Dr. Faruk Umar Abubakar is the Commissioner of Health, Sokoto State, who previously served as the Secretary General/Registrar CEO of the Nursing and Midwifery Council of Nigeria (NMCN) from 2016 to 2024. In this interview, Abubakar speaks about the transformation in the health sector, which was comatose and its place in the 9‑Point Smart Agenda of Governor Aliyu Sokoto

How did the Nigerian Medical Association (NMA) react to your appointment, because of medical doctors’ position that they must always lead?

Let me start by stating that the appointment of all commissioners is political, except that of the Attorney General and Commissioner of Justice, which the Constitution lists the qualifications that the candidate must have. …specific number of years at the bar, etc. So, every other position is at the discretion of the governor and he is at liberty to appoint anyone that he believes would add value to his administration.

I am aware of that issue, but in my own case, my appointment was welcomed by the entire professionals in the health sector. And I want to believe that it’s because they know my antecedents. Having been around for the last 35 years, I have established a very good working relationship with all the professional bodies. I have utmost respect for every profession in the healthcare delivery system as critical stakeholders, because it is about teamwork. So, I wasn’t surprised that they celebrated me on my appointment and have ever been very supportive. In return, I have been fair and respectful in my relationship with them.

Take the issue of the new National Minimum Wage, I engaged with the governor and thankfully he agreed with me that they deserved to be better remunerated. I am very proud to announce that today the Sokoto State Government pays better than the Federal Government, such that those who had wanted to leave have withdrawn their letters of resignation. The various professional bodies wrote the governor thanking him for approving a salary package that matches that of the federal government.

So, being a commissioner is about protecting and advancing the interests of your constituency and ensuring that they have the necessary working tools and a working environment that is conducive. …which is what the governor has been doing since 2023 and they can see the difference with the last administration. I must thank the governor for his huge investment in the health sector, for ensuring that their allowances are fully paid. At the end of the day the cooperation that a commissioner receives depends on how he leads and his recognition of the other professionals …which is key. A doctor needs medical scientists, nurses, cleaners, pharmacists, etc., to function effectively.

You retired as Registrar/CEO of the Nursing and Midwifery Council of Nigeria; considering this background, I want to conclude that it wasn’t difficult for you to hit the ground running on your appointment?

Having been in the health sector in the last 35 years, I would say, yes it wasn’t really difficult. Luckily, I started from the very scratch as a nurse, and I have worked in hospitals and I interacted with all professionals in the healthcare system… so I have a good understanding of the issues. And my background as a unionist has equally been helpful. And as an administrator, I understand the issues that must be addressed so that we can deliver quality healthcare to our people.

I am lucky to have a governor who truly believes in delivering quality healthcare to the people. He has, for instance, approved my memo for the State Specialist Hospital to run internship programmes for radiography and medical doctors. We have applied to the Medical and Dental Council for the necessary accreditation. Sokoto State has more than 100 medical doctors who have graduated and they need a specialist hospital for their programmes… So, this initiative would solve a big problem for us.

Today, we have about 270 medical students on the payroll of the state government. They have been placed on Level 07, which is about ₦82,000 monthly. It’s the same with pharmacy students, medical lab scientists, etc. So, we are solving the problem of inadequate personnel and at the same time making life easier for the students and their families. We stand to benefit in many other ways because, being indigenes, they understand the culture of the people.

On admission, they get scholarships, but once they start their clinical practice they are transferred to the Ministry of Health and the ministry will in turn transfer their documents to the Civil Service Commission, which would process and send their details to the Ministry of Finance for implementation. His Excellency, in his magnanimity, also paid the registration fees of all our foreign‑trained doctors. This has helped address the shortage of medical personnel.

I was going to come to the issue of shortage of medical personnel, but you have thrown light on how you are tackling the issue at the root—are they on bond?

Absolutely yes. They can’t leave until they have served the state for a specific number of years. But I can assure you that they won’t leave because of our package, which will only get better. Allow me to state that Governor Sokoto’s 9‑Point SMART Agenda is no fluke—it’s something that he genuinely means. The State Executive Council recently approved a memo by the ministry that would ensure equitable distribution of manpower between the urban and rural areas. I am thankful to my colleagues for graciously approving the memo.

The beauty of the policy is that every medical professional sponsored by the Sokoto State Government must serve in a rural health facility for a minimum of two years and this is compulsory. These are some of the measures we are putting in place to holistically address the inadequate manpower at the grassroots. Before I initiated this policy, I ordered a needs assessment and visited all the general hospitals in the 23 local governments and I noticed this gap. The gap is unacceptable… we have excess nurses in the special hospital. Do note that there is a recommended number for hospitals.

Everybody wants to work in the urban area, while we have acute shortages in the rural facilities—that’s not okay by me. My memo was well received such that even the Commissioner of Education wanted it applied to the educational sector, because it’s a strategy that’s innovative. In addition to the fact they are under bond, to motivate them the governor approved a 10% addition to their basic salary. We foresee a future where people after their compulsory rural posting won’t want to leave. The governor understands how to motivate his workers. On the issue of security, we are working with the security agencies to ensure that our facilities are safe. The governor is not resting to ensure that every inch of the state is safe. It’s important that the rural communities have access to medical care. With qualified medical professionals in the rural areas, there will be a reduction in the number of referred cases. The specialist hospital will truly be a specialist hospital treating only cases referred to it.

So, what other things did you find out from the needs assessment you carried out?

I equally found a health system that was on its knees due to the neglect by the Aminu Tambuwal administration. Infrastructure at the hospitals was practically nonexistent with obsolete equipment, decayed and uninhabitable wards. Even the mattresses were torn into pieces and the beds broken. The first thing that we did was to urgently provide critical equipment and mattresses.

We have equally procured nine ultrasound machines that will be distributed to the general hospitals—three for each senatorial district. Same with X‑ray machines, one for each geographical zone, so that investigations can be carried out at that level. Our people don’t have to travel to Sokoto for such investigations. To date we have also procured about 240 beds, 240 mattresses, and 240 stands. I want to assure the people of Sokoto State that the governor has just started because he is more than determined to change the story.

Governor Sokoto means business when he says that health is a critical component of his 9‑Point SMART Agenda. The other benefit of my needs assessment is that it enabled me to come up with a strategic framework that would give us the direction to address the problems at the primary healthcare, the secondary and tertiary levels. So, very important is infrastructural development. We are going to tackle 10 general hospitals in the first instance and we have sent requests to the Ministry of Works to carry out an assessment to enable me make my submission to His Excellency.

I have visited the specialist hospital and the orthopedic hospital. I must say that I was scandalized that the entire maternity ward was without light. How can doctors operate without power? The governor has since approved the installation of solar power—we now have 24‑hour light at the labour room, in the postnatal ward, and in the prenatal ward. We have also acquired incubators for premature babies…there is also 24‑hour power. We have embarked on a comprehensive rehabilitation of the wards. We have provided functional toilet facilities for families and visitors—the era of open defecation is past.

We sank boreholes, with overhead tanks to ensure availability of water 2/4/7. Even though the hospital is almost 100 years old, we can make it functional. To help in the general cleanliness of the hospital, I engaged the services of prisoners. We are working on the drainage system. The environment and general sanitation of the hospital has greatly improved. I know His Excellency is planning on building a new world‑class facility. The other thing I am working on is the attitude to work of our personnel. I have had series of meetings with them on the need to be diligent and caring in their work. They have no reason to be lackadaisical—especially as the government is prompt in payment of their salaries and allowances. I will no longer accept negligence of duty, where workers abandon their duty posts and leave patients unattended to. The abandoned amenity ward is receiving attention, same with the new theatre. It’s a shame that the equipment has been stolen. I intend to get the hospital functioning at full capacity.

For the record, how many hospitals and healthcare centres do you have?

We have about 824 primary healthcare centres, health posts and clinics across the 23 local government areas. In each of the 240 wards, we have a primary health centre; health posts and clinics in villages—that is what gives us the 824 facilities across the state. Presently, we have about 21 hospitals, meaning at least one general hospital in each LGA. We have two in Tambuwal. It’s only Dange Shuni and Wamakko governments that presently do not have general hospitals.

…bandoned by the Aminu Tambuwal administration?

Yes, but the government is working assiduously hard to ensure that we have a general hospital in these two local government areas… Dange Shuni and Wamakko. The Aliyu Wamakko administration in 2013 awarded the contract for the construction of the hospitals but it was unfortunately abandoned by the Tambuwal administration.

Mr. Commissioner, you were talking about a new world‑class general hospital?

Yes, but meanwhile we’re making efforts to ensure that all our general hospitals are renovated. We started with 10 hospitals. For the rest of the hospitals, His Excellency the Deputy Governor, who is also the Commissioner of Works, has constituted three committees—one for each of the senatorial districts—to assess the hospitals. So, we are awaiting the reports from the Ministry of Works. I am grateful to the governor for his unprecedented investment in the health sector.

What is the critical issue that needs to be addressed to get this sector functioning?

Well, accountability is key—especially under Governor Ahmad Aliyu Sokoto, who constantly reminds you that it’s the people’s money. So, the judicious use of the limited resources is important, and planning. You might have all the money, but without a strategic framework you can squander the resources. Money is important, but planning and prioritization are crucial. In my ministry, I have in a systematic way addressed fundamental issues, one at a time. We ensure we have a detailed report of whatever we want to do and that has helped us in achieving results. I will give you an example.

Recently the governor sent me a text message: “Honorable Commissioner, do you have an outbreak?” I replied that indeed there were some issues of an outbreak of Hepatitis in the prison and that it had been resolved. He replied that I should investigate further. Eventually we discovered that there was an outbreak of measles. I quickly deployed our epidemiologists to the following villages: Sayyinna, Jabo, Salla, Alassan and Barkeji—all in Tambuwal local government area.

We established that 20 children were affected and that three had unfortunately died. We then moved in the team with the necessary drugs and had a camp erected to isolate the children that were affected because we didn’t want it to spread.… So, the issue is not always about money—even though money is important.… it’s essentially about planning. This is our approach in tackling every issue. We engage in sensitization and advocacy and that has helped us contain any outbreaks of diseases.