By Amina Usman
In this report, Amina Usman unravels the distressing reality behind the dire state of Gombe state’s healthcare centers, uncovering a web of mismanagement, theft, and diversion of vital medical supplies.
In the dimly lit corridors of a rural healthcare facility in Hammadu Kafi community, Akko Local Government Area of Gombe state, a heart-wrenching incident unfolded, revealing the stark realities of healthcare challenges faced by Hassan Sani and his daughter, Asma’u, during a cholera outbreak in 2021.
Mr Sani’s agonising cries for help echoed through the facility’s halls as he clutched his ailing daughter, Asma’u, in his arms. The nurses on duty insisted on a pack cell volume, PCV, test before treatment could commence. In the absence of electricity and a functional generator, the test was delayed.
The nurses bound by protocol and perhaps fear of contagion, withheld assistance, demanding hand gloves and a diaper from Mr Sani. By the time he gathered the required supplies, it was too late and the daughter had died. The lack of medical supplies and the tragic passing of his daughter left a profound void, a painful reminder of the consequences of inadequate healthcare infrastructure in Gombe state.
“If she had been attended to on time, and if we had sufficient and standard facilities, she might have survived,” Sani lamented, with his face etched with sorrow. This distressing narrative shines a light on the impact of shortage of resources occasioned by mismanagement, theft, waste and diversion of medical supplies within Gombe’s healthcare system.
Regrettably, these issues have not only resulted in avoidable fatalities but have also eroded the very foundations of healthcare delivery in the state, findings by this newspaper revealed. One of the most disturbing consequences of the poor state of healthcare in Gombe State is the widespread practice of drug diversion within public hospitals. This practice involves healthcare workers diverting essential drugs and supplies away from patients and selling them for profit.
Ibrahim Yahya, a nurse working at the Zainab Bulkachuwa Women and Children Hospital in Gombe, shared insights into this distressing reality. He lamented, “Malaria drugs, RTF children peanut, and family planning products are known to be free products, meant to be provided to the community without cost. Unfortunately, they are being sold.”
The diversion of these vital drugs and supplies has had a devastating impact on the health of Gombe residents, particularly women and children. Many patients are unable to afford to purchase the drugs they need, which has led to an increase in preventable deaths.
“We have had cases of women who have died because they couldn’t afford to buy the drugs they needed after delivery,” Mr Yahya said. “And children are also dying because they don’t have access to basic medicines like malaria drugs and antibiotics.”
Addressing the issue of drug theft, he stated, “Quite sure some officials from the hospital are diverting drugs to the black market, especially malaria treatment drugs and family planning products.”
Mr Yahya went on to reveal the various channels through which these critical drugs are siphoned out of the hospital. This includes the complicity of certain officials who collude with individuals posing as hospital guests, using their vehicles to transport drugs and supplies out of the hospital premises. Findings also showed that another insidious method involves a gradual process wherein staff members clandestinely stock these drugs within their office briefcases, day by day, until they deem their haul sufficient.
Findings by this newspaper showed that contraceptives such as oral pills, condoms, implants, and injections, which are supposed to be free of charge, have been turned into a money-making venture by some officials of the hospital.
For context, the Zainab Bulkachuwa Hospital’s planning unit is divided into two sections: a maternity unit and a family planning unit. Both units are complicit in the diversion of medical supplies, findings have shown.
The maternity unit is supposed to provide contraceptives such as oral pills, condoms, implants, and injections free of charge as part of the Gombe State Family Planning Initiative. This initiative aims to increase the state’s average modern contraceptive prevalence rate from 4.5to 25.2 percent, thereby reducing maternal and child mortality.
However, some staff members are selling these products to the public.At the family planning unit, contraceptive pills are being sold for N100 and implants are being sold for N1200.
“I know the pills are provided for free by the government but upon getting to the hospital, I was asked to pay N1200 for an implant. This was affordable for me but what about indigents who have only recently accepted family planning as a way to reduce maternal mortality?” Sani Musa, a victim of the exploit bemoaned the situation.
Clarifying whether the hospital was charging a profit on the sale of these products, or whether it is simply charging a fee to cover the costs of providing the services, Yahya, a nurse at the hospital said, “The hospital has nothing to do with it. Those involved are only doing so of their own volition.”
Other medicines like Artesunate Injections, and Artemisinin-based Combination Therapy, ACT tabs for malaria treatment are regularly sold at N600 and N400 respectively.
“Sadly, even malaria drugs and injections are sold. The healthcare system needs sanitization and workers require sensitization because if this keeps going on, we are going nowhere in fighting even the most common disease in the state,” Mr Yahya added.
Diversion and theft of medical supplies are a common practice in most government-owned hospitals in Gombe state including rural health facilities. Adamu Bello, who works in the Registrar’s office at Gombe General Hospital, shared his firsthand account of the diversion of Ready-to-Use Therapeutic Food, RTF, meant for malnourished children at a rural health facility.
He recounted, “During my practical training at Tudun Wada Primary Health Care Centre, I observed a concerning practice. Whenever RTF peanut supplies arrived, the staff on duty would set aside a portion for their own use, leaving only a meager amount to be distributed to the public.”
Under the condition of anonymity, an individual who sells these drugs at Tabra Community of Akko local government shared a startling confession with DAILY NIGERIAN, shedding light on the illicit trade of free malaria pills.
She revealed, “My husband, who works at a hospital in Akko local government area, is the one who procures these drugs for me. They come in four categories: By-One, By-Two, By-Three, and By-Four. By-One and By-Two are intended for children, while By-Three and By-Four are for adults. We distribute them to nearby pharmacies, selling each pack for a price ranging from N3,500 to N4,500, with each pack containing 30 pieces.”
She emphasized that her selling prices were a result of her goodwill, as the market rate for these drugs stands at N6,000.
The detrimental impact of illegal drug diversion on malaria and maternal-child mortality in Gombe State
The diversion of critical malaria drugs in Gombe State poses a significant threat to public health, as it fuels corruption within the healthcare sector. This practice erodes citizens’ trust in government and healthcare systems, resulting in compromised patient care and worsening treatment outcomes for malaria.
In a recent initiative, the Gombe State Government launched a comprehensive distribution campaign, with over 2.3 million Insecticide Treated Nets (ITNs) and implementing Seasonal Malaria Chemoprevention measures. This endeavor, part of a broader national strategy, seeks to combat the persistent challenges posed by malaria in Nigeria. While strides have been made in reducing malaria-related fatalities, the ongoing menace of illegal drug diversion threatens to undermine these hard-won gains.
Likewise, the use of oral contraceptives not only empower women to manage their fertility but also serve as a vital safeguard against various reproductive health risks, including endometrial and ovarian cancers, acute pelvic inflammatory disease, and ectopic pregnancies. The lack of these contraceptives hinders efforts made to reduce the burden of these diseases in the state.
Experts said the prevalent issue of drug diversion stems from insufficient regulatory oversight and a lack of transparency, creating an environment conducive for the misappropriation of these critical medical resources. Such malpractice exposes women to the heightened risk of unintended pregnancies and unsafe abortions, exacerbating the challenges faced by the healthcare system.
Attempts to contact the director of the Gombe Primary Health Care Board for comments during the compilation of this report proved abortive as he was unavailable, and his phone number remained unreachable.
However, in an interview conducted by DAILY NIGERIAN, a staff member at the board who asked for anonymity shed light on the matter. The staff recounted an incident when a report was submitted, detailing the large-scale sale of RTF peanuts by a woman in an area. Alarmed by the revelation, the board swiftly mobilized security personnel to investigate the matter. According to the Staff, the collaborative effort led to the arrest of the woman, yet details concerning the source of her supplies remained unclear, as the investigation was subsequently handed over to the Secret Security Service.
Community Head comments, experts cite causes and proffer solution
In an interview with DAILY NIGERIAN, Abdullahi Muhammad Galdima, Sarkin (traditional ruler of) Galdimari community, Akko Local Government Area, said that the traditional leadership is aware of the unscrupulous act and supports the government in disciplinary actions.
Mr Galdima lamented the distasteful act bysome members of the community and how such activity is frustrating government’s effort to provide necessary support to reduce disease burden in the state.
“The diversion of drugs and other medical consumables by some community members for selfish benefit has always kept me up at night, why would someone sell what is meant for the poor? And this is why in some cases we make sure they lose their job since they cannot serve humanity selflessly. The state government is doing its best to carry out her mandate but such people make it seem they are doing nothing. It saddens me.
“At the middle of October, one Ahmad Sarduana was caught in the act. He was part of the distributions officers sent from the Ministry of Health to distribute malaria drugs among others at the grass root unfortunately, he did not. He was discovered when the ministry came for inspection and realized after investigation that he in fact was selling those supplies while no one in the areas he was suppose to cover got anything,” Mr Galdima narrated urging the authorities in charge to be more proactive in monitoring such initiatives.
Communication Officer of the Nigerian Red Cross (NRC) of Gombe Branch Abbas Muhammad, told DAILY NIGERIAN that there has been significant improvement in primary healthcare in the area, in terms of infrastructure, equipment, and staffing. However, he said that some midwives have been transferred from secondary healthcare facilities to primary healthcare facilities, which has led to a shortage of staff at the secondary level.
According to the Red Cross officer, despite the improvements recorded in the state’s primary healthcare, “Diversion of drugs, other pharmaceuticals and consumables poses unprecedented challenges to health and wellbeing of Gombe citizens especially the poor who make up the majority.
“The medical supplies are known to be effective. For instance, the state has recorded 12 per cent reduction in malaria prevalence hence; such diversion would lead to inaccessibility to drugs, purchase of substandard ones, refusal to seek medical attention because of cost and retrogression in any progress made in tackling preventable diseases.”
Commenting further, “Government should put stringent rules on culprit; penalties like jail term or fines to serve as deterrent for other who hatch such evil plot; hospitals should have guards mounted at supply stores and should only allow drugs outside with signed papers from higher hospital authority or head of medical supplies,” Muhammad opined in an attempt to proffer solution to the uglyproblem.
Dr. Mu’azu Shu’aibu from Gombe General Hospital identified several factors impeding Nigeria’s healthcare system and preventing it from fully participating in the advancements of the medical ecosystem. These factors include a lack of proper training and compensation for health workers, inadequate funding, and obsolete or deficient medical equipment. Additionally, Dr. Shu’aibu highlighted the pervasive issue of misappropriation, diversion, and theft of supplies as a significant bottleneck specifically hindering healthcare delivery in Gombe State.
“The theft and diversion of these supplies for personal gain not only tarnishes the government’s image but also poses a significant obstacle to the fight against diseases in Gombe State. Several thousand women and children die annually from complications of malaria during pregnancy in sub-Saharan Africa. By diverting malaria drugs, these individuals are directly contributing to the state’s high maternal mortality rate of 1002 per 100,000 live births, leading to avoidable deaths as residents are often unable to afford treatment.”
Mr Shu’aibu emphasized the urgent need to improve the welfare of medical workers, particularly first responders battling diseases at the grassroots in primary health facilities. He emphasized that enhancing their welfare is the most fundamental approach to curbing this issue, as many resorts to such practices to meet their family responsibilities, given that their take-home pay is often insufficient, even though this is not a justification.
