By Chima Azubuike
The first cry came just before dawn.
Ali Zambukk had barely slept through the night. His two-year-old son had tossed restlessly on a thin mattress inside their small mud house in Kanawa Wajari, a rural settlement in Yamaltu-Deba Local Government Area of Gombe State.
What began as a mild fever the previous evening had grown worse with each passing hour.
By morning, the boy’s body was burning. His breathing had become rapid and shallow. Every few minutes he whimpered weakly, his small hands clutching at his mother’s wrapper.
Zambukk watched helplessly as his wife tried to calm the child.
In the dim light of early morning, panic began to creep into the room.
There was only one place they could go.
The village health post.
It was not a hospital. It was barely even a clinic.
The small building stood quietly at the edge of the village — a worn structure with cracked walls and rusting zinc sheets that rattled violently whenever strong winds blew across the settlement.
Some of the roofing sheets had started leaking months earlier.
During heavy rain, water often dripped into the room where patients were meant to sit.
But for families like Zambukk’s, it was the closest place where someone could examine a sick child.
“I carried him and ran there immediately,” Zambukk recalled.
That morning, the rain had already begun.
When he arrived at the health post, several villagers were already waiting outside, standing under the narrow veranda to escape the downpour.
Inside the building, water dripped slowly from the roof into a corner of the waiting area.
“It was raining heavily,” he said quietly.
“Water was dropping from the roof into the room where patients sit. But we had no other place to go.”
Despite the conditions, the community health worker on duty began attending to patients.
For Zambukk, what mattered most was not the condition of the building.
It was the hope that someone could help his son.
When the Clinic Moves Into a Village Home
In Gafara Galadima, a small community in Kwami Local Government Area, the situation has grown even more desperate.
The health post that once served the village has deteriorated so badly that it can no longer be safely used.
The building now stands abandoned.
The roof is partially collapsed, the walls cracked and weak.
Yet healthcare services did not disappear entirely.
Instead, the community improvised.
Today, medical services are delivered from the house of the village head.
Inside the modest compound, patients gather daily under a tree or along wooden benches placed in the courtyard.
Mothers arrive with babies tied tightly to their backs.
Elderly men lean quietly against the wall.
Children sit beside their parents, coughing or crying softly.
A small table serves as the consultation desk where the health worker attends to patients.
The arrangement is far from ideal.
But for residents of Gafara Galadima, it is better than having no healthcare access at all.
“If this place closes completely, we will suffer,” said 38-year-old mother of four, Aisha Mohammed.
She remembers the fear that gripped her one afternoon when her infant suddenly developed a high fever.
“I didn’t even think,” she said. “I just carried him and ran to the village head’s house.”
Several mothers were already waiting when she arrived.
“I was shaking because the baby was crying and shivering,” she said.
The community health worker examined the child and suspected malaria.
After administering medication, the fever gradually subsided.
Mohammed sighed with relief when she remembered the moment.
“But honestly, we are just managing here,” she said.
“This place is helping us, but it is not a real clinic.”
A Roof Repaired by Villagers
In Kanawa Wajari, where Ali Zambukk lives, the health post continues to operate despite years of neglect.
The building had developed severe roof leaks that made parts of the facility unusable during the rainy season.
Rather than abandon the centre completely, villagers decided to act.
They pooled their resources and purchased bundles of zinc sheets to repair one section of the roof.
Even with the partial repair, the building still shows signs of wear and age.
Cracks run along parts of the walls.
Sections of the ceiling remain weak and vulnerable to rainwater.
But the health post remains open.
Every day, residents walk through its doors seeking treatment for fever, cough, infections and other illnesses.
For many families, travelling to the nearest Primary Health Centre would require several kilometres of movement, often on rough roads.
Transport is scarce and expensive.
“When someone is sick, you don’t always have money for transport,” Zambukk said.
“So this place is the only hope.”
A Night Lit by Torchlight
For Josephine Adamu, the condition of the health post nearly turned into a tragedy.
One night, her four-year-old daughter suddenly began vomiting.
Soon after, diarrhoea followed.
Within hours, the child had grown weak and could barely stand.
“The child became weak very fast,” Adamu recalled.
“She was just lying there. She could not even sit.”
There was no hospital nearby.
Transport at night was nearly impossible to find.
Panicking, Adamu wrapped the child in a shawl and rushed to the health post.
But when she arrived, the facility had no electricity.
The health worker on duty had to use a torchlight to examine the girl.
“I was very afraid,” Adamu said.
“You could barely see inside the room.”
Using the dim beam of a phone torch, the health worker administered oral rehydration salts and medication.
The treatment stabilised the child.
“They told me if we had waited till morning it could have been worse,” she said.
The memory still troubles her.
“When your child is sick, you don’t think about buildings,” she said softly.
“You just pray that help is there.”
Healthcare at the Frontline
Across Nigeria’s rural communities, health posts and clinics serve as the frontline of the healthcare system.
They provide basic treatment for common illnesses such as malaria, respiratory infections, diarrhoea and minor injuries.
They also offer maternal and child health services including immunisation, antenatal counselling and postnatal care.
Preventive services are another key function.
Health workers educate communities about hygiene, nutrition, family planning and disease prevention.
They also help monitor disease outbreaks and report cases to higher health authorities.
Most importantly, health posts act as referral points, connecting patients to larger health facilities when specialised treatment is required.
For remote communities, they often represent the difference between immediate care and dangerous delays.
The Situation in Gombe
In Gombe State, where the population is estimated at about 4.5 million, the role of these facilities is particularly critical.
Over the past seven years, the administration of Governor Muhammadu Inuwa Yahaya has renovated Primary Health Centres across the 114 wards in the state’s 11 local government areas.
The effort has improved healthcare access in many locations.
However, many smaller health posts serving remote communities remain in poor condition.
For residents living far from major roads or urban centres, the condition of these facilities often determines whether healthcare is available at all.
Health Posts as “Mini PHCs”
Resident Community Health Physician, Dr Ibrahim Obel-Yaji, described health posts as smaller versions of Primary Health Centres designed to serve remote communities.
“Structurally, the health post is like a mini-PHC,” he explained.
“They were created because it is not always possible to establish a full Primary Health Centre in every settlement.”
He explained that most health posts focus mainly on outpatient services, noting that patients usually receive medication and return home.
“In some locations where skilled midwives are available, deliveries may also take place.
But such services remain limited. In most health posts you don’t have advanced services like eye care, dental care or comprehensive antenatal services,” he said.
Despite these limitations, he emphasised their importance, adding
“They are very important for remote communities.If a child has diarrhoea or fever, at least they can get immediate treatment before being referred.”
Nigeria’s healthcare system continues to face significant challenges.
According to the World Health Organization, more than one billion people globally risk becoming impoverished because their household healthcare spending exceeds ten percent of their income.
The WHO recommends strengthening primary healthcare as the foundation of universal health coverage.
Increasing investment in primary healthcare services in low- and middle-income countries could prevent up to 60 million deaths and increase global life expectancy by nearly four years.
Nigeria, however, still struggles to meet these goals.
The country ranks near the bottom in global health system performance.
Inadequate infrastructure, shortages of trained medical personnel and weak health systems continue to limit healthcare access.
About 70 percent of Nigerians depend on primary healthcare facilities for medical treatment.
Yet many of these facilities struggle to function effectively.
Nigeria has more than 34,000 primary healthcare centres across the country.
But only about one-fifth are estimated to be fully functional.
Beyond Infrastructure
Health experts say improving buildings alone will not solve the problem.
Dr Obel-Yaji believes manpower investment is equally important.
“In recent times, His Excellency Governor Muhammadu Inuwa Yahaya has invested so much in infrastructural improvements of the PHCs in the last 7 years and I strongly believe he can extend that volume of investment into Human Resource for Health Development and training which will improve health outcomes in those rural settings. In terms of employment, the government can also employ more hands in those health posts especially many of the volunteers who are serving in many of the PHCs across the state, their wealth of experience will impact service delivery if employed appropriately,” he added.
He noted that many facilities rely heavily on volunteers.
He added, “Most of the people working in PHCs are volunteers.They are trying to support the system while hoping for employment.”
If trained health workers are properly recruited and deployed, he said, service delivery could improve significantly.
He added that strengthening health posts could also help reduce maternal and child mortality in remote communities.
“If you have a health post with even one skilled midwife who can receive deliveries, it can reduce maternal deaths and under-five mortality,” he said.
State Programme Officer of the African Coalition for Malaria Elimination in Nigeria (ACOMIN), Samuel Chuwang, said his organisation has been advocating for the renovation of the Kanawa Wajari health post.
According to him, the chairman of Yamaltu-Deba Local Government Area has indicated willingness to address the issue.
“He has agreed to renovate the health post,” Chuwang said.
“But we need to follow up to ensure it is done.”
He acknowledged the government’s efforts in renovating Primary Health Centres across the state.
However, he stressed that health posts and smaller clinics must not be overlooked.
Chuwang said, “Some of the wards that are big, the former PHCs were converted to PHCC, so in such wards they have two. Despite this development, health posts and clinics are of great importance,” he said.
“As you know, there are health posts, clinics, and primary healthcare centres. The health post is expected to serve communities that are far from the PHC. Normally, the PHCs are where communities should get immediate services close to them. The health post is to render outreach services like immunisation and ANC, but they don’t receive births in such facilities. They give immediate aid to residents far from the PHC.
“The health clinic is where they operate fully; they don’t transfuse blood.”
He continued, “This is done to give every community access to healthcare without stress, so that services will be closer to the people. PHCs are supposed to have at least a doctor where they can do blood transfusion and carry out manual operations like appendectomy, and where HIV and Tuberculosis patients can collect their drugs as a door service because they can be monitored and observed as they take the drugs.
“The health clinics and posts are very important. They are like first aid centres where people access services before they can be attended to at primary or secondary facilities.”
Chuwang urged authorities to leverage the renovation of PHCs across the 114 wards by also focusing on health posts and clinics.
“In my opinion, all these health posts should be given 100 percent attention to ensure they have adequate services that can be rendered to the community. They are the first point of contact and should have adequate staff and facilities so community members can get help before being referred to primary or secondary facilities.
“There are community members who cannot go to the PHC, maybe because of the distance. It may still be in the same ward, but there is a distance, and some cannot afford transportation. As you know, most PHCs are situated at the headquarters of the ward. Imagine travelling from a remote community to the ward headquarters — it is a long distance.
“It is supposed to be where they obtain healthcare services at a cheaper rate or at no cost.
“Some of the health posts have beds where people can receive intravenous drips. They don’t have doctors there, and remember that PHCs that are supposed to have doctors sometimes don’t have them because of the dwindling number of doctors, caused by government inaction to pay doctors — except in some instances where there are corps member doctors. You will see them in PHCs.”
Across rural Gombe, health posts continue to perform a quiet but essential role.
In Gafara Galadima, healthcare now takes place in the village head’s house.
In Kanawa Wajari, a community-repaired roof keeps a struggling clinic open.
In Dong community in Balanga Local Government Area, a clinic with cracked walls continues to receive patients daily.
For residents, these facilities represent more than infrastructure.
They represent survival.
They are the first place a mother carries a feverish child.
The first stop for pregnant women seeking antenatal advice.
Often, they are the only place where a sick villager can obtain medicine without travelling long distances.
For communities living far from major hospitals, health posts are more than small buildings on the edge of villages.
They are lifelines.
And for millions of Nigerians in hard-to-reach communities, strengthening these modest facilities could mean the difference between illness left untreated and lives saved.
Efforts to obtain official reactions from former Gombe State Commissioner for Health, Dr Habu Dahiru, and the Executive Secretary of the Gombe State Primary Health Care Development Agency, Dr Shuaibu Abdulrahman, were unsuccessful.
Calls and text messages sent to their personal lines were not answered as of the time of filing this report.
