In Kwara, It’s One Doctor to 12,000 People

By Adeniyi Ìṣhọlá

A silent but devastating crisis is unfolding in Kwara State’s healthcare sector. Yet people seem not to be paying attention or asking critical questions from the government. While public discourse remains fixated on politics and surface-level governance narratives, the state’s health system is steadily deteriorating under the weight of neglect, poor prioritisation, and systemic failure. At the heart of this crisis lies a troubling combination of decayed infrastructure, acute shortage of medical personnel, and glaring lack of essential medical equipment. All of these factors have limited the fundamental capabilities of state-owned hospitals to deliver effective service. These are not abstract concerns. They are real issues affecting real people who depend on public health facilities for survival.

Across the state, public health facilities are struggling to function. For instance, at the General Hospital Ilorin, now known as the Kwara State University Teaching Hospital (KWASUTH), service delivery has declined alarmingly in recent months. What I found out when I visited the facility early this month was quite revealing and distressing. I learnt that persistent power outages, lack of water supply, inadequate staffing, and a shortage of basic surgical equipment have crippled operations at the hospital. The facility now struggles to perform even the most basic lifesaving procedures. It is disheartening to note that relatives of patients are sometimes pressurised to buy fuel to power generators and water so that their loved ones could be attended to.

I was even told that for nearly two weeks between the months of February and March, Caesarean Section (CS) procedures could not be carried out. Pregnant women in need of urgent surgical intervention and who had been given prior appointments, were left stranded, forced either to endure dangerous delays or seek care in private hospitals they can barely afford. Families that turned to public hospitals for accessible and affordable care are now pushed into financial distress, while lives hang in the balance. In a system meant to provide affordable healthcare, this is nothing short of a failure.

If a secondary state-run healthcare facility in Ilorin, the state capital, is in this dire condition, one can only imagine what the situation of primary healthcare facilities across the state are, especially in remote areas. In many of these areas, health centres lack essential medical equipment and operate without doctors, relying on nurses or volunteers. The consequences are predictable: delayed treatment for patients, avoidable complications, and preventable deaths. It is unfortunate that despite the improved revenues at the disposal of the government, public hospitals in the state remain ill-equipped as evident by the lack of MRI machine and other critical medical equipment in these facilities. Nearly two months ago, the state government claimed to have procured an MRI machine but till now, the public does not know where it is installed.

Beyond decayed infrastructure and inadequate medical equipment, Kwara faces a major healthcare workforce gap. According to the 2025 Health Preparedness Index released by SBM Intelligence, a research and strategic communication consulting firm, Kwara has only 362 medical doctors serving a population of about 4.2 million people. Of these 362 personnel, only 99 were on the payroll of the state government, serving across its 45 health facilities. This was confirmed by the Executive Secretary of the Kwara State Hospitals Management Board (KW-HMB), Dr. Abdulraheem Malik, at an event sometime last year. The number could have even dropped below 99.

To put this into perspective, neighbouring Osun State, with a comparable population with Kwara, boasts over 1,300 medical doctors. The disparity is not just numerical; it is a reflection of policy choices, governance priorities, and commitment to public welfare.

With only about 362 doctors serving a population of 4.2 million people, Kwara’s doctor-to-patient ratio stands at approximately 1:11,767. Even though Nigeria itself is below global standards, Kwara is significantly worse than the national average of 1 doctor to 2,500 people. A doctor in a Kwara government hospital handles over 10 times more patients than the recommended standard.

This reveals a staggering deficit that underscores a deepening healthcare crisis in the state. This also translates to the fact that the state currently has less than 10 percent of doctors it needs to adequately serve its population. The implication of this situation is burnout for the few available doctors, overwhelmed hospitals, longer waiting times for patients, delayed care, risk of misdiagnosis, medical emergencies, and preventable deaths.

Why are doctors leaving Kwara? According to a former chairman of the State chapter of the Nigerian Medical Association (NMA), Ola Ahmed, poor medical infrastructure, economic hardship, and insecurity are some of the reasons doctors and other medical health workers are leaving Kwara. The problem is not that the doctors are leaving; it is that the system is giving them no reason to stay. If the state government’s constant claim of improving medical workers’ welfare packages is true, why are medical personnel leaving, not just for foreign countries but to other states within the country?

Yet, perhaps the most troubling aspect of this crisis is not just years of neglect but misplaced priorities. While hospitals lack basic equipment and personnel, public funds are being channelled into projects that offer little or no value to the average citizen. The disconnect between government spending and the urgent needs of the people, including access to quality healthcare services, is glaring. The fiscal commitment of the present administration of Governor Abdulrahman Abdulrazaq to the state’s health sector is largely insufficient. Healthcare, which should be a fundamental responsibility of any government, has been relegated to the background. In its place, the state government appears to prioritise projects with minimal impact on the daily lives of citizens. The government is fond of investing in white elephant initiatives that consume vast public resources without addressing pressing needs of its people.

Equally concerning is the pattern of excessive spending of taxpayers’ funds on frequent local and foreign travels of the governor. Outside his numerous foreign travels, it was gathered that Governor Abdulrazaq shuttles between Ilorin and Abuja at least two times a week, often using private jet charters. The cumulative expenditure on the governor’s Abuja trips runs into hundreds of millions of naira annually. No wonder the state spent a whopping N4 billion on foreign and local trips in 2025 alone.

At a time when hospitals cannot perform basic surgeries due to lack of equipment and power supply, such spending raises serious ethical and governance questions. It paints a picture of a government out of touch with the realities of its people. Can a government genuinely claim to prioritise healthcare while allocating scarce resources to luxury travel and non-essential projects?

Kwara’s healthcare system does not need cosmetic interventions or public relations campaigns that have become the forte of the Abdulrazaq administration. It needs urgent, deliberate, and sustained investment. The government must prioritise the procurement and maintenance of essential medical equipment, improve working conditions for healthcare professionals, and ensure equitable distribution of medical personnel across the state. Beyond that, there must be transparency in public spending and a clear shift away from wasteful expenditures to initiatives that directly impact the welfare and well-being of the people.

*Adeniyi writes from Ilorin