Yusuf Buhari as a metaphor for Nigeria’s health sector

Last weekend, some national dailies reported the appreciation of the wife of President Muhammadu Buhari, Aisha, to the medical personnel tending to the needs of her son, Yusuf, who was involved in a bike accident last month.

The letter, which came alongside reports that the Minister of Health, Isaac Adewole, was at the head of the medical team treating the young man was the first credible information on the first son’s state of health since the unfortunate incident a little over two weeks ago. It gladdens the heart to hear that the young man is responding to treatment and gives hope that Nigeria could at least handle a case with the delicacy of the one at hand.

But that letter and the revelation of the role being played by the health minister communicated an unpleasant message that has continued to plague the mind.

Adewole, Nigeria’s health minister for more than 24 months, can hardly lay claim to any significant impact on the country’s health sector. As a matter of fact, on more than one occasion in the year that just ended, various medical unions, including the Nigerian Medical Association, which he belongs to, raised questions about his effectiveness in office. An umbrella body of health workers actually called for his removal!

And for me, that this same minister would head the team of doctors attending to the President’s son testifies to the widespread corruption of values and the communal indignity that permeates our political landscape. I will explain.

On the website of the Federal Ministry of Health where Adewole is honcho, there is a list of 44 tertiary health facilities comprising 20 teaching hospitals and 24 federal medical centres, a number of which should have been able to handle the condition upon which the health minister sits on a team of experts in a private hospital! But these medical institutions have remained that only in name. Two years ago, it was widely reported that budgetary allocations to all these facilities were dwarfed  by the provision made for a sole facility known as the Aso Rock Clinic, so they have remained mere skeletons of the ideal.

The other repulsive thing about Adewole’s headship of this team is that it gives him away as a mere busybody who abandons his primary responsibility to attend to the needs of Yusuf Buhari- because of whom the latter’s father is.

This is the thing that worries me about public officials in Nigeria. Very few of them have a sense of loyalty to the state they serve. The Minister of Health sure imagines that he is in that office to serve the pleasure of the President, but that is very far from the truth. It would be totally understandable if the personal physician of the President had taken charge of the medical situation of his principal’s son.

Although the state also picks up the bills of this personal physician, he is specifically employed to attend to the medical needs of the President and his family. As a result, being in charge of the immediate health needs of any member of the family would neither cost the nation more nor bear any tone of absurdity.

Unfortunately, the same cannot be said of the health minister. In his own case, his allegiance should be to the Nigerian people such that he is responsible for the health needs of 160 million Nigerians. On the day he was sworn in as minister, Adewole became a father of all Nigerian children such that if he chooses to sit at the head of the medical team of the President’s son, every other Nigerian child should get the same measure of attention.

But such attention should not even be necessary if this man had stood up to the duty of driving innovative policies that would give every Nigerian parent confidence that they or their children would get proper medical care whenever they need it. In conjunction with the President, state health commissioners and the larger National Health Council, the minister should drive policies to improve access to affordable and quality healthcare and save Nigerians from avoidable deaths.

The question to ask Adewole is what will be his legacy when he eventually leaves office as he sure will, some day? Nigerians still eulogise the late Prof. Olikoye Ransome-Kuti for his dogged pursuit of the entrenchment of Primary Health Care; what recollection will Nigerians hold of Adewole when he leaves?

What has happened to the implementation of the National Health Bill, 2014 for example? How much has been achieved with the penetration of the National Health Insurance Scheme and the expansion of the programme to include ordinary Nigerians, what are the plans of his ministry to improve Nigerians’ access to health information as an important ingredient for preventive care?

Another important issue is the welfare and conditions of service for medical personnel in the country. Just two months back, Chairman of the Lagos State Chapter of the Nigerian Medical Association, Dr Olumuyiwa Odusote, raised the alarm about the exodus of doctors from Nigeria.

According to him, while more than 40,000 of the 75,000 registered Nigerian doctors, practise abroad, 70 per cent of those in-country are actively seeking more profitable outlets.

Odusote put out such alarming figures that have not been contradicted by any other authority to the effect that 100 doctors resigned from the services of the University College Hospital, Ibadan, in 2017 while about 800 doctors left their jobs in Lagos State hospitals in the last two years! The implication for this, he explained, is that the average new patient in Nigeria needs to wait for two weeks to see a doctor. That is a period within which a lot of cases would be beyond redemption.

Now, the emigration of these doctors and medical personnel is not just due to insufficient wages but also about the parlous and tedious conditions of work. While the rest of the world, including countries like India and South Africa, parade first class medical equipment that aid diagnostics and treatment, Nigeria relishes in obsolesce. One dangerous effect of this is that negligence and errors, which largely go unpunished, have become a regular occurrence in the health sector.

Another problem, which one expected the minister to tackle, is the impossible position young doctors who desire to become specialists find themselves towards enlisting for residency programmes. Even as we speak, without the recommendation of some high up in government, most Nigerian doctors are unable to get into any of the teaching hospitals to actualise their dreams. You then wonder whether Nigeria is thinking about the future of medical practice!

There is also the abominable rivalry among different professions in the health sector. It is true that this has gone on for long and may never end, but it is something that a minister of health with the interest of the country should endeavour to tackle and minimise in the interest of the public good.

These and so many other challenges, which stand between Nigeria and a reasonable health system, are what authorities in the health sector should face instead of the abandonment of duties and eye-service that the self-imposed assignment under discussion represent.

It should be said at this juncture, however, that this intervention is not about any bad blood for Yusuf. What the Buhari’s currently experience is one which no parents deserve and I, like millions of other Nigerians, sure have them in our prayers and look forward to the young Yusuf getting on his feet again.

But this is about political appointees living to the demands of their offices and specifically about delivering an enviable health system where no child would need a father or mother in some high place before they receive quality care. It is about engendering a Nigeria where medical personnel practise with satisfaction, where brain drain would be a thing of the past and where we can save the millions of dollars that Nigerians expend on medial tourism annually. That would be the change.

Twitter@niranadedokun