Nigeria’s Healthcare: Both the Poor and the Rich Cry

I believe that I am not alone in feeling distressed about the situation of healthcare in Nigeria. Everywhere you look, the   problems stare you in the face. In the public health care space, you face poor infrastructure, old or inoperative equipment and generally poor attitude. Even skill and competency levels are often suspect. If you have taken a seriously ill patient to our public health facilities – be they primary, secondary or tertiary institutions, you will have known that many more people are healed by faith in Nigeria than by medical care.

If you go to the private healthcare institutions, may be infrastructure and equipment may be better but attitude and skills are subject to national averages. Additionally, in all cases, affordability remains a key limiting factor. Since managed care and health insurance are still in their infancy or rather has remained in a state of stultified growth, most Nigerians have to deposit cash before they can be attended to or admitted in hospitals.

If you have no cash, then chances are that you will depend on faith. Then, there is a large grey market that spreads from the Mallam trying to sell you   “burantasi” at the filling station, to the unlicensed “doctor” hanging a stethoscope and trying to diagnose “staphylococcal” infections, to the illiterate medicine dealer who is mixing you a concoction of black and red capsules and yellow tabs from his illegal and ramshackle kiosk for the treatment of malaria and thyphoid, pretending to be a “chemist”.

Meanwhile, on certain TV and radio stations you are daily assaulted by all kinds of herbalists who claim to heal everything from HIV/AIDS to prostrate cancer. Many are deceived and are despatched to early grave in a largely unregulated or poorly regulated healthcare environment. Meanwhile, the licensed healthcare professionals are busy squabbling and fighting for tuff and freebies while quacks are taking over the market and causing mayhem. All over the world focus has shifted to preventive and patient care, necessitating an enhanced professional specialisation and inter-disciplinary collaboration amongst healthcare professionals.

Unfortunately in Nigeria, this global development seems to be opposed or resisted by some professional groups, thereby denying the patient of the benefits, leading to preventable mortalities and morbidities. We then end up with one of the most miserable health statistics in the World in infant mortality,maternal mortality , under-5 mortality; HIV/ AIDS prevalence rate and life expectancy. Malaria and seasonal cerebrospinal meningitis are still ravaging us and we remain one of the world’s last bastion for poliomyelitis, yellow fever, lassa fever and dengue fever .It must however be admitted that some improvements have occurred over some time but only in spurts.

During the days of Prof Olikoye Ransome Kuti as Health Minister, he refocused the nation on primary health care and certain statistics improved. President Obasanjo seemed determined to equip our tertiary institutions and he engaged one of his friends who dumped sophisticated equipment in hospitals that were not ready to receive them, leaving some of the equipment in crates up till very recently. Following the embarrassing handling of the illness of President Umaru Yar’Adua, Professor Osotimehin, then Health Minister empaneled a committee of experts of which yours sincerely was one of them to propose four centres of medical excellence that would compare with the best in the world and which would help to reduce medical tourism by Nigerians to Europe, America, China, India, Egypt, and Dubai, and help remove the shame from Nigeria. The committee went to work with much enthusiasm and grit but that effort seemed to have ended with the death of Yar’Adua and the removal of Osotimehin as Minister of Health.

Another spurt   occurred when President Goodluck Jonathan set up the SURE-P committee and mandated it to focus on primary healthcare with emphasis on maternal and childcare. So much happened in that season: Building of new healthcentres, rehabilitation and refurbishing of old ones, supply of essential medicines to health centers across the nation, distribution of ambulances, employment, training and deployment of nurses and midwives to several health centres. But all that seem also to have ended with the end of Jonathan’s tenure, because I do not get to hear much in this direction. Indeed the way Nigeria handled the Ebola outbreak during the tenure of Professor Onyebuchi Chukwu as Minister of Health showed what is possible if Nigeria gets its act together but we often become victims of the stop and go syndrome due to policy inconsistency. That’s why President Muhammadu   Buhari came to power and soon became sick and could not find any health institution good enough to deal with his matter and has had to travel abroad a couple of times, some for extended periods to seek healthcare.

Things became extremely embarrassing when the wife and daughter of the President complained openly that the State House Clinic which was supposed to be the best specialist outfit in Nigeria lacked the most basic of facilities, drugs and medical consumables. And that is despite all the huge annual budget provisions for the Clinic. If things can be this bad in Aso Rock that forced the outburst from the President’s family, do we have to show any surprise if I tell you that there is lack of critical equipment or essential drugs in the General Hospital in my town- Arochukwu. Many people have died prematurely because they could not access proper care in Arochukwu and before they could get to Umuahia through the long and neglected Arochukwu road, they would have run out of ‘vital gas’. (Thank God, the contract for the road rehabilitation has recently been awarded by the FGN). Just recently, PMB had to undertake another 10-day medical vacation to the UK and I felt sorry for Nigeria.

Three years is long enough time to fix one hospital in Nigeria to take care of our President. If the health of our President is not enough motivation to take the bull by the horn to create one centre of medical excellence, then what would? President Yar’Adua was sick while in office, and rather than invest in providing a properly equipped and resourced centre that would care for him and others, we preferred to play politics with the health of one of the best men that this country ever produced. Now another opportunity has been offered us by nature, and it looks to me that we seem poised to miss this too! I am pained.