Views of both the Department of Biological Sciences (left) and the Iya Abubakar Computer Centre (right).

The University Health Services Directorate, Ahmadu Bello University Zaria.

The building of the University Health Services initiated as a sickbay in 1952 by the Nigerian College of Arts and Science. It has grown through thick and thin to its bigness now and continues to grow bigger. A population in excess of hundred thousand (100, 000) people with 35000 student population is now served. Of the new patients we see daily 60-70% is students and we expect to see more.

At the beginning when the scheme smaller and more intimate, it seemed easier to know the students. The basic philosophy was of service to staff and student with genuine caring. The bigness and business of the Health Service now fogs this philosophy but if you look carefully it's still there.

From the beginning, the struggle has been of space and resources. On the Main Campus, the present location of the ‘Sickbay’ adjacent to Suleiman Hall covers a total of over 2,600 sq meters, and was occupied in 1968. Before this date, the ‘Sickbay’ had been located in various areas at various times, from Nagwamatse road in residential Area A, to the Cappa housing unit, then to the former Community Medicine Department and finally to the present site.

Apparently, the movements and the expansions of Sickbay had been necessitated by the need to create a more conducive space to cope with rising demand for these services as the institution’s population rapidly grew. An appreciation of this rising demand may be gained from the fact that whereas in 1972 the main campus Sickbay had attended to an estimated average of 350 cases on daily basis, this figure had gone up to 500 by 1982 and 700 by 1987 and 700-1000 in 1997 to 2002.

On the Kongo campus, on the other hand, the Sickbay had occupied its present location (opposite the Security office) since the inception of the campus, albeit with expansion programme at various stages to cope with the rising demands for its services. Presently, the Unit occupies about 2,000 sq meters and has attended to, on a daily basis, about 200 cases by 1972, 286 cases by 1982 and 309 cases by 1987, accordingly. The same trends have characterized the Sickbay in all other campuses of the University and, like the libraries, the Sickbays constitute points of daily convergence by University staff of all categories for the purpose of meeting personal and family needs.

With the growth of the population, the scheme has struggled to expand and is has now become a full fledged University Health Services unit with a curative wing at the status of secondary health care facility. It has used begging at times in order to grow!

Attempt in 1981/82 to expand it to a full fledged health center could not be accomplished (refer to ABU Life Project, Vol. 5), while in 1985 an extension of Child Welfare Clinic was carried out. In 1990, without the involvement of University Health Services, the user department, a building was erected by Physical Planning Unit vide National University Commission as a Sickbay extension. The use of the building had to be strongly debated and later on the Laboratory Unit, Dental section, Infant and Child Welfare, Ante-natal and Family Planning clinics took it over. The scheme has continued with the struggle.

A crisis in the University brought a Sole Administration to head the University. Before the Sole Administrator, 1995, the entire structures were dilapidated; equipment and service vehicles such as Ambulances, six refuse vans were all grounded. These are short of several other problems to be addressed. There was virtually zero funding coupled with inflation and increased population. Such important sections like pharmacy, laboratory, preventive and environmental health were almost completely crippled. The staffing situation especially in the medical and public health centre became terribly poor with only three medical doctors serving the whole community. There was generally low morale coupled with indiscipline. There was a total failure of sanitation and hygiene in the entire University. This was indicated by failure of refuse and solid waste disposal with heaps every where and also collapsed drainages and stagnant water. Mountains of refuse are seen along the frontage of the university etc etc. The UHS Director then was DR. J. U. Fasori an Indian who headed the department from 1978.

In 1996 the department was handed to Dr. A. Usman and to Dr. S.K. Musa in June 1997. The key player in the progress and management of University Health Services is the Director.

The Decline In Manpower:   By 1995, the clinic was reduced to a mere transit camp for doctors due to inadequacy in the University policy for attracting and retaining them. There is an exit of 13 doctors within five years. The Unit which had 266 staff (80 senior and 186 junior staff) by 1998 now has 194 (61 senior and 133 junior), shrinking by 19 senior staff and 53 junior staff due to retrenchment without replacement.

The Dawn:  Despite the odds the dream of achieving the goal and objectives of an African University health services was never lost. Success began with the period of military sole administrator rtd Major General Mamman Kwantagora, the unit was renovated in 1996 though the contract was terminated at a stage and could not be completed, 80% of the work was achieved. This administrator gave some level of autonomy to the UHS department began to strengthen sanitation activity of the health services as well as the medical arm.

Working closely with the unit, the Mahadi administration (1999 -2004) made remarkable progress in sanitation that has significant positive impacts on the environment, touching the physical, social and psychological well-being of the community. The standard of environmental health is exemplarily high such that the future leaders trained within the University will help in promoting similar standard in the villages and towns they may later work. There is emphasis on preventive health and curative medicine, with curative care expansion as in: 
ngagement of casual labourers in Samaru and Kongo campuses with more than 2000 people who have benefited and so far we have constantly 935 (excluding Students Affairs) currently on the payroll. There is the expansion of preventive and sanitation to four sections: environmental and sanitation, parks and gardens academic and parks and gardens residential and the addition of forest guard with employment of more technical staff. In each residential area workers are now permanently assigned to maintain sanitation.

1. The employment of the casual labourers has socioeconomic and security effect for the entire community It has enhance too the relationship between the University and its neigbours which is now very cordial. As a social service to the neighbouring communities, this has reduced unemployment tremendously.
2. The sewage disposal and treatment system also received significant attention especially with the construction of new inspecting chambers and rehabilitation of the collapsed ones. Over the years this has stemmed frequent incidences of sewage spillage in various parts of the University and has ensured adequate treatment of the sewer. More than ten prototypes public toilets/urinals were constructed in both Kongo and Main Campus. There are also more than ten refuse collection points erected. 
   In a study it was found by Mbuh e tal between 1997 to 2001 that there was a general decrease in the pattern and prevalence of most of the diseases as the environmental sanitation improved over the years. The prevalence of typhoid fever has reduced by 16.9% and that of diarrhoea has reduced by 14.02% respectively. The prevalence of hookworm too has reduced by 17.33% while that of ascaris infestation reduced by 14.12% (Book of Proceedings of the First National Conference on Environmental Health Society of Nigeria (EHSON).
   There was also tremendous decline in the cases of snake bites in recent years. There was no record of a single case from 2000 till now! (Emergency health records)
3. From the carcasses that constituted nuisance in the Estate yard, the administration was able to rehabilitate/refurbish up to 14 vehicles for sanitation work. It is also able to sustain regular repairs, servicing and fueling of these trucks. It has also purchase two new motor cycles for supervisions. Also for Kongo campus sufficient sanitation working implements that will last them for many years were procured recently. As a result, Kongo is wearing a new look.

Registration of the Facility by the National Health Insurance Scheme:
The clinic has successfully gotten registered as a Primary Health Care Provider for NHIS Social Health Insurance Programme. It also warn recently Secondary Health Care Provider in Ophthalmology, Internal Medicine, Dental Pharmacy and Laboratory. This also requires the improvement of UHS master plan.

Policy Issue:
The university through its health services unit and the teaching hospital provides medical and health services to staff and their family limited by its resources. It also carries out pre-employment medical examination to staff and insist on pre-registration medical examination to new students. However there is now the new monetization and the National Health Insurance Scheme policies