When a woman is in labour, what is the first thing that comes to mind? Probably grabbing the already packed hospital bag and ensuring the woman gets to the hospital on time. Not so for residents of some communities in Osun State, South West Nigeria. When a pregnant woman is in labour, the first point of call for residents of these communities is the local water vendor, commonly called “meruwa”.
Many Primary Healthcare Centres (PHCs), the only source of health care in many rural communities across the state, do not have access to potable water. Healthcare officials are forced to demand kegs of water from patients, especially pregnant women.
Perhaps in response to this need, between 2019 and 2020, the state government awarded contracts worth N1.27 billion for water projects in PHCs.
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According to details on the Open Contracting Portal of the state, between 2019 and 2020, four contracts were awarded for the construction of boreholes and the supply of tanks to PHCs in the state.
In April 2019, the state awarded the sum of N288.750 million for the construction of 150 boreholes and the supply of 150 overhead tanks in selected PHCs in the state.
In May of the same year, N350.350 million was awarded for the drilling of 182 boreholes and the supply of 182 overhead tanks across 182 PHCs in the state. Both contracts were awarded by the state’s Ministry of Health.
In July 2020, this time, it was the Osun State Road Maintenance Agency that awarded two contracts for the drilling of boreholes and supply of overhead tanks.
In total, between April 2019 and July 2020, contracts worth N1.278 billion were awarded for different water projects in the state’s PHCs.
To ascertain if the contract has improved the availability of potable water at the healthcare facilities, Dataphyte visited 15 randomly selected PHCs across the state.
Tracking the Project
The first challenge to tracking these projects is that details on the location of these PHCs were unavailable on the portal. At least 332 PHCs out of the state’s 846 benefitted from the boreholes and overhead tanks based on the details sourced from the state’s open contracting portal. However, without the specific location of the water projects, it is impossible to name all the PHCs that were project beneficiaries out of the total number of PHCs in the state.
FOI requests sent to the ministries that awarded the contracts were never responded to.
Water Projects but no Water
At Akarabata Primary Health Centre, though the water project was constructed, residents said their hopes were dashed as the project has never been functional.
Asides from the inability to supply water to the Akarabata PHC, the metal scaffold on which the water tanks were placed has started rotting, and the plastic pipes and tanks were leaking.
“We have barely used this project before the tank started leaking, and since then, it has failed to serve us”, said an official of the health facility who identified herself as Oluwatoyin.
She said health centre officials walk kilometres to fetch water in buckets.
Similarly, at Asunmo PHC the water tank could no longer hold water because of leakage. Officials said their efforts to fix the tank yielded no result.
Asides from leaky tanks, in many of the health centres the water pumps were broken and could no longer pump water into the overhead tanks. Officials at the PHCs said they now rely on water from dug-out wells to perform essential healthcare procedures.
“The water project here has failed to work, and we walk many miles now to get water and even at the location of the well where we fetched water, the residents sometimes deny us from fetching. When the government erected this project, we were happy but since it has failed to work, as staff, we carry buckets and look for water, even sometimes getting water to use the toilet is a challenge” a health worker in one of the PHCs who pleaded anonymity for fear of being victimised said.
At the Sabo-Olaolu PHC, Dataphyte was told communal clashes prevented the water project completion at the PHCs there.
“The external water supply facilities have been destroyed due to communal clashes and each time we repair them, it is destroyed, now we have given up, Olayeni Abimbola, the Officer in Charge of the Health Centre noted.
“We have just two bathrooms here, so when we need to bathe babies who run temperatures, and we urgently need to bathe them, we have no means to do that, we rely on the two bathrooms, which can be crowded at times” Olayeni said.
The story was not different at Ojatitun PHC where the water project has been destroyed and abandoned.
Some PHCs officials who spoke under anonymity said although the water project has been installed they lack electricity to power the water pump.
“We have not had light for many months now, we do not even have a generating set, there is no way we can pump the water, even if it were working, so we rely on water from residential neighbours.” Some PHCs officials noted.
Pregnant women bring water, and kerosene from home on their delivery day
When Dataphyte got to the National Model Primary Health Centre at Ipetumodu, it cut a figure less than what is expected of a “national model”. There were only a few people in the building although the facility serves hundreds of people.
Despite its importance to the community, the health centre lacks water. The Assistant Chief Health Officer of the facility, Amusan Cecilia, told Dataphyte that the only source of water cannot be used because it is unsafe.
“We have no water here; the one we have cannot even be used to bathe babies because it is unfit for use. We rely on sachet water or ask husbands of pregnant women who want to deliver to come with water. Since we cannot use the water here for such purposes, it is either they come with water in Kegs from their home, or they come with Kerosene; we use this kerosene to boil the water and then add Dettol to it for use” Mrs Amusan noted.
She further stated that they are sometimes stranded when a patient urgently needs to drink water at the Centre.
“Because we rely on sachet water for drinking, we buy it from the area, but sometimes we do not have any of these ‘sachet water’ at the PHC and those who sell it fail to come, so we face challenges when a patient needs to drink water at this place. Over a hundred people rely on our services here,” she said.
Corroborating the development, Agbaje Bose, who recently gave birth at the Model Primary Health Centre in Ipetumodu noted that when she was to deliver her baby, she had to bring Kerosene to the hospital.
“When I was to give birth, I had to bring Kerosene which they used in boiling the water; this is because the water at the health centre is bad. They use the Kerosene to boil water before it can be fit to use. If they use the water, the baby is at risk of being exposed to diseases, if you see the water, you will see insects inside. They cannot even use it for bathing any baby. If we do not bring Kerosene, we can boil water and bring it from home”. Agbaje stated.
She further noted that even at those points, she had to get ‘Sachet water’ if there is any need to drink water.
Agbaje said she had to give birth at the health centre due to the cost of doing so at other places.
“If I go to other places that are not government-owned, they will make a lot of demands, that is why I rely on the PHC for childbearing”, she noted.
Another respondent, Alabi Toyin, noted that when she wanted to give birth at the health Centre, she was told of the need to provide Kerosene, given the fact that the water of the place cannot be used.
“I had to buy Kerosene when I wanted to give birth, so they could use it to boil the water. The water is very bad, and in fact, I cannot use it to take my bath, not to talk of the newly born baby,” she noted.
Lab Test Result of Ipetumodu Model PHC Water
Dataphyte did a laboratory test of the water at Ipetumodu model PHC to further verify the accounts of the women who gave birth at the health centre and those of the officials.
The result of the test revealed the presence of bacteria and urine in the water. The test result stated that the water is unclean and turbid.
It was noted that after a twenty-four hour culturing, a moderate growth of pathogen(Gram Positive Bacteria) was discovered in the water. According to SafeWater, this kind of bacteria causes diseases and causes illnesses.
Healthline also noted that many gram-positive bacteria are collectively referred to as pathogens. According to Healthline, some of the species of these pathogens are Staphylococci, Staphylococcus Aureus, and Bacillus Anthracis which cause vomiting, nausea, abdominal pain, coughing up blood, high fever, and nausea among others.
Ilare’s non-existent water source
According to Iya Afin Sogbon an official of the health centre “As you can see, we lack water here, we buy buckets and go many miles to fetch water. Even at that, sometimes we have no water at all. When we resume, we sometimes take a bucket ourselves and go in search of water. We even rely on rainfall to get water here. This health centre is the one that serves the Ilare community, although we are under Enuwa.”
The situation is the same at Orisunbare, PHC. The Head of Departments at the health centre noted that they fetch water from a well some kilometres away. She said they also rely on rainwater for their water needs. When asked how hygienic the rainwater is, she said that was the only choice available to them most times.
“Gush” of Hope at some PHCs in Osun state
At the Yakooyo and Enuwa Primary Health Centres, the water projects were not only successful but the staff at these centres also noted that it has aided service delivery.
Contracts Award Process Open to Questions
The technical capability of the organisations that got the contracts raises questions on the award process. For instance, in Asunmo Primary Health Centre in Ede North where the borehole tanks and electrical connection were faulty, the organisation that was awarded the contract was established about ten months before winning the contract.
The company’s registration details on the Corporate Affairs Commission’s website show that the organisation listed as Dotfam Multiventures Limited was established on June 11, 2018, and got contracts awarded between April/May 2019.
Some of the companies who won these contract awards were also inactive according to the CAC companies portal.
Inactive Companies Image
A non-existent company on CAC portal also got a contract.
Government Needs to Tackle Water Challenges at PHCs, to boost Maternal Health, access to Healthcare
In March 2022, the Osun State government noted that it was committed to ending maternal mortality in the state, lamenting the numbers of deaths during childbirth and pregnancy.
Already, Water Project noted that half of the World’s hospital beds are occupied by people suffering from water-related diseases. One out of five deaths worldwide is also related to water diseases.
The organisation further noted that about 80% of illnesses in developing countries are linked to poor water and sanitation conditions.
Improving health outcomes, especially for maternal and child health, highlight the need for healthcare centres to have clean water. For instance, if data says that water is the leading cause of illnesses globally, then it is important that the places where treatment will be gotten, or health services will be rendered have access to clean water. This will also strengthen Water, Sanitation and Hygiene in the state’s health care delivery.
Absence of Clean Water, Danger to People’s Health- Expert
The Chief Executive Officer of Water with Development, Wilson Atumeyi, while reacting to the findings, told Dataphyte that contaminated water at Primary Health Centres could lead to more diseases being contracted by residents.
“In a case where because they use contaminated water, you pick up another disease, say, for instance, Diarrhoea or Cholera, and this is highly detrimental to people’s health,” he noted.
Wilson stated that to ensure the proper delivery of projects. People need to be empowered with information to ensure that important projects such as water for health centres are properly executed, and people are aware that they are entitled to such developmental projects.
He also expressed concerns about the lack of proper mechanisms to ensure that after erecting projects such as Water, a follow-up is done to see if they are serving their purposes.
“The government does not feel the need to put structures in place that help to ensure that these projects are not just built and left without serving their purposes”, he stated. He also calls for proper monitoring and accountability in helping to deliver better healthcare services.
Osun State Government Reacts
Dataphyte reached out to the Osun state Commissioner for Information, Funke Egbemode. However, several calls to her were not picked up nor returned, and she also did not reply to messages sent to her seeking a reaction to the developments.
The Chief Press Secretary to the Osun State governor, Ismail Omipidan, was also contacted to react to the findings.
He denied that the state awarded contracts to drill boreholes in 664 PHCs; according to him, only 332 health centres were earmarked to benefit from the project. He also stated that the contract award should not be up to N1.27 billion.
When told that the details that led to the number of PHCs expected to benefit from the project and the amount spent were obtained from the state’s Open Contracting portal, he promised to ‘cross-check’ and revert.
However, when our reporter contacted him again to get his reaction, Mr Ismail insisted he was unaware of contracts amounting to N1.27 billion contract. He said only 332 boreholes were to be sunk. He stated that all the Primary Health Centres that benefited from the projects have their project working and tap water running.
When asked if the government is aware many of the projects are in a bad state, he declined comments.
He said the state has hundreds of PHCs, some of which may not have benefitted from the water project.