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Friday, October 2, 2015

Nigeria At 55 - Citizens Demand Better Healthcare

As the country marks its 55th independence anniversary, Nigerians are demanding for better health care under President Muhammadu Buhari, writes Martins Ifijeh
Can Buhari transform the healthcare system for good?
When Flora Shaw, a British journalist and novelist, gave the most populous black nation its name, Nigeria, in preparation to becoming an independent state, and having been dominated by Britons until October 1st 1960, one would think by now the name should be ranking among developed nations of the world considering its enormous natural and human resources, which were all waiting to be enhanced after the foreigners had left more than five decades ago.

But at 55, various institutions in the country, including the health and educational sector, as well as our economic institutions are still grappling to be at per with institutions of some other countries that got their independence at about the time Nigeria did. Singapore, Malaysia, Cyprus, among others, according to some school of thoughts, have long passed Nigeria in terms of healthcare, economic level, poverty alleviation and other several parameters that determine the strength and progress of a country.
THISDAY investigations as Nigeria turns 55 today, revealed that the chief sector where the citizens feel the country has not faired well considering the resources at its disposal is the health sector. Majority of the populace says they have lost confidence in the Nigeria's healthcare system, especially its primary healthcare, hence there was no need celebrating Nigeria at 55, rather, stakeholders should look inwards and reflect on what must be done to prevent the abysmally high maternal mortality rate, lack of primary healthcare for the ordinary citizens, especially in hard to reach areas, lack of quality and affordable healthcare, incessant strike actions in the sector, high cost of treatments, among others.
For instance,a Radiologist in Lagos, Mr. Kingsley Oragwa, said mortality rate was still very high in the country due to lack of quality healthcare system. "How can we say we are successful at 55 when the average life span of a Nigerian male is 47 years while that of the female is 53 years. This means any Nigerian male living above 47 years of age is living on a borrowed time, same with the women. Compare this indices to that of other countries, even most African countries that are our neigbhours still have better mortality rate than us. We should be ashamed of these indices because they depict how poorly our healthcare system has fared," he said.
He also added that most countries that got independence alongside Nigeria have met Millennium Development Goal on maternal mortality. "Our women are still dying in high number daily, due to pregnancy related complications. Children and mothers dying in the country due to lack of quality healthcare are still much. We must reduce all these indices to its barest minimum before we can say our healthcare system has grown."
According to him, most Nigerians living in rural and hard to reach areas of the country were still grappling with having to survive without basic healthcare, which are the rights every country must provide for its citizens, adding that, until the country give priority to primary healthcare, the issues would continue to halt the country's progress."For a country to have a healthcare system that directly affects its citizens, priority must be given to primary healthcare, rather than what Nigeria is currently concentrating on - secondary and tertiary healthcare. We must tackle the basics first, otherwise, in the next 20 years, we'll still be where we are," he noted.
He said for the country to boast of a world class health sector, there should be infrastructural development, skilled personnel and world class equipments. "Nigerian hospitals should look like habitable places. They should be seen to be clean and livable. The idea of patients and relatives having to go get treatment materials themselves is sickening. The basic things and drugs should be made available in our health centres. Our laboratories should be made up to standard," he stressed.
Adding, he called on the Federal Government to motivate doctors and other health workersso that they can put in their best into delivering healthcare to Nigerians. "This would in turn encourage other Nigerian doctors and health workerspracticing outside the country to come back and contribute to the health sector. "If we must pride ourselves as the giant of Africa that we are, these are things that must be put in place," he stated.
Also for the Chief Executive Officer, UBA Foundation, Ijeoma Aso, the tales are the same. The health sector has not fared well in recent times. She believed Nigerians were still dying needlessly from illnesses that are preventable, adding that, the government of President Buhari must make healthcare one of its cardinal focus so that there would be improvement in the health sector.
"I was in Ghana recently and a friend who was transferred there told me that one significant difference he has witnessed since he left Nigeria to the neighbouring country was the sharp upgrade in healthcare system. He told me that he can confidently send his family for treatment there because of the quality of their healthcare system, as opposed to what entails. In Nigeria," she said.
She queried why there has not been significant improvement in our primary healthcare to Nigerians despite the enormous wealth in the country, adding that, recovered stolen money should be put into shaping the health sector.
"We also need to borrow leaf from countries that have gotten it right. In England, they have realised that Indian doctors are about the best in the world, and they have decided to let them come into their country to help them develop their health sector. We should not be shy to adopt same. It is not about ego, it is about common sense. Let's encourage these doctors to come in and assist us in improving our healthcare. Why do you think the whole world go to India for one form of treatment or the other? We should study them and learn from their successes, we need more of those doctors here; not just for treatment, but to train our doctors on new trends in medicine and use of new technologies," she stated.
According to her, another area the government of President Buhari needs to focus on was the accessibility of healthcare to every nook and cranny of the country. "We must focus on primary healthcare. We can only be said to have gotten it right if we are able to give qualitative, accessible and affordable healthcare to every Nigerian, whether in the urban or rural areas.
"We need trauma centres in the country such that accident victims will have where to be taken to immediately accidents happen. There should be ambulances every where that should be ready to attend to emergency situations. These are forgotten, yet important things that must be put in place in every location of this country, otherwise, there will be no use saying our healthcare system is improving. This will also mean that the government places value on the lives of its citizens," she said.
She, however said, this was some of the reasons why she sometimes don't blame Nigerians who watch accident victims in pain or dying at the accident location instead of helping them by calling the ambulance or take them to trauma centres. "Even if these people decide to help accident victims, where would they take them to? No where! We need these trauma centres, not only in cities but in rural areas as well because people also live there," she explained.
A Medical Officer, Dr. Jude Areogbu also wants more from the government. He believed the health sector can be said to have improved if government officials, politicians and wealthy Nigerians do not have to travel abroad for medical treatments. "Nigeria at 55, I want a working health sector such that even our government officials and rich Nigerians would treat themselves here rather than travel abroad for medical purposes. There should be adequate training for our medical students and the sector should be well funded," he added.
Areogbu is one of the optimistic Nigerians, who believes the change agenda of All Progressives Congress and its leader, President Buhari, would transform the sector. "If things are done accordingly, we will achieve our goal as a country," he noted.
But for another medical doctor, Adebayo Tunde-Vincent, the exodus of doctors and other health workers to other countries where they are appreciated was an evidence of how degraded the country's health sector has reached.
He explained :"If we continue to undermine medical doctors in this country, I can tell you authoritatively that in the next 10 years, we won't have up to 10,000 doctors around because there will be brain drain, while the younger ones who intend to study medicine would rather not bother themselves over it.
"Do you know that Nigeria presently has 21,000 doctors practicing in the country, while over 22,000 are currently practicing in the United Kingdom and 4,000 in United States. This statistics shows that we have more Nigerian doctors in the UK than even in our own country, " he stressed.
He added that majority of those he graduated with several years in his class have travelled to other developed countries where they are better appreciated. He believed an average Nigerian doctor wants to be practising in countries like, United States, United Kingdom, Saudi Arabia, Canada, among other developed countries.
"Are you aware that an average Nigeria doctor working for the government earns about N170,000 per month, while their counterparts in South Africa earn about N300,000 per month and even more in several other countries? So you can see there are many reasons for the brain drain, which at the long run also affects how our healthcare is positioned," he explained.
He explained that one of the major reasons Nigerian health sector was still having challenges was the relativity crisis among doctors and other health workers. "If President Buhari can decisively settle this crisis, it would go a long way in stabilising the healthcare system. Efforts should be put in place to minimise strike actions by health workers and doctors. A situation where citizens are unable to access healthcare because the hospital personnel are on strike will in no small measure hamper healthcare provision in the country," he stated.
On the way forward, he advised that private investors should consider investing in the health sector of the country like the way they have invested in the country's power and oil sector. "Public Private Partnership of the health sector would mean that when private investors partner government in the management of hospitals, part of the running cost would be taken care of by such investors, while regulation of the hospitals would be under the guideline of the medical council.This would enable infrastructural development and the staff of such hospitals would be more serious and not go on strike for trivial issues, just like the way we are presently going on strike in the sector. Of course, if such workers go on strike, you and I know what would happen," he added.
Tunde-Vincent believed private public partnership of the health sector has helped the healthcare system of developed countries and as such, Nigeria should adopt same approach.
Also, a security consultant in Lagos, Mr. Azeke Usigozu, told THISDAY t that the health sector needs to do more in the area of child mortality reduction. "A country's infant mortality rate is a reflection of the quality of health delivery available to its citizens, and to a large extent, a reflection of the quality of life enjoyed by the citizens of that country. The government should pay more attention to our local clinics where the low class go to anytime they have health challenges - this is where majority of our women go to during pregnancy as well as child birth.
It wasn't all about the knocks, Usigozu also has good things to say about the health sector; from the curtailing of Ebola Virus Disease (EVD) to reducing Human Immuno Virus (HIV) and eradicating polio in the country. He believed these are models for improvement.
According to him, "It is a big kudos to the government for the management of EVD in recent times. We have also been able to manage the incidence of HIV to a certain level. If these efforts are channeled into areas like malaria, typhoid and other common but dangerous diseases, I believe soon Nigeria health system will reach international standard," he explained.
He also commended the country for its de-listing from countries still affected by polio, adding that, maintaining such efforts and spreading such good news to other disease areas affecting the people would determine how far a country's healthcare system has gone.
But not everyone believes the country's healthcare system hasn't fared well. To some, Nigeria has made considerable progress, even though it hasn't reached the desired level.
While speaking with THISDAY, Dr. Ibeauchi Chinasa, said Nigeria's healthcare system has improved if figures from 55 years ago till now are relied on. "In 1960 there was just one fully accredited medical school in Nigeria, two in 1965, six in 1975, 11 in 1984, 18 in 2005, and as at today, we have more than 26.
"If you also look at the number of medical doctors graduating every year, you'll know we have improved. According to medical and dental council of Nigeria, Nigerian medical schools graduate between 2000-3000 medical doctors annually, and even higher number of health care personnel being produced in other disciplines has increased," he added.
He said new diagnostic facilities have been introduced, thereby improving the quality of patients' management, including; ultra sound scan, CT Scan, MRI, endoscopy, "to mention but a few."
"New drugs with greater efficacy and lesser side effect have been introduced to curb endemic, emerging and re-emerging diseases, a good example is the introduction of ACTs as replacement for chloroquine which is being resisted by malaria causing parasites," he said.
According to him, favourable government and World Health Organisation policies like the roll back malaria initiative, the Bamako initiative, kick polio out of Africa, Millennium Development Goals, among others have been put in place to improve health care delivery.
Also putting the country's healthcare system on the positive note is a banker, Ayegbeni Kanabe. He said medicare has improved since 1960. "There was a time when sicknesses like tuberculosis kills easily even during my time as a child. In the North, health facilities have also improved unlike before. I give it 50 percent," he stated.
As Nigerians have brought to bare their thoughts on the healthcare system, President Buhari, incoming Health Minister, health institutions, stakeholders and every Nigerian must make deliberate efforts to actualise the Nigeria's dream of a stronger healthcare system.
Martins Ifijeh, AllAfrica]

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