Building Without Amenities: Sokoto Hospital Where Women Deliver On The Floor
In the heart of Gada Local Government Area of Sokoto, a pillar of healthcare stands tall. The Wauro Primary Healthcare Centre (PHC), situated kilometers from the Gada headquarters, serves as a vital lifeline for the community, providing essential medical services to those in need. This healthcare centre is a testament to the resilience and determination of the people.
Arriving at the PHC from the outside seemed promising. Freshly painted walls, solar-powered lights and a functional borehole. At first glance, it appeared to be the kind of healthcare facility rural communities dream of– neat, well-structured and powered by sustainable energy. A well-structured building that gives off the appearance of a 21st-century rural hospital.
But cross the threshold, and the illusion vanishes. Inside this sleek-looking facility is a reality that health workers describe as “heartbreaking and community members deem dangerous”. There is no hospital equipment. Not even a proper delivery bed. Just a shell of what a healthcare facility should be, with health workers holding the line with sheer resilience and little else.
Despite boasting of solid infrastructure and a borehole; an impressive achievement in water-scarce communities, the facility lacked even the most basic items like gloves, cotton wool, syringes, antiseptics, and delivery couches.
I GAVE BIRTH ON THE FLOOR: A MOTHER’S ORDEAL
Amina (not her real name), 28, had walked four kilometers while in labor, only to deliver her baby on the cold cement floor. “When I arrived, there was another woman in labour, so there was no delivery bed for me. When the health workers noticed I was about to give birth, a midwife nurse quickly placed a leather mat on the floor for me. She did her best, but I was scared. What if there had been complications? What if my baby hadn’t cried?”
Rashida, popularly referred to as “in-charge” by others, oversees the Wauro Primary Healthcare Centre (PHC). She told this reporter that what just occurred is a daily reality at the facility.
She lamented that the lack of proper equipment is not limited to the labour room but extends across other wards in the PHC. According to her, in the female ward, for instance, there are only a few hospital beds—and none have mattresses. “It has become normal for patients to come with their own mats, knowing full well that they will not find a mattress at the PHC. Imagine the level of discomfort a patient has to endure on such a bed,” she said, shaking her head in frustration.
HEALTH WORKERS HOLDING THE FORT WITH GRIT
What keeps this facility alive is not funding, equipment, or government oversight. It is the determination of its health workers.
“We lack the basic amenities,” said a community health extension worker who asked not to be named. “But we come here every day because people have nowhere else to go. We buy soap with our own money. We boil water to sterilize. Even our cleaners made some sought of sacrifice to maintain the facility
The staff’s morale is hanging by a thread, stretched thin by years of abandonment, yet they continue to serve. “If we stop, people will die,” he said.
THE ROAD THAT BREAKS YOU
The journey to the PHC is a trial on its own. The road leading to the facility is so bad that even motorcycles struggle to pass. It took this reporter hours to reach the facility from the main town. The physical exhaustion was so intense that she had to take a full day’s rest after the visit.
For patients in emergencies, particularly expectant mothers the road is a barrier, not a lifeline. And without any ambulance service, the sick is often forced to ride on motorcycles which is the easiest option worsening their conditions or leading to avoidable deaths.
A HEALTH SYSTEM HOLLOWED BY NEGLECT
An assessment by BudgIT reveals that Nigeria has over 30,000 PHCs, but only 20 percent are fully functional. In Sokoto State, a 2023 assessment revealed that 73% of PHCs lack essential drugs, equipment, and personnel.
The Nigeria Health Watch’s PHC Scorecard 2023 listed Sokoto among the bottom five states in terms of PHC functionality. More than 68 percent of facilities in the state lacked delivery beds, while 54 percent lacked access to clean water or sanitation facilities, even though water infrastructure like boreholes are often cited as completed in government records.
Additionally, in September 2024, The Punch reported The Executive Director of the National Primary Health Care Development Agency, Dr. Muyi Aina, saying that too many women still die from complications related to pregnancy and childbirth in Nigeria as a result of PHCs failure.
“Maternal mortality in Nigeria is a crisis that needs to be addressed with utmost urgency, It’s not because we lack buildings. It’s because those buildings are not equipped. You can’t deliver a baby with concrete. You need trained staff, clean water, power, a bed, sterile tools and unfortunately none of those are guaranteed at many PHCs, says Dr. Halima Garba, a public health specialist based in Sokoto.
POLITICIANS BUILD FOR OPTIC NOT IMPACT
One of the biggest ironies is that this particular PHC stands as part of a widely publicized state-wide rural healthcare development initiative. The solar panels and water facilities are part of capital projects hailed as success stories in state budget performance reports.
Abubakar Aliyu, 42, of Wauro village describes the facility as a showpiece project. According to him they are built to be photographed. But once the media leaves, there’s no follow-up. Nobody ensures they work. And nobody ensures the facility serves the people.
In 2024, Sokoto State earmarked over 30 billion for the health sector including equipment and consumables. According to the State Budget Performance Report, less than 30% of that equipment budget was released as of the third Quarter of 2024.
Despite everything, this PHC has potential. The infrastructure is already there. With adequate beds, emergency kits, essential drugs, an ambulance, and trained personnel, it could become a hub for maternal and child care in the region.
“It would take less than ₦20 million to make this facility fully functional,” said Engr. Yusuf Lawal, a health infrastructure consultant. “That’s less than what is spent on many government convoys per year.”
He emphasizes that functional PHCs reduce pressure on general hospitals and save the state billions in preventable emergency care.
The failure of this PHC is not an isolated incident, it is a symptom of systemic neglect. But it doesn’t have to be permanent.
“If nothing changes, this PHC will continue to offer hope at the gate and despair inside. The contrast between its promising exterior and its non-functional interior is more than symbolic , it is a matter of life and death he said
A GIGANTIC BUILDING WASTING AWAY
At Zangolawa in Bodinga LGA, a towering structure that once held promises of accessible healthcare for more than 40 surrounding communities now stands as a monument to neglect.
The Zangalawa Primary Healthcare Centre (PHC), located in the eastern outskirts of Sokoto State, collapsed six years ago due to alleged shoddy construction work, leaving behind a ghostly shell now occupied by reptiles and persons battling mental illness.
The massive building, funded to bring basic health services to rural dwellers, has since become a hazard to both staff and patients. Today, health workers manage operations from a narrow corridor and one small surviving room, forced to deliver critical services from consultations to labour in a space never meant to handle such strain.
“Patients don’t feel comfortable disclosing their health issues here,” said Nura Sifawa, a health worker at the centre. “The consultation room also serves as the antenatal care room, labour ward, and sometimes even a storage room. When a patient seems hesitant to talk, we have to excuse others from the room just to create a moment of privacy.”
He described the daily challenges of operating in such a compromised setting. “Sometimes, women in labour are forced to share the room with people waiting to see the doctor. There’s no dignity in that.”
Sifawa blamed the collapse on the contractor’s substandard work. “The building barely lasted before the cracks started. The roof began leaking within the first year, then part of the wall gave way. We raised alarms but nothing was done until the structure gave out completely.”
VOICES FROM THE COMMUNITY
Residents of Zangalawa are frustrated and feel abandoned. A community leader, Alhaji Umaru Sidi, said the situation has forced many residents to travel long distances to access basic health care.
“This PHC was supposed to serve communities including Bunazawa, Marmaro, Danduguza, Zanzaro, Runjin kwarai,
Tikkau, Kwacciyar lalle, Runjin Bature,Dandamu,Gangare, Gidan ruwa among others.
Now we have to travel kilometers to reach the nearest functional health facility in Bagarawa or Sokoto town. “Women in labour, the elderly, and children are the worst hit”, he said
Shafa Musa, a pregnant woman attending antenatal care at the centre, described her experience as distressing. “It’s not safe. There are snakes in the abandoned part of the building. We sit outside for hours waiting for our turn in the only room they use. Sometimes, when a woman goes into labour, they send everyone away. Where are we supposed to go?”
COMMUNITY’S PLEA
The community is now calling on the Sokoto State Government, the Ministry of Health, and relevant agencies to urgently rehabilitate the facility.
“We don’t just need buildings; we need functioning healthcare centres with proper staffing, equipment, and safety,” said Mallam Bashiru Aminu, a youth leader. “The government must also hold contractors accountable. Public health infrastructure must not be treated with such recklessness.”
As the rainy season approaches, fears grow that the remaining structure could be further compromised. For the residents of Zangonlawa, hope is fading fast unless decisive action is taken to rebuild the PHC and restore their right to quality healthcare.
As Nigeria pushes toward Universal Health Coverage (UHC), the foundation must be strong, especially in rural areas like this. The federal and state governments, development partners, and civil society must prioritize functionality over optics.
Until then, another woman may deliver on the floor tomorrow.
This story was produced for the Frontline Investigative Program and supported by the Africa Data Hub and Orodata Science.
Building Without Amenities: Sokoto Hospital Where Women Deliver On The Floor is first published on The Whistler Newspaper
