SPECIAL REPORT: Dying for Care: How Neglected Clinics Leave FCT Villagers Helpless

SPECIAL REPORT: Dying for Care: How Neglected Clinics Leave FCT Villagers Helpless

By Kabir Abdulsalam

At the edge of Gombe village in Kuje Area Council, a goat bleats near the crumbling walls of what used to be the community’s beacon of hope, the Primary Health Care Centre.

The signboard is rusted, barely visible, and a large termite mound has claimed one of the windows. Inside, cobwebs hang like curtains from the rafters, and the smell of damp cement and mold makes breathing difficult.

“This place used to save lives,” says 55-year-old Sarki Fada, Dambayi Gomo, the Village head, as he puts it, “this building collapsed during a heavy rain over a year ago. There’s no one else left.” He walks us into the ward, a dark, empty room without a bed, with no roof. “Now, the villagers are trying to rebuild  it.” 

Gombe PHC once served over 1,000 residents, but today, it barely has a pulse. We have a health worker who was assigned to this PHC, but since the building has collapsed, he only visits once in a while, citing insecurity and lack of distance to his residents’ village. 

During the visit by this reporter, a woman from a nearby village arrived holding her two-year-old son, who was burning with fever. She found no help. “They said someone might come on Monday,” she told us, eyes red with desperation. “It’s Thursday.”

A journey to Gombe PHC is arduous due to the bad road, which can jeopardize pregnancies and complicate patients’ conditions. To reach this healthcare facility, the reporter, fixer, and motorcyclist encountered serious challenges crossing hills, nearly falling from the motorcycle five times on sandy roads, and amidst large stones before reaching the healthcare center.

It took this reporter three days to recover from the body pains he experienced while traversing the road.

No Water, No Light, No Life

Just like Gombe PHC, clinics in places like Ebagi and Nanda also operate in near-ruins. At Enagi PHC, the delivery bed is propped up with bricks, and the borehole water is shared with goats and chickens. The only source of light is a flickering torchlight that health workers bring from home.

At Kulo Primary Health Centre, also located in Kuje Area Council, the scene we encountered was one that could easily pass for a family tragedy only it is a daily reality here. Inside the dimly lit emergency room, a middle-aged man lay unconscious on a worn-out stretcher. His relatives hovered anxiously around him, fanning him with pieces of cardboard, sweat trickling down their faces as the heat suffocated the poorly ventilated room. 

The man had collapsed due to severe respiratory distress, but there was no functional oxygen cylinder to save him.

“The only oxygen tank we had rusted through years ago. We’ve sent requests over and over. Nothing has come,” a visibly exhausted health worker said. Her voice cracked with a mix of frustration and helplessness. “We improvise. We pray. Sometimes, that’s all we can do.”

Once considered a model rural clinic, Kulo PHC was built with solid infrastructure and equipped with solar panels during a 2019 federal initiative aimed at strengthening primary care in hard-to-reach areas. Today, that promise lies in ruins. 

The solar panels are now dysfunctional—some stolen, others damaged by harsh weather and lack of maintenance. At night, the clinic plunges into darkness, leaving staff to work by torchlight or cell phones with dying batteries.

Inside, the ceiling shows signs of water damage, and large cracks stretch along the walls like scars of prolonged abandonment. The overhead water tank behind the facility, meant to supply clean water for patient care and sanitation, is dry. For water, staff and patients alike fetch buckets from a nearby stream, or far away in village borehole exposing them to additional health risks.

The clinic sits on a wide expanse of land enclosed by a perimeter fence that has since lost its purpose. Once intended to provide security and maintain hygiene, the compound has now been converted into farmland. Cassava leaves sprout where ambulance vehicles should be parked, and the front of the building is overrun with plantains.

“This place used to look like a health centre. Now it looks like someone’s backyard farm,” a community elder remarked as he guided us through the once-proud compound.

The staff quarters intended to accommodate healthcare personnel on duty have also deteriorated beyond use. The rooms are damp, filled with broken furniture, and infested with rodents. No one lives there anymore.

 “We only have one permanent staff member here,” said Victor, a young volunteer from the village who now plays the role of both administrator and assistant. Clad in faded scrubs, he helps monitor patients and assist visiting in-charge whenever they come. 

“We don’t keep patients here for long,” Victor admitted. “The conditions are too poor. Most people prefer to stay home even when they’re sick because at least home is clean and dry.”

The Staff Shortage Crisis

Across Kuje and Abaji area councils, staff shortages are acute. Several clinics are manned by one or two health extension workers who double as janitors, security, and emergency responders. In Enagi, we met 38-year-old Bala Jatau, a community volunteer who teaches during the week and takes shifts at the clinic on weekends.

“I was trained in first aid by an NGO three years ago,” he said. “Now people treat me like a doctor. I know I’m not. But if I say no, someone might die.”

These ‘clinics’ have turned into symbolic structures—mere evidence of a system that once worked but now bleeds from every corner.

A Population Left Behind

In the remote communities of Mawogi and Rimba, both under the Abaji Area Council of the Federal Capital Territory (FCT), Nigeria’s promise of equitable healthcare rings hollow.

 

Here, the primary health centres (PHCs), designed to serve as the first line of medical access, are barely functional and grossly under-equipped. We uncovered a disturbing pattern: villagers are forced to rely on self-medication, traditional remedies, or undertake treacherous journeys to already overstretched general hospitals in Abaji town or beyond.

With no ambulances, no motorcycles, and not even the most basic transport support from the area council, the sick are ferried in wheelbarrows, bicycles, or, in the most severe cases, not at all. The roads leading to these villages are rugged, mostly untarred, and, during the rainy season, virtually impassable.

“Last year, I lost my cousin during labour,” said Sani Yusuf in Mawogi. “We tried to take her to Abaji town. The road was bad. The baby died first. She bled out halfway.”

But the issue runs deeper than emergency cases. The PHC in Mawogi, according to the head of the facility, primarily serves hard-to-reach communities.

 “During our outreach, we suffered a lot to get children immunized because of the terrain,” he said. “Some of the villages we are meant to cover under our catchment area are completely cut off. No motorcycle, no fuel support, nothing.”

These inaccessible settlements, scattered across forests, hills, and narrow bush paths, present a logistical nightmare. Community health workers are unable to deliver essential vaccines, and the ripple effect of this neglect is profound.

Globally, the cost of missed immunization is staggering. According to the World Health Organization (WHO), failure to immunize children can lead to outbreaks of vaccine-preventable diseases, putting entire populations at risk. 

The WHO warns that every year, approximately 1.5 million deaths could be prevented if global immunization coverage improves. In areas like Mawogi and Rimba, the consequences are already being felt; measles, tetanus, and other preventable diseases still claim lives.

The health challenges of these villagers are further exacerbated by poverty. The absence of nearby functional health facilities means people often forgo care entirely. Many cannot afford the transportation costs to reach distant hospitals. Women in labour, children with fever, and accident victims face one grim reality: either survive the journey or die trying.

While on assignment, a local volunteer who had been assisting me across the area councils told me of yet another community in even more desperate condition. 

“There’s a place far, far, far away,” he said. “From Abaji, you cannot access it directly. You have to pass through Suleja-Lambata-Lapai Road to even think of reaching it.”

That village is part of Gawu ward, where the Gaskpard PHC is located. According to residents, it takes multiple hours, sometimes a full day on foot to reach the facility, and in the absence of proper support from the local council, health workers and supervisors rarely attempt it.

The PHC is largely abandoned, visited only a few times a month, and almost always without the resources needed to make a difference.

The state of primary healthcare in the FCT’s outskirts is a glaring indictment of misplaced priorities. 

While Abuja’s city centre gleams with modern infrastructure, especially under the current Minister, Nwson Wike, who prioritized this, its the surrounding rural communities are left to wrestle with neglect, particularly on human development. A population left behind—not just by development, but by the very system meant to protect its health.

Toxic Waste, Sick Children

Another distressing layer of tragedy in Nigeria’s overstretched healthcare system is the alarming mismanagement of medical waste, particularly in rural and semi-urban communities. 

In the Abaji New Township Clinic, what should be hazardous waste, such as used syringes, contaminated gloves, expired medications, and blood-stained bandages, is often or dumped carelessly burned in open pits in makeshift spaces behind clinic walls.

 

There is no incinerator, no protective gear, and certainly no adherence to medical waste disposal protocols.

“The council used to send staff to collect the waste,” one of thel clinic workers revealed. “But for the past six months, we haven’t been able to find anyone to do the job. So, we resorted to open burning. We are very close to residential areas and people have complained a lot. Sometimes, the waste doesn’t even burn completely.”

This crude method of disposal is not just unsightly, it is outright dangerous. The fumes from burning medical waste release toxic pollutants such as dioxins, furans, and heavy metals into the atmosphere. 

These substances are scientifically proven to cause cancer, disrupt the endocrine system, damage the immune system, and impair reproductive health. 

The World Health Organization (WHO) explicitly warns that “the open burning and incineration of healthcare waste without adequate controls can result in the release of toxic pollutants into the air.”

The environmental impact is equally catastrophic. Ash and partially burned residues from these fires often get washed into nearby water sources during rains, contaminating drinking water and threatening aquatic life. Children playing near these waste sites are frequently exposed to sharp needles or infectious materials, increasing their risk of contracting hepatitis, HIV, and bacterial infections.

Moreover, the proximity of these clinics to residential zones compounds the danger. Entire communities are involuntarily breathing in poisonous smoke, and there is no systematic education or warning provided to the public. It’s a silent epidemic one that doesn’t make headlines, but shortens lives and cripples communities.

“Improper disposal of healthcare waste poses serious health risks to both the public and the environment, especially in low-resource settings,” the United Nations Environment Programme (UNEP) affirms.

Unfortunately, the lack of proper waste management systems, funding, and trained personnel has turned clinics like the one in Abaji into breeding grounds for both disease and environmental degradation.

If the current trend continues, the cost of this environmental pollution will far exceed any immediate savings made by avoiding proper disposal techniques. It will reflect in higher disease burdens, loss of productivity, and irreversible damage to Nigeria’s already fragile ecosystem.

Urgent investment is required, not only in infrastructure such as incinerators and secure waste transport, but also in the training of healthcare workers and waste handlers. 

Public awareness campaigns are necessary to educate communities on the dangers of improper disposal, while holding local and national governments accountable for negligence.

As the WHO also notes, “Safe management of healthcare waste is a fundamental step towards universal health coverage, as it ensures patient and worker safety, while protecting the environment.” Anything short of this is a failure to protect both human health and our shared environment.

The Government’s Deaf Ears

When reached for comment, officials at the Abaji Local Health Department declined to speak on record. However, one senior staffer, speaking anonymously, admitted: “We don’t have the manpower, and funding is a big problem. PHCs aren’t political priorities.”

 In early March 2025, the House of Representatives Committee on Federal Capital Territory (FCT) Area Council and Ancillary Services expressed dissatisfaction with the 2023 budget performance of the Department of Primary Healthcare at the FCT Area Council Service Secretariat. 

During their oversight visits, committee members lamented the poor execution of projects and the underfunding of critical healthcare interventions meant for rural communities like those in Abaji.

Unfortunately, this neglect is not a sudden development. On February 16, 2025, at  an earlier visit by this reporter to several facilities in Abaji Area Council, it was discovered that health workers were on strike. 

Many residents seeking care were left stranded, groaning in frustration. At that time, union officials cited unpaid hazard allowances, poor working conditions, and the government’s failure to meet agreements on wage adjustments as reasons for the industrial action.

In a tragic reflection of systemic inertia, by the time this report was being finalized on April 27, 2025, health workers had again embarked on another round of strikes — this time over the government’s failure to fully implement the new national minimum wage. 

This new strike comes after an earlier one that began in November 2024, was temporarily suspended in December 2024 following promises of resolution, but was reignited when those promises were broken.

The ripple effects of these repeated strikes are devastating. 

Without consistent access to healthcare, routine immunizations are missed, pregnant women are left unattended, and minor ailments become life-threatening.

Contextually, in Nigeria’s governance framework, local government areas (LGAs) are primarily responsible for the provision and management of Primary Health Care (PHC) services, including Primary General Clinics (PGCs) and outreach programs.

While the Federal and State governments contribute through policy frameworks, grants, and large-scale health campaigns, the responsibility for day-to-day operations and maintenance of PHCs rests largely on the shoulders of local councils.

However, local governments across Nigeria  and especially in FCT area councils like Abaji often face acute challenges, underfunded. According to a 2022 report by the Nigerian Governors’ Forum (NGF), only about 15% of PHCs in Nigeria are fully functional, and financial mismanagement at the local level is a key driver.

What Experts Say

Health policy analyst Mrs. Monsurat Abdullah  described the situation as a “public health ticking time bomb.” She said, “What’s happening in Abuja’s rural communities is state abandonment. 

These are not isolated clinics failing. This is a system collapse. Children are dying, women are suffering, and the ripple effect will hit the city soon.” She added that poor waste management and decaying clinics pose not only local threats but national ones: “We’re one epidemic away from a disaster if this continues.”

Dr. Kabiru Abubakar, a public health expert and consultant with an international NGO operating in Nigeria’s North-Central region, paints a bleak picture. “When primary health care fails, everything else collapses,” he said. “The essence of PHCs is to bring essential services to the people — maternal care, child immunization, malaria treatment, health education. Once these are inaccessible, the community becomes a breeding ground for preventable diseases, and that’s what we are witnessing in areas like Abaji.”

According to a 2023 report by UNICEF, over 3 million Nigerian children under five miss out on essential vaccines annually due to poor access, insecurity, and underfunding of PHCs. The same report highlighted that FCT’s rural councils like Abaji and Kwali have some of the worst immunization coverage in the territory, despite being just miles from the federal capital.

“There is an illusion of progress in the FCT because Abuja city is well developed,” said Mariam Sule, program officer with the Health Access Initiative. “But once you leave the highways and enter villages like Mawogi, Rimba, and Gasakpa, you find people living as if they are in a forgotten century — no health workers, no drugs, no ambulances. The gap is shameful.”

Health workers themselves are not spared from the crisis. Many are posted to these rural facilities without accommodation or incentives, leading to absenteeism and burnout. Some facilities visited during this report, including Gasakpa PHC in Gawu ward, were locked, with cobwebs on windows and no staff in sight.

One health official, who spoke anonymously for fear of reprisal, said: “They post us here without considering the risks or the logistics. Some days we trek for hours, only to find the facility broken into or vandalized. There’s no regular supervision, and no one really cares what happens out here.”

The National Primary Health Care Development Agency (NPHCDA) has repeatedly acknowledged the challenges. In a 2022 media briefing, Executive Director Dr. Faisal Shuaib admitted: “Outreach to hard-to-reach areas remains our greatest challenge. The terrain, insecurity, and lack of dedicated funding for rural logistics slow down vaccine delivery and maternal care.”

Yet despite these admissions, little seems to be changing on the ground. Local councils cite a lack of funds, while the FCT administration continues to focus primarily on urban renewal. Villagers, in turn, remain trapped in a cycle of preventable suffering.

In one emotional testimony from Mawogi village, a father, Aliyu Dansarki, recounted losing his twin daughters to measles in late 2023. “We waited for the health workers; they never came that month,” he said. “The medicine seller in the next village said it was just rash. It was too late when we realized it was measles.”

If change is to come, it must begin with equity. Health should not depend on where one lives. For the people of Mawogi, Rimba, Gasakpa, and other hard-to-reach communities, it is not just about policy — it is about survival.

What Needs to Change

From Mawogi to Kulo, from Nanda to Rimba, the stories are the same, and the demands are simple:

• Immediate rehabilitation of all nine identified PHCs.
• Solar power and borehole projects completed with community oversight.
• Recruitment and regular payment of healthcare staff.
• Provision of basic medical equipment and emergency transport.
• Independent audits of rural health budgets and spending.

These communities don’t need promises. They need presence.

While Abuja’s city center dazzles with infrastructure and foreign investment, just 40 kilometers away, its rural residents live in medical darkness. 

In many of the PHCs visited by this reporter,  a faded poster on the PHC wall still boasts “Universal Health Coverage for All by 2020.” It’s now 2025.

That mother who walked 5 kilometers with her sick child? She went home with no medicine, no doctor, no hope. That’s not just a healthcare failure, it’s a national disgrace.

Unless the government turns its attention to the grassroots, the heartbeat of the FCT may soon stop altogether.

This investigation was produced under the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science.