Ibom Multispecialty Hospital: Dashed hope?
by ANIEFIOK UDONQUAK,
October 15, 2017 | 10:00 am| | | Start Conversation
What would make a health facility which gulped about N30 billion of public funds to establish, and several hundreds of millions of naira to run, suddenly close shop barely two years after it started operation?
As different shades of answers to the above question continue to emerge, one obvious fact remains that the Ibom Multispecialty Hospital in Uyo, Akwa Ibom State, which was shut down recently, failed because those who conceived and executed the project did not properly plan for its sustainability in the long term.
Going by what Dominic Ukpong, Akwa Ibom State commissioner for health, told BDSUNDAY, the burden of financing the hospital remained with the state government two years after it opened its doors to the public. This includes payment of salaries as well as other basic needs like clearing of the lawns, repair of equipment, and buying of diesel for the hospital generators.
It was gathered that while the Akwa Ibom State government practically funded the day-to-day running of the hospital, the operators of the facility did not make any “appreciable returns on the huge investment made by the state government”.
Moreover, most of the specialists whose services were engaged at the hospital were expatriates who were paid in foreign currencies.
When the price of oil, Nigeria’s major revenue earner, was high, it could be managed. But in the face of the country’s economic challenges, some observers had questioned the rationale behind such an arrangement when Nigerians who are equally qualified and are also occupying top positions in renowned medical facilities abroad could be brought in to reduce the running cost, but the defence had been that the strategy was for expatriates to start the process and transfer to Nigerians in the near future.
Conceived and executed by the Godswill Akpabio administration in the state, the Ibom Multispecialty Hospital was intended to serve not as an ordinary hospital but as a reference centre where cases too difficult for teaching hospitals and other health facilities would be referred to. As such, it was supposed to check the perennial medical tourism in Nigeria and by extension plug the huge foreign exchange losses that result therefrom.
The 308-bed ultra-modern international specialist hospital with six fully-integrated modular theatres is equipped with 640 slides CT scan, digital mammography, endoscopy surgery, highly sophisticated intensive care units and medical gas plants and is built to run on paperless and fully-automated laboratories. It also has a helipad to facilitate easy emergency movements to and from the hospital and the entire hospital system is hooked up to a global system for best practice.
The hospital has a housing estate for mostly the expatriate staff as well as a special transport scheme to convey the workers to and from the hospital.
After it was completed, the medical facility, said to have cost Akwa Ibom State about N30 billion to establish, was handed over to Cardiocare Medical Services Limited to run under agreed terms based on a Memorandum of Understanding signed between the state government and Cardiocare, though the terms of the agreement are not public knowledge.
A tall order
At the opening of the hospital in May 2015, shortly before he left office as governor, Akpabio had said, “We lose billions of dollars every year to medical trips abroad. We have also lost a lot of people, not because we don’t have the expertise in the country. We needed a hospital that can run at international standard. I decided to build general hospitals in local governments that did not have and in areas that are very populated, even if the local government already had one.
“I found out that what we have here can go for a teaching hospital. 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. It is not like a teaching hospital, it is like a quaternary hospital, it is higher than a teaching hospital.”
In a chat with BDSUNDAY earlier this year, Adeyemi Johnson, the then chief medical director, concurred with Akpabio, saying the hospital had all it took to stem the tide of medical tourism.
“Anybody going abroad is doing so because he or she wants to go abroad, not because of medical care. People from other countries do come here for medical care. We are getting ready to start the open heart surgery,” Johnson said.
But many sceptics had said it was a pipedream given wealthy Nigerians’ legendary preference for foreign hospitals. Now, BDSUNDAY gathers that the hospital has struggled for survival from inception because it did not enjoy much patronage from people within and outside Akwa Ibom.
Recall that when Akpabio himself, who conceived the idea and committed a huge chunk of the state’s money into the project, was involved in an auto-crash in 2015, shortly after he left office and was elected into the Nigerian Senate, he had jetted out of the country to seek medical attention.
It also alleged that even Governor Udom Emmanuel never personally used or promoted the hospital in order to encourage local patronage.
The biggest setback is that even the country’s number one citizen, President Muhammadu Buhari, spent a total of 154 days in London this year attending to his medical needs while the Ibom Multispecialty Hospital lay fallow.
If the rich and powerful shunned the hospital, where then would the patronage come from? This is even as the indigenes of the state had been complaining that the hospital’s bill was “beyond their reach”.
A retiree who spoke with BDSUNDAY in Uyo on condition of anonymity earlier in the year had said he could not afford medical treatment in the hospital because “it is for some class of people; it is for the super-rich”.
Etim Daniel, a 56-year-old civil servant in the state who also successfully underwent a brain surgery at the hospital, had said he was billed N1,533,011.
“The cost is much but life is more than money. When I was given the initial estimate, it was frightening,” Daniel had said.
But even then, Johnson had cleared the air on the impression that the facility was built for the moneybags, insisting that it was not out to make profit and that majority of the patients were not rich. He, however, explained that bills must be charged in order to keep the dream alive.
“I can safely say that majority of our patients are not rich. Our costs are not subsidised by anybody so we cannot make it free because we have to cover our costs, but we are not a profit organisation. The hospital is not here to make profit but it has to be able to meet its cost. It is not free but the prices are reasonable,” he said in March.
Johnson had also debunked the rumours making the rounds then that the hospital had been closed, saying, “At this point we are able to meet our expenses. The recession is hitting everybody, but we have made some adjustments, we are back on track. All the rumours that the hospital has been closed are not true. We ran into the same turbulence like everybody has run into in the recession, but we have adjusted and we are back on track.”
Seven months later, the long-rumoured closure of the hospital came to be a reality, with the state government saying the hospital was a huge drain on its finances and that the MoU the previous administration signed with Cardiocare Medical Services was no longer operable.
When BDSUNDAY visited the hospital located along Ikot Ekpene road, off Itam Junction in Uyo, the security guards at the gate confirmed that the hospital has been shut since early September.
“All the doctors and nurses have left. There are no workers again,” one of them said, adding that nobody knew when the hospital would reopen.
A huge burden
“We have given them N250 million before, we gave them N50 million after, and we gave them N30 million repeatedly. At the same time, we were the ones providing diesel in their quarters. A lot of things were supplied to them,” Health Commissioner Ukpong told BDSUNDAY in an interview.
He said during the Reigners Bible Church building collapse of December 10, 2016, in which many died and scores of others sustained various degrees of injuries requiring emergency attention, Ibom Multispecialty Hospital came to the rescue and acquitted itself well.
However, at the end, the hospital had sent an astronomical bill to the state government. In addition to the bill of N150 million, there was a request for an additional N28 million to repair a faulty hospital equipment, and another N2 million to mow the grass in the hospital premises. The government, therefore, paid a total of N180 million to the hospital management, Ukpong said.
At a meeting attended by the former governor and others, Ukpong said they had agreed with Cardiocare Medical Services that there should be a new Memorandum of Understanding on how to run the place “because the former MoU was not possible to implement based on the economic recession in the country”.
“By the time that MoU was written, oil prices were good, everything was running fine, it was a dollar-based discussion at that time. They complained that they could not meet some of their responsibilities because of the economic situation. That was not the responsibility of government. Normally, we should not even bother. They should go ahead and run the place; government had addressed a lot of those issues for them,” he said.
A hope dashed?
So much hope was reposed on Ibom Multispecialty Hospital, with the then CMD Johnson projecting it would be the best hospital in Africa in a few years’ time.
“This is the best equipped hospital in Nigeria in terms of latest technology and equipment. We have got all the hi-tech equipment that we require. The most advanced scanning machines are here, advanced MRI, mammogram, we are not short of equipment. We have the best radiology facilities in the country,” Johnson had said.
The hospital boasted of doctors in multiple specialist areas including neurosurgery, cardiology, oncology, internal medicine, general surgery, orthopaedics, gynaecology, and so on.
An expert in health sciences who spoke on condition of anonymity had told BDSUNDAY that “with the best facilities for radiology in the country and on the verge of being the first health facility in the country to commence non-surgical removal of fibroid, the Ibom Multispecialty Hospital is in a class of its own in terms of specialised healthcare”.
All those hopes invested may have been dashed following the closure. Ukpong said Cardiocare Medical Services had arbitrarily shut down the hospital after it had planned to scale down its services at a time the state government had asked for a new MoU on the how the hospital was to be run since, according to him, the old MoU was not workable.
To be fair, in its two years of operation, the hospital recorded many feats, including about 40 to 45 successful neurosurgeries. One celebrated case was that of a two-year-old child whose head was shattered in the tragic church building collapse of December 10, 2016. The child, according to a doctor in the hospital at the time, was brought in a very critical condition and a major emergency surgery had to be done during which the “brain of the child had to be put back as his skull was shattered and the brain was sticking out”.
Opinion is divided on the how best to run such a high profile medical facility in a country where the budget for the health sector falls far below the World Health Organisation (WHO) standard and to ensure that its services are readily accessible to many Nigerians.
Charles Obot, a senior lecturer in the Department of Communication Arts, University of Uyo, said the problem of the hospital had nothing to do with lack of patronage, adding that any facility that is established to reduce pressure on existing ones should be seen as a good idea.
“It was a good idea in the first place to establish the Ibom Multispecialty Hospital, but the state government should revisit the management model to make the hospital operations sustainable. Government should take a second look at the cost of service delivery,” said Obot.
“Honestly, I don’t think the hospital would have a problem of patronage. People are dying because they don’t have options to have expert care,” he said.
Some have called for a thorough investigation into the operations of the hospital to ascertain what went wrong and who did what. Others have, however, alleged that the hospital might have been a conduit pipe for embezzling public funds as government spent huge amount of money monthly on it without any commensurate returns.
Speaking on condition of anonymity, a highly informed source maintained that shutting down the hospital would enable the state government carry out a review of the terms of the contract to ensure that it is run as a profitable venture, adding that the way and manner the hospital was run, it was clear that it was not going to be sustainable.
“Any form of agreement after huge investment has been made, it is up to the parties to take a second look at the profitability of the business venture. In this case, the agreement did not yield any dividend,” the source said.
“There is not much the state government can do under the present economic situation. It cannot continue to foot the bills of the hospital endlessly without the facility making any profit. The closure will help the government to renegotiate a new term of contract with new operators,” the source added.
And a glimmer
There is a ray of hope as Ukpong says the closure will be temporary.
“That hospital is a very big asset not only to Akwa Ibom State but to the people of this country; the minister of health said so when he visited the place. We cannot let it go waste. What we have decided is to get investors to look at it,” he says.
Efforts to get the response of Kofo Ogunyankin, chief executive officer, Cardiocare Medical Services, were not successful as he did not answer calls to his phone and did not respond to an SMS sent to his mobile phone.
ANIEFIOK UDONQUAK, Uyo
(Additional reporting by CHUKS OLUIGBO)
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