Benue State healthcare system is facing a crisis as the state suffers severe shortage of doctors, years after it scrapped a programme that helped to sponsor medical students in return for serving in public hospitals.
The situation has deteriorated that several state hospitals have as few as two medical doctors catering to hundreds of thousands of patients.
Data from the state Ministry of Health shows there are only two doctors at the general hospital at Buruku in Ukum Local Government Area, an area with a population of 206,215 people.
At Idekpa General Hospital in Ohimini LGA, with a population of 71,482, only two doctors tend to the medical needs of the people. There are also two doctors serving at Ugba General Hospital in the Logo council area.
There are only three doctors each at the general hospitals in Naka (Gwer-West), Obagaji (Agatu), Igumale (Ado), Wannune (Tarka) and Ugbokpo (Apa) LGAs.
The situation is the same at hospitals in Obarike-Ito (Obi), Sankera (Ukum), Gbajimba (Guma), Lesse (Ushongo) LGAs and the Family Support Programme (FSP) in Makurdi, the state capital.
Four doctors man each of the general hospitals in Tse-Agberagba (Konshisha LGA), Okpoga (Okpokwu), Oju and Vandiekya.
Otukpa (Ogbadibo), and Aliade (Gwer-East) have five doctors each, while Adikpo (Kwande) has seven. Gboko and Otukpo LGAs have nine doctors respectively.
The World Health Organisation recommends one doctor to 600 patients as the minimum.
The government in 2017 cancelled a programme established to address shortage of doctors in the state and enhance public health delivery. The Bond Doctors Scheme, which aimed to help with the training of doctors, was inaugurated during the administration of Gabriel Suswam, from 2007 to 2015.
Under the programme, medical students received financial support from the state government while at university and were required to serve for at least two years after graduation. The scheme currently contributes 69 of all 92 doctors across the state’s 23 general hospitals.
The administration of Governor Samuel Ortom ended the programme five years ago but that was not reported until now. The Commissioner for Health, Joseph Ngbea, told PREMIUM TIMES “The bond doctors programme has been stopped.” He declined responses to further questions on alternatives and implications.
A government official who said his name should not be mentioned as he did not have permission to speak to the media on the matter, told PREMIUM TIMES the programme stopped because the government could not sustain payment of N100,000 monthly to student doctors. Mr Ortom’s administration is beset by problems with workers’ salaries and retirees’ pensions.
Dire Situation
Doctors and government officials at the Benue State Ministry of Health and Human Services are concerned about the development. “The acute shortage of medical personnel and critical medical equipment will ground healthcare services to a halt,” said one official who also asked not to be named as required under civil service rules.
A major concern now is that things would get worse as many doctors in the state have completed the required time to serve and may be leaving the state.
The chairman of the Nigerian Medical Association (NMA) in Benue, Samuel Otene, said the situation was “dire” and has the potential of “crippling the primary and secondary healthcare sectors of the state” if urgent steps are not taken to address the shortage.
“Eighty per cent of the doctors at the general hospitals across Benue are ‘bond doctors’, who have finished serving their bond, and will leave the hospitals anytime,” he said.
The NMA chairman said shortage of doctors in the state is made more critical by the fact that only about 20 per cent of doctors work in the rural areas. Most serve at the Benue State University Teaching Hospital and the Federal Medical Centre, the two tertiary health institutions in the state located in Makurdi, the state capital.
“In Makurdi, there are over 80 per cent of the doctor population of Benue State. That leaves you with the rest of the 22 local governments battling with 20 per cent of doctors. Yet, the rural areas have the largest population in the state,” Mr Otene pointed out.
The implications of the lop-sidedness in doctors-distribution “leaves patients journeying from the hinterlands — Zakibiam, Katsina-Ala and Owukpa — to Makurdi in search of medical help.”
The concentration of doctors in Makurdi and a couple of towns in the state is occasioned by “problems of poor infrastructure in the rural areas — electricity, water, schools and roads,” Mr Otene said.
“Most of the doctors gravitate towards the main townships. That leaves a large chunk of the population’s health needs unmet by qualified medical personnel.
“This explains why we have a lot of quackery in the state. Nature abhors a vacuum, by the time the doctors are not there, someone else (a quack) will occupy the space and begin to cause mayhem,” he said.
Other Personnel, Equipment Too
PREMIUM TIMES found that the shortage is not only limited to doctors as there are only 14 medical laboratory scientists manning the entire state’s government-owned hospitals.
An official of the Benue State Hospital Management Board (HMB), who asked not to be named, said of the 14 laboratory scientists in the state’s employ, only 10 are deployed to hospitals, while four are engrossed with administrative duties.
“There are only 14 laboratory scientists in the Benue State government employ, and only 10 are currently doing hospital jobs, while the remaining four are busy with administrative duties,” the staff explained.
Officials who spoke to PREMIUM TIMES said most of the government-owned hospitals have only technicians who are diploma holders.
“Otukpo and Makurdi general hospitals have two scientists in their laboratories,” one official said.
Multiple doctors who spoke during the reporting for this story also raise concerns about non-availability of “critical medical tools such as oxygen, X-ray machines, ventilators and chemical/blood analysers.”
“The combined effects of these inadequacies are – misdiagnosis, poor patient management, delays in making decisions,” a doctor who heads one of the hospitals lamented.
Another doctor disclosed that “delays in making emergency blood transfusion and attending to emergency cases could lead to patients’ death” as a result of the dearth of key medical facilities at the hospitals.
He said “carrying out surgeries in substandard operating theatres could lead to surgical site infection and even patient’s death.”
“Referral of patients to distant health facilities, especially private hospitals for investigations thereby delaying decision making and patient management,” are other negative effects of how hospitals are under-equipped to deal with patients’ care.
Efforts to get the state’s health commissioner to comment on the issues failed.
Mr Ngbea directed questions to Ogwu Emmanuel who heads the state’s Hospital Management Board, the agency in charge of the 23 general hospitals in Benue.
When contacted, Mr Ogwu declined comments arguing that he had not received authorisation from the commissioner.
In 2017, the Hospital Management Board earmarked N3.2 billion for general hospitals. The state’s budget shows that in 2019, the government allocated N149 million for “procurement of modern medical equipment for all the 23 general hospitals and the Benue State University Teaching Hospital (BSUTH).”
It is not clear whether the money was released or how it was spent. Some doctors who spoke with this reporter said they doubted major equipment were bought.
Poorly Funded
Overall, the state’s spending on healthcare is low. The entire health budget in 2019 stood at N4.5 billion, a meagre 2 per cent of the entire N190.9 billion budget that year.
A 2016 report by the National Bureau of Statistics (NBS) said life expectancy in Benue for males is 46, and 50 for females.
Benue’s neonatal mortality is 25 per cent while infant mortality is 40 per cent. Child mortality is 19 per cent while under-5 mortality is 59 per cent.
