Tuesday, 13 October 2009

Killing our citizens softly! The primary healthcare mess in Nigeria.

Killing our citizens softly! The primary healthcare mess in Nigeria.

By Kayode Ogundamisi

Professor Babatunde Osotimehin is Nigeria’s Minister of Health, I don’t know the schedule of the minister but I have a humble suggestion for him, the professor should take time off his very busy schedule of addressing international forums and visit some of the rural areas in Nigeria and see for himself the gory details of what happens when a government abandons its people. One of the legacies of the ministers in the Umaru Musa Yar'Adua government in Nigeria is the length of time they spend outside Nigeria. Thus it is no longer unusual to walk along major European cities and meet Nigerian ministers conducting everything but the affairs of state. Their seeming lack of knowledge and understanding of what is going on in the nook and crannies of the country means the difficulty in their different ministries look ordinary and nothing unusual to them and their advisers.

I have listened to Nigeria’s minister of health PROFESSOR Babatunde Osotimehin. He is a frequent visitor to the United Kingdom and loves international forums. And it is quite commendable to see our minister “network” with the who is who in the international community; I would have been hoodwinked by the smooth talking professor, the professor earlier in the year called on Nigerian physicians in the Diaspora to return home and showcase their talents he particularly challenged Nigerian medical practitioners in the United States of America to “return home” I completely agree with the minister that all citizens should in one way or the other volunteer time and resources to develop the country but the minister should show a good example and take the lead. He should start by doing something worthwhile to encourage Nigerians in Diaspora.

I accompanied some German based Nigerian medical team to Nigeria in august of 2009. Private citizens who visit the country unnoticed, to help out in the hinterland and communities that appear to have been wiped out of the map of Nigeria by the Nigerian government. The professor should please take time off and visit the following health facilities; I have seen them and they are a painful travesty of what primary health care delivery should be.
In Kano state we visited health facilities in Waraw, Tsanyawa and Bagwai, Birnin Magaji in Zamfara, Ibeju Lekki in Lagos, Nkpor in Anambra state and Ikare in Ondo State Nigeria and these health centres are junky medical showrooms visited by people who have no alternatives, knowing that they even lack the resources to go to bigger neighborhoods’ where they can find private hospitals that are well above their range financially.

I am not a medical expert but you do not have to be a professor of medicine, or a practicing medical expert to notice the presence of anything but functional healthcare facilities at the most important level of healthcare delivery in our country. Primary health care delivery in some cases is offered in dilapidated buildings, and in other cases very well built fancy structures that are cursed with the absence of skilled health workers, functional equipments and grouchy poorly motivated health workers. At the level of these communities, the poor level of awareness of the importance of healthy living is as a result of inability of health workers to provide health education to the people.

The federal government has of course dumped the responsibility of health education on the shoulders of international aid agencies. Furthermore, the result of World Bank policy is the decision to replace the provision of drugs with the national health insurance which is available only to civil servants who form about 10% of the total population of Nigerians while the local governments who are meant to provide drugs are stretched to the limits. Besides massive corruption drains funds meant for primary health care delivery and never mind the government’s promise to raise the total budget for health to 15% of; Nigerians could survive a bit if the current allocation was spent on them.

I am hoping that by the minister would read this, and resolve to give primary health care the required attention. Relying on the opinion of sundry consultants in the assessment of our current health situation and the performance of the ministry of Health is irresponsible.
The minister should knuckle down and get involved in what is happening in his ministry. He should personally know whether Nigerians can get attention when they need it.
He should know whether the health centres and hospitals have the technical and human capacity to provide this attention. He should know what it takes to replace the travesty we call health care delivery with a system that is empowered in all ramifications to work.

The National Primary Health Care Development Agency (NPHCDA), was established in 1992 with the main aim of ensuring sustainable primary health care in all noon and crannies of the Nigerian federation, Mr Minister your agency is as of today not fit for purpose, beyond the regular radio jingle and the millions of naira dolled on media houses and spin doctors, the NPHCDA should connect to ordinary Nigerian’s.

Beyond rhetoric, Nigerian health practitioners home and abroad should rise up and confront the orchestrated deficiencies that are killing our people all over the country. Some of those in the Diaspora come in trickles with their colleagues to provide free medical services where it is badly needed. May God empower more of them to do same. These volunteer could become foreign legions that will visit the rural health centres and provide time and facilities.

It bears re-emphasising that we must make the health ministry more accountable. To make matters worse, we have that fraud called interventions by the United Nations Development Fund; in Ikare for instance where three different health centres are reported to have been built for the community, I was terribly shocked and disappointed. Between the United Nations and their local partners some one must take responsibility for the lie that’s called a health centre.
Our inability to make our government accountable is giving those in office the courage to do whatever they want to do and more painful is the fact that those in the rural community have little or no voice. No avenue to cry out. If we continue to define our “development” on the bases of the number of sky scrappers and 10 lane roads coming up in Lagos and Abuja. Or the number of international forums our minister’s attend or the laughable statistics we exhibit out on daily basis to a gullible section of the local and international media, then we are more or less a nation with a greater percentage of unwell population.

It is dreadful enough that we cannot provide our people with a the basic needs in life , even as basic as clean water, accessible road network, corrupt free institutions, a lasting and transparent electoral process, at least we should not burden our local communities with slow death, that farmer in Northern Nigeria should not have to worry about treating a snake bite, the Niger Delta woman in the riverside area should be able to seek advice from a health care assistance close to the river bank. The Ibeju Lekki bus conductor should have a place to go to effortlessly for health advice. Ordinary Nigerians do not ask for more, they see local schools become glorified poultries, open greeneries that used to be the meeting points for youths to interact are taken over by uncaring elite and primary health care is now added to the list of “hard to find hard to get”.