464 views | Dr. Biodun Ogungbo | April 6, 2020
Words are futile
Given what is happening in Nigeria and indeed the world today, you would think that words are futile. That we are all living witnesses to the exposition of the dilapidated healthcare system in Nigeria. COVID-19 has exposed our ass for all to see. You would think that even the blind can see how terrible it is and the depths to which we have sunk. You would think we need not say a word.
Words are not futile
You would be wrong in Nigeria. The humans in Nigeria have long resigned and common sense has long left our shores. There are many who have no shame and those who forget so easily. Therefore, we still need to scream and shout, to get the attention of those in the animal farm.
The World Health Organisation (WHO) recently commended Nigeria for its success in combating Ebola a few years ago. The organisation described “Nigeria as a spectacular success story, containing the number of cases to 19, with 7 deaths. This is ascribed to the world-class epidemiological detective work which eventually linked all cases back to either direct or indirect contact with the air traveller from Liberia”.
Nigeria was lucky that three conditions favoured us. The public hospitals were closed due to a healthcare workers’ strike. The patient went to a private hospital. The doctors and nurses at First Consultants hospital made the ultimate sacrifice and gave their lives. That singular act, rather than any efforts of government contained the Ebola epidemic in Nigeria. Dr Stella Adadevoh and her colleagues have still not been immortalised in Nigeria.
This is Nigeria
The healthcare situation in Nigeria was terrible before the pandemic and is currently non-existent. The lack of preparedness of our healthcare system was exposed by reports of medical personal and nurses running away from possible COVID-19 patients. You would not blame them. The isolation centre in Enugu was hurriedly exhumed only after the first patient showed up on their doorstep. We are still playing catch-up in many states.
We have either been running away from treating patients or allowing them to die in our public hospitals. Don’t forget that most of the healthcare in Nigeria depends on out of pocket payments and in many of our public hospitals, patients and relatives go out to buy drugs and necessary materials. Our hospitals never have the essentials including blood and oxygen in ready supply. If you cannot afford it…
So, with this Coronavirus, who pays for the care?
For many years our leaders and institutions have relied on the ability to travel out to other countries for basic healthcare, so they saw no need to develop our hospitals. Successive Nigerian governments have deliberately run down the healthcare system and impoverished doctors. The condition of service has always been poor and now more so with the pitiable economic policies of the government. Doctors, nurses and even teachers are not valued in Nigeria, though our collective future depends on these people.
Do not be a martyr for Nigeria
In this epidemic, there have been complaints about the inadequacy of testing kits, insufficient laboratories capable of conducting tests, a drag in response time to distress calls, a lack of preparedness of isolation centres and a dearth of intensive care beds and specialists to care for critical cases.
This is Nigeria where life means nothing and the government expects healthcare personnel to go to war on this virus without the proper protective equipment. We do not have enough testing kits; lack the personal protective equipment (PPE) for healthcare staff, lack drugs and other essential materials including even feeding arrangements for patients with COVID-19 in the hospitals.
Healthcare personnel should not sacrifice their lives for Nigeria. It will not be recognised nor valued. You have no moral obligation to cater to the poor, the rich, powerful or go on a suicidal mission. There is honour in protecting yourself: so we can save more lives after COVID-19.
Worse, some people still see this epidemic as a money-making exercise. For example, businessmen raised the price of face mask from N500 to N20, 000, during this period due to increasing demand. Oh, its business, they say. This is the same protective wear that doctors on the frontline require to do their job: saving lives. If doctors turn round and make huge demands for their services, the same businessmen will cry foul. You are humanitarians, they will say. The irony!
There are conflicting reports of the amount of money being shared to the poor. Apparently, there is no sense, no system and no accountability, so you know a substantial amount will be stolen by government officials. No lessons learnt even during this critical period!
Life after COVID-19
So, we pray that this is a wakeup call for every Nigerian and most especially the ones in positions of influence. Everyone including healthcare personnel, patients and the government must work collectively and push for responsive and responsible delivery of health services in Nigeria. We must restructure our healthcare systems to be able to provide a high quality of care for all Nigerians. The hope is that we see a fundamental change and a complete overhaul of the healthcare system in Nigeria.
We do not have a choice as we have been terribly exposed by the current situation.
Can you see our future now?
I would like to echo the words of Jameel Ismail Ahmad writing in Premium Times as regards the way forward for Nigeria’s healthcare revival.
1. The federal government, in collaboration with philanthropists and corporate bodies, should launch a special three-year quaternary healthcare plan (2021-2023) in which two state-of-the-art heart, kidney and cancer centres will be fully established yearly in the six geopolitical zones alternatively so that by 2023 each zone will have at least each of those three centres. This will go a long way in reducing or even reversing medical tourism, especially for the lower and middle class. If peradventure (although not praying for this) a similar or a different travel ban arises in the future, the upper class can also utilise these services.
2. The federal government should form a special committee to understudy the extent and impact of the brain drain of physicians and other health workers with a view to understanding the push and pull factors involved in this and to offer realistic solutions. A sustainable strategy for brain-gain and brain circulation of diaspora Nigerian medical experts should be designed.
3. The federal and state governments should liaise with the Nigerian Universities Commission (NUC) and regulatory agencies, such as Medical and Dental Council of Nigeria (MDCN) to provide the requirements for increasing the enrolment and graduation of physicians, nurses, pharmacists, medical laboratory scientists etc. in federal and state universities and other institutions.
4. The federal government should encourage medical entrepreneurs (medipreneurs) to establish standard private hospitals, medical universities and medically-related manufacturing industries, through soft loans, special interventions and ease of doing business via the Central Bank of Nigeria (CBN), Bank of Industry (BOI), Development Bank of Nigeria (DBN), as obtained in countries like India.
5. A special fund should be dedicated to supporting the treatment of cardiovascular diseases, kidney diseases and cancer for indigent patients.
6. The National Health Insurance Scheme should cover cardiovascular diseases, kidney diseases and cancer treatments and more states should hasten to commence a form of health insurance scheme.
7. Healthcare workers need to be more dedicated to their work with sympathy, empathy and selflessness, while the government should reciprocate the gesture through the provision of incentives and welfare packages.
8. The legislature being representative of the people should ensure the above suggestions are initiated and perform the oversight functions on their implementation.
9. The electorates and civil liberty organisations should ask and advocate for improved basic and advanced healthcare from elected leaders as a fundamental human right.