The Making Of Ogbuebulle Health Centre

*OJIAKU KALU unveils the untold story of Nnanna’s efforts toward universal health coverage*

The Journey To Ogbuebulle:

I spent the first weekend of this April at a community with a somewhat intriguing name: Ogbuebulle. It was one of those journalistic expeditions from which I derive an indescribable kick; and this particular one wasn’t a disappointment – even though some challenges threatened its embarkation. As a media scholar and teacher, my Department of Mass Communication, in adherence to the country’s regulating agency for universities – the National Universities Commission [NUC]’ quest for sustainable modification of the programme, had added Health Communication as a course for my students at the Evangel University Akaeze. So, we needed to do some research to enable us to deepen the course content. Particularly, there was a need for us to have an empirical study of a functional primary healthcare centre – especially one established by its host community; that is if ever we could find one of such! It was hereupon that Miss Chioma Uruakpa, one of the students and native of Oboro, pointed the Department to Ogbuebulle and its primary healthcare centre. As the Head of the Department, I volunteered for the trip – after several declines by my colleagues.

Ogbuebulle turned out as a sprawling community along the Umuahia-Ikot Ekpene Highway in the Ikwuano Local Government Area of Abia State. Despite the encroachment of Western civilization and resultant tampering of its aboriginal look and feel, Ogbuebulle still bears visible traces of peace in its surroundings – indeed, a major attraction for anyone seeking escape from the noise of city centres.

Although I had been told the prospective health facility promised interesting content –going by the history of its establishment and operation, I was nevertheless awed at what I met upon my arrival. The physical facility is as impressive as its evolution – so much so that my journey of upward of 155 kilometres was worth it.

The OGBUEBULLE HEALTH CENTRE, it seems, was destined to never come about – but for the arduous push by some members of that community who were determined that some of the developmental indices attainable in their various places of residence were replicated in their native land. And that had proven a tall order at the beginning. Indeed, their quest to link their kith and kin to modern healthcare was a tortuous one. Without the benefit of retrospection, most of the present beneficiaries of the health centre; and indeed contemporary crop of politicians now superintending over it [directly and indirectly] may imagine that its establishment was a mere walk in the park. But that would be far from the truth!

The present Ogbuebulle Community Health Centre was attracted and constructed in the year 2020 by the National Association of Nigerian Nurses in North America [NANNNA] under the facilitation of an illustrious daughter of the land – Dr. [Mrs.] Ngozi Florence Mbibi – a professional nurse of global repute and founding member of thatcontinental medical-intervention organization – with additional contribution from [the] Ogbuebulle Community Development Union [OCDU]. Indeed, for future researchers on rural development through concerted communal efforts – devoid of input from the government, this health centre would be an empirical example.

The idea of a primary health centre for the people of Ogbuebulle came out of dire necessity – given the relative perennial maternal mortality in the area before its establishment – as is still significantly typical of many rural communities in sub-Saharan Africa. Before the coming of that primary health centre, the entire stretch ofAla-AlaOboro area– comprising of the 9 villages ofAbala, Umuchukwu, Obokporo, Obodo, Umukpabi, NdiNkporo, Umuebulle ukwu, NdiEkpinma, and Umuoyiwas completely bereft of even the least semblance of a community health outpost. That was unacceptable and posed a serious health crisis for the population of well over 71,000 as of 2012 – according to a study. Hitherto, for every health emergency, the people had to travel to Umuahia – the capital city of Abia State – a distance of some 20 Kilometres, to be attended to at its Federal Medical Centre, or made do with the services of the then dispensary at Ariam – run by one Mazi Uma.

As crucial as a health centre is to rural development, successive authorities – council and state, never saw the need to site one to cater for the teeming populace of AlaAla Oboro and its immediate environs – which was a clear contravention of the WHO stipulation for community health care regime – especially for rural Africa, which recommends at least a primary health care centre for an average population of 10, 000 people. And Ogbuebuelle as an integral community of AlaAla Oboro since the 2020s, has had a good population to merit the siting of a primary health outpost by the government.

So, regardless of how loud the peasants of that significant territory of the Ikwuano Local Government Area cried out to successive administrations in the state, it was never loud enough to attract sympathy from the authorities on their health security – at least for their teeming childbearing, infant, and aged demography. Looking back, it is now not clear whether the failure to site a healthcare centre in the community was an outright neglect on the part of the state; or lack of political clout on the part of the community’s leadership. What has however gone into records is that the entire AlaAla Oboro was denied a primary health facility up until just the past 15 years – despite the [evident] collateral effects of such inaction on the poor masses!

The Birthing Of A Health Centre:

However, once the community identified the undeniable relevance of a primary health centre and its urgency in their territory, the quest for it assumed a life of its own – especially among its native elites. While some well-meaning stakeholders crusaded among their kinfolk for its establishment; another deeply concerned individual – Dr. Mrs. Ngozi Florence Mbibi – a professional nurse in diaspora, had to kick-start [in real term] and finally drive the process to reality.

According to Mr Okaraonwolu Michael Ifeanyichukwu – the immediate past youth president of the community, the idea of a health centre for the area was mooted some 15 years ago – with some of the pioneer crusaders being the late AnyalewechiJibueze – a retired banker, Elder E. N. Nwagbo – a retired teacher and one-time councillor representing Oboro Ward 4 in theIkwuano L.G.A.; and another son of the community, Onyenaturuchi Okeugo, still serving at the Department of State Services [DSS]. These three men took steps toward the realization of the then vision of a health centre at Ogbuebulle. However, the dream could not materialize – even with the efforts at the time, due to lack of [a]communal land on which to site it.

The idea would remain a mere dream until February of 2018 when one Onyeze Nwandu, a local immunization officer then with the Local Government, was approached by Michael Okaraonwolu – a close friend of his, for advice on how to go about realizing the lingering dream. It was through the guidance of that immunization officer that a 2-room shop was located and eventually paid for by the Ogbuebulle Youth Association – under the leadership of its then president, Mike Okaraonwolu, for its take off.

Before the ultimate take-off of the health centre, the then Health Authority Secretary of the Ikwuano L.G A., Mrs Catherine Nwosu, visited the proposed site and approved what had been put on the ground by the promoters. Coincidentally, on that very day of her visit and approval in February of 2018, the women of Ogbuebulle were having their general meeting. One of the community leaders, High Chief EronduEze, accompanied by the youth president, took the L.G.A. Health Secretary to the venue of the meeting and broke the good news to the joy of the womenfolk. So one would not be wrong to say the Ogbuebulle Health Centre was established [in principle] on that day in February 2018.

With that statutory approval, everybody rallied behind everybody in communal cooperation, toward the actual birthing of a functional health centre for the community. And so it was that the Ogbuebulle Health Centre was eventually inaugurated on the 5th of April 2018 and operated from that rented location until the 8th day of April, 2021 – a total period of 3 calendar years.

Movement to the New Site:

Recalling the evolvement of the Health Centre, the Vice President General of the Ogbuebulle Community Development Union [OCDU], Elder Chief Ejindu Ndubuisi Osuh said,‘’ It was during the second year of the Centre’s operation at the old site that one of our beloved daughters, Dr Mrs Florence Ngozi Mbibi, informed the community through its leadership, that her professional association – the NationalAssociation of Nigerian Nurses in North America [otherwise known as NANNNA, and of which she was then the President] had decided to adopt community health centre around the environ and had availed her some money to renovate such a centre to service the primary health needs of the beneficiary community. However, there was a caveat attached to the offer by NANNNA, the donor organization. The condition was that such a health centre must be in a facility owned by the community; and NOT in a rented accommodation.

Upon receiving such a cheering hint, the Ogbuebulle community mobilized and started scouting for a piece of land on which the health centre may be relocated. They were determined not to miss such a rare opportunity to finally actualise their longstanding dream of attaining universal health coverage. Recalling the length of time and resources the people had expended on their quest for a standard health centre without government support, this offer by Dr. Florence Ngozi Mbibi and her professional association, was Heaven sent.

The people were determined to make further sacrifices to achieve such an amenity in their domain. And so the search for a permanent location began in earnest. It was in the course of their search for some land that someone remembered the empty portion of the expanse of land on which both the Ogbuebulle Central Primary School and the  Ogbuebulle Community Secondary School are built.

Just then, a consensus was reached that that empty portion of the school land was perfect for the proposed infrastructure– especially because it was a communal property, and had long been designed by their forebears for such a project, whenever there was a need for it in the future.

Being that the two schools are run by the government and the said land within their compound, the community directed the 3-man team of Mike Okaranwolu, Super High Chief Erondu Eze, and Elder Chief Ejindu Osuh to meet with the then principal of the secondary school, one Mrs Ogbonna, and inform her of the community’s desire to site the health centre thereon to serve the primary health needs of the schools and the locales. Following her advice, they wrote and jointly signed a letter to the state Ministry of Education [under the commissionership of Dr. K.C.K. Nwangwa] requesting its permission to allow the community’s use of the school land for the proposed health centre, and got approval thereto.

Upon that approval from the Ministry, the leadership of Ogbuebulle got back to NANA – the donor organization, through its then president, Dr Ngozi Florence Mbibi, for the financial pledge. The donor fund from the National Association of Nigeria Nurses in North America [NANNNA]was released to the community and with it, the community started construction of the permanent site of the health centre. Dr. Ngozi Mbibi soon brought another tranche of money after that first one as the building progressed. Buoyed by the speedy progress of the project, the Building Committee created a WhatsApp platform: the Ogbuebulle Progressives, to acquaint their sons and daughters in the diaspora with the new development and they started their voluntary donations. Whatever donations that came through that source were remitted to the Ogbuebuelle Community Federated Development Union [OCDU – of which Engr. Okechukwu Agbaja is the President General, and Elder Chief Ejindu Osuh is the VP] for the project.

‘’In fact, such was the cooperation of members of the community in the diaspora that this building you now see was realized within 4 months – from September to December of 2020’’, said Elder Chief Ejindu Osuh, the Vice President General of the OCDU. ‘’…and in the first week of January 2021, Dr Florence Ngozi Mbibi brought her team of medics from NANNNA – comprising of nurses and doctors and ran a full-day awareness clinic to announce the readiness of the permanent site of the health centre for public use. The present Ogbuebulle Health Centre was officially inaugurated on the 3rd of January 2021 by His Royal Highness, Eze Kalu Omeleobum Uja, the traditional ruler of Ala-Ala Oboro Autonomous Community.’’

Government SupportFor The Project:

Asked to speak about the government’s financial support in the course of the project, Super High Chief Erondu stated, ‘’It is noteworthy that the cost of this project – from foundation to inauguration was borne by theNational Association of Nigerian Nurses in North America [NANNNA] – through our daughter, Dr. Mrs Ngozi Florence Mbibi; plus additional donation from the people of Ogbuebuelle under the auspices of the Ogbuebuelle Community Development Federated [OCDU]. Since its inception till date, the community has never gotten any financial support from the government. It was entirely the making of NANNNA and support from OCDU’’.

Continuing with his recollections, Chief Erondu said, ‘’Remember that this Health Centre has been in continuous operation since 2018 from its temporary location. When the community established the Centre – of course, being a community health centre, it has to be under the government – regardless of how it came to be established. So upon its establishment, the government provided the nurses for its day-to-day operation. In essence, the government only provided the personnel to run its daily activities. Upon completion of this permanent site, all the staff of the Centre from the old site moved to the new site and continued their work. Besides the staffing, the government however donated the following items: 3 beds, 1 stand fan, 1 table [for front desk purposes] and 2 plastic chairs to the Centre, and nothing more.’’

Corroborating Chief Erondu’s submission, Elder Osuh said: ‘’After the first tranche of money from NANNNA, Dr Mrs. Mbibi brought in another tranche of money from her purse and with that, the project was able to take off properly. After these lump sums from NANNNA and Dr. Mbibi, members of the community in the diaspora – under the OCDU, contributed through crowdfunding to ensure that the project continued without a hitch. Apart from these three sources of NANNNA, Dr Ngozi Mbibi, and the OCDU, there was no financial assistance from any other source. The Ogbuebulle Health Centre project was started and realized through nongovernmental efforts. We can only thank God for giving us such a wonderful daughter in the person of Dr. Florence Ngozi Mbibi, who used her rich connection to attract her professional association to come to the aid of our community. If we had continued to rely on government, our people would have remained without a standard primary health centre; and the consequence could only be better imagined.’’

And when eventually the permanent site was erected, the government continued its oversight of it – with the staff migrating from the temporary location. The rest of the items and equipment used at the Centre were provided by the community – that is besides the few aforementioned items from the government.

It is instructive at this point to note that Dr. Ngozi Mbibi, apart from being instrumental in the establishment of the centre, has continued to help in its operational maintenance. This she does by bringing her team from NANNNA every January to conduct a daylong clinic under the NANNNA’sannual medical mission – in keeping with the association’s strategic mandate of ensuring universal health coverage for Nigerian communities – especially those in rural settings.

During the said clinic day, members of the community are examined and diagnosed by the doctors in attendance, and then the pharmacists among them dispense free of charge, the medications prescribed by the doctors in attendance. Whatever medicines are left from the day’s exercise are kept back in the custody of the Health Centre – in case of any medical eventuality in the year. However, patients buy their drugs – that is if such prescriptions are not readily available among the NANNNA’s leftover. This has been the modus at the Health Centre since its establishment in 2018, from the take-off to this permanent site.

Goodwill From Other NGOs:

Upon finishing and inaugurating the building in 2021, the facility was left open without perimeter fences. It was on second thought that the community decided to have it fenced to enact visual appeal, privacy, and security in the facility as is required by the regulatory authorities – especially because most of the staff of the Centre, and a greater percentage of the patients, are women who visit there for maternal issues sometimes at the dead night and so needed to be protected from danger while accessing its services.

It was upon the decision to have the Health Centre fenced that another Diaspora NGO, the Ikwuano Sons &Daughters In Canada, volunteered to undertake the fencing, as its contribution to the project. The said perimeter fence donated by the Canada-based organization, was inaugurated on Thursday, March 21, 2024, by the Mayor of Ikwuano Local Government Area, Hon. Osinachi Nwaka. Again, it is instructive for the public to note that the government’s participation in the establishment of the Ogbuebulle Health Centre was only to the extent of inaugurating the perimeter fence – as financed by the Ikwuano Sons & Daughters In Canada. The construction of the building itself and the equipment thereof had been financed by NANNNA, Dr Florence Ngozi Mbibi, with the cooperation of OCDU]long before Mr Osinachi Nwaka became the Mayor of the Ikwuano L.G.A.

While being conducted around the primary health facility, I ran into Evangelist [Mrs.] Vivian Omeruo, the focal person for the Ikwuano Sons & Daughters In Canada on the perimeter fence project. When asked for her comment on the coming of the Ogbuebulle Health Centre, Mrs Omeruo who was had made a stop at the Centre route the airport for a flight back to her base in Canada, enthused at her organization’s pride in being part of the good history at Ogbuebulle; and thanked both NANNNA and Dr Ngozi Mbibi for their initiative in ensuring the establishment of the primary healthcare centre for the people of the area. Mrs. Omeruo, however, frowned at the growing practice by the country’s politicians of appropriating amenities provided through communal efforts as testimonials for their tenure in the office!

It is gratifying that the Ogbuebulle Health Centre as a project has continued to enjoy lots of goodwill from outside government since its advent in 2018. In fact, in the course of my visit, the leadership of the community hinted at its plan to further upgrade the Centre by constructing doctor-nurse quarters in the space behind the clinic. ‘’We believe this would provide some comfort to the personnel running the Centreso that instead of having to return to their various places of residence, they would have a place here to retire to any time they happen to work late. We believe this would enable them to be more dedicated to their work here. Even, Dr. Mrs. Ngozi Mbibi is aware of this proposition and is in full agreement with it. When eventually we have the said quarters constructed, members of the community can easily run to the Centre even at the dead of night for medical attention – knowing that the place is open 24 hours with medics always present.’’, revealed Mike Okaranwaolu. ‘’Presently, the Ogbuebulle Health Centre boasts of a maternity ward, a men’s ward, a women’s ward, and another ward dedicated to immunization; and attends to an average of 26 persons a day. The current traffic is expected to improve as soon as the planned staff quarters are eventually put in place.’’ Okaranwolu concludes.

The trio of Ejindu, Osuh and Okaranwolu also spoke of a plan to even upgrade the Centre for better service delivery – part of which is to establish a medical laboratory wherein patients would be tested to properly determine their ailments toward enhancing treatments by the medics. Plus, the community is also looking at the possibility of engaging a resident doctor – instead of one that comes in at intervals – as is presently the case.

Need For Community Integration:

As upbeat as the people are over their achievement with the Health Centre, there is however one sore point for them in the whole development. There was an easy hint of discontent among my respondents over what they term as the government’s unfairness over the people’s effort at providing alternate governance – upon the failure of the government. They decry in unison, decry the exclusion of the community’s sons and daughters in the staffing of the health facility they strove to build. According to them, not even one person from the community is on the personnel of the centre. ‘’We are not asking for much. At least, our people should be drafted into the junior cadre of personnel – like gatemen, cleaners, gardeners, and messengers. But everyone who works here – from top to bottom, is from outside the Ogbuebulle community. We hope the government will carry us along in its employment scheme at the health centre. With that, we would feel a bit appreciated for all our efforts at establishing this clinic when the government couldn’t. The reality is that we built this place from conception to construction and are religiously maintaining it. The authorities at the state and local council should extend to us some inclusion in return.’’, they chorused to my prodding.

Besides their complaints of being left out of employment, the good people of Ogbuebulle brim with pride at their attracting a modern primary healthcare centre in their community – thereby helping their people to attain better health and longer life span. They remain eternally grateful to their daughter, Dr Ngozi Mbibi and her NANNNA – for pushing their long-held dream to reality – to the benefit of all and sundry.