It is no secret that Governor Amaechi marked out four areas of focus in his first tenure. These included roads, security, education and healthcare. By the end of his third year in office, he had spent over N208 billion in the Ministry of Works, over N39 billion in the office of the Secretary to State Government which was in-charge of deploying most of Governor Amaechi’s security initiatives, over N58 billion in the Ministry of Education and over N35 billion in the Ministry of Health.
While Governor Amaechi was praised for his outstanding security initiatives by many institutions including Andy Briggs Report, assassinations, kidnapping, armed robbery and official extortion of citizens through task forces and security forces remain widespread in Port Harcourt. The deteriorating state of roads in the state has raised a lot of anger, frustration and talk about what must have happened to Governor Amaechi’s ambitious two hundred billion naira investment on roads. People have attributed the crumbling state of many Port Harcourt roads to the governor’s insistence on using local contractors without any track record on his numerous road projects. The people he wanted to empower betrayed the trust he placed in them and wasted his opportunity to revolutionize Port Harcourt roads. Now that the roads are needed to hold up, they are falling apart. The use of sub-standard materials was another reason for the collapse of roads such as the Rumuokwuta-Choba Road which has gulped an amount in the region of N10 billion. Wimpey Road is presently impassable and the traders in that area recently staged a prtotest march regarding the hardships imposed on them by this state of disrepair. The model primary schools done by the Ministry of Education and the Health Centers by the Ministry of Health have however continued to be two sources of praise for the Amaechi administration. There can hardly be any gainsaying amongst Riverspeople that these two projects remain for now Rotimi Amaechi’s best work. It has taken almost four years to bring them to the present level and the administration will probably need another two or three years to put them at par with the best school and healthcare systems in Africa.
While the impact of the model primary schools are limited to children in government schools and their parents and teachers, the health centers now offering free health care are available to all citizens of Rivers State. As one doctor in the Rivers State Ministry of Health pointed out, ‘without health care newborn infants will not live long enough to go to school, adults do not need primary education, every one needs healthcare’. The sheer impact and potential of Amaechi’s primary healthcare centers make the project easily the greatest legacy he will be leaving to the state, as long as the work in progress is completed. Sustainable free healthcare administered through the health centers and other government hospitals will be the first serious step towards social security in Rivers State.
Over all, the Ministry of Health among other ministries of the state government parades the most relevant selection of projects including as already stated free healthcare for Rivers State residents in all state government owned health facility, a staggering initiative including lately even free food and drugs for patients. There is also the Malaria Elimination Project with the goal of eradicating malaria from Rivers State, the auto disabled syringe factory which now supplies syringes to all Rivers State Government owned health facility, the Kelsey Harrisson Hospital, the Maxilo-Facial Complex, the Karibi-Whyte Specialist Hospital which remains an ongoing project and many other healthcare initiatives to improve the quality of life in Rivers State. These high impact projects are assessed in detail below:
Today, the health centers guarantee accessible healthcare to many communities in Rivers State. There is now a health center within reach of most people in the state who wish to use one. In sheer numbers of available and functional health centers, this is probably the best record in the country and the West African region. When all the health centers (160) are fully functional with an adequate population of healthcare providers and an adequate drug supply regime, Rivers State will boast the best primary health care service in the country at an average cost of N200 million for building and equipping each center.
There are ofcourse challenges to achieving this. A lot of people are skeptical or even ignorant of the state government’s free healthcare scheme for all. The state government has also tied eligibility to free healthcare to payment of the social levy. In a culture where the healthy can even live a lifetime without visiting any clinic, some people are tempted to assume that it might be more convenient not to bother with the levy and by extension, registration for free health care. Technically, paying the levy means that healthcare is not free.
There were health centers in Rivers State before the Amaechi administration came into office in 2007. In an interview with Andy Briggs Report in September 2008, Dr. Sampson Parker, then serving his first term as the state’s commissioner for health pointed out that when the administration came into office, ‘we had over 350 health centers but these were basically dysfunctional’. According to Dr. Sampson Parker, the Amaechi administration had ‘decided to collapse the sub-standard ones into these new ones that we are building afresh’. Focusing on quality instead of quantity of health centers, the Ministry of health demolished many of the old, squalid and dysfunctional health centers to erect in their place, the new model of modern and beautiful health centers now spread across the state.
The first of the new health centers was commissioned in October 2008 by Hajia Turai Yaradua, then the first lady. Built on the site of an old health center in Churchill Road, Borikiri the new Churchill Health Center, a model of those to be commissioned later could be mistaken from the outside for a private clinic catering to the middle class. It has a huge reception room, male and female wards, a labor room, a dispensary, a laboratory, consulting rooms, offices and even a two bedroom bungalow at the rear to provide comfortable accommodation for the resident doctor. Two years later when the health centers at Sama and Odufor became functional, they would be used to house security personnel due to the insecurity in the area..
Sampson Parker had noted in 2008 what he described as ‘learned helplessness…because of the neglect over the years of the system’. Doctors, he said, complained of rural postings. ‘If you go to most of these rural places where doctors are expected to live, some of them are below where you would keep goats and pigs’. In adapting the new health centers to the challenges of state-wide primary healthcare, the Amaechi administration had ensured comfortable accommodation for doctors. There is a doctor and three nurses per health center outside Port Harcourt while there are two doctors per center in Port Harcourt. This is not ideal but it is the best anywhere in the region.
The centerpiece of activities to mark Governor Amaechi’s third anniversary as Governor of Rivers State was the ambitious 60-60-60 project which entailed commissioning sixty new health centers in sixty different communities in sixty days without a break. More than twelve new health centers had already become functional since Turai Yaradua had come to commission Churchill in 2008. Every new health center came with a stand-by generator while an ambulance center at BMH handled emergency evacuations. The whirlwind commissioning and hand-over of sixty functional health centers to sixty communities in sixty days would underline how advanced the primary healthcare program of the administration had become. Parker had said in 2009 that the government had decided to take drastic measures to plug the hole in healthcare in the state. ‘When primary healthcare is functional, ‘he had forecast, ‘we would have taken care of 70% of our health needs’.
David Mark, Senate president was in Port Harcourt at the kick off of the 60-60-60 tour on 28th October 2010 and accompanied Governor Amaechi to Bunu, Tai LGA to cut the tape at the first of the new sixty centers to go functional. Afterwards, David Mark described the health center project as the first of its kind in the country. ‘Bringing health care to the people at the grassroots,’he said, ‘is worth more than gold and silver’. Though sixty health centers were going functional in sixty days, 160 health centers were being built in all.
The second town on the second day of the 60-60-60 tour was Obonnoma in Akuku-Toru LGA, third day came Isiokpo in Ikwerre LGA, Odufor in Etche LGA on the fourth; every day the tour rolled into a new town and by the time they departed, the town had a functional heath center. At Odufor, the leaders of the town signed a statement revealing that they had never until the 60-60-60 tour felt the impact of the state government in infrastructural development. Really, most of the communities on the 60-60-60 itinerary had existed since time immemorial without any modern health care facility. At Omoku, an urban community Dickson Ordu, chairman of the town’s development committee said that the health center would alleviate the suffering of the people caused by oil and gas exploration activities. At Obuama in Degema LGA, the vice president of the Federal Republic of Nigeria Namadi Sambo turned up to cut the red tape. The well renowned architect took one look at the new health center, declared it of international standard and revealed that Amaechi had told him that he was going to build more.
The introduction of free healthcare for all citizens of the state has not been without hitches. People have complained of shortages in drug supply but sources at the ministry of health attribute this to the occasional difficulty encountered by some health centers in paying for their drug supply at the Central Medical Stores. Apparently, doctors who run the centers are required to submit the bills for dispensing free health care to the relevant authorities within a certain period of the month. Health centers which fail to forward their bills within this time window have to wait for the next monthly cycle to get paid and this hampers their capacity to get the adequate supply of drugs. Despite such challenges, the free public health care program is a breakthrough, the kind of gigantic welfare programs that are needed to lift the quality of life for the majority of people in the Niger Delta and beyond.
THE MALARIA ELIMINATION PROJECT
In 2001, an ECOWAS delegation led by Dr. Mohammed Ibn Chambers then the commission’s president visited Cuba. Also on the team was Prof. Babatunde Oshotimehin then the Nigerian minister for Health and Dr. Sampson Parker, the Rivers State commissioner for Health. The key reason for the Cuban trip was to study how Cuba, with a tropical climate like Nigeria’s had succeeded in eradicating malaria from their island and was even helping other countries achieve the same goal. Cuba has one of the most respected medicare systems in the world.
In September 2009, the Government of Rivers State pro-actively signed two contracts with the Cuban firm Labiofam S.A. These contracts were valued at US$5,860,750 for the supply and application of biolarvicides in Rivers State and US$22,307,688 for the building of a biolarvicide production factory in Rivers State.
In October 2009, the Rivers State Government released the funds for the production and supply of the bio-larvicides, the products arrived Rivers State almost a year later in August 2010, were cleared from the Onne Port and moved into the Ministry of Health warehouse at Emekuku Street, D-Line, Port Harcourt in November 2010.
As should be expected, laboratory tests, investigations and environmental impact assessment had to be carried out to ensure safety and effectiveness of the larvicide. Actual spraying of the larvicide started on 14th February 2011 while the official flag-off ceremony took place on the 8th of March 2011.
Apart from bio-larviciding (killing of the mosquito larvae in bodies of water where they breed) and adulticiding (killing of adult mosquitoes) by means of smoke fumigation and indoor residual spraying using World Health Organization (WHO) approved chemicals; bio-larviciding in inaccessible areas is also being carried out through aerial spraying by low flying helicopters which take off from the Nigerian Air-force Base, Port Harcourt.
The Malaria Elimination Project is to be carried out in two phases. The first phase is expected to last for two years and has been underway for six months. Areas of the state already covered include Port Harcourt, Andoni, Ogu-Bolo. Okrika. Opobo-Nkoro, Bonny and Eleme LGA. The process is currently being carried out in Obio-Akpor while a second round of spraying has commenced in Port Harcourt. The inaccessible areas of Port Harcourt, Andoni, Okrika, Ogu-Bolo, Opobo-Nkoro and Bonny have been covered by aerial spraying. Over a hundred youths from various LGAs have been employed in this exercise and many more are expected to be recruited as the process extends to more LGAs. According to Health ministry sources, the data collated from monitoring the process indicate that both mosquito population and malaria incidence has decreased.
Following the Rivers example, the Federal Government has adopted the same strategy, starting pilots in Nassarawa, Lagos, Jigawa and Ogun states. The Federal Government is also about to commence bio-larviciding programs in the neighboring states around Rivers. It is hoped that this will contain the spread of malaria and mosquitoes into Rivers State.
The bio-larvicide factory contract ensures that the factory when completed will produce 6million litres of bio-larvicide. This far exceeds the need of Rivers State and has the capacity to meet the need of the entire country and parts of the West and Central African region. Apart from a bio-larvicide factory in Ghana, the Rivers factory will be the only one of its kind in the West African region. The factory project is to be jointly financed by the Rivers State Government, the Venezuelan Government and the ECOWAS Bank for Investment and Development (EBID). The building of the factory is yet to commence because all funds are yet to be secured.
KARIBI WHYTE SPECIALIST HOSPITAL
The Karibi Whyte Specialist Hospital is probably the most controversial healthcare project being undertaken by the Rivers State Government. It is also the most grandiose. Originally envisioned to be an eighteen floor skyscraper, it was later redesigned to be an eight floor, one thousand bed specialist hospital that would offer the most advanced medical care to stem the mass flight of Nigeria’s upper middle class to Europe, Canada and the U.S.A in search of medical treatment and even routine check-up. It was an ambitious projection by the Amaechi administration which brought the Canadian firm Clinotech and its Nigerian-born CEO Dr. Harrisson Ofyai into collaboration with the Government of Rivers State. Dr. Harrisson Ofyai, a Canadian citizen of Bayelsan and indeed old Rivers extraction is believed to have been introduced to Governor Amaechi by Tonye Princewill of Princewill Political Associates. In an interview with Andy Briggs Report in September 2008, Dr. Harrison had disclosed that his company Clinotech Diagnostic & Pharmaceuticals Inc. is ‘primarily a manufacturer of medical diagnostic kits…’we are one of the leading manufacturers of medical diagnostic kits in Canada and export it to about 75 countries. Beside that Clinotech participates in building and managing hospitals…our collaboration to bring up a state of the art specialist hospital…as well as trying to address the need of staffing a specialist hospital of that capacity will need capacity building…to train people in diagnostic and investigative medicine, imaging technology, instrumentation of medical equipments which is very challenging, risk management and use of hospital facility. People need to be trained and retrained, got ready for maintenance schedules, re-calibrations and doing reference, comparative analysis with in-house data for better test values…’
The project kicked off with the controversial and total demolition of the old University of Port Harcourt Teaching Hospital, the intention being for it to serve as the site for the mega-hospital. Thereafter, the project site was moved to Omagwa and finally to a third site near the Port Harcourt Airport where the final preparatory work for building the hospital including road construction began. The hospital was at the foundation level when the project ran into a brick wall.
It is not possible at this point to have a clear picture of developments behind the scene but after Gov. Amaechi’s visit to the site where he expressed his dissatisfaction with the pace of the work, a dispute between the Rivers State Government and the contractor arose and the construction of the hospital was eventually put on hold. The state government then brought in an arbitrator to take inventory of the site to ascertain the level of work done by the contractor. A committee was also set up to investigate the disagreement between the contractor Clinotech Turnkey and Management Ltd, a subsidiary of the Clinotech Group and the state government and to recommend a way forward. The committee is chaired by the director-general of the Rivers State Bureau of Public Private Partnership Mrs. Anita Laz-Nwokeafor.
The committee has since submitted its preliminary report and a final report is expected soon after which the construction work at the mega-hospital is expected to resume.
Logistical challenges in projects of this scope are not unexpected in Nigeria where a massive operation of this nature had never been attempted by a state government outside Lagos. In the development of the state, a learning curve from such a crucial project even with flip-flops is better than no curve at all. Though the review has slowed the project considerably, it should ensure the avoidance of irreversible errors in this potential flagship of healthcare delivery in Nigeria
THE AD SYRINGE PROJECT
The Auto Disable (AD) Syringe factory in Ozuoba is another vital health sector initiative of the Amaechi administration. The auto-disable syringe being produced there differs principally from the regular syringe in the market because it is built to be used just once. Any attempt to pull back the plunger for a second use will cause it to break at a very thin neck area known as the fracture point. This auto-disable mechanism is aimed at preventing the spread of diseases like Aids and Hepatitis in Africa which are transmitted in many ways including through the widespread practice of using the same syringe for more than one patient. The AD syringe can not be used twice, not even on the same patient.
Initiated in 2004 by the Pan African Health Foundation (PAHF), a not-for-profit organization which supports the establishment of locally owned, non-profit medical supply factory, the Ozuoba factory project, sitting on 4 hectares of land donated by the Rivers State Government under the Odili administration started with funding provided by the Federal Government and other donors; President Obasanjo laid the cornerstone.
By 2007, the factory production area had taken shape but finance for the project was no longer forthcoming, not until the Amaechi administration provided a financial bail out package. The factory would be commissioned by Governor Amaechi in October 2008.
Though the project was initiated by PAHF, the MD Jon Gunnar, an Icelander says that the factory is now run by PAHF on behalf of the Rivers State Government. Currently all Rivers State healthcare establishments are required to use only AD syringes made at the Ozuoba factory. This is expected to boost the campaign against the spread of HIV. The factory has a production capacity of 160 million syringes which far exceeds the requirement of Rivers State and is currently participating in a tender for order from the Federal Government. Other projects under the Ministry of Health include the Malaria Booster Project formerly Roll Back Malaria, Rivers State Action Committee Against Aids (RSACA) and more.