Despite the economic recession that hurt government finances in recent years, Katsina has soldiered on, ensuring that key projects in the health sector are not allowed to wallow in decrepitude. Ibrahim Shuaib writes

The popular perception of most Northern states in Nigeria is that of poverty. “In 19 northern states of Nigeria, human development indices showed they are by far poorer than other parts of the country,” Vice President Yemi Osinbajo said in 2015. And with poverty comes an avalanche of social problems, including a poor health system. But one state, Katsina, is proving the bookmakers wrong, judging from the recent developments in the state’s health sector.

Katsina’s massive engagement with the state’s health sector is quite palpable at the Daura General Hospital in Daura, a town which is about 72km from Katsina, the state capital.

When THISDAY visited, a lot of construction activities were ongoing.

The hospital’s Medical Director, Mohammed Abdulazeez, told this newspaper that 70 per cent of renovation and retrofitting had been completed.

A Radiography Department had been added to the facility, the ward capacity expanded from 150 to 200, and the construction of water fountain roundabout, all completed. The hospital’s entrance gate, too, had been fixed and its fences expanded. The Outpatient Department, Accident Emergency Unit, Dental and Eye Units and some laboratories had all undergone renovation. A new Paediatric Unit had also been built. “Maternal and child drugs are free,” Abdulazeez said. “Cesarean operation and deliveries are also free at the hospital.”

According to the Medical Director, the hospital’s renovation was divided into three phases, with the entire project 70 per cent completed. “I can authoritatively tell you that we have completed phases one and two while work in phase three is just about to commence,” he said. “Initially, it was just the renovation but lately there were other new buildings that were added to the renovation.”

Abdulazeez also emphasised the progressive nature of the project.

He said: “After renovating the buildings, the wards, the operating theatres, the examination rooms, departments like the Laboratory Department, Radiology Department and the likes, there were also newer buildings that we added. You have the Conference Hall that wasn’t initially there, the main entrance gate wasn’t like this before. We have a roundabout there that has water fountain and then, an entirely new Radiology Department which comprises X-rays, Ultra-Sound and other medical equipments. Those are additional buildings at the site and they translate to more additional buildings because the initial Radiology Department was converted to another department and that department now is converted into two units. We have the Entrance Stabilisation Services Department. In essence, there is an addition.”

However, the Medical Director admitted challenges were still numerous, especially as they relate to the social and cultural dimension of the community. With Daura sharing boundaries with Niger, about 50 per cent of patients are foreigners.

“Of course they are human beings and we must treat them when they come to our hospital, but they overwhelm our health facilities,” Abdulazeez said.

“Also, some of the patients come to the hospital only when their conditions have become critical.

“That is a very big challenge because you have patients that come they are so exhausted and you can hardly differentiate the patient from the relatives. This increases our mortality rate because when a patient comes to the hospital after being mismanaged by local quacks, chances of survival are slim.

“We would have expected some form of first aid given to them before they come to us,” Abdulazeez said. “Most of our patients from Daura are better because they know their health status – they make use of the PHCs. In the environment of course, we are trying to create awareness, but people are used to their traditional beliefs.”

Another challenge was convincing the patients to stick to the usage of one hospital card, so their medical history can be catalogued in one place.

Abdulazeez stressed: “When I came here, patients come and buy cards every time. So we decided to create awareness. We go to the communities, we meet the traditional and religious leaders that they listen mostly to. We tell them that if you have a reference card, that reference card is enough for you for a lifetime. When you come to the hospital with a reference card, your card will be sorted out and it’s easier for whoever that is treating you to know your medical history.”

There is also the issue of dearth of manpower despite the state’s massive recruitment. Initially, 12 doctors were allocated to hospital, but some declined the appointment. “So we are now six and the workload is not only on those that are working, it cuts across all cadre, but still we are having support from the state government in the sense that the state government maintains the general hospitals,” Abdulazeez said. “Officially, Daura General Hospital is being taken care of by the Usman Dan Fodio University. We have consultants that come from there and they spend a week when they are here. The mother and child mortality rate has reduced drastically with all these interventions.”

Pursuing a progressive path

Katsina’s health development project is being driven by the state Governor, Aminu Masari. And, despite the country’s recent economic misfortunes, he has invested heavily on capital projects in the sector.

“I think it has proved one thing, it’s not about paucity of funds alone that is the problem, the problem in this country has been poor leadership,” Masari told THISDAY. “From what we met on ground and from what we have been able to discover, we believe that with good leadership all these things are possible and they are doable.”

He pointed out that his administration does not possess a magic wand, but has achieved so much only through financial prudence. “Pricing is equally important in terms of costing projects and the insistence on executing quality job,” he said.

Masari noted that when his administration assumed power in 2015, the state’s healthcare system was in tatters. And, understanding the importance of health in the development of any society, the new governor was keen on revamping the sector.

Katsina has three premier hospitals: Katsina General Hospital, Daura General Hospital and Funtua General Hospital and the Masari government resolved to bring these central institutions to a standard level, in terms of infrastructure, hospital equipment, and medical personnel. This January alone, the state is set to employ 50 doctors and about 65 nurses into its health institutions.

“We employed about 690 that consist of nurses, doctors, midwives and other technicians in order to make sure that these hospitals provide minimum requirements,” Masari told THISDAY. “Then, we spent over N700 million on hospital equipment to equip these three hospitals, and now we have brought MRI Scanning in three of our general hospitals. So nobody will go to Kano for scanning. Our plan, is to make sure in the next few years any person who leaves Katsina for medical vacation, is doing it based on his or her choice, and not because state hospitals do not have the capacity to fend for their health needs.”

Beyond the three premier hospitals, other General Hospitals – in Kankia, Musawa, and Malumfashi – have also been drafted into the three-pronged development scheme. This year, the state wants to build three more General Hospitals in Dunsuma, Kpare and Jibia. “We intend to have 11 comprehensive general hospitals,” he said.

A number of medical consultants now working in the new look Katsina hospitals come from neighbouring states. To improve local talent and spur medical research, the state has also gone about establishing a medical school. According to the governor, the National Universities Commission (NUC) has visited the state on inspection and the first batch of students are expected to file in during the next academic session.

They are also working with the Islamic Development Bank, to finance about 103 healthcare centres in 34 local governments. “Our intention is to have one in each of the 361 wards in the state,” Masari said. “I think if we are able to provide education, health, water, agriculture, our people are limitless, they have the capacity, Katsina has the history.”

Excellence at the centre

At the Katsina General Hospital in Katsina, the story of progress is the same. The Hospital’s Deputy Head of Department, Clinical Services, Dr. Aminu Abdullahi, who spoke to THISDAY, noted that the institution has undergone massive changes since the Masari administration took over. Among numerous other developments, a new administrative building, Dental and ENT Departments have been put up.

“The hospital is being renovated in phases by His Excellency, Alhaji Aminu Bello Masari,” Dr. Abdullahi said. “Phases one and two are completed while we will soon commence phase three of the project.

“The phase one includes the external emergency department, the building of the new OPD and the building of the Radiology Department. They are all newly installed.

“Then phase two includes the renovation of wards and the erection of the Admin building.”

According to Abdullahi, this current administration “has done quite a lot in rebuilding the health sector. The government has improved manpower at the hospitals in Katsina State. The government employed over 500 people in all the various cadres in the health sector which is a major kudos to the current administration.”

He added: “Socially and psychologically wise, any patient that sees the facilities, half of the sickness will go and he or she will believe and have confidence in the treatment we give them. In this hospital, we run so many specialties, we have so many doctors, we have consultants, house officers, medical officers from various specialties. The medical officers we have are about 30 and we have resident consultants and expatriate consultants, about 17 of them.”

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