Meningitis and shame of our health sector 

When Nigerians assess the performance of political office holders, they mostly consider interventions like rehabilitation or construction of roads, flyovers and such tangibles.

I do not blame the people. Since the conscientious maintenance of infrastructure has become an exception in public administration here, people have lived with poor public utilities for so long that a leader who manages to upgrade a trunk road or approve the construction of a culvert becomes an instant hero. The politicians cash in on the lean expectations of the people, impoverish them as much as decently possible and serve them tokens that throw them into euphoria.

But the world does not measure development by those standards. Since world leaders agreed that the development of one affects the other, arriving at compromises on communal indices for progress amongst nations, construction of roads and such do not measure the effectiveness of administrations.

I do not suggest that the building of physical infrastructure has no bearing on development, but this should be part of the very basic functions of a government and never become the yardsticks by which government and the governed pat themselves on the back for having accomplished.

But that is where are at. A top official of the federal administration recently found ample point for gloating in the fact that the power, works and housing minister, Babatunde Fashola, should be the only minister to have travelled on all federal roads across the country.

Added to the fact that this gallivanting adds nothing to the effectiveness of the minister is the fallacy accompanying it. Mike Onolememen also once did the rounds, yet he left thousands of kilometres of roads as life threatening as he met them! A nationwide ministerial journey is therefore, nothing of pride. Check the Millennium Development Goals set in 2000 and the Sustainable Development Goals that succeeded it.

And when the MDGs talk about infrastructure, the framers do not imagine that a country of Nigeria’s capitals would roll out the drums in celebration of laying asphalt on roads, they talk about attaining grander milestones in transport, safety and providing comfort for the people in tandem with the advantage that technology bestows.

The world cares about the well-being of the people, their state of health, the kind of education they get, the way they relate with the environment, the hope that the children have for the future and the survival of women in the process of giving birth to children, amongst others.

Concerning health, which is the interest of this column today, the rest of the world is keen on access to health care delivery, the quality of the same, life expectancy, systems in place to avoid and deal with epidemics when they occur, arresting the increasing effects of non-communicable diseases on people and so on.

Ask questions about all of these and you will see that Nigeria comes last on all fronts. This is why as of Wednesday morning; we are still helpless in the face of the outbreak of Cebrospinal Meningitis.  Over 300 lives have been lost with another 2,997 suspected cases spread across half of the country.

Again, our nation has been caught napping just like when Lassa fever struck. We are a country almost always unprepared for eventualities that we do not have the presence of mind to insulate ourselves against. But for the Providential, even the good stories told about after the Ebola epidemic in 2014 would have been different.

Like literary experts and dramatists who employ the Deus ex machina technique to resolve issues, the heavens intervened such that the infected Liberian was not a commoner that would have been rushed to a general hospital where patients sleep on verandahs and corridors. Without impugning the sacrifices made by noble Nigerians who put themselves on the line, would our songs have been the same if the late Sawyer were received in just any hospital other than First Consultants where personnel had a ready protocol and system? This is what is pathetic about country. As large, endowed and respected as it is, Nigeria cannot boast of a health system, let alone an efficient one.

Defined as “the organisation of people, institutions, and resources that deliver health care services to meet the health needs of target populations,” building such a system is one top item one hoped to find in the change package of this administration. But we still only have a mumbo-jumbo where everyone seems to do what they like.

Take medical records. True, every health facility or joke of it in Nigeria will claim to have a record of patients, but shouldn’t Nigeria be talking about computerised record keeping in which medical personnel anywhere in the country would be able to access the history of patients at the touch of a button. If this existed, Nigeria would not have lost Miss Ifedolapo Oladepo, the young first class graduate of Ladoke Akintola University of Technology, Ogbomoso while doctors remained uncertain about the symptoms she presented with.

What about access? It is ideal that there should be a facility within a 15-minute distance of people, but what do we have in Nigeria? You could travel hours without any hospital, no matter how basic in sight. In January, 2016, Health Minister, Prof Isaac Adewole, told about the Federal Government’s plan to build or resuscitate 10,000 primary health centres in the country, can we get a update on where we are with that now, Sir?

And when these hospitals are ready, where are the doctors and other medical personnel to take charge? Writing in TheCable over the weekend, Simon Kolawole informed: “Nigeria posts a doctor-patient ratio of 1:3500. This is way below the WHO-recommended 1:600. To put that in perspective, a doctor in a country that meets the WHO ratio will have attended to six patients before a Nigerian doctor attends to one. The Cuban ratio – reputed as the world’s best – is 1:250. To see a doctor, a Cuban has 14 times more chances than a Nigerian; that could mean a Nigerian patient waiting for two weeks longer than a Cuban.” Incredible!

Yet, we produce possibly hundreds of doctors that we cannot gainfully employ annually. Those who desire residency training have to wait for years or get frustrated waiting after they fail to get a governor, minister or senator to speak to the Chief Medical Director of their desired institutions. When we subject the future of tertiary medical practice to rent and patronage, we take away hope and get prospects angry.   If they are not of the privileged few, able to travel abroad and further populate the 10, 000 Nigerian medical experts in western and Middle East countries, they become partially committed terrors in public and private hospitals, perpetrating medical errors that terminate lives prematurely all over the place. Even this typically goes without consequence so laxity is almost permissive.

What about diagnostics?  There are enough of examples of very prominent Nigerians who have lost their lives or got close to it as a result of wrong diagnostics. But where is the strategy to combat the situation and ensure that this fundamental part of our health care delivery attains some level of quality? Nigerians just live by chance, leave everything to chance and rot away.

We cannot plan to help our people prevent disease, even if the system fails to cater to their needs when they fall sick. How does the country save its people from Non-Communicable Diseases, which are beginning to get more prevalent in developing countries? What effort does the Federal Ministry of Health put into health education and enlightening people about lifestyle changes that could prolong their lives?

Here is a country that does not discriminate on the importation of all sorts of indulging consumables, yet there are no well laid out enlighten strategy on what to eat, the kind of exercise to engage in and how just to maximise lives. Didn’t it take the United Kingdom for us to get a risk alert on Fanta and Sprite recently?

The wickedness of the hearts of our leaders becomes evident in the way they run abroad to seek medical attention even when a cough lasts longer than they hoped. Hear President Buhari speak about having received the best medical attention in the UK recently and you will wonder if these people get it all.

I suggest that they do not. So it is in the hands of Nigerians to demand good governance from this indifferent lot. What is the state of the Health Act, 2014? When will our people have access to community health insurance? How will the National Health Insurance Scheme become more inclusive? What are we doing about the welfare, training and discipline of doctors? What is happening to improving the state of diagnostics? These are endless questions for health administrators at federal, state and local government levels. And here is where you wonder what the civil society groups in the health sector are up to.

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