The recent illness of President Umaru Musa Yar’Adua, for which he had to seek treatment in a foreign hospital, has again raised questions about the deplorable state of medicare in Nigeria. Ever since the 1980s, when our hospitals were described as “consulting clinics”, the trend towards a loss of confidence in our health institutions, and their glaring inability to meet the expectations of discerning Nigerians, have continued, unabated. The reality today is that our hospitals are the only choice for most Nigerians who cannot afford to seek better healthcare outside the country. This, even more so for the teeming masses of our people who live below the poverty line.

It has become accepted that government officials, politicians and those who can afford it travel abroad for medicare while the government’s commitment to upgrading the quality of medical service in the country remains just what it is: A lot of hot air. The quality of service in our hospitals have not improved much over the years, no matter the propaganda, and the president and the Nigerian moneyed class are not about to allow themselves to be used as guinea pigs to try out just how well the hospitals have improved with their own delicate frames!

What exactly ails our medical institutions? Why must the rich travel out for medical in foreign lands while the poor and other Nigerians have no choice but to brave out whatever is dished out by our health institutions?

The protracted illness of the respected legal practitioner, Chief Gani Fawehinmi, should serve as a useful lesson to explain one of the ills that plague our hospitals. For years, the legal titan had been undergoing treatment for a supposed heart condition, for which he had been advised to be under a strict regime of regular physical exercises, for years, until a thorough physical examination at a hospital in London, last year, determined that the lawyer was actually suffering from lung cancer. Since then he has been in London, receiving the correct treatment for lung cancer.

Gani is not alone in this predicament. Many other Nigerians, both prominent and not too well known, have been faced with the uphill task of getting the correct diagnosis of their ailments, in the country.
There have been reports of several wrong diagnoses and treatment for conditions which turned out to be unnecessary because the actual illness troubling the patients had really not been diagnosed.
The problem, in these instances, is therefore not only that of the quality of the medical personnel, but also that of adequate and up–to–date technology for correct diagnoses, as obsolete equipment are the mainstay of the system.

In places where the correct equipment are available, electricity, which is necessary to power the equipment is epileptic and tests frequently have to be repeated over and over again, sometimes, because the quality of results e.g. of x-rays and other tests, are not as clear as they should be. This often leads to loss of time in diagnosis and prompt treatment, and the additional danger of over-exposure to x-rays with its deleterious effect on even healthy cells in the body.

The problem of inadequate and obsolete equipment, which was believed would be solved with controversial VAMED contracts, during the Obasanjo regime, is still bothering the nation today, as some of the equipment have been reported not to be functioning as well as they should, while some are even yet to be installed.

Beyond the equipping of our hospitals with the right medicare machines, however, is that of the quality of care given by health professionals. Oftentimes, some health professionals appear not to be in a hurry to determine what actually ails patients. In my view, there appears to be an overwhelming penchant for prescription and re–prescription of anti-malarials for ailments that later turn out to be hypertension, kidney disease, and the like. Medical doctors in some government hospitals often appear to be inattentive.

The senior professionals amongst them appear to work at their own pleasure while important operations are sometimes delayed for days owing to lack of ordinary things, like laboratory coats!, which should not be the case in a country that is serious about its health institutions.

While Nigerians should not begrudge the decision of those who have the means to travel abroad for medical treatment, those among them, like the President, who have the power to make the required medical facilities and personnel available in Nigeria for those who cannot travel abroad, have a responsibility to do so.

With the billions of dollars available to the country, a large chunk of which is being squandered on questionable projects and others that never see the light, the present administration should seriously consider the establishment of a world-class hospital with requisite facilities to give the best of medicare so that Nigerians can avail themselves of excellent treatment locally, without the added costs of international air fare.

The Teaching Hospitals and General Hospitals should be upgraded and properly equipped with the latest technology for diagnosis and treatment. Doctors and other professionals in the hospitals should be exposed to constant training and re-training in the world’s best health institutions to get the best out of them in the interest of Nigerians. There is nothing wrong with Nigeria, with her petrol–dollars, bringing these same foreign experts to work in specialist hospitals in the country.

The recent lamentation of the medical director of a General Hospital on the problems posed by epileptic electricity supply to the operations of the hospital, and the stress visited on the institution by broken down generators, should be taken seriously.

Doctors and other health professionals need to be encouraged to continue to practise in Nigeria through an enabling environment, because their profession, which is largely humanitarian and sacrificial, is critical to the well–being of the people. They should not be unnecessarily frustrated, given the impression that the work that they do is not important or that the Nigerian masses that they cater for are not important to the government.

With one year almost gone in the four-year term of President Yar’Adua, Nigerians expect to see changes in important areas like the public health sector on which the majority of the people depend.
Beyond the nicety of all the talk about the national embarrassment of the President travelling abroad for treatment of common ailments like the common cold and allergy is the more important stark reality that the lives of the greater majority of Nigerians depend on a responsible and responsive public healthcare system. It is one sector the President cannot afford to ignore.

MAIL BOX
Thank you for the ideas expressed in the column, As Yobe Doubles Teachers’ Salaries. You have spoken the reality of students’ poor performance in public exerminations. I am an SS2 student and I thank you for bringing this problem out for all to see. I love you.

Nneka, Enugu State
08068767186

The government should have understudied the problem to come out with an approach which will affect the entire system and not only the teachers emolument. The question is, why are private schools performing? The commissioners can’t even prove their worth. Responsibility should be based on competence.
Francis Udo, Akwa Ibom State.
08029606542

My estimation of the dilemma of Nigerian graduates is from two factors – quality of students and quality of teachers, both in primary and post– primary, but especially, post-primary. Invariably, poor quality primary school pupils find their way into tertiary ins titutions where quality teachers are flabbergasted by their inability to cope with required academic work. By way of compromise, these teachers adopt the-let-my-people-go consideration. Thereafter, half-baked graduates are sent into the labour market, from where employers will reluctantly employ them. Apart from poor grammatical expressions, their level of intelligence and mental capacity are nothing to write home about. This informs their inability to have imagination and initiative. Their I-Q (Intelligence Quotient) is suspect.
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