Why did COVID-19 hit Kano State below the belt?

• Kano budgeted N1,805.88 per head in 2020 health projection

When Kano state recorded its first confirmed case of COVID-19 on April 10, 2020, many people knew that there were going to be issues in respect to the level of preparedness of the state government to adequately manage the emerging cases of the virus.

The irony, however, was that before the Nigerian Centre for Disease Control (NCDC) announced the Kano case,  Governor Abdullahi Umar Ganduje addressed journalists and provided information on the patient.

It was a 75-year-old retiree and former ambassador, who had travelled to Kaduna, Abuja and Lagos, and came back to Kano on March 25. He was ill for few days and voluntarily invited a medical team, who took 10 samples of his blood for testing.

“After the sample was returned, it was found out that he was positive while the other nine (samples) were negative. It is confirmed today that we have a positive case of COVID-19 in Kano. He has no history of travelling abroad in the last six weeks. Also, his medical report shows that he has a heart problem, which aggravated his case,” he said.

No doubt, on the fact that Kano state is one of the most populous state with a projection of over 17 million people. It was apparent that, Kano was one of the first Nigerian states to establish isolation centers and one of the first to close their borders as first measures taken to curb the spread of the virus.

Health Minister, Dr Osagie Ehanire

• The state’s oversight

In its 2020 budget, Kano state government had set aside a  total of N30.7 billion, representing about 15.5% of the budget is devoted to the health sector in managing two tertiary health facilities, 34 secondary facilities, 1,066 primary facilities and 244 private health facilities as well as other health related issues for the over 17 million people in the state. Looking at the health budget per head, it means Kano State planned to spend only N1,805.88 on the health of each indigene or resident in the state. Because of this meager vote for health, it was also apparent that one wouldn’t expect a prompt and rapid response to the pandemic as it emerged, taking into consideration what was put aside for the sector.

Unfortunately, the state government concentrated on surface dressing the issue and forgetting the safety and adequate provision of working equipment and Personal Protective Equipment (PPEs) to the personnel and the facilities.

Initially, the state had three isolation centres but later increased them to eight, with 27 ventilators and 29 oxygen cylinders.

Moreover, the state didn’t do much in public awareness campaign as up till this day. There is a huge number of people in the state who didn’t believe in the existence of COVID-19, while some believe that it exists but it affects only the rich.

•  Lockdown Vs Palliatives

Immediately after the recorded index case, a fund raising committee was inaugurated and over N600 million in cash was realized and food items worth over N150 million was received as donations from organizations, individuals and groups within and outside the state.

When new cases kept arising, the state announced a total lockdown to curb spread of the virus and the lockdown was again emphasized by Mr President with two weeks extension. However, the state flagged-off  palliatives for just 50,000 people and the federal government announced a donation of 60 trucks of food to the state.

However, the main issue that is said to have influence the failure of the lockdown measures taken by authorities is linked to  the state’s high population density; sociocultural and behavioral factors as well as the lackadaisical attitude among many of the city’s residents towards curbing the spread of the virus.

Most importantly, it is clear that the health sector of the state is very weak and the leaders lack the political will to make the needed improvement in the sector.

State of Health Facilities in Kano.

• Too many deaths

Gradually, the state began to record mass deaths of the elderly and authorities in the state kept denying the mass death, while the media kept the pressure going till when the state government succumbed and admitted that people are dying.

Verbal autopsy was conducted by asking caregivers of the diseased or their family members to provide the health conditions of those who died. Based on that there were indicators that the mass deaths could be related to COVID-19. Initially, the report failed to specifically take a stand on cause of the deaths, but it later admitted that most of them were connected with Covid-19 infections.

• Many health workers tested positive

Due to inadequate provision of PPEs at the state’s facilities a lot of innocent health personnel have contracted the virus. They had made several calls  to the authorities to provide effective PPEs.

It could also be recalled that the National President of the Nigeria Society of Physiotherapy (NSP), Dr Rufai Yusuf Ahmad has revealed that four of its members had tested positive for coronavirus in four states across the federation.

It is clear that the health sector of the state is very weak and the leaders lack the political will to make the needed improvement in the sector.

The national president disclosed this in a statement issued in Kano. It revealed that the society had lost one member in Uyo.

“Report reaching the society revealed that four Physiotherapists have contracted Covid-19 while discharging their duties, with first incident in Bauchi, Kano, Lagos and Jigawa respectively and 16 physiotherapists that came in contact with confirmed cases of Covid-19 have gone into self-isolation across the country with one death of a Physiotherapist/Medical doctor in Uyo state some weeks ago,’ he had said.

Similarly, Kano state chapter of Nigerian Medical Association (NMA) had revealed that 34 doctors tested positive for the virus in the state.

The state’s NMA chairman, Dr Sanusi Bala, stated this in a statement issued by the association. According to him, one of the confirmed cases had died. He added that many of the victims were doctors at Aminu Kano Teaching Hospital (AKTH) and other private clinics across the state.

“These members were infected while on normal clinical routines by attending to unsuspected COVID-19 patients,’ he said.

• Kano elders say government’s response to COVID-19 is ineffective

An initiative called Kano Against Covid-19 has expressed concern over the ongoing fight against the COVID 19 in the state.

The initiative, in a press statement signed by elders such as the former NRC presidential candidate, Alhaji Bashir Tofa, Barrister A.B. Mahmoud, SAN, Professor Auwalu Hamisu Yadudu, Professor Jibrin Ibrahim and Mrs Maryam Uwais, among others, observed that the situation in the state was becoming worrisome.

The Initiative observed that while some states, like Lagos, had exhibited capability and professionalism in dealing with the crisis, the situation in Kano State has been quite worrisome.

“It was obvious that there was inadequate preparation at the state level and control measures were ineffective. There was lack of clear messaging to the citizens. Discordant tunes were also coming from some religious and community leaders expressing doubts about the existence of the disease,” it said.

It is vividly clear that, the state’s response to COVID-19 pandemic was inadequate. Also, the people’s attitude to precautionary measures leaves much to be desired.

Therefore, there is a need for an effective approach to curtailing the spread; there must be distribution of palliatives  through credible channels, coupled with a transparent and accountable process. More public awareness campaigns, using all available resources that can educate the public on what they need to do in the fight against the spread of the virus.