TO THE WAILING WAILERS LAGOS JOHESU,WE ARE PROFESSIONALS NOT QUACKS.
It was with great dismay that I read the recent broadcast titled “Quacks take over government hospitals” credited to LAGOS JOHESU. It would have been observed that there has been a nationwide strike by their members in government hospitals including Lagos State for a while now and despite making significant gains, they have still refused to abort the so called strike to face the core duty of saving lives. They mentioned in their statement that some of their members run skeletal services which I consider ill defined and has done nothing to reduce the pressures on Primary Health Care Centres in Lagos.
They referred to Community Health Extension Workers as quacks in their recent statement for no obvious reason but for lack of will, sincere purpose and gross unprofessionalism! In order to achieve your aims, why would you tongue lash fellow professionals because they are not part of your union? The Lagos State government in a bid to keep the public hospitals functional for the time being, recruited Community Health Workers to fill in for the striking nurses particularly in offering support to the Medical Doctors during emergencies. This single act, shocked JOHESU and prompted them to release a statement to withdraw their ‘Skeletal Service’ fully and called those the Lagos State government temporary engaged as quacks for no other reason apart from being scared of intimidation.
Perhaps JOHESU has gotten really busy fighting for their demands which has now obviously affected their position on the truth. As a result, I consider it an urgent need to educate them on who we are! For the record, Lagos State has been a front runner in virtually every area including its choice of people to run its establishment, facilities and hospitals. It is a fact that Lagos State government does not deal with quacks or unqualified personnel as only qualified personnel with valid licenses were deployed to assist the Doctors in public hospital while the strike lingers.
The community health profession in Nigeria was borne out of the Federal government’s urgent need to transition from curative health care to preventive and to address the imbalances in the nation’s health care delivery system. Particularly, it’s third basic health service scheme BHSS of the late sixties highlighted these. This decision came when the World Health Organization also clamourd for Health for All, which moves to provide equality in “health care for all” in all the then WHO member countries.
This ideal model of healthcare was adopted in the declaration of the International Conference on Primary Health Care held in Alma Ata, Kazakhstan in 1978 (known as the “Alma Ata Declaration”), and became a core concept of the World Health Organization’s goal of Health for all.
Our dear country was represented at that conference by then Minister of Health, Professor Olikoye Ransome-Kuti. At the conference, the need to offer health care to individual, families and the entire populace was discussed; so also was the need to offer essential, affordable and accessible health care for all. This led to the adoption of the ‘Primary Health Care’ PHC which is “an essential health care based on practical, scientifically sound and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation at a cost that the community and country can afford at every stage of their development in the spirit of self reliance and self development”
PHC encourages health care to be offered to people where they live and work. Core principles include equitable distribution of health care, community involvement and participation, multisectoral approach, use of available resources among others. Core components include health education, Immunization, provision of adequate food supply, water sanitation, maternal and child health including family planning, among others.
Despite these outcomes, it was not until the early eighties, that Nigeria officially accepted PHC service and adopted a new strategy using its Ministries across Federal, State and Local levels. Thereafter, fifty-two Local Government areas nationwide were selected for the construction of PHC model centers( locally referred to as Health Centers).
The Nigerian government prior to the adoption of that policy had professionals who managed its mostly curative health care system – Doctors and Nurses. But in a swift response to the ‘Health for all’ policy, it became an imperative to train middle level professionals who would provide majority of the services to the Nigerian populace, the first set of professionals trained were at the Institute of Child Health, LUTH led by Prof. Ransome-Kuti, it is these set of professional that are today referred to as Community Health Practitioners. Worthy of note is the establishment of the first CHO training programme in Nigeria’s premier Teaching Hospital, the University College Hospital, Ibadan in 1979 and thereafter the establishment of the Primary Health Care Development Agency (NAPHCDA) for grassroots inclusion in 1992.
They have been previously known as Community Health Aides, Assistants and Supervisors but are presently referred to as Junior Community Health Extension Workers(JCHEWs), Community Health Extension Workers (CHEWs) and Community Health Officers(CHOs). With a minimum of 5 Credit passes in English, Maths, Physics, Chemistry and Biology. The JCHEWs receive a 2year post secondary training from a recognized college of Health Institution, pass the prescribed exams which qualifies them to get a license. The CHEWs, receive a 3-year post secondary training from the same institution, pass the prescribed exams which qualifies them to practice license. The CHOs are CHEWs who possess a minimum of 2yrs field experience plus a valid practice license prior to undergoing a 2year training in a recognized Teaching Hospital. They also pass an exam to get licensed.
They fit into every sector as mentioned in the components of PHC above. They also function optimally at the Primary Health Care centers established by the state governments in their respective local governments. Services offered in these centers include immunization, antenatal and family planning services, treatment and management of common childhood illnesses, health promotion and outreach services etc
Some of these individuals have gone further to receive training in Basic and Advanced Life Support, Phlebotomy, infectious disease control and Biosafety, health in humanitarian crisis, diabetes education and prevention among many other areas all of which have prepared them for the ever challenging health sector in Nigeria. It is these sets of people that JOHESU refers to as quacks; how shallow!
Over the years, we have contributed immeasurably to Nigeria’s healthcare system and government across federal, states and local are clearly aware of these immense contributions and have continuously acknowledged our commitment and contributions.
Community Health Workers have benefited from employment abroad and have offered quality services to people on an international front, we have CHEWs in the military and navy contributing immensely to their health successes and some of them have proceeded to seek further study in Community Health (BSc) and other disciplines in the health sector including Medicine in order to contribute even more to the health care needs of the teeming Nigerian population. In collaboration with other health care and government authorities, we were instrumental in the containment of the Ebola outbreak of 2015.
It is indeed a profession that takes passion very dear and considers patient first before any other thing which is why I am proud to write this as a Community Health Extension Workers myself! It is often said that “your value does not decrease based on someone’s inability to see your worth” therefore I do not blame JOHESU for not seeing this but I must confess that lately they have been really busy having had so many fishes to fry which is why this break they are taking is perfectly timed for these exceptional professionals to relieve their stress now that Ebola has placed all African countries on high alert.
Let us remember that we are not defined by what a group says but by what we pride ourselves as! We have excellent capabilities to work both in the hospitals and in the communities for contact tracing and surveillance should there be an outbreak. So without mincing words, we are indeed great assets and blessing to the Lagos State and Nigerian healthcare system moving forward and as pointed out clearly, it is ludicrous to say we are quacks after knowing all of these because whether JOHESU cares or not, “WE DESERVE SOME ACCOLADES!”
