But for the conspicuous signpost erected at the fringe of the settlement, it is unlikely that frequent travellers on the Ilorin-Omu Aran Highway in Kwara State are aware of a crumbling hospital and a cluster of poverty-ridden colonies of abandoned leprosy victims located at the Okegbala axis of the expressway. Established about 75 years ago by a Canadian doctor and evangelist for the advancement of missionary activities, the hospital is virtually in ruins five decades after the legacy project was bequeathed to the Evangelical Church Winning All (ECWA). WALE AJETUNMOBI reports the deplorable state of the hospital and the pathetic story of Okegbala inmates who wallow hopelessly in hunger, diseases and severe living conditions.
IT took Madam Felicia Adeoti, an amputee, about five minutes to crawl from her dingy room to the corridor of the mud house she has lived in for 58 years. She was pressed around the dim-lit corridor by the urge to answer the call of nature at the nearby bush; but her crutches were not in sight to facilitate easy movement to the bush.
She rambled through the passage filled with grubby objects and utensils. Her speed was dictated by the pressure from her bowel. She mustered all the energy she could to crawl faster, so she could prevent an embarrassing situation.
About 12 minutes after, Madam Adeoti got to the bush to pass out the waste, feeling relieved afterwards. At her own pace, she crept back to the decrepit mud building she has lived in since she was 30 years old.
With the aid of her crutches, the 88-year-old woman retired into her room to sleep. About three hours later, she bolted out of her isolated building and limped towards the expressway to look for her daily bread. She fends for herself through street begging.
Hours later, she returned, clutching a black polythene bag in which she wrapped a meal of amala and ewedu soup, a local delicacy given to her by a Good Samaritan. She retired into her room to savour the delicacy and then waited for the break of another day for the daily routine.
Madam Adeoti’s routine aptly depicts life at Okegbala, a secluded settlement in Kwara State bequeathed by European missionaries to the Evangelical Church Winning All (ECWA) formerly known as Evangelical Church of West Africa.
Located between two ancient towns of Oro and Omu Aran in Irepodun Local Government Area, Okegbala is the site of ECWA Leprosarium, a hospital established 75 years ago by missionaries who were recruited for evangelism activities in Africa by Soudan Interior Mission (SIM), a gospel body founded in 1893. The hospital is circled by three depleting colonies of leprosy victims.
As its name connotes, Okegbala (Mount of Redemption) used to be a famed healing hamlet for people infected by mycrobaterium leprae otherwise known as leprosy. The community became famous at the time the infectious disease was rampant in rural communities. Beyond administration of effective therapeutic drugs and efficient surgical operations to heal victims, the hospital’s founders also believed in the efficacy of prayers as a cure for the leprosy victims taken to the leprosarium.
Alas, all these clinical triumphs have become past glory about eight decades after the leprosarium was established in the remote community. Okegbala has become a classic narrative for misplaced priority, forgotten evangelism, government’s insensitivity and failure of humanity.
It is a story of disappointment and neglect; a grim and discomforting picture of the appalling condition that can become the lot of any human being neglected by the society. Okegbala is a seething cauldron of acute hunger, endless starvation, apparent malnutrition and life-threatening diseases.
For the inmates, poverty is not a choice or an accident but a way of life. In the settlement, penury is an integral part of life. While none of the inmates was born to be lazy, they lost their productive instincts the day they contracted leprosy, a non-tropical disease that causes inflammation of nodules beneath the skin and mutilation of finger digits.
A settlement of necessity
In the pre-independence period, the prevalence rate of leprosy in Nigeria was put at over 20 per cent, according to a 2013 Leprosy Review journal co-authored by Sunday Udo, Joseph Chukwu and Joshua Obasanya. The journal, titled, Leprosy Situation in Nigeria, was published by Lepra, a United Kingdom (UK)-based organisation.
The figure was staggering for a populous country with significant population of women and young people.
Before the infusion of orthodox therapy in Africa’s traditional medicine, Africans had little understanding of the causes of leprosy. Among the Yoruba, a prominent ethnic group in Sub-Saharan Africa, it used to be a popular belief that leprosy could only be a spiritual affliction from the deities.
As a result of this belief, leprosy victims were not allowed to live among the populace. This became the practice until a global action was initiated to combat the infectious disease. In line with global response at the time, leprosy settlements were set up across Nigeria to safeguard public health and provide relief to victims.
This ostensibly necessitated the establishment of the ECWA Leprosarium in Okegbala. The site used to be a thick forest far removed from the town. The community is located about six kilometres away from Omu-Aran town.
The leprosarium was founded in 1942 by Dr. H. Herbold, a Canadian physician who came with his wife, a nurse, for SIM evangelism. In the course of their missionary activities in the Kabba Province of the evangelical group, Herbold established a makeshift leprosarium in response to the widespread cases of leprosy in communities around the old Kwara State.
The leprosarium took off in Kabba, a town in present Kogi State, with about 50 patients from communities in Ekiti, Oyo, Kogi and Kwara states.
Since it was regarded a taboo for leprosy-infected persons to live in the town, the late Herbold moved the patients to a withdrawn location between Omu-Aran and Ilofa. The unfettered access which the leprosy patients had to the community water necessitated the expulsion of the Canadian missionary by the Ilofa people, who did not want the spread of the disease in their town.
The expulsion from Ilofa prompted Herbold and his wife to approach the then traditional ruler of Omu- Aran, a nearby town, to get a permanent location to build the leprosarium. The Omu-Aran traditional council, it was gathered, granted the missionary’s request after the traditional ruler was convinced the leprosarium would not be built close to the town. The entire perimeter of the Okegbala settlement, The Nation learnt, used to be covered by a thick forest and it was far removed from the town at the time the leprosarium was built.
In 1943, the leprosarium started operation with 36 leprosy patients. The Nation gathered that the hospital was conceived as a healing home where leprosy-infected persons would get free treatment. Herbold deployed personal resources to treat leprosy patients without collecting a dime from the victims’ family members.
The late Herbold’s wife, it was learnt, established a clinic and maternity home within the leprosarium to extend medical services being freely rendered by the SIM missionaries.
Since Okegbala was a withdrawn location, Herbold and his wife were based in Omu Aran town. But they visited the leprosarium twice daily to attend to the medical needs of the patients. For giving free treatment, the hospital became popular and this led to the influx of leprosy-infected persons from far and near.
In response to increased population of leprosy victims, Herbold, it was gathered, permanently relocated to Okegbala to fully engage in the mission of healing people of leprosy and other life-threatening diseases.
After healing, Herbold engaged some of the victims to work in the hospital. Some joined him in missionary activities. With the increased population in the settlement, the missionary body built houses in Okegbala to accommodate health workers being engaged by Herbold in leprosy work and evangelism.
Once patients were cured of leprosy, they would be discharged and reunited with their family members. Some of the patients who suffered digit mutilation and deformities because of late access to treatment were rejected by their families.
Due to stigmatisation and rejection, the deformed patients returned to Okegbala to start a new life. These rehabilitated patients created three colonies – Alabe, Aiyekale and Oloruntele – around the leprosarium, which they later saw as their new homes. Each colony had an average of 150 inmates and the population of lepers in the three colonies was shooting up before Herbold and his wife permanently returned to Canada in 1965.
In 1956, SIM founded ECWA and set up the church to continue its missionary projects in Nigeria. As the SIM missionaries returned to their respective countries, it was gathered that Herbold handed over the operations and management of the leprosarium to ECWA. The leprosarium became the sole referral centre for leprosy cases in Kwara State. As a result of this, it was learnt that some missionaries volunteered to come back to treat leprosy patients on part-time basis.
Herbold was billed to visit the hospital on inspection before he died childless in 2007.
Failure of partnership
ECWA naturally became the beneficiary of the SIM legacy projects, because the church was founded by the missionary body to propagate and expand its activities in communities where populations of Christians were few. Findings showed that leprosy treatment was incorporated into the SIM’s activities because of the prevalence of the disease in the rural areas where its evangelism was targeted.
Since SIM was the parent body of ECWA, it was plausible for the missionaries to will their legacy projects to the church when they were returning to their countries. Herbold transferred the proprietorship of the leprosarium to the church before he left Nigeria in 1965. The leprosarium was renamed ECWA Hospital after the church was registered.
But the deplorable state of the hospital, The Nation gathered, shocked the SIM representatives who recently visited Nigeria to inspect some of the legacy projects left in the care of ECWA. It was learnt that the SIM emissaries were traumatised to see the condition of the hospital. They were said to have expressed disappointment over the church’s inability to maintain the hospital.
Since the management of the missionary projects and properties had been willed to ECWA, it was learnt that the missionary body could not do anything to optimise the hospital.
A member of the church in Omu-Aran, who wants to be identified as Elder Ogundele, told our correspondent that ECWA seems overwhelmed by the management of missionary projects left in care of the church.
Ogundele said: “The church is biting more than it can chew. ECWA has numerous clinics scattered across the country. Some of these facilities were bequeathed to the church by SIM. The facilities are too much for the church to properly manage.”
It was also learnt that the politics of leadership in the church and policy summersault are part of the impediments inhibiting the church from properly managing the legacy projects bequeathed to it by the missionary body. Ogundele said top-level members of the church’s leadership don’t have interest in the management of the legacy projects inherited by the church.
Ogundele said: “Each time ECWA holds election to choose its national leaders, the people don’t talk about how the church can maintain and manage the projects inherited. All they care about is the church administration. The fact is that no national leader of the church has visited the ECWA Hospital to ascertain the state of the hospital’s facilities.
“When new leaders are elected, they discontinue existing projects and embark on new ones. This is why the state of the ECWA Hospital and other legacy projects deteriorate. It would surprise you to know that there is no subvention for the leprosarium in the budget of the church. If the hospital must be improved, the church needs to make funds available for its running. But, is ECWA leadership ready to do this?”
Kwara government’s ‘opportunistic’ alliance
In response to the global effort to combat leprosy, the Federal Government in 1979 directed the federating states to open referral centres where victims would be treated and rehabilitated.
In 1989, the then military government of Gen. Ibrahim Babangida established the National Tuberculosis and Leprosy Control Programme (NTBLCP) to implement policies and strategies initiated by the World Health Organisation (WHO) aimed at eliminating the disease in member states.
Between 1991 and 2012, finding showed that a total of 111,788 leprosy victims were successfully treated with Multi-Drug Therapy (MDT). In the 11-year period, Nigeria achieved the WHO elimination target of less than one case per 10,000 population. In practice, however, the disease remained highly endemic in rural communities in the northern part of the country where leprosy prevalence was said to be greater than one in 10,000 population.
Rather than setting up a stand-alone Leprosy Referral Centre as directed by the Federal Government, the Kwara State Government collaborated with the privately-run ECWA Hospital to treat and rehabilitate leprosy victims.
Following investigation, The Nation gathered that the Kwara government’s opportunistic partnership with the ECWA leprosarium was initiated at a time the hospital was grossly under-funded by its owner.
The hospital’s operation at the time was run through Internally-Generated Revenue (IGR). The hospital was in distress for many months because it was struggling to maintain the cost of operations. ECWA, the owner, did not make funds available to rescue the dying leprosarium.
The state government made the ECWA Hospital its sole referral centre for leprosy and tuberculosis.
Findings made by our correspondent revealed that this partnership was not supported by any statutory agreement. In maintaining this informal partnership with the ECWA Hospital, the government offered to be giving a monthly subvention to the hospital to augment the cost of running its operations.
The subvention, The Nation gathered, started from N20,000 when the partnership agreement was sealed. The monthly subvention was increased over the years to N100,000, which is presently paid by the government.
While the government’s monthly subvention has achieved little in the day-to-day running of the hospital, the fund, The Nation gathered, is not regularly paid by the state Ministry of Health which has the duty to sustain the partnership with the hospital.
The hospital’s Administrative Officer, Mr Samuel Abiodun, told our correspondent that the monthly subvention from the government was hardly enough to augment the cost of running the hospital. He said the bulk of the operational cost came from the hospital’s income through services it rendered to out-patients referred from outside its area of operation.
Abiodun said: “The hospital’s income is shored up by the medical services rendered to out-patients. The management expanded the hospital’s wards to accommodate as many patients as possible. We had periods when the hospital wards were fully occupied by out-patients. The money we collect from these patients is used to run the hospital. The monthly subvention paid by the Kwara government is not enough. It falls short of what should be remitted to a state’s referral centre for leprosy.”
The management of the hospital said the subvention does not come regularly. Abiodun said the money is given out only when the Kwara State Ministry of Health officials deem fit.
“Except the government willingly makes the money available to us, we cannot force them to give us the money because the government considers the hospital not to be part of the state’s liabilities,” Abiodun said.
An NGO’s rescue mission
The inadequacies of government’s partnership with the ECWA Hospital led to the intervention by The Leprosy Mission of Nigeria (TLMN), a non-governmental organisation (NGO), in 1980. The NGO’s partnership with ECWA was meant to provide operation funds and equipment support for the hospital in keeping with its leprosy treatment mission.
TLMN also partnered with Kwara State government to facilitate treatment of new leprosy cases and management of old ones. The partnership, which lasted for 29 years, restored the leprosarium’s lost glory as the sole referral centre in the state for leprosy.
The leprosarium was in a deplorable condition before TLMN made the move to support it with funds, equipment and manpower.
Before TLMN came in, the hospital was said to be an “abattoir” where people died daily. The hospital could only boast of three employees. The TLMN’s partnership brought life back to the hospital.
Our findings revealed that TLMN brought in doctors, nurses, drivers, cleaners, gardeners and other staff to revive the hospital. Before the hospital’s partnership with the NGO was sealed, there was no electricity in Okegbala. Activities in the hospital were at the lowest ebb until TLMN provided a big generator to light up the community. The NGO also brought poles and electric cables that connected the community to the national grid.
A former employee of the hospital, Dr. Ajayi Olawale, said the church’s “unpredictable politics” and “unsympathetic leadership” have been the factors slowing down its progress. Describing the hospital as a “glorified mortuary”, he said the story changed when the TLMN moved in with massive support.
He said: “Before TLMN partnered with the hospital in 1980, there was no presence of government in the hospital. Yet it was a referral centre for leprosy and tuberculosis cases in the state. The money invested in the operation of the hospital was generated by the hospital itself.
“TLMN moved in because the NGO felt ECWA Hospital was the best place to achieve its aims of funding leprosy treatment in the state. Kwara government officials were happy when they learnt that the NGO came with funds, equipment and manpower. Government saw the TLMN’s intervention as opportunity for it to reduce and stop supporting the leprosarium. We should not heap blame on the government because there is an original owner, which is ECWA.”
If the hospital must be effectively run, Dr. Olawale said, ECWA must hand the running of the leprosarium to the government. But he said the government may not run it effectively because of dwindling resources.
Dr. Olawale added: “The point is that ECWA does not have the capacity to take the hospital to any level. The church doesn’t even have the means. The only thing that can take the hospital out of its deplorable state is when ECWA decides to render other services in that place apart from leprosy treatment.
“The church can establish Community Health School in that place. The leprosy treatment is no longer lucrative because of the minimal cases we have in the country now.”
The Nation gathered that between 2001 and 2005, facilities in the hospital were upgraded by TLMN. The hospital’s Ophthalmology Department was supplied with modern tools and gadgets to treat eye diseases. Also, the surgical theatre where amputation is conducted was fitted with state-of-the-art gadgets to make it functional.
In this period, the medical services rendered by the ECWA Hospital were of premium quality, it was learnt. But all these happened as a result of the support by TLMN, which committed funds and equipment to running the hospital.
The intervention by TLMN led to improved earnings for the hospital, which resulted in the raising of the number of employees to 40. It was gathered that TLMN took up the responsibility of paying the professionals working in the hospital, which included doctors, nurses and other health workers.
The NGO, it was learnt, also paid the cleaners and drivers to ensure the hospital did not place unnecessary burdens on its income.
In 2009, TLMN, however, stopped funding the hospital because of the global economic meltdown. The foreign donor could not provide adequate funds to support the hospital in rendering premium service. This made TLMN to drastically reduce its funding of the leprosarium.
Despite the hospital’s appalling condition, it remains the only hospital treating leprosy in Kwara State. It is also the only hospital offering internship on leprosy and tuberculosis therapy and management for nursing and medical students studying in the state.
Equipment shortfall, traumatic amputations
Findings made by our correspondent showed that more than 1,000 amputations had been carried out since the establishment of the leprosarium about 75 years ago. But these medical procedures were done without the use of basic clinical instruments to make the surgeries painless.
The hospital’s surgical theatre falls short of standards. The expansive room is visibly empty and lacks basic instruments. The only gadgets seen in the theatre are an outmoded motorised lighting stand and a rickety stretcher on which amputations are carried out.
There is no anaesthetic machine that can be used to deliver anesthesia to patients as they undergo a medical procedure. For any medical operation to be embarked on, standard practice requires that a patient be placed on anaesthetic machine to ensure a steady flow of gases such as oxygen and nitrous oxide. The machine delivers the anaesthetic gases to the patient at a safe pressure and flow, which makes the procedure pleasant.
The hospital does not have an X-Ray machine to scan and assess acute bone damage. It also lacks modern devices to disinfect sterile surgical instruments used by a surgeon during an amputation operation. The sterile surgical tools are wrapped in pieces of cloths and kept in an outmoded vacuum machine for purification.
As obligatory for a standard surgical practice, the hospital lacks post-operative recovery section where amputees can be further examined to prevent complications and to hasten recovery process. No bone files and haemostatic plug used for proper shaping of bone and to prevent continuous bleeding after limb amputation.
Without these basic gadgets and tools, patients are subjected to traumatic amputation process, which may bring about unplanned complications or lead to untimely death. This has been the practice in the hospital for a long time.
To stop unprofessional medical practice in the hospital, some instruments were procured and donated to the hospital last year under a one-year supporting project initiated by TLMN. The Nation gathered that the aim of the project was to renovate key hospitals in Kwara State, supply them with drugs and equipment.
The ECWA Hospital was picked as one of the three hospitals selected as beneficiaries. Some modern instruments were donated to the hospital’s Ophthalmology Department.
Abiodun lamented lack of modern X-Ray machine for scanning. He said the mobile X-Ray machine brought by the missionaries could not be used again because of its excessive rays, which, he said, could constitute hazard to patients.
He said: “We decided to abandon the X-Ray machine a long time ago. We cannot continue to be compromising people’s health and putting their lives in danger by exposing them to hazardous radiation because we want to make money for the hospital. This is why we decided to stop using the X-Ray machine that we have. Apparently, we don’t have X-Ray machine at present; we have not been able to procure another one.
“It is the X-Ray machine that will be used to assess the level of damage done to the bone if any patient is battling ulcer. Without this machine, early detection of damaging effects of ulcers is difficult and patients may suffer digit mutilations and loss of limbs as a result of this.
“We also don’t have physiotherapy instruments and iteming machine. These are important medical tools that should naturally be in the hospital. An infection that has gone beyond the knee cannot be managed. We will need to do an amputation for such patient. We would need to refer the patient to our sister hospital in Egbe, Kogi State.
“But if the infection is below the knee, the amputation is done in our theatre with a lot of stress, because there is no modern equipment to properly carry out amputation. If we have the equipment, our medical personnel can successfully carry out the amputation.”
‘Hospital’ll naturally collapse’
Dr. Olawale said except the government and its owner inject funds to revive the hospital, he saw no hope of survival for the leprosarium. In a few years, he said, the ECWA Hospital would collapse because of the successes recorded by action against leprosy in Africa.
He said: “Let me tell you that ECWA Hospital will die a natural death in a few months. This is because the leprosy work is almost going into extinction. Unlike HIV/AIDS, there are no doctors working on the field again, since there are no complicated medical issues that would require doctor’s attention. The focus of donors is on the socio-economic burden of leprosy to victims and their communities.”
If the hospital must remain active, the former employee suggested, that the government needs to take over the hospital and turn it into a full-blown community health centre. But Dr. Olawale believes that ECWA lacks the financial capacity to rescue the hospital from the edge.
He added: “ECWA must accept the reality of the fact it does not have the wherewithal to keep the hospital functioning. The church needs to approach the government for help in rescuing the hospital from the brink of collapse. Except there is a miracle, I don’t see the hospital surviving another decade.”
A hell on earth
While Nigeria records an average of 3,000 fresh cases of leprosy annually, according to statistics released on World Leprosy Day by the Minister of Health, Prof Isaac Adewole, the virulent disease does not pose any significant health risk to the country again. This is as a result of the breakthrough achieved with the successful application of MDT.
What poses a menace is the management of the old cases. The socio-economic burdens which the virulent disease wreaked in rural communities are immeasurable. Victims have had their lives inadvertently re-organised or disorganised. Many of them have accepted their fate, abiding by the interminable consequences which the disease brought to their lives. Some others who could not live with the harsh fate breathed their last on a note of regret.
Okegbala is a poignant paradox. Life in this place is brutish and unbearable, yet the inmates cannot leave because they have no other place to go. There is famine in the community and inmates literally live in hell. Their daily survival depends on how much they can realise from street begging and handouts from kind-hearted individuals.
In the last 10 years, street begging has been the source of survival for Mrs Abigail Olaiya, 65, and her senior, Mrs Olufunke Olaiya, 80. Married to the late Pa Jeremiah Olaiya, both widows have been living in the lepers’ colony in the last 30 years after they were cured of leprosy.
Olufunke, who suffered digit mutilation after she was cured of leprosy, became sightless some 15 years ago after she contracted glaucoma. She permanently stays in a hut and depends on the food brought home by her junior wife, Mrs Abigail, an amputee. For the widows, hunger is part of everyday living. Their continued survival depends on how much they get from street begging.
Pa Samuel Asaolu cannot afford to miss the first bus to Omu-Aran town for alms begging, else there would be no food for that day. The 90-year-old amputee from Erin Mope village in Moba Local Government area of Ekiti State described life in the colony as tormenting. He burst into tears as he relived the suffering of inmates in Okegbala to our correspondent.
Asaolu said: “I cannot recall the exact year I was brought to Okegbala for leprosy treatment, but I am sure I had been living in this community before Independence. I was about 30 years old when I contracted the disease. My wife and members of the family brought me to this place.
“When I was cured of the disease, I returned home, but I was sent back here because my leg was amputated. They felt I would infect them with the disease. Since I got here, I never set my eyes on any family member. They abandoned me here and never came back to check on me. Even, the wife I married before I contracted leprosy did not come again.
“I used to be a farmer in my village, but I could not engage in farming when I got to this place due to the amputation. I cannot engage in any trade and this is making life tormenting for me. If I fail to join the first bus to Omu-Aran to beg for alms, I will not eat. This is how many of us have been living in the past 50 years. We depend on begging and handouts some kind-hearted people send to us through the ECWA Hospital.”
Finding love in hopeless times
Beyond bearing the endless pain of limb amputations and digit mutilations, the Okegbala inmates also carry scars of emotional injuries in their hearts. To the leprosy victims, the disease re-designed their destinies and turned around their life dreams.
Having been abandoned to their fates by spouses and family members, the inmates believe life must go on. Many of them resigned to fate and started a new life. Courtship became a necessity in the three colonies as the number of abandoned leprosy victims increased.
Awawu Fulani, an 85-year-old Oro indigene, said she was married with three children before she became a victim of leprosy 50 years ago. She had digit mutilation, which led to the amputation of her legs. She said the deformity made her first husband and children to abandon her in the community.
Though hurt by the stigmatisation, Awawu’s rejection did not deter her from getting married again. Some 40 years ago, she got married to Pa Amodu, a 90-year-old amputee, who was equally rejected by family members.
Explaining the reason for the match-making, Pa Julius Fabunmi, who makes leather covers and crutches for the inmates, said the marriage became necessary because some of the victims were relatively young when they contracted the disease which made their families to abandon them.
Fabunmi said: “All the old people you see here were brought to the leprosarium when they were younger. I can remember that there are some of them who were brought here with infants. This tells you that they were sexually active at the time many of them started living in the colony. This is why it did not come as a surprise to us when they started courtship and marrying themselves.
“We have some of them who were never married but got married in the colony and became parents. Some had been married but had to remarry because of the stigmatisation they suffered from family members back home. They all started new life here, because they could not afford to allow the disease to deprive them of procreation.”
For some of them, however, it is goodbye to marriage. Such is the case with Mrs Nafisatu Aminu, a 72-year-old Ilorin indigene, who has been living in the colony for 35 years. According to the mother of two, she was a successful fish trader in Idi-Ape Market in Ilorin before she was struck by the disease.
Mrs Aminu, who suffers digit mutilation, said she had no reason to fall in love again, since she was abandoned by her husband and children.
She said: “I used to be one of the successful fish traders in Idi-Ape Market. I cannot vividly remember the year but I know I traded in the market during the regime of President Shehu Shagari. My husband and two children used to look up to me because I provided my children whatever they needed on the home front.
“But everything changed when I suffered leprosy. My fish business crumbled and I lost my means of livelihood. I was brought to this place by my husband. After he left, I never set my eyes on him again. He abandoned me here until his family members came here some seven years after to tell me he was dead. I never felt any sense of loss after they broke the news of his death to me, because the man never loved me.
“He took my children away and abandoned me in this place. For this reason, I decided not to remarry. It is hard for me to fall in love again with anyone. I have accepted the fate brought to me by the disease. If I ever have the opportunity to live again, I would be wiser to choose a life that will be different from this. This is not the kind of life I prayed for.”
Famished inmates battle malnutrition, hypertension, terminal diseases
While leprosy has wreaked irreparable socio-economic havocs in the lives of the inmates in Okegabla community, the victims’ harrowing existence is daily compounded by the unhealthy conditions in the community.
Apart from the growing cases of malnutrition resulting from persistent hunger and lack of balanced diet, lack of sanitation in the colonies is posing a great danger to the survival of the inmates who live their lives every day in an extremely unhygienic environment.
The deplorable conditions in the community are exposing the famished inmates to terminal health challenges. Glaucoma is spreading among inmates in the colonies, leaving many of them with impaired vision.
According to patients’ records obtained by The Nation, 80 per cent of the inmates battle hypertension, diabetes and asthma. The cause of growing cases of hypertension and diabetes, according to Dr. Kayode Ajayi, the hospital’s Tuberculosis and Leprosy Supervisor, is as a result of lack of dietary supplements.
Dr. Ajayi said: “Since the inmates don’t have means of survival, there are growing cases of hypertension and diabetes among them. The colonies were established because of high stigmatisation in the cities. Some of the inmates had businesses before they contracted leprosy. The loss of economic opportunities has got some of them thinking, thereby raising their blood pressure, which leads to hypertension.
“The inability of the inmates to take in balanced diet is the reason for the growing diabetes among them. The inmates eat whatever foodstuffs are given to them, which are mostly starch. Some of them who have high tendency to have diabetes become vulnerable easily. We regularly treat and manage these conditions in the colonies.
“There are other conditions, which we manage regularly. These include asthma and glaucoma. We have many of the inmates develop visual impairment as a result of untreated glaucoma. But this is less frequent compared to asthma and hypertension, which are affecting majority of the inmates.”
Allegations baseless, says commissioner
Dr. Alege, the Kwara State Commissioner for Health, however, denied the allegations of neglect levelled against the government, saying there was no time the inmates were neglected. Through an MoU signed with the National Tuberculosis and Bilirubin Programme, Alege said, the government regularly supports the inmates.
He said: “The government also gives monthly subvention to run the leprosarium. As I speak to you now, we have paid the subvention up to date. The ministry recently made passionate appeal to Governor (Abdulfatah) Ahmed to increase the subvention in the state’s 2017 budget from N100,000. I can assure you that by the time the budget is ratified, the monthly subvention would increase. But you can rest assured that there has been no day the government neglected the leprosy patients.”
The commissioner disclosed that there had been efforts to increase humanitarian aids to the Okegbala settlement, revealing that he recently had “extensive discussions” with the national coordinator for National Leprosy Control Programme on the need to improve support for the hospital and members of the community. Alege said the government also partnered with philanthropists, religious groups and organisations to regularly donate materials to members of the community.
He said: “We have a little problem. After treatment, some of the leprosy patients don’t return to their homes because they are always rejected by their families and communities. Some of them, after the government has taken care of them by giving them free drugs, their families would still send them back to Okegbala. This is why we signed the MoU with National Leprosy Control Programme to complement the state government’s effort to support these rejected victims.
“When the government learnt that the discharged patients were being stigmatised, we embarked on public advocacy across the local councils to stop stigmatisation so that these treated patients could return home. It seems difficult for people to live among the victims after they have been healed. That is why some of them remain in the community.”
On the allegation that the monthly subvention was stopped, Alege said: “There was a period in 2015 when we could not pay the money due to dwindling revenue of the state. Civil servants were equally affected.
“But since March 2016, we have not failed to remit the subvention to the hospital. It is not only ECWA Leprosarium that gets the government’s subventions, other centres such as tuberculosis centre, also get.”
On whether the monthly subvention is meant for feeding the inmates or to run the hospital, the commissioner said: “We normally give the subvention to the hospital management, which uses its discretion to disburse the funds according to its needs and liabilities. For now, the government does not give stipend to the inmates. We have been taking care of the victims through our partnership with the National Tuberculosis-Leprosy Centre.
The commissioner said the government had been in talks with the Federal Government to take over the leprosarium and make it a national centre for leprosy in the North Central zone.
“We are working on the modalities to achieve this aim. If we seal the agreement with the Federal Government, we will then approach ECWA for the formal handing over of the leprosarium to the government to run,” he said.
On government’s failure to initiate socio-economic programme and employment opportunities for the inmates’ children, Alege said: “They have not made any representation to the government in that regard. When they come forward with their socio-economic challenges and employment request for their educated children, I believe Governor Ahmed will listen to them and make move to relieve them of their burdens. The government has been making social impact in every area. We would be willing to help them when they come forward with their requests.”
Efforts by our reporter to get the comments of ECWA Trustees in charge of the hospital did not succeed as the leadership did not respond to our enquiries as promised.
