ON May 30, The ICIR wrote to the Office of the Accountant-General of the Federation to request details of money released to support the Federal Teaching Hospitals in the country as part of COVID-19 interventions during the pandemic.
The move was to establish the exact sum earmarked for each teaching hospital in the country and if the money was used for its purpose and in alignment with the Public Procurement Act (2007).
The procurement guideline was put together by the Federal Government to prevent corruption in contract awards following a world bank assessment report that the country was losing an average of $10 billion annually due to contract inflations and other procurement illegalities.
Earlier findings by The ICIR showed some agencies of government embarked on fraudulent COVID-19-related procurements during the pandemic, flouting the procurement law.
The case of the Nigerian Centre for Disease Control (NCDC) awarding N202 million contracts without a procurement plan was among the infractions reported here. Another contract reportedly offered to a non-existent company was exposed. N853 million flawed contract at the Jos University Teaching Hospital was made public here, and another N244.6 million was exposed here.
Nevertheless, the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) is not left out because the management has not been transparent in their public spending.
It provided little or no information on its awarded contracts, as found via the National Open Contracting Portal (NOCOPO) platform created by the Bureau of Public Procurement (BPP) to showcase details of awarded contracts during the pandemic.
A check on the BPP’s NOCOPO shows that only four contracts were awarded and executed by OAUTHC, but this was contrary to The ICIR findings.
The four listed contract awards include the supply of AVL 9180 electrolyte analyser awarded at N1.2 million; the procurement of hand sanitisers offered to Nickteck Medical Nigeria Limited for N1.17 million; the procurement of hospital mattresses for the isolation wards awarded to Mogbonju Nigeria limited at N350, 000 and the fourth is for molecular laboratory equipment.
Public records revealed that all the above contracts were funded through the hospital’s Internally Generated Revenue (IGR), except for the fourth project, molecular laboratory equipment solely sourced from the COVID-19 intervention. It was awarded to JNCI Turnkey Medical Equipment Services at N21.16 million.
The institution has another construction of the molecular laboratory (pictured below) awarded to Rot-Kay and Associates Limited, which never made it to the BPP portal. This is a violation of the BPP guidelines, which mandate all Ministries, Departments and Agencies (MDAs) of government to upload their procurement plan on NOCOPO. Thus, establishing the contract sum and other details surrounding the awarded job was difficult.
“All Procuring Entities are to prepare Procurement Plans for all projects that
specifically respond to the COVID-19 pandemic. These Plans should be uploaded into the Nigeria Open Contracting Portal (NOCOPO), where it will be accessed by the BPP,” it reads.
Plethora of findings
As part of the investigation process, on Tuesday, April 19, The ICIR wrote to the OAUTHC. The letter was to inform the hospital of the reporter’s planned visit to verify all projects awarded during the pandemic.
The letter was acknowledged the same day with a promise to revert, but they never did.
Ten days after, on Friday, April 29, The ICIR sent a reminder. Still no feedback. Thus, on Wednesday, May 4, the reporter sets out on the investigation.
Findings would later reveal the OAUTHC received funds to execute over four other projects but failed to make public the procurements.
Efforts to get the Acting Chief Medical Director, Owojuyigbe Afolabi, a medical doctor, speak on the fund’s disbursements and its utilisation failed.
Meanwhile, on Wednesday, May 4, he earlier agreed to comment on the awarded contracts but rescheduled the appointment for the next day, May 5.
Before 10 a.m. on the appointment day, the reporter was already seated waiting. He sighted this reporter but later decided not to grant the request. He said he had no authority to speak on the projects and the allocated sums.
This was despite earlier notice, calls and an eventual visit to the hospital.
Regardless, the reporter sighted a newly constructed molecular laboratory and an isolation ward for infectious disease. It was awarded to Rot-Kay and Associates Limited, but the project cost remained unknown as the hospital did not provide it in accordance with the procurement act.
OAUTHC received N3.07 billion in three years
In the course of this finding, The ICIR can confirm the OAUTHC received N3.07 billion in capital allocations and supports from the COVID-19 fund from 2020 to July 2022.
Documents from the OAGF, with reference number FD/OAGF/DDE/184/T/I/DF signed by the Director of Funds, Sabo Mohammed, at the Treasury House in the Ministry of Finance, show that the the teaching hospital got more money than it disclosed.
A breakdown of the releases to the hospital showed N345,848,653.92 (N345.8 million) released solely to procure molecular laboratory equipment. But the publicly disclosed sum for this particular item on the BPP portal was N21.16 million. This showed a huge gap between what was released and what was publicly disclosed.
The hospital got another N224,493,482.50 (N224 million) from the national treasury to equip the 10-bedded ICU.
The hospital also got N100 million to equip the COVID-19 isolation treatment centre.
Furthermore, N149,750,000.30 (N149.7 million) was also released from the Office of the Accountant-General to procure Personal Protective Equipment (PPEs).
In addition, the OAUTHC also got N129,141,132.00 (N129 million) to install oxygen plants and an extra N129,141,132.00 (N129 million) for the ICU.
The entire amount released from the COVID-Fund, thus, was about N1.07 billion.
Meanwhile, beyond the above financial unveilings, the hospital also received money from the capital budget allocations from 2020 to 2022 (July 1).
During the outbreak in 2020, the OAUTHC got over N1.01 billion as extra funding from the approved budget for the year.
The hospital got N673,391,684 from the N796.78 million approved allocation in 2021.
Also, findings revealed that OAUTHC, as of July 1, has gotten N299,780,090.
However, what was shown to the general public through the BPP is N23, 887,140.18.
Rots, anomalies in the hospital
Management of the OAUTHC denied The ICIR access to inspect the supposed procured COVID-19 projects, but this reporter went around in search of possibly executed projects. Old structures majorly littered the facility.
From the administrative building to the generator house, the cafeteria, laundry, the general outpatient wards, the renal ward, and the surgical outpatient department, to mention but a few, there was no serious sign of development.
Rather than renovating the existing buildings, it has instead been expanding. The hospital’s structure is currently in four phases of development yet densely populated with abandoned buildings.
For instance, a walk into the surgical outpatient department tells nothing but rots, equipment of primitive quality, poor management and neglect. The only two rickety ambulances are also ill-equipped.
The feelings among most health workers, hence, were that of detestation for the health system. It is the same for the patients and even their relatives due to the archaic operational system. Medical students who virtually see these realities daily could not but express their disappointments.
“Yes, they have very experienced doctors, but the hospital is not well managed,” said a male student doctor found behind the Accident and Emergency Unit. He could not provide his identity due to the fear of being victimised.
“You could see it yourself.”
“What is more worrisome is that the good hands are also leaving,” he added and walked away as he pleaded for anonymity.
“With how things unfold, practising here might be a challenge. I cannot wait to finish my programme and leave; said another male student doctor whose mother currently works at a government hospital in another state.
For instance, the laboratory to the pharmacy is like two continents apart. Patients would often walk miles within the large hospital to conduct tests before returning to the patient wards to present test results to the doctor. So, also the payment points and pharmacy.
It was gathered that most surgeries occur at midnight, and because the in-house pharmacy lacked adequate drugs, relatives of patients would often go out at odd hours, like 2 a.m., to procure drugs outside the facility.
President of the Association of Resident Doctors (ARD) in the hospital, Fayowole Olabanji, however, identified the need to improve the hospital’s administration and management.
He was emphatic that infrastructural development, staff welfare and right procurements of needed equipment in the hospital should be made of utmost priority. “Few little comforts drive people (health workers) to leave.”
“That is why you see nurses are angry at patients out of frustration,” he told The ICIR.
The comrade cited an instance of how a young doctor who was assisting him during a surgical procedure suddenly collapsed. “…he said he was feeling light and suddenly fell. But for quick intervention, he would have hit his head.”
“No fan or air conditioner in the consulting rooms. The basic things that ought to be in the emergency unit are not there.”
Other medical officials who spoke anonymously complained about a series of anomalies in the hospital and mismanagement.
“Just to pay money, you will see a long queue, and you might need to pay more to still get little,” one of the sources said. “The system is failing and is not self-sustaining.”
The ICIR can confidently report that the hospital is still being run, similar to the primordial days when files were physically moved around before patients got to see a doctor. Internal Taxi drivers have, however, latched on to the poor physical structuring of the hospital complex to earn a living. For instance, relatives of a patient might need to take a taxi from the Accident and Emergency Unit to the Pharmacy or Laboratory to get the required service.
This implies a patient might take more than a trip along the stretch, as the case may be, just to get medical services.
One of the taxi-men, who plies Obafemi Awolowo University (OAU) to the teaching hospital, claimed preferential treatments are given to patients at the private suites. “You will see student doctors taking care of patients in the general ward, but it is not the same at the private suite.”
Low workforce, increasing patients.
Radiation Oncology is a new department set up under Oncology Department at the OAUTHC. Experts in the new unit have been trained in the use of radiation to kill cancer cells. Basically, to treat cancer.
Cancer, no doubt, is a significant killer not just in Nigeria but globally. It kills more than 10 million people worldwide. But the practice of using radiation to treat cancer is called radiotherapy. It is considered an essential part of different approaches used for cancer treatments.
Experts believe it is quite expensive to train in this specialisation. According to Runcie Chidebe, the executive director of Project Pink Blue, a Non-Governmental Organisation (NGO) that specialises in cancer prevention awareness, “it costs between 200, 000 and 272, 000 euros to educate a radiation oncologist.”
For regular Cancer Doctors recognised as clinical oncologists, it would cost between 100 000 and 136 000 euros to acquire the requisite training.
This implied cancer could be treated through drugs, surgical procedures and the use of radiation. One of the advanced radiation technologies used in this case is the Linear Accelerator machine which replaces the Cobolt 60.
But at the OAUTHC, findings revealed the hospital has a single Radiation Oncologist Consultant.
“Imagine just one consultant managing almost 500 patients,” an expert from the department told The ICIR during the visit. “Just today, he got three referrals from Owo, Ido, and another hospital.”
“The brain and expertise are here in Ife (OAUTHC), but there are no tools or machines to care for patients.”
This reporter saw patients sitting on the floor receiving drips. It would be wrong to capture pictures of these patients due to the issue of confidentiality. A man who appeared to be a traditional ruler was among the few who sat on a white plastic chair with a drip stand beside him at the outpatient department.
Efforts to get Federal Ministry of Health officials to speak to the findings failed.
Deputy Director, Media and Public Relations at the ministry A. A Chindaya advised this reporter to rather attend the bi-monthly meeting organised by the ministry, meant to address COVID-19-related issues.
But the meeting has been repeatedly postponed. The last notice of meeting sent out on June 15 for the July 18 media briefing was again postponed to July 25. That was on July 17. Reminders were sent. Still, the meeting did not hold.
Experts have advised the federal government to give the sector the attention it deserves to prevent brain drain and total collapse of the sector.