- Government Health
delivery system in chaos, lack of care and due diligence
on the rise as hospitals lay neglected and patients
forced to share beds. Bogus contractors get a field day
and fuel use, as in all government departments and
ministries a money-making enterprise. Regular drugs
amounting to Le7,897,500 and Free Health Care Drugs
valued at $13,701 were procured and not consumed. A
We have been
taking a closer look at the government's health delivery
system, the tip of which has been highlighted in
the 2012 Audit Report
which appears to have been largely ignored by an
uncaring government that would have us believe that the
health delivery system under the rat was all rosy with
all Sierra Leoneans receiving much needed support in the
health sector. As with all government transactions,
those in the health sector are also victims of financial
manipulation and outright theft of the peoples'
The Audit report looked at the
Dialysis Unit, a set-up that is so vital for human
beings in a country where such a functioning unit could
save lives, thousands if not tens and hundreds of
thousands of lives, especially of the poor and
8.23.7. Contracts Awarded Not Completed
Contracts which were awarded for the rehabilitation of
the Dialysis Unit amounting to Le250,691,043 and the rehabilitation of the
Connaught Hospital amounting to Le1,231,694,200 were not satisfactorily
There was a leaking roof in the Dialysis Ward, damaged toilets, and
fans not in working order in the Hospital, while a work completion certification
had been issued to the contractor.
However, interviews with some personnel
revealed that the consultant in post had taken up the rehabilitation of the
unit, from her own personal funds.
A generator was procured for the Hospital but
has still not been installed. It was recommended that the Procurement Officer,
Ministry of Health, should submit a written explanation within thirty (30) days
of the receipt of the report as to why those contracts were not satisfactorily
carried out or refund the amount of Le250,691,043, and Le1,231,694,200 for the
rehabilitation of the Dialysis Unit and Connaught Hospital respectively. It was
recommended that the Facilities Officer should provide an explanation as to why
the generator had still not been installed.
We would dare say - don't hold
your breath as no explanation would be offered. It is
the same lack of accountability and lack of respect for
financial orders disease that affects every sector of
government activity where "the cow eats the grass where
it is tethered" (read - corruption given an official
stamp to steal resources wherever those with the right
connections find themselves) syndrome is actively
encouraged from State House.
It would be recalled that the
AWOKO news outlet carried a story in March 2012
Lady opens Dialysis Unit" and stated just
how important the Unit is in the country's health
"In a bid to
the lives of
Unit at the
Unit at the
one of the
part of the
He said that
is now on
to make sure
use of the
lack of a
8.23.5. Drugs Procured For The Hospital and Not Put Into Use -
Regular drugs amounting to Le7,897,500 and Free Health Care Drugs valued at
$13,701 were procured and not consumed.
Upon inspection, the auditors noted that
those drugs had also been expired but had not been disposed of. It was therefore
recommended that the pharmacist should provide plausible explanation, within
thirty (30) days of the receipt of the report, why the drugs were kept until
they expired and why they had not been disposed off.
The 2012 report also took a peek
into what obtains on the ground in Sierra Leone with a
look at the Ola During Children's Hospital and there we
saw these observations.
Review of the Free Health Care System -
The following were observed:
Due to the presence of the
Free Health Care Programme, the wards were congested;
There were instances where
more than two patients of diverse diseases were
clustered on a single bed;
There was a serious shortage
of medical doctors at the Hospital;
There were only three doctors
attending to an overwhelming number of patients;
Interviews with key personnel
revealed that doctors were usually not on duty at night;
Several patients of diverse
ailments were using one oxygen cylinder at the same
The above account is the tip of
the iceberg in a rotten system, the symptom of which
permeates every vein of government machinery in the
capital Freetown. The picture in other parts of the
country is even more pathetic, even more worrying and we
dare say damning. This is the picture at the Government
Hospital in Kenema.
General Observation - The
general management and condition of the Kenema
Government Hospital was far from being pleasant. This
was evidenced by the following observations:
Paediatric Ward: - Beds for hospitalised children
were insufficient; the situation resulted in bed
sharing; There was poor ventilation and low visibility
in the Ward; and No electricity, water and toilet
facilities existed for hospitalised children.
Male Ward: - There was no toilet facility for
hospitalised patients, resulting in the use of plastic
kettles for defecation; There were no trolleys for the
movement of medication within the Ward.
Surgical Ward: - No electricity and toilet
facilities existed for hospitalised patients.
Laboratory: - Basic equipment and consumables
like needles, syringes and gloves that should facilitate
the smooth and efficient delivery of medical services to
patients were not available.
Store: - The following were observed: The
floor space for the proper storage of drugs was
insufficient; Air conditioners required for the
recommended temperature of drugs were not available; and
there was no shelf, electricity and furniture for the
efficient running of the store.
8.30. GOVERNMENT HOSPITAL MAGBURAKA (2011) - 8.30.1.
Records Of Diets And Firewood Not Maintained - The
Hospital did not make available any record in the form
of store ledgers, request forms and distribution list,
to justify how diets and firewood supplied to them for
Le182,383,238 were consumed/utilized.
It was recommended that the Medical Superintendent
should provide all the records in respect of diet
consumption to the Audit team for verification within
thirty (30) days of the receipt of the report;
otherwise, the full amounts should be refunded and in
future, the Medical Superintendent should ensure the
maintenance of records of all diets received and
consumed by the Hospital.
Officialís Response - The Hospital
superintendent replied that records relating to the
utilisation of diets and fire wood had been maintained
based on the recommendation.
Auditorís Comment - The records in respect of
the consumption of diets and firewood were not made
available for verification.
8.27. PRIMARY HEALTH CARE TONKOLILI DISTRICT (2012)
8.27.1. Fuel Allocation Not Brought To Account
A comparison of the fuel allocations received from
the Tonkolili District Council and the amount of fuel
consumed by the PHC Tonkolili District revealed a
difference of Le18,508,000 that was not brought to
It was therefore recommended that the DMO should
within thirty (30) days of the receipt of that report
provide an account of the Le18,508,000 to the ASSL;
otherwise, the whole amount must be refunded. In future,
all allocations made to the PHC Tonkolili District in
respect of fuel should be properly accounted for.
The DMO stated the issue was as a result of the late
disbursement of the first and second quarterly
allocation of funds in 2012 and because of that, the
sector took fuel on loan to carry out health activities.
He said that the amount might have been for the fuel the
sector used before the allocation. He however promised
that the Primary Health Care would ensure that records
in respect of fuel were properly maintained in the
An account was not given on how fuel amounting to
Le18,508,000 was consumed by the PHC.
8.27.2. Revenue From The Sale Of Cost Recovery Drugs
Not Brought To Account
A comparison of the Supply Vouchers of cost recovery
drugs and the Bank Statements revealed that the sum of
Le89,365,048, in respect of the sale of cost recovery
drugs by the PHUs, was not brought to account.
It was therefore recommended that the DMO should give
a full account of the outstanding balance in respect of
the cost recovery drugs sold, to the ASSL within thirty
(30) days of the receipt of the report; otherwise, the
sum of Le89,365,048 must be immediately refunded. In
future, the DMO should ensure prompt payment of revenue
generated from the sale of cost recovery drugs into an
authorized bank account of the Ministry of Health and