Both Margaret and Friday would not have faced life-threatening situations if the Akwa Ibami health post had been functional.
By Archibong Jeremiah
In the remote community of Akwa Ibami, located in the hills of Cross River State, the promise of healthcare feels like a distant hope for residents like Ntui Margaret and Friday James. They have faced life-threatening challenges due to the closure of their only health post. With limited access to medical services and the poor condition of the roads leading to the nearest healthcare facility, many individuals are left vulnerable.
On the morning of Sunday, January 5th, 2025, Ntui Margaret’s water broke, signalling that labour had begun three weeks early. Deep within the isolated hills of Akamkpa Local Government Area in Cross River State lies Akwa Ibami, her community.
This is Margaret’s first pregnancy, and she was filled with fear, not just because it was her first time but also due to the distance and the poor condition of the road to Uyangha Primary Healthcare Centre, where she had registered for antenatal care.
Recalling the event, she told TheInvestigator, “I was hoping to move to Uyangha town the following weekend because I knew our health post had no one working there, and I wanted to avoid the bad road. I was preparing to take my bath that morning to go to church when I noticed my water had broken. Quickly, my brother brought his bike, and the painful journey began. It feels like it was just yesterday.”
Further narrating her experience, she said, “The journey felt like it took two hours, but I was told it took us about an hour to arrive. The pain I felt during the ride was so real and severe. The road was muddy from heavy rain the night before. I prayed the entire time; we almost fell twice. Eventually, I delivered, though we were referred to the General Hospital the next day for proper care.”
Later in January, Friday James was working on his farm when he slipped and fell. That night, as he slept, he woke up in the morning with intense pain in his lower back. “I felt a sharp pain that prevented me from standing up at first. After several attempts, I managed to stand, but the pain wouldn’t allow me to stand straight,” he recounted.
To relieve the excruciating pain, Friday took four paracetamol tablets he had at home. “The pain eased a bit, but it didn’t last long. I live alone; my family is in Ikono, Akwa Ibom State, and I only farm here. The pain was so unbearable that I couldn’t sit, let alone ride my bike to Uyangha for treatment, since our health post was closed. I had no choice but to seek help from traditional bone setters here.”
According to him, “I had never used them before, but in that situation, even if someone offered to take me there, how could I sit on a bike when I couldn’t even sit in a chair? I had no option. After a week, I started to feel better, but I still went to the general hospital in Akamkpa town to ensure I was fine.”
Both Margaret and Friday would not have faced life-threatening situations if the Akwa Ibami health post had been functional. Unfortunately, late last year (2024), the only health worker managing the health post was transferred to another facility. Before the transfer, he had left for studies, and the facility was closed for about two months. In December, he returned only to pack his belongings and informed the community of his transfer. No staff member has come to replace him since then.
Side view of Akwa Ibami health post.
This routine transfer led to the closure of Akwa Ibami’s only health post, leaving thousands of residents without access to essential medical care.
In June of last year, during the “Optimised Maternal, Newborn, and Child Health Week Flag-Off in Cross River State,” Dr Vivien Mesembe Otu, the Director-General of the Cross River State Primary Healthcare Development Agency, highlighted several challenges facing the state regarding maternal and child health.
She reported that the maternal mortality ratio in Cross River stands at 1,200 deaths per 100,000 live births, which is significantly higher than the national average. Additionally, the state has concerning infant and under-five mortality rates, with 64 deaths per 1,000 live births for infants and 89 deaths per 1,000 live births for children under five.
State Of The Facility
During TheInvestigator’s visit to the community, the four-room apartment was found to be empty, with medical records, cooking pots and buckets scattered on the floor.
Medical records on the floor.
Goat faeces were present on the floor of the walkways and veranda, indicating that the goats sleep and spend time there. The roof of the apartment lacks a ceiling, and one room, which has no door or windows, is being used for wood storage.
The roof without ceiling and veranda filled with goat faeces.
The room used to store wood.
The facility is also deficient in water, sanitation, and hygiene (WASH) facilities, having no toilet, a makeshift outdoor bathroom, and no source of water.
The makeshift bathroom outdoors.
The Cry For Help
Honourable Patrick Orok Agbor, a former member of the House of Representatives for the Akamkpa/Biase constituency and a prince of the community, expressed his concerns when visited by TheInvestigator.
He stated that the health post is just one of many problems facing the community. “Although the facility is not in great shape and lacks medications, it was helping meet our needs. However, transferring staff without ensuring replacements for a community like ours is not acceptable.” He asserted.
Prince Agbor went on to list other challenges faced by Ekpri Ibami, stating, “We lack good roads. You saw how long and difficult the road is to the health post, which is located at the entrance of the village. Imagine the vast areas that remain uncovered. We need electricity, a health centre to support the health post, more schools, and, most importantly, a reliable water supply.”
Asuquo Princewill, a local farmer, said he is unhappy about their struggle to access health care. He said, “We cannot allow our community to suffer in silence any longer. This healthcare crisis affects us all—our mothers, our children, our brothers, and our sisters.”
He asked rhetorically, “How can we expect to bring new life into this world when our only health post is closed?” He called for urgent intervention from the authorities.
Veronica Asuquo, a mother of four, expressed her worries, saying, “Every day, I worry for my children. If they fall sick, how will I get them to the hospital? The government has forgotten us.”
When contacted by TheInvestigator, Mr Richard Inoyo, the Country Director of the Citizen Solutions Network, expressed alarm over what he termed “bureaucratic negligence”. He stated, “The situation is very, very sad. Oftentimes, when you look at situations like this, you start asking yourself if the government genuinely cares about governance or if it is only focused on how much money those in power can accumulate.”
Inoyo continued, “This issue is not just about the removal of the paramedical staff in charge of the health post and the government’s failure to replace that individual. It also highlights the poor state of infrastructure in this community.”
He further expressed concern for the community’s health, saying, “If this condition continues, it could result in the death of a pregnant woman. This means that people are unable to receive the necessary treatments in a timely manner.”
Commenting on the distance to the nearest Primary Health Center in Uyangha, Inoyo remarked, “The distance from the community to town underscores the reality we face: the government portrays itself as one that cares, but in rural areas like Cross River, where the majority of the population lives, there is virtually no government presence.”
Inoya criticised the government, asserting, “You don’t see the government providing the real essence of democratic dividends. This reflects just how dire our situation is. When some of us speak out about these issues, we are accused of trying to incite the public.”
He called for collective action, stating, “It is time to share this revelation with all Cross Riverians so they understand that the government needs to do more. As stakeholders, it is our responsibility to hold the government accountable to take the necessary actions. This situation is very sad and must be condemned.”
Dr Vivien Mesembe Otu Promises Staffing Solutions For Uyangha Facility
The Director-General of the Cross River State Primary Healthcare Development Agency, Dr Vivien Mesembe Otu, spoke briefly with TheInvestigator and promised to ensure a staff resume in Akwa Ibami.
The Director-General of the Cross River State Primary Healthcare Development Agency, Dr Vivien Mesembe Otu.
“For the facility in Uyangha where the person was retired or transferred, we will get the Director in Akamkpa to address it. One or two staff will be sent there to man the place.” She promised.
Dr Vivien concluded by asking TheInvestigatorto send her the details of the facility “so that it can be addressed”.
This story was produced for the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science.
