Nigeria Investigation: Families Reject Compensation in N117.5bn Medical City Dispute

A state government's silence on a major infrastructure project's displacement costs raises questions about accountability in large-scale Nigerian public investment.

The Akwa Ibom state government in Nigeria has not publicly responded to compensation disputes surrounding its N117.5 billion Medical City project, according to an investigation published September 19, 2026, by Premium Times Nigeria.

The Premium Times investigation found that multiple families displaced to make way for the project rejected compensation payments offered to them, describing the sums as insufficient to cover the cost of relocating and rebuilding their homes. The report did not specify the exact number of households affected, but described the dispute as involving several families across the project site.

The Medical City project is one of the largest healthcare infrastructure initiatives in Nigeria's Niger Delta region. At N117.5 billion, it represents a substantial commitment of state resources in Akwa Ibom, a state whose finances depend heavily on federal oil revenue allocations, according to publicly available Nigerian budget records.

Compensation disputes of this kind arise frequently in Nigerian infrastructure development, where the legal framework governing compulsory land acquisition falls under the Land Use Act of 1978. That statute vests all land in each state governor, a structure critics have long argued gives displaced residents limited legal standing when negotiating compensation amounts, as documented in academic reviews published by the Nigerian Institute of Social and Economic Research.

Under the Land Use Act, state governments are required to pay "revocation compensation" for improvements on land, such as buildings and crops, but are not required to compensate for the land itself, since the state is considered its statutory owner. Affected families who reject initial offers have the option of pursuing their claims through state land tribunals, though Premium Times did not report whether any families in this case have filed formal legal challenges.

The Akwa Ibom state government did not provide a statement to Premium Times before publication, and the investigation did not indicate that any official had commented on the compensation figures or the timeline for resolving the disputes. What specific compensation amounts were offered to affected families, and the methodology used to calculate them, remains unknown. A formal government response or court filing would be the documents most likely to reveal those figures.

Nigeria's federal government has promoted healthcare infrastructure expansion as a national priority, citing the country's physician-to-patient ratio of approximately 4 doctors per 10,000 people, a figure the World Health Organization recorded in its most recent Nigeria country profile. State-level projects like the Akwa Ibom Medical City are part of a broader pattern of sub-national governments investing in tertiary health facilities to reduce medical tourism abroad.

Displacement disputes linked to public projects have drawn scrutiny from Nigerian civil society groups in recent years. The Social and Economic Rights Action Center, a Lagos-based legal advocacy organization, has documented multiple cases in which affected communities in Nigerian states received compensation that courts later found to be below market value, according to the organization's published case records.

The Medical City project's construction timeline and current completion status were not detailed in the Premium Times report. It is also not known from available public records which contractor or contractors have been engaged for the project, or whether environmental impact assessments were completed and published before construction began, as required under Nigerian federal environmental law administered by the National Environmental Standards and Regulations Enforcement Agency.

The combination of a large public expenditure, a government that has not commented publicly, and families who say they cannot afford to relocate on the offered terms means the dispute is likely to persist in the absence of either a negotiated settlement or a court ruling. Premium Times stated it would continue to report on the matter as new information becomes available.