Broken System: The sad state of Benue’s General Hospitals

Nkem Igweike was just a month into his mandatory one-year service in the National Youth Service Corps (NYSC) in Buruku Local Government Area of Benue State when he fell ill on the night of 1 October.

The following morning, a doctor attended to him at the General Hospital, Buruku, and prescribed some drugs. However, the pharmacist was not on duty. “I waited for over two hours in pain,” Mr Igweike recalled.

When the pharmacist eventually arrived, he told the patient that the hospital had only two of the five drugs prescribed in stock.

“I was told to go to Gboko – over 50 kilometres away – to buy the medicine.”

Ill-equipped

Ewada Inalegwu, the assistant secretary of the facility, said it is ill-equipped for its role as a secondary healthcare service provider. He said the hospital is grossly understaffed and does not have an ambulance or any vehicle that can be used in emergencies.

“We don’t even have inexperienced staff, let alone experienced ones,” he said. He said the few health workers do multiple shifts to cover the manpower shortage. “It is incredibly overwhelming,” Mr Inalegwu said.

“We frequently refer patients to the teaching hospital,” he explained. “We have only one full-time doctor. The other doctor is an NYSC member who will soon complete his service. Doctors in the state are currently on strike, so that one corps member is working around the clock,” he said.

Aja Ewa, the medical doctor posted by the NYSC to General Hospital Buruku, described its lack of basic facilities as frustrating. “There are essential resources that every general hospital should have that are simply not available here,” he said. “The hospital is severely understaffed. With state doctors currently on strike, I’m covering both day and night shifts.”

Mr Ewa recalled a recent incident. “A patient needed to be placed on oxygen but we had none in the facility, so we had to refer them to the teaching hospital. Only God knows the patient’s fate after that,” he said.

“We don’t even have an X-ray machine,” Mr Ewa continued. “Basic tests like Electrolytes, Urea, and Creatinine (EUCR), which are standard initial tests for any patient, can’t be done because we don’t have the equipment. We cannot run even a full blood count test, yet these are routine procedures in any general hospital.

“The theatre is under-equipped. Many of our instruments are incomplete, and sometimes we have to delay surgeries until we can borrow what we need from private facilities, especially in emergencies,” he said. “There are surgeries where oxygen should be on standby, but without it, we are forced to refer patients elsewhere. Pediatric cases are often referred, too, as we don’t have an incubator.”

Since his posting, Mr Ewa’s schedule has left him virtually on call 24 hours a day.

“Whenever a patient arrives, I’m immediately called in. I don’t have time for any personal activities I would normally enjoy as a doctor. I love football, but I can hardly ever play now,” he said with a sigh. “Even Gboko close by, I hardly visit. Sometimes I’m on my way somewhere, and a call comes that a patient needs urgent attention, and I have to turn back. I once had a banking issue that took over two months to resolve because I couldn’t find time to go there—it’s that bad.”

The absence of scanning equipment creates further complications.

“There are cases where patients show symptoms that require scanning for proper diagnosis, but without a scanning machine, I have to refer. For instance, if a patient presents with symptoms of a threatened miscarriage, we’d normally do a quick scan to identify the issue. But here, I just have to refer them to a federal medical centre or teaching hospital, and the long distance, especially on a motorbike, can make the situation critical.”

Mr Ewa noted that a pregnant woman should have a minimum of three scans before delivery. “Today alone, five patients needed scans, and we had to send all of them to where they can do scanning,” he said, underscoring the persistent limitations they face daily.

The Deputy Chief Nursing Officer at the hospital, Priscilla Juku, said the nursing unit has only 14 nurses. “We had to collapse one shift – the afternoon shift – so now we’re only working two shifts: morning and night,” she said.

She also highlighted the effects of poor electricity supply. “Power supply is unreliable, and we often face challenges during night shifts, especially when we have women in labour or patients needing critical care,” she said. “When there’s an outage, we use phone lights to perform procedures, which can be very overwhelming.”

Water supply is another pressing issue. “Our only source of water is an open well, which dries up during the dry season. Both patients and staff are then forced to fetch water from nearby communities,” Mrs Juku said.

She said the hospital has only three wards – children, female, and male wards – with no isolation unit. “We have to mix different cases together. Ideally, cardiac and tuberculosis cases should be isolated, but without dedicated space, they’re combined with others. There’s no private ward either – it’s that bad,” she added.

Mrs Juku also lamented the absence of basic equipment at the hospital.

“We don’t have mosquito nets for patients, so they’re asked to bring their own. When nets were distributed, our Chief Medical Officer made a request, but they were never delivered,” she said.

“There are no emergency cupboards either, which should be standard in each unit for urgent situations. When there’s an emergency, we have nothing on hand. We have applied for these supplies, but they haven’t come through. We don’t even have a side cupboard for patients’ belongings, nor a refrigerator for storing insulin, so we keep it in water. It’s just not ideal.”

The impact of these shortcomings is deeply felt by the staff. “Sometimes, we see cases that we could easily manage, but due to a lack of equipment, we are forced to refer patients to other hospitals. It’s disheartening,” the senior nurse lamented.

A facility in disrepair

Thomas Maaji, the hospital’s accountant, walked this reporter through the facility. He said residents of the community are reluctant to visit for treatment because the hospital is exposed.

The hospital has no perimeter fence. The wards do not have window nets, and weeds cover the entire grounds, creeping close to the wards. The postnatal ward does not have a door, and by the entrance to the children’s ward, the shed skin of a snake lay ominously close by.

Inside the wards, the conditions are distressing. Beds are stained, some without covers or mattresses. Simple medical items, like clinical containers, are absent; instead, a bottle of children’s pear cream is used as a makeshift substitute. The toilets looked like they had been abandoned, adding to the hospital’s grim atmosphere.

At the staff quarters, broken ceilings and windows leave the residents exposed. With only two cleaners for the entire facility, both the hospital grounds and quarters are left largely unattended.

Hospital Types

Nigeria generally runs a three-tier public hospital system – Primary, Secondary and Tertiary. The primary health centres (PHCs) are officially controlled by local governments, although, like other systems in local government administration – they are in reality controlled by the state governments. They are the closest to rural and poor communities are are supposed to treat basic ailments and attend to primary health needs of communities.

General hospitals fall into the secondary category. They are often owned and controlled by state governments. They are supposed to address major ailments that PHCs cannot treat and are thus expected to be well-equipped and staffed.

The tertiary hospitals are mostly university teaching hospitals and federal medical centres that are supposed to be reserved for the most serious ailments and surgeries. However, many Nigerians go to teaching hospitals to treat illnesses like malaria that PHCs should ordinarily handle, due to the poor state of the primary and secondary facilities.

The general hospitals visited in this report are secondary hospitals owned and controlled by the Benue State Government.

A life lost

Alev Philip was just 30 years old when he fell seriously ill in Ugba, the headquarters of Logo Local Government Area in Benue State. Living about half a kilometre from General Hospital Ugba, help seemed near. But on 2 October, as his condition worsened, his family did not even consider taking him to the nearby hospital. “The hospital is in such a bad state—it just wasn’t an option for us,” Ungwan Uwua, a close relative, said.

Instead, the family arranged for a private vehicle to take him across 181 kilometres to the Benue State University Teaching Hospital in Makurdi. Tragically, on the night of 2 October, Mr Philip was pronounced dead on arrival.

Mr Uwua believes he might not have died if the hospital at Ugba was functional. “Philip was a victim of our broken healthcare system,” he said.

Inside General Hospital Ugba

On 3 October, this reporter visited the hospital at Ugba. Upaa Terkuma, the hospital’s secretary, said: “We lack basic equipment like microscopes, x-rays, oxygen tanks, and incubators

“There’s no isolation unit, no private wards, not even the capacity to perform a full blood count test. We have just one lab technician. Anything functioning here has been donated by NGOs.”

Philip Kwaghgba, the hospital’s Chief Nursing Officer, said the hospital has 10 nurses. “But by next year, that number will drop to eight – two of us, myself included, are retiring,” he added. Mr Kwaghgba said the hospital also faces persistent power outages, lacks an incinerator, and has no stable water source, all of which affect the care they can provide.

Quarters for hospital staff also pose a challenge, Mr Kwaghgba added. “The quarters only house principal officers – the Chief Medical Officer, Chief Nursing Officer, Secretary, and Pharmacist. Others must find accommodation outside, which adds to the daily difficulties.”

In the pharmacy, Cosmas Gege, the hospital’s sole pharmacist, echoed concerns about resource scarcity, particularly due to a drug revolving funds policy introduced by the previous administration in the state.

“The funds generated are sent directly to the Benue State Internal Revenue Service (BIRS), leaving us with shortages of essential medicines like antibiotics, antimalarials, and even basics like paracetamol and anesthetics,” Mr Gege said.

He noted that since 29 May 2023, the percentage of self-generated revenue that the BIRS is supposed to return to the hospital had not been received, leaving the hospital to buy drugs from suppliers on credit.

As this reporter toured the hospital with Mr Terkuma, numerous deficiencies were observed. The beds were old and stained, some lacking covers altogether. Cupboards inside the wards were rusted, the beds torn, and several wards’ doors broken. The facility also lacked a perimeter fence and water supply, and the toilets appeared abandoned. Waste was disposed of openly, and the reception area had broken seats. Inside the delivery room, the bed was rickety, and the roof leaky.

Inside General Hospital Idekpa: A Healthcare Facility in Decay

When this reporter arrived at the General Hospital, Idekpa in Ohimini Local Government Area, the hospital resembled an abandoned storeroom rather than a medical centre. Inside, the Chief Nursing Officer, Josephine Ogbaji, said there were only three nurses and one doctor and the hospital had no electricity, solar backup, or water supply.

“For the past 10 years that I’ve worked here, we haven’t had water. During the rainy season, we collect rainwater in containers, but during the dry season, both staff and patients must go to nearby communities to find water.”

The facility’s lack of critical medical equipment has already led to a tragedy. “In September 2024, twin newborns died because they needed an incubator, but we don’t have one,” she shared, her voice heavy with frustration. The hospital had no incubator, oxygen supply, or drugs in its store.

As Mrs Ogbaji guided this reporter through the facility, the extent of the hospital’s neglect became evident. The wards had no mattresses, with only a few metal bed frames remaining, stripped down to bare iron. “We don’t admit patients because we lack the basic resources to care for them,” she admitted.

The operating theatre was covered in cobwebs and overgrown by bushes. Many windows and doors were broken, allowing the elements to enter freely. In some wards, the ceiling was missing, and where panels remained, they hung dangerously. Parts of the hospital’s roof had been torn off by windstorms.

Inside the female ward, only a single bed had a mattress. Medical equipment sat abandoned and gathering dust in a nearby room, forgotten and unusable. For the residents of Ohimini, General Hospital Idekpa stands as a hollow promise – a reminder of a healthcare system in need of urgent intervention.

Adikpo’s General Hospital: Neglect Define Patient Care

The situation at General Hospital Adikpo in Kwande Local Government Area mirrors that of other facilities across the state -one marked by neglect and insufficient resources. The hospital secretary, Saint Hange, one of only two staff members seen on-site during the visit, described the challenges they face daily. “We don’t have an x-ray, no scanning machine, no oxygen, no computers, no incubator,” he said, pointing out that at the time, no patients occupied the hospital’s beds.

Mr Hange said the state’s drug revolving funds policy had strained hospital resources, contributing to the facility’s poor state. With just 19 nurses, a single doctor, and two attendants (but no cleaner), weeds crept around the hospital doors, giving the grounds an unkempt and neglected look.

Elizabeth Sase, head of the Laboratory Department, spoke on the lack of a blood bank, describing how this gap has led to tragic outcomes. “We don’t keep blood here because there’s no blood bank. When emergencies require urgent transfusions, the absence of stored blood often turns into a fatal delay.”

Inside the hospital, many of the beds lacked covers. In the lab, the cupboards were rusted, and other equipment were outdated or simply non-functional. “Some of the functioning equipment you see here came from nongovernmental organisations,” Mr Hange said.

General Hospital Katsina-Ala

At General Hospital Katsina-Ala in Benue State, the lack of basic medical supplies and a limited workforce has left the staff struggling to provide healthcare. This reporter met only three workers at the facility: two nurses – Ikoamo Juliana and Yakubu Mark, and a midwife, Grace Ushile.

Mrs Ikoamo said the nursing unit lacks essential delivery tools. “We don’t have delivery scissors, no children’s weighing scale, no episiotomy scissors,” she said. “We end up using ordinary atric scissors during deliveries.” She added that the unit has no dedicated antenatal room for pregnant women. “We use the amenity room for antenatal care, but it’s not ideal,” she noted, expressing concern over the lack of a BP apparatus and wheelchairs for patients in need. “There’s no autoclave, no boiling drum, and we don’t have an incubator.”

The midwife, Mrs Ushile, recalled that on 21 October, she helped deliver a set of premature twins, and referred them to Makurdi Teaching Hospital due to the lack of an incubator. “We have no private wards, no isolation unit, and no blood bank,” she explained. “We have to bleed and transfuse patients immediately.”

Mrs Ushile continued: “Just before you arrived, I discharged a mother and her newborn without checking her BP because we don’t have a BP apparatus. I couldn’t even weigh the baby due to a lack of a weighing scale. Something is seriously wrong here.”

Mr Mark said the hospital uses water from an open well. “We have only one medical doctor, and he’s on strike. We’re left with 12 nurses, and have had to collapse the afternoon shift, only working two shifts, which isn’t healthy for us.”

An inspection of the facility revealed that the delivery beds were non-functional, and the antenatal area had been damaged by a windstorm. Bushes had overgrown around the entire unit, leaving limited space. “The amenity room we use for antenatal can’t hold more than 10 women,” Juliana said. “Some women have to sit outside when there’s a large turnout.”

Drug Revolving Fund Policy Leaves Hospitals in Crisis

The Drug Revolving Fund (DRF) policy, introduced under the administration of former Governor Samuel Ortom, was designed primarily as a revenue-generating measure for the state government. Because revenues collected are transferred to the Benue State Internal Revenue Service (BIRS), hospitals are unable to restock.

Mr Gege, the pharmacist at General Hospital Ugba, voiced his frustration with the policy’s damaging effects: “Essential medicines such as antimalarials or antibiotics are not available within the facility. No paracetamol, no infusion fluids, no anesthesia. Sometimes, I feel like I am not practicing my profession.”

Maaji Thomas, Buruku General Hospital accountant, said, “The hospital now borrows drugs directly from suppliers and pays back when they’re sold,” highlighting how the policy has left hospitals struggling to serve their communities.

Billions Spent, Yet Hospitals Remain Under-Equipped

Between 2019 and 2024, the Benue State Government allocated N14 billion (N14,368,884,721) for the acquisition, upgrading, and purchase of medical equipment across the state’s hospitals. The state government refused to provide details of the exact amount released and how it was spent. The conditions of the general hospitals in the state, however, suggest they did not siginificantly benefit from the funds.

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At each facility this reporter visited, common issues include the absence of X-ray and scanning machines, oxygen supply, blood banks, incubators, and basic diagnostic tools like BP apparatus and weighing scales. Notably, each hospital lacks the equipment necessary to screen or diagnose cancer, which has led to numerous patients being referred to private hospitals or distant medical centres. The lack of incubators in particular has contributed to tragic outcomes, such as the death of newborn twins at General Hospital Idekpa in September.

Mr Philip’s sad death after his family took him on a lengthy journey to Makurdi, and the inability of hospitals to provide safe delivery support, as noted by Mrs Ushile, underscore the severe deficiencies at these hospitals.

Health Commissioner Silent on Hospital Conditions

This reporter made efforts to speak with Yanmar Ortese, the state Commissioner for Health and Human Services, on the state of the general hospitals and the utilisation of the health budget. He picked the reporter’s call but disconnected after the reporter introduced himself. He did not answer several subsequent calls or respond to a WhatsApp message outlining the story’s focus and requesting an interview. Although Mr Ortese read the message, he did not respond, even after a reminder.

Budget Shortfalls

In its 2024 State of States report, BudgIT – a civic organisation leveraging technology to enhance public accountability – analysed Benue State’s healthcare budget and highlighted critical gaps in funding and service delivery, particularly in rural and underserved areas.

According to BudgIT, Benue’s healthcare system faces “profound challenges.” The state has 1,613 health facilities, including 1,489 primary healthcare centres, but many lack adequate resources. This scarcity, compounded by insufficient government investment, has contributed to a high maternal mortality rate of 1,189 per 100,000 live births in 2020, starkly missing the Sustainable Development Goals (SDG) target of 70 per 100,000 by 2030. 

BudgIT also noted that “child mortality remains high, especially among children in urban slums and rural communities,” where the likelihood of dying before the fifth birthday is twice as high as in wealthier areas.

The report criticised previous administrations for failing to prioritise healthcare, citing that only 56.5 per cent of the N7.35 billion allocated for the sector in 2023 was disbursed, accounting for a mere 6.1 per cent of total state expenditure.

Of this amount, only N115.46 million went toward hospital and health centre rehabilitation, while N266.24 million was earmarked for drugs and medical supplies, and N192 million for new hospital constructions.

BudgIT recommended a strategic shift, urging the state to allocate at least 15 per cent of its budget to healthcare, ensuring 70 per cent or more of allocated funds are spent. This increase, according to BudgIT, would help build infrastructure, secure medical supplies, and bolster staffing, particularly in rural areas, where workforce incentives and ongoing professional development are essential.

By adopting a proactive health strategy that includes stronger disease surveillance and response capabilities, BudgIT concluded, Benue could significantly improve healthcare access, align with SDG goals, and deliver higher-quality care to its residents.

This story has been produced with support from the Centre for Journalism Innovation and Development (CJID).