N41B Ibom specialist hospital stripped, on life support

Only a few days before leaving office as governor of Akwa Ibom State in May 2015, Godswill Obot Akpabio, commissioned an uncompleted multi-billion naira Ibom Specialist Hospital, Uyo.At the unveiling ceremony, Akpabio told Nigerians that the facility, which he described as “world-class specialist hospital” with ultra-modern medical facilities including, 164-slides CTscanners, digital mammography machines, and devices to perform endoscopy surgery, highly sophisticated intensive care units and medical gas plants, with fully automated laboratories, would attract medical tourism to state.

He added: “We needed a hospital that can run at international standard. We also decided to have a hospital that would answer to the needs of Nigerians in terms of advanced health management. And that was why we built the Ibom Specialist Hospital.”Sadly, barely two years after the inauguration, the facility, which was meant to provide quartenary healthcare to the people of the state and beyond is in itself on life support and gasping seriously for breath.

Now in the middle of a brewing crisis between its owner, the Akwa Ibom State government, and the maiden private managers, Cardiocare Medical Services Ltd, both construction work and service provision have come to a screeching halt.As the public condemns the very poor script that is playing out at the facility, it has just emerged that sophisticated equipment, about half a billion naira have allegedly be carted away from the facility.

After Akpabio, now the Senate’s Majority Leader, opened the hospital when it was still far from completion, tongues kept wagging over the rational behind such despicable action, as the facility was still less than 70 per cent completion at that time.Akpabio further de-marketed the facility by travelling for medical attention in the United Kingdom to treat injuries he sustained in a car crash, after his car collided with a United States embassy vehicle.

After the accident in Abuja, the lawmaker was initially treated at the National Hospital, Abuja, before hopping into a private jet for further medical attention abroad, forgetting about his “world-class” hospital.Right now, even though the state government is posturing as if all is well, the fate of the facility is highly uncertain, and except highly proactive steps are taken to stem the gradual slide, the N41b quartenary health facility, could soon qualify as a white elephant project.

During a recent visit to the facility, there was no sign that the facility would run maximally or function at full capacity anytime soon, and critics are already alleging that the project was profit-driven, and not necessarily out of necessity.

Though it never operated at full capacity since it was opened, the specialist hospital has several unique features/equipment, which if put to good use, would rival their contemporaries in the western world. These include the 164 slides C-T scan (the latest technology), the latest magnetic resonance imaging (MRI) machines, varied types of scanning machines, three modular theatres, full interventional cardiac facilities, highly sophisticated intensive care units (ICU) distinct from the pediatric ICU, both with dependency facilities, about 380 suites, hordes of operating wards and full-fledged neurosurgical facilities.

The hospital also plays host to a wide range of scopes for laparoscopic surgery, a laboratory, which is fully automated and boasts of the latest technology equipment connected to the lying inwards, with conveyor belts for collection and delivery of specimens and reports in record speed.

Beginning Of Rough Journey
BEFORE the maiden private managers, Cardiocare Medical Services Ltd terminated the contract with the state government and walked away, the hospital had in its employ, about 150 expatriate professionals, largely Indians. This comprised of highly reputed specialists in the fields of neuro-surgery, plastic surgery, interventional cardiology, oncologists, medical laboratory scientists, radiologists, physicians and biomedical scientists among others.

Besides this glut of expatriates, which was to make the facility a one-stop shop for medical treatment (being a quartenary hospital), the facility was also in agreement with a Swiss hospital group and an Arab healthcare group.With such a heavy wage bill occasioned by the high number of foreign professionals and lack of patronage from locals, it was only a matter of time before the hospital grinded to a halt. And it did in September 2017, when the private managers promptly terminated the contract with the state government, allegedly without giving the latter the mandatory six-month notice.

Few weeks after the hospital closed shop, Governor Udom Emmanuel, at a Government House prayer meeting said the hospital’s operations were suspended as a result of failure of the managers to live up to the terms of agreement, adding that the managers also could not offset the cost or declare any profit despite the huge investment made by the state government.

Udom said: “If as a businessman I receive 50 per cent of the support we give to the person managing the specialist hospital, I will declare profit. It came to a point where I asked the manager, where is the money you are charging the patients, can’t it be used in payment of salaries in the hospital? “I took over the payment of the consultant’s salary and I paid the consultants from my imprest, I have the vouchers. I took an oath that I would not place my interest above that of the state. If people don’t know certain things let them ask questions and not to castigate the governor. I don’t play politics with the development of the people.”

In the wake of the shut down, the Commissioner for Health, Dominic Ukpong, admitted that there was a disagreement between the state government and Cardiocare Ltd., over the funding of the hospital, alleging that the administration of the hospital, has not satisfactorily delivered.After an initial $5m start-off fund the state government gave to Cardiocare Medical Services Ltd, Ukpong said the government (at the firm’s request) gave the outfit N250m for salaries payment, and a further N50 million, still on Cardiocare Ltd’s, request for the same purpose.

Last June, Akpabio intervened and mediated a meeting between the state government and Cardiocare Ltd, but the latter allegedly did not honour any of the agreements reached at the meeting, among which was that the company should present to the state government, a price-list of the services the hospital was rendering as people were complaining about the high cost of getting medical services there.

Ukpong had also alleged that after Cardiocare insisted that it was scaling down the hospital operation owing to lack of funds, it refused to present a proposal for the exercise to the government as agreed during the meeting. All that notwithstanding, the state government still released the sum of N180m to it after the meeting. This was to cover the cost of treatment of about 300 victims of a church collapse, repair of ambulance and tidying of the hospital’s premises. The private managers left not long after this last payment was made.

Another major issue that caused serious disaffection between the incumbent administration and Cardiocare Ltd is the allegation that the agreement between the state government and it (Cardiocare Ltd) was done clearly in favour of the latter, and even the ministry had no supervisory role in the entire arrangement.
Non-completion Of Work As A Disincentive

ONLY recently, the Nigerian Association of Nephrology (NAN) revealed that 25 million Nigerians (13.9 per cent of the 180 million people) have kidney failure- a condition where the kidney can no longer work without dialysis or transplant.

With 18, 000 people in the country needing dialysis yearly, and with only 149 dialysis centre in the country (both private and public) to serve 25 million Nigerians, there is big market for functional dialysis centres in the country.

But the dialysis section at the specialist hospital, which was running just about half of its total capacity, is still not yet in order because some key areas are still uncompleted, as contractors are yet to be paid all their money.This non-completion of vital sections of the hospital, perhaps, made Governor Emmanuel to say in June last year that the hospital was not well-equipped to produce optimum results.

As if being not being fully equipped to produce optimum results was not enough headache, a new vista opened in the troubled existence of the facility, when the state House of Assembly last week revealed that it has summoned Cardiocare Ltd to explain the alleged disappearance of key items from the hospital.According to Chairman of the house Committee on Finance and Appropriation, Dr. Usoro Akpauso, the committee’s position was prompted by the alleged vandalisation and inability of the outfit to explain to the state government, the whereabouts of about 93 items worth about half a billion naira.

Akpauso, who represents Esit Eket/Ibeno State Constituency, threatened that should the management of the outfit fail to appear before the committee for clarifications, its risks legal action.The lawmaker, who said that the committee was out to ascertain the items that were missing, ascertain their current worth and the best way to recover such items, added that the state would adopt every approach necessary to ensure that the team cooperates, so as to put the hospital to the use it was originally meant for.

Hospital Now A Ghost Town
SINCE September 2017, the provision of medical services at the hospital has been suspended, but the health commissioner says the state government never shut down the facility. He is also of the view that issues surrounding the hospital’s current state were being over-hyped.

Last week when The Guardian visited the place, it looked completely deserted with just a handful of security operatives and a few health personnel on ground to carry out skeletal services and maintain the equipment, but the environment is clean, and the lawns, well maintained.One of the few staff members on ground, who spoke on condition of anonymity, said: “We are just sitting down here doing nothing; nothing is really going on here at the moment, in spite of the fact that we have some of the best equipment in the world for healthcare. The people that were managing the place have gone away, and for now, we are just working to maintain the equipment on ground until government looks into our matter.”  

An Uyo-based businessman, Udeme Uta said, “It is unfortunate that we have this kind of facility wasting away when it is supposed to be generating a lot of revenue for the state. Why is it that nothing good works in Nigeria?“I appeal to the incumbent administration to step in and do something urgent to enable the hospital bounce back. Even though the poor among us cannot afford the cost of treatment there, but I believe rich people in the state and other parts of the country will come here instead of going to India and other countries, where they spend so much money. It will be a big shame if we allow this hospital to go the way of the Aluminum Smelting Company of Nigeria (ALSCON) in Ikot Abasi.”
A retired senior health officer in the state, Mr. Inyang Akpan said: “Even though constructing the hospital at the sum of N41b was very expensive, it is still good for us to have it working here, in view of the positive things it would attract to the state, including revenue. All you need to come to terms with is the number of Nigerians going to India daily for treatment of one ailment or the other, all in the name of medical tourism. We are losing a great deal of foreign exchange. If the human traffic changes in our favour, you will know that building the hospital was not a waste of resources.”
While expressing optimism that the facility would truly serve its purpose in the years to come, he pointed out that, “the only problem we will have with the hospital is poor management, just as we are seeing today. The government needs to step up and do something immediately. If well managed, money from the facility can be used to maintain other health facilities like primary healthcare centres in the state.”
Other members of the public are concerned that the facility has serious potentials for becoming a white elephant project, but Dr. Ukpong dispels such fears stressing, “we are working hard to ensure that the hospital regains its status. When it was given out, it was operating about 50 per cent level of what it was supposed to be. Right now we have interviewed a number of organisations, who are prepared to take it over and run it at international level, drawing people and patients who need care instead of going abroad. That is what we are doing, and right now, we have four consortiums and we are on the verge of selecting one. For now, we are running skeletal services, and the level that the hospital is operating is not what it is supposed to be operating now. Essentially, Governor Emmanuel is poised to change the face of healthcare in the state and that is what he is doing now”.

He insisted that the hospital was not shutdown as it still runs skeletal services, and on factors that may have been responsible for Cardiocare Ltd running into financial difficulties, the commissioner said, “I will suppose that the team that was selected to run the hospital did not have the required experience to do that. They encountered a lot of difficulties.  If you look at the content and potential of that hospital, you will know that if you give it to somebody who is capable, then there is no way that hospital could have run out of funds. The diagnostic section alone, the CT scan about the only one in Africa and one of the best in the world. So, people naturally will come from other parts of the country to do their CT scan at the hospital. There are lots of sophisticated equipment for the treatment of cancer and orthopedic issues and the rest, and each of those areas could sustain itself. If you could not do that, then you don’t have the required experience to manage such a facility.
“The people who handled it are, may be specialists in cardiac problems, that is different from hospital administration, but they saddled them with the administration of the facility and they did not run it well; they could not maintain it, and of course the place went down, and they withdrew. As soon as they withdrew, we took it over and commenced skeletal services and began to discuss with many other interested parties. Very soon we will announce the new managers.

On the allegation that the project was contract-driven, and not need-driven, he said, “the Akwa Ibom Specialist Hospital was established because up till now, Nigerians still go abroad for medical treatment because of poor facilities in the country. I have a lot of hope that it will do well because of the number of people that are still traveling out. Once that happens, the about $1 billion, which the country loses to medical tourism will be reversed.

Ukpong, who could not precisely say when the hospital would be able to commence operations again. He said: “The hospital will take-off within months; we are very close to it, and have already gone through the MoU and agreement contents. It’s just a matter of time before take-off, but skeletal services are going on.” For those insisting that it would have been better for the government to put in place state-of-the art primary healthcare facilities across the state, as against a specialist hospital, Ukpong said primary, secondary and tertiary health sectors were all very important in the lives of the people.

“Everywhere healthcare is paramount. We met a lot on ground when we came in, but they were in a terrible state. The state of primary healthcare services was very poor, facilities were poor, many of the staff were unpaid, and as a result that sector was abandoned.

“Right now, there are significant improvements that we are bringing to bear; we have been refurbishing hospitals, which were very dilapidated. Go to Etinan Hospital, Ituk Mbang General Hospital, as well as, the ones in Ikono, Eket, Oron and others in the senatorial districts, there is serious reconstruction going on there, where huge sums of money have been spent. We also have imported 100 containers of various medical equipment and 25 have already arrived, and we are equipping the hospitals as the equipment arrive.”

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