By Ekemini Simon
As the upswing of the novel coronavirus pandemic continues to put strain on hospitals and health workers, many societies have struggled to find space to care for the growing number of COVID-19 patients.
As of 4:40 GMT on May 5, 2020, the world recorded 3,646,225 cases of COVID-19. Among these, 252,480 deaths were recorded while 1,200, 203 recovered. This leaves 2,193,613 active cases to be taken care of.
In Nigeria, according to Nigeria Centre for Disease Control, there are 2,802 cases. 93 have died while 417 have been discharged after recovery. This leaves 2292 patients as active cases.
In Akwa Ibom State, there are 16 cases. Two have passed away while nine (9) have been discharged after recovery. This leaves the State with five (5) active cases to be cared for.
However, owing to the infectious nature of the virus, patients who are active are not kept in the same hospital ward with patients suffering from other ailments. They are kept in Isolation and Treatment Centres.
Unfortunately, in some societies where the cases are soaring, some isolation centres have been overwhelmed leaving the government of such societies with an option to either build new permanent structures or opt for makeshift isolation and Treatment centres.
For instance, in Lagos State, Nigeria which has 1183 cases of COVID-19, the highest in the country is grabbling with isolation and Treatment Centres to cater for her patients.
On Wednesday, April 22, 2020, the Lagos State Governor, Babajide Sanwo-Olu, inaugurated a 70-bed COVID-19 Isolation and Treatment Centre located within the premises of Landmark Exhibition Centre in Eti-Osa Local Government Area.
Already, the State has a 110-bed isolation facility at Onikan and another 100-bed capacity centre at the Infectious Disease Hospital in Yaba.
The Lagos State government says that the
Gbagada facility with 160-bed capacity will be ready soon.
Another 150-bed capacity is being set up at Infectious Disease Hospital, Yaba, and another 300-capacity permanent facility at the same hospital which the State Government says will be ready in the next two to three months.
Yet, that seems not adequate for the epicentre of Coronavirus in the country. The state is still finding itself scrambling to build makeshift centres.
After two years of reconstruction, the Onikan stadium in Lagos, which was to be the centre of sports activities in the country – is instead opening as an isolation centre for Covid-19 cases. The State government has turned the 5,000-capacity stadium into a medical facility as part of effort to curb the spread of the disease.
It has capacity for 110 beds, and was built by the Lagos state Government in partnership with a commercial bank so as to ease the pressure on other isolation centres.
In Kogi State, the temporary Isolation center recently built by the Kogi State government, in preparation for possible outbreak of COVID-19 in the State got destroyed by a pre-rainy season wind on Tuesday 28th of April 2020.
Interestingly, these States are not the only States that have given attention to providing Isolation and Treatment Centres during this era of COVID-19 Pandemic.
According to Governor Udom Emmanuel during a media parley with Journalists on Monday, April 27, 2020, COVID-19 met the State prepared.
Although with lesser patients of COVID-19 as compared to Lagos State, Akwa Ibom State currently has two Isolation centres at Ikot Ekpene and Ibom Specialty Hospital in the Capital City of Uyo. According to the State Government, both are well equipped. At the Media parley, the State Governor, Mr Udom Emmanuel noted that with the cases the State has witnessed so far, not up to 50 per cent capacity of the Isolation Centres have so far been used. Yet, the State Governor had recently announced that the Akwa Ibom state government is building a new Isolation and Treatment centre to add to the existing two isolation centres in the State in readiness to battle the novel coronavirus.
Features of the New Isolation Centre
The new Isolation and Treatment centre currently under construction is located at the General Hospital, Ituk Mbang, Uruan Local Government Area. It is on a 240 square metre area. The Isolation and Treatment centre which is gated is 60 by 40 metres length and width and is designed to have space for 300 beds; 200 for general ward and 100 for VIP ward. To compliment this centre is a two storey building of 20 ensuite apartments designed as doctors quarters, laboratory for full testing capacity, canteen and administrative offices.
When this reporter during the weekend accompanied the leadership of Nigeria Union of Journalists for an unscheduled visit to the project, he noticed that the project which started on April 6 is now being roofed with construction workers offering insight to the fact that the construction work is done day and night so as to meet up with the one month deadline given by the State Governor.
Conducting journalists around the building, the Commissioner for Works, Akwa Ibom State, Akparawa Ephraim Inyang-eyen offered insight to the fact that the building is designed to meet not just aesthetical architectural taste but also attain a standard of an international Isolation and Treatment Centre.
The Commissioner pointed out that the wide hall, would be partitioned into four standard sections to serve as women and men wards. He explained that there is a provision for a closed circuit television and intercom services which would engender virtual communication for doctors and nurses.
Inyang-eyen said that the facility which would at the initial stage host 200 beds for the general ward and later 100 beds for the VIP ward would also house doctors’ dressing room, doctors’ consulting room, a reception space and a shower, all by the entrance of the main building.
He added ” This facility is built in a way that Doctors would be very comfortable to stay and provide services to patients. We don’t want any excuse especially during emergencies. That is why each of the doctors’ quarters would consists of a tastefully designed sitting room, a kitchen, a store, a bedroom and a toilet facility.
” There will also be steady power supply here. That is the reason we are providing a 150KVA sound proof generator, where smoke would be properly handled. To encourage green environment, we are also linking the facility to the national grid for effective power supply.”
He also noted that the large spaces between the main structure and the Laboratory, canteen and doctors’ quarters are to allow ventilation and free movement of vehicles, especially creating access for critically ill patients who will move directly to the Laboratory for testing.
According to the Commissioner, the level of work done at the Isolation centre keeps the work at 90 per cent of completion. He says the fittings for the finishing touches are all in the premises.
Akparawa Inyang-eyen points out that canteen, laboratory and the administrative offices for the Medical Director among other senior medical officials are already at 98 per cent completion awaiting painting.
Nevertheless, owing to the level of speed used in the building, one may wonder, is the project really safe and durable?
The Project Manager, Engr. Ekemini Ukim assures that nothing has been compromised towards the safety and durability of the project. He insists that instead of compromise, materials are rather used in excess.
He explains that since they are building the project day and night, they have decided to use Grade 32 concrete which is known to easily dry off and compact effectively.
The Commissioner for Works points out that to have a balanced and lasting roof, they ensured they made 24 roofing beams of 9 by 6 ratio at the Isolation and Treatment centre.
He adds ” We have taken care of the load balancing thoroughly. Our roofing is not the normal roofing you find anywhere. If an individual was to build what we have done here, he would abandon the building.
Inyang-eyen mentions that although 4cm thickness of floor is recommended by engineers since the building will take care of only human traffic, to ensure lasting durability, they built it at 6cm.
He assures “If all these were compromised, then, you would have considered problems. For now, that has been fully taken care of.”
Besides petty food businesses springing up at the site, this reporter sighted over 400 workers at the project site. Some of the workers interacted with noted that the project has helped them financially especially during the period of “stay at home order “.
Idoreyin Archibong a labourer who says he has worked on the site since excavation noted ” I can tell you that over 90 per cent of the workers you see here are from this community. There is no single day anyone you find here will not take home at least N2000 depending on your work. The mason and the mixers earn quite higher than us”.
A mason, Utibe Inyang who says he owns a family adds “Imagine there was no work like this during this period of lockdown, how do you think we would have survived as a family? For this project to come in a time like this has really helped us”.
According to the Commissioner for Works, Akwa Ibom State, 99 per cent of workers at the site are from the host community. He says with the permission of the Governor, they are paid sightly above the usual pay.
Yet, in spite of these provisions and economic benefits to the locals, is building a new Isolation and Treatment centre really necessary at this critical time?
Critics Condemn Project
Many critics have condemned the rationale behind building a permanent Isolation centre for COVID-19 response in a critical time were earnings are depleting and funds must be prudently managed towards the managing the pandemic. These critics insist that the funds for the project should rather be channeled to other COVID-19 response.
While a few allege that the project is an avenue to siphon funds, some note that since COVID-19 will not last forever, it would have been a wise course for the State to imitate the pattern of other States by building a makeshift structure or convert public buildings not currently in use in the State for a temporary Isolation and Treatment centre.
Others opine that the government has not done well to build an isolation centre in the midst of existing hospital facility as that may spiral infection to others who visit the hospital because of other ailments.
One of the critics noted in a Facebook post “This is why citizens are complaining about AKSG’s approach to the COVID-19 response. What’s the reasonable justification for building a brand new isolation centre (with sand and cement blocks!) instead of remodeling an existing facility as it is being done in other places?
“The time that has been used for supervising this structure and the funds would have been invested wisely in other aspects of the State’s response.”
Justification of a New Isolation Centre
Inyang-eyen adds “If it is an airborne disease, it will be controlled within the ward. The airborne disease will be an issue for the doctors to manage within the environment.
The Commissioner for Works disagrees with the stance of critics. He insists that the location of the project within the hospital is safe against spread of infection to other wards.
He explains that the provision of fence around the centre is to secure the place so that once a patient gets in, he would not have the power to leave on his volition except approval is given by the authorities.
“It is only people with the same sickness that will be kept together. Thus, it will not be possible for the airborne disease to escape here to another place because this place will be completely sealed.”
The Commissioner notes that to further prevent the spread to other part of the hospital, it is designed that doctors who are involved in the treatment will only specialize and focus on working in the Isolation and Treatment centre.
He says the 20 rooms ensuite is built specifically for the doctors so that they can stay aware from their family after having contact with infected patients.
Inyang-eyen states “When a doctor finishes treatment, he will stay at the doctors quarters and quarantine sufficiently to know that he has not been infected before they can go and meet their family.
What is more, the Initiator of the project, Akwa Ibom State Governor, Mr Udom Emmanuel has more reasons on why he embarked on the project.
At the media interaction with journalists, he offers insight into why his administration decided to embark on building a new Isolation and Treatment centre.
He explains that one of the things that inspired him to embark on the project was when he was approached by the Private sector-led Coalition Against COVID-19 (CACOVID) that they desire to support the State with 100 beds and some equipments towards COVID-19 response.
The State Governor mentions that one of the condition the organization gave was that the beds and equipments they would donate must be fixed in a permanent building and not a temporary one.
In addition, he said during the lockdown, one cannot get Marquee tent anywhere to hire around the region even as interstate lockdown would not give room for the the tents to be conveyed to the State in the instance any of such tents would be seen for purchase.
To buttress the Governor’s point, the Commissioner for Works notes that the decision of the Governor is economically rational since the State would pay more for rentals than erecting a permanent building.
He notes that a large tent that will accommodate an Air Conditioning system is rented at N3.5 million daily which will amount to N350 million within 100 days.
Inyang-eyen adds ” It is very likely that this project will not take N350 million. So, has government done wisely? The answer is yes.”
The Governor however delves into deeper reasons over his choice for the project. He says ” In our region, you know how much it rains and the kind of breeze we experience here.
“To put a COVID-19 patient in a temporary tent used as an isolation and Treatment centre under the kind of weather we have here, tell me whether you as a person or governor will love to be in those temporary tent when it rains or under a poor weather condition.
“So, why will I as a governor put other people in a place I will not like to stay myself if situation arises. I understood that I can do something better.”
Governor Emmanuel further notes that since one cannot predict how the pandemic may affect the State in the near future, he cannot loose guard until the active Isolation and Treatment centres become overwhelmed by patients with no provision of other centres.
He states “Life is a curve. It slopes up and down. That tells me that I have room at the initial curve where it peaks and before it declines to actually put up something better. I have the land, I have everything, so the best is to put something enduring.”
The State Governor also explains that he made the decision for futuristic purposes even after the pandemic. He says since the facility won’t be taken away after the war against COVID-19 is won, he saw the situation as an opportunity for the State to put in place more medical facilities in case of unforseen circumstances in the future.
Governor Emmanuel also points out that any isolation and Treatment centre expected to function optimally must be purpose built.
He states “If you are providing a proper Isolation and Treatment centre, such a centre suppose to have special equipments which you must run a separate conduit for oxygen among others.
“You cannot run that in a temporary tent or building which you can pull down anytime or breeze can blow it off.”
While elucidating further, the State Governor says that he was also concerned over the safety of health professionals who work in an Isolation and Treatment centre hence the reason he was resolved to make a provision for a place they will operate in line with international best practices.
He says “There is a direction where a doctor comes in. We considered: how does he change, how does he put on his Personal Protective Equipments, how does he see the patient?
“We insisted that for their safety, it must be totally about real Isolation and Treatment centre. There must be a provision on how he will remove the PPEs, have his shower and put on his clothes, then move to his office.”
Governor Emmanuel mentions that currently, since there is no provision for doctors’ quarters, at Ibom Specialty Hospital, all the doctors managing patient cases are lodging in a hotel hence not appropriate for an emergency situation.
He insists that with well-equipped Doctor’s Quarters, doctors will have reasons to stay in the hospital facility and will thus be on standby to address any emergency.
While noting that he has seen the benefit of planning ahead through his decision to have imported ventilators among other medical equipments used currently in the fight against COVID-19 earlier before the outbreak, Governor Emmanuel adds ” In two weeks, the Isolation and Treatment centre will be ready. It shows that we are thinking ahead. We may never really use it for COVID-19. The facilities will be there for a very long time. Peradventure, you never can tell the future.
“If need arises, will we come back and live in regret that we had opportunity and could have put something down on ground which we did not.”
Nonetheless, with all the plausibilities outlined by the Governor, will this project be delivered on time?
Delivery of Project.
The Governor has assured that in less than two weeks from Monday, April 27, 2020, the building will be ready.
Currently, the roofing of the project is near completion leaving the project at the level of finishing touches.
The Commissioner for Works, Akparawa Ephraim Inyang-eyen who is tasked to deliver the project assures that his Ministry will meet the deadline for the delivery of the project.
He notes that the Ministry has the best of equipments and they have also assembled enough adequate materials to aid the quality and speed of the project.
The Works Commissioner reveals that the Governor has shown personal interest in the project and has released the needed funds for its realization.
He notes that owing to the challenges of the lockdown, the Governor personally called his Cross River State counterpart to allow access to stones and granite needed for the project from Akamkpa in Cross River State.
Akparawa Inyang-eyen adds ” It is our decision here to work day and night to deliver as planned. We brief the Governor daily on the progress of the job. Most times, pictures of different levels of work taken under floodlight at night are sent to him.
“Everything needed to complete the project is on ground. The Governor should be back in few days time to receive the project and declare it open for public use.”
The Project Manager, Engr. Ekemini Ukim collaborates the assurance from the Works Commissioner. He says the project execution has, like the speed of light, progressed remarkably with engineers, masons, technicians and other levels of personnel working diligently with high-tech equipment fully deployed to fast-tract construction.
While noting what has contributed to the success recorded so far, he remarks” The Commissioner for Works in his usual element of taking any assignment given to him very seriously, has practically relocated to the site, he ensures we work here day and night and he makes sure all workers are comfortable towards delivering this project to standard”. Nevertheless, since the project was not among projects earmarked for the 2020 fiscal year, how do the Akwa Ibom State House of Assembly and the host community feel about the project?
AKHA/ Host Community React
The Akwa Ibom State House of Assembly has
given a nod to the State Executive for embarking on the project.
The disposition of the 7th Assembly was made known by the Speaker, Rt. Hon. Aniekan Bassey, when he embarked on-the-spot inspection of the project on Monday, April 27, 2020.
The Speaker commended Governor Udom Emmanuel over the ongoing construction of the 300-Bed Isolation Centre at the General Hospital, Ituk Mbang, Uruan Local Government Area, as part of efforts to contain the ravaging Coronavirus (COVID-19) in the State.
The Speaker, an indigene of the area was accompanied to the project site by Deputy Leader of the House and Chairman of the House Committee on Information, Barrister Aniefiok Dennis (Etinan), and Chairman of the House Committee on Health, Hon. Udeme Otong (Abak).
The Speaker described the project as a right step in the right direction, noting that his “constituents and the House of Assembly are pleased with the State government’s response to COVID-19.”
He added “This project is highly commendable. The Governor has taken the right step at the right time. Nobody saw COVID-19 coming, but we are pleased that the State Government has responded swiftly. We will support the Executive in this fight and we are ready to help in whatever area”.
In the same vein, the host community of the project have expressed approval and delight of the choice of the facility in the area.
The Chairman of Uruan Local Government Area, Rt. Hon. Henry Udofia while leading members of the Executive and Legislative council on a visit to the project recently commended the Akwa Ibom State Governor, Mr. Udom Emmanuel over the choice of the project in Uruan.
He expressed satisfaction with the ongoing project, adding that the people of Uruan are happy that Governor Udom Emmanuel’s administration has chosen hospital in the local government to expand its usefulness for the entire state.
He noted that the citing of such project in Uruan Local government area, was an indication that the Governor recognizes Uruan as a veritable partner in the development of Akwa Ibom State.
As the people look forward to the delivery of the project, many would equally yearn for the manifestation of the sentiments expressed by the Akwa Ibom State Commissioner for Works, Akparawa Ephraim Inyang-eyen “This facility at completion will become one of the best in the State. Even after COVID-19, it will stand out as a reference point with facilities and personnel known for saving numerous lives of Akwa Ibom people and beyond”.