We used to go to Juwah to collect vaccines for weekly immunisation and routine immunisation campaigns. This was the cold store facility we used to use and we usually close before 4 p.m because people do not come to the PHC.”

Ms Zdikko said availability of light and storage facility changed the face of immunisation and service delivery in Dakwa.

She said they no longer need to go through stress of getting vaccines “because we now store our vaccines here.

“We now work night shifts too. We do birth deliveries with ease, thanks to the constant power supply. Gone were the days when we used torchlight and lanterns. This has made our work easier and we now have more people visiting us for deliveries and immunisation,” she said.

Ms Dzikko said the PHC, which was established in 2014, serves four communities, Gofina, KoKoife, Dakwa and Sarki.

The 12 solar-powered panel system is strictly for the Dakwa PHC and since its installation in 2016, the PHC has not experienced a day of power outage, she said.

“Since then, the patronage has increased to an average of 100 patients per month. We now admit people overnight and treat different ailments such as malaria, dehydration among other. We also operate a mini-laboratory,” Ms Zdikko said.

She said the PHC has also stopped depending on water vendors for water supply.

“We now have more time for community enlightenment and vaccination campaigns in the community. This is possible because VAYA Energy also gave us a refrigerator to store vaccines. This has reduced the time we spend on the road to go collect vaccines and return them to Juwah.

“We can now effectively use the time for community enlightenment and mobilisation. We have enough power to spare, we don’t need generators. We used to allow people to come and charge their phones here, but stopped when this place was becoming rowdy,” she said.

Ideal Facility

The Director, Planning and Research Statistics, Nigeria Primary Healthcare Development Agency (NPHCDA), Abdullahi Bulama, earlier in August at a one day health dialogue on routine immunisation in Abuja, said no PHC in the North-central zone of Nigeria meets the five star requirement.

For a PHC to meet the requirement, it must be well-equipped with steady electricity, functional and well-equipped laboratory, and fully staffed with presence of a doctor and nurses.

Unfortunately, such is not the case in all the PHCs visited in the FCT.

Though the federal government says it has been revitalising some PHCs across the country, many still need attention.

Even the Dakwa PHC which has steady power supply does not have a well-equipped laboratory, nor is it fully staffed.

A laboratory scientist, Abdulfatai Ibrahim, who spoke with PREMIUM TIMES, said constant power supply is essential for any healthcare facility to function at maximum capacity.

Mr Ibrahim said not having electricity in a healthcare centre “is as good as having no life”.

He said steady power supply would not only revive PHCs, it would also motivate the staff to work better, even stay around the premises and encourage patients to patronise the centres.

“If we have light in the PHCs security of the staff and patients would be guaranteed. If you have light, the environment will be secured and people will have confidence in the system, knowing people are there working day and night and when they come in, they know at least, basic things would be attended to.”

Mr Ibrahim explained that there are a lot of things attached to having light in the PHC.

He said it is worse when there is no power to work with in a laboratory. “It is as good as not having anything. We are not running an analogue system anymore; we are running a digital system.”

Mr Ibrahim said because ”most PHCs are dead, secondary and tertiary health institutions in Nigeria are congested and handling issues which ought to be handled at the PHC level.”

“Tertiary hospitals are not supposed to be treating malaria or other basic ailments. They are supposed to be attended to at PHC levels. But when you don’t have light, which means your personnel would not be able to stay, the doctors may not be able to come and do call inside the hospitals, the laboratory scientist/technician knows he does not have light. This means his equipment cannot work, so what is he going to work with?” he said.

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