Anambra Healthcare Crisis: Public Health Centers Operating in Unconventional Settings

Sokoto Road Heath Post in Odoakpu Ward 4, Onitsha South Local Government Area in Anambra State was supposed to be found at its original address at Sokoto Road inside the popular Main Market, Onitsha but that was not the case.

For no fewer than seven hours in the scorching sun, this reporter trekked the entire Sokoto Road nine times, pushing through the market crowd and asking for the supposed popular health post, to which no one knows. Many people said they had never heard about it. The search lasted till nightfall without success.

The journey in search of a health center which should be easily accessible to the community continued the following day. An interaction with one of the staff members of the health post led to the revelation that the health facility was operating in a tailor shop at 69 Bida Road, Odoakpu Ward 4, Onitsha.

This is the case with many primary health care centers in Anambra State with no well-built and maintained structure of their own, instead, they are squeezed either in a cubicle meant originally to be a security post in a recreation club or a one-room apartment, either rented in a residential house shared with other tenants or a room or classroom donated by a church for temporary use. 

Even though the first step in ensuring that a primary health care center functions effectively and efficiently is for the center to have a standard structure, the lack of structural facilities has become a great militating factor against the effectiveness and efficiency of many primary health care centers in the state.

The terrible state of some primary health care centers that have structures in the state and the overall structural deficit in many primary health care centers in the state have continued to impose serious dangers to both communities who depend on their services and the health workers assigned to such facilities.

“Don’t be angry with me, my dear. I am very sorry for all the stress you passed through looking for us at Sokoto Road. Actually, that place is rented and we are no longer fully there, though some of our things are still there. This is where our chairman here gave it to us to be managing,” a Sokoto Road Health Post staff member who attended to this reporter after waiting for over two hours said.


Located a few meters from the ever-busy Bida Road, the tailor shop belonging to the community chairman’s wife, where the health post was currently operating from, is a one corridor-like room filled with a sewing machine, clothing materials, a double seater sofa and a show glass with a few drugs, a fridge for vaccine, a table and a few medical records.

“We are even really grateful to our chairman for giving us this place to use. We also fetch water from inside his compound for free. We are still functional at all because of him,” the health worker said when asked how they fared in such a place.


The health worker, while satirically laughing at the condition of the health post located in such a densely populated area, lamented that not having a well-built and maintained structure had denied the health post the opportunity to have the needed equipment and medical materials due to a lack of space to keep such.   


“Well, we can’t do more than what we have. There are many things we don’t have, including beds because we don’t even have space to keep them. Of course, we are working and doing our best, treating people within our capacity but we know we would have been doing much better if we had a well-built structure of our own.

“Even the few beds we have are packed somewhere because if we are to bring them here, where is the space to put them and attend to patients? And unless the government provides a suitable place for us, we don’t have millions of Naira to buy even a plot of land in the heart of a city like this,” she said.

With no structure, Sokoto Road Health Post has no ward, no consulting room, no hospital beds, no bandages, gloves, personal protective equipment, injection ample, GV ink, methylated spirit, disinfectant, weighing scale, thermometer, drip and drip stands, oxygen gas for patients, stretcher, hence, it refers most of its patients to a larger hospital. 

The health workers at the health post said that the condition of the health post was as it was even though 10 communities rely on the health facility for medical services, with an estimated 20,007 persons visiting the health post annually. 

Further investigation and visits to other primary health centers and health posts in Onitsha South, Oyi and Awka North local government areas of the state revealed more heartbreaking state of primary health care facilities in the state.

When visited, St Barnabas Health Post located inside St Barnabas Anglican Church in Emordi Street, Onisha in Onitsha South Local Government Area, presented another heartbreaking scenario.

Asking for directions to the health post, this reporter was told by a food vendor whose shop was located beside the Anglican, that the health facility is located in what looks like a gatekeeper’s house inside the church with the deafening noise of prayers and worship services coming from several loudspeakers in every corner of the church.


Like Sokoto Road Health Post, St Barnabas Health Post relied on by more than 10 communities and an estimated 800 persons visiting it annually for medical service, has no well-built and maintained structure of its own, nor does it have any ward, consulting room, hospital beds nor any restroom.

 It also has no syringes, medications, bandages, gloves, personal protective equipment, injection ample, GV ink, methylated spirit, disinfectant, weighing scale, thermometer, drip and drip stands, oxygen gas for patients and stretcher.

Asked how they handle the noise pollution coming from the church which donated the one-room space to them, one of the two Community Health Extension Workers assigned to the health post said, “We are helpless. We have no option. We can’t stop the church from holding service when they did us a favour by giving us the space to manage. Anyway, they will soon finish and they don’t hold service every time.”

However, for close to two hours this reporter spent at the health post, the loud and vibrating noise of prayers and sermons from the church kept going. 

A visit to the Recreation Health Post in a one-room gatekeeper house inside Recreation Club, Bridge Head 2, Housing Estate, Onitsha in Onitsha South Local Government Area of the state, did not present a better or more pleasing scenario.   

Squeezed in the small gatekeeper room, though the medical staff on duty at the time of the visit said they had four hospital beds packed inside a packing store of the Recreation Club building, it had wards. Recreation Health Post has no consulting rooms and has referred most of its patients to larger hospitals basically as a result of no structure.


Along with having no structure of its own, Recreation Health Post has no scissors, syringes, medications, bandages, gloves, personal protective equipment, injection ample, GV ink, methylated spirit, disinfectant, weighing scale, thermometer, drip and drip stands, and oxygen gas for patients. 

Also, St Stephen Primary Health Care center located inside Brothers of St Stephen Chaplaincy Catholic Church, Nkwelle Ezunaka in Oyi Local Government Area of the state, took this reporter over three hours to find. 

Squeezed inside one of the classrooms of the church’s primary and secondary school building, the health facility was easily mistaken for the school’s first aid room – which it looks like.


The health worker on duty said, “There is land where we ought to build a house as a health center but no house has been built on it. This is where we are managing. The church just gave us this one room to use but we are pleading with the government to help us move to our own place.”

The worker further lamented, “Not having our own standard place is really affecting our effectiveness and efficiency. Though we are trying our best here with the little we have, it is not enough and just like you found it difficult to locate, that is what some people do experience while trying to come here.”

Similarly, a visit to Amansea Health Post in Amaowelle Village in Awka North Local Government Area of Anambra State was another heartbreaking experience. 

Though located less than two kilometers from Amansea Junction along the Enugu-Onitsha expressway, at least the first three residents of the village including commercial bike riders our reporter approached for directions to the health post neither knew about it nor where to find the health facility.


“I know the place, sir. But many people don’t know about it because it is not really working. Most people go to the other health center in a village across the main road. It is actually farther than this one but that one is working,” one middle-aged bike rider said as he approached the reporter who was already looking frustrated and confused, having asked several residents for directions to the health facility without success. 

It was another confusing moment when the motorbike rider arrived at a residential building surrounded by overgrown grasses where no one could expect to find a health facility.  


A female health worker who identified herself as a Community Health Extension worker and the only health worker available at the time of the visit lamented bitterly that the health facility lacked virtually everything needed for healthcare service delivery.

It was observed that one of the two bedrooms served as a ward while the health post had a total of four beds, out of which, one was completely damaged while one, though being used, was no longer in good condition. 

SaharaReporters confirmed that the health post had no bandages, gloves, personal protective equipment, injection ample, methylated spirit, disinfectant, blood pressure apparatus, weighing scale, drip, oxygen gas, stretcher, drip stand and scissors.


“We don’t have anything here. Our blood pressure apparatus is not working. There are not enough drugs here. We buy syringes that we use to attend to a few people that come here because the people that come here are not even many,” the health worker who spoke on condition of anonymity lamented. 

She added that they buy water from the neighbouring compound as they do not have any source of water supply at the health post.

Asked if the staff of the health post were satisfied with their working conditions, she said, “No, how can we be satisfied with a place like this? Imagine our kerosene stove is not even working. We don’t have many things to work with here. Sometimes we just come and stay here because we have no option. People hardly come here. They prefer going to other health centers. Some of the materials we use, my head buys them.”


She lamented that the non-availability of the needed medical supplies and equipment had become the major hindrance to their effective service delivery, adding that annually, only about 50 persons visit the health post for medical services. 

She pleaded that the health post needed urgent intervention including moving it to a permanent site where they had land in the community.


A source in the Department of Primary HealthCare centers in Onitsha South Local Government Area, who did not give out his name when this reporter visited his office, lamented that his most urgent needs for primary health centers in the local government were structures.

He said, “Our biggest challenge here is structure. We have many primary healthcare centers and health posts but many of them do not have structure. Recreation Health Post, Sokoto Road Health Post, St Barnabas Health Post are just a few of the health centers we have that have no place of their own.


“It is really affecting us and it is giving me serious worries. I am pleading with anyone, any organization and the government to help us get permanent places for these health centers. It is really important for me and the good people of this local government.”

Beyond the primary healthcare facilities identified to be operating either in a cubicle meant originally to be a security house in a recreation club or a one-room apartment either rented in a residential house, less than five out of 16 primary healthcare centers and health posts visited across Anaocha, Aguata, Onitsha North and South, Oyi and Awka North local government areas have well-built and maintained structures without the problem of leaky roofs, damaged doors, broken windows, abandoned or no restroom, and other dilapidations. 


At Ora-Eri Primary Health center in Aguata Local Government, apart from one building said to have been renovated a few years ago, there were dilapidated buildings and a broken perimeter fence through which workers lamented that thieves used to gain access to the center to rob them. 

A young female health worker at the facility lamented, “We don’t have toilets. Our staff quarters are leaking and the doors are no longer good. Thieves pass through the broken fence and steal our money when we are at work. Sometimes they even come at night trying to force themselves on us. We really need help.” 

A Community Health Extension expert and healthcare researcher, in Awka, Anambra State capital, Francis Unah, said it is unfortunate that the healthcare sector, especially primary healthcare in Nigeria has continued to be given less attention by the government and leaders.


According to him, Anambra State and every other state of the federation have great healthcare workers and experts, “but the problem is that when this kind of your finding lingers, health workers will be doing their best to provide healthcare services, but the lack of proper facilities and resources will continue to make their efforts seem futile”. 

“The implication is that even the ones that have dilapidated and decaying buildings, rather than being places for getting healthy, would become places of a mysterious illness that would be spreading like wildfire among the patients and the entire society,” he added. 


Efforts made by SaharaReporters to reach the Anambra State Commissioner for Health, Dr. Afam Obisike, on its findings on the state of primary health centers in the state and to find out what the government could do to salvage the situation were not successful. 

He did not answer calls to his mobile phone nor reply to the message sent to his mobile line.


This story was produced for the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science

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