Barely a year ago, I wrote a piece with the title “Our fate after COVID-19: Public alert,” on April 6, 2020, where I highlighted a wide range of issues to be worked on, if Nigeria is to take advantage of the pandemic that has thrown up opportunities for the improvement of Nigeria’s heathcare facilities, notwithstanding the impact of the virus on the people. At that period, Nigerians across board seemed to agree that the health sector of the country was in a coma and needed urgent resurrection. Remember the statement of the chairman of the Presidential Task Force on COVID-19, Mr. Boss Mustapha, who doubles as the Secretary to the Government of the Federation, that he was alarmed by the state of healthcare facilities in the country. Similar views were expressed by other well-meaning Nigerians, from the public and private sectors. Against that background and by way of demonstrating concern, a lot of entities, internationally and locally, embarked on donations in cash and kind towards regenerating the healthcare facilities.
It was in the midst of these humongous donations that I scripted the thoughts on the aftermath of these developments. In the said piece, I interrogated various issues that could lead to the recovery of the healthcare sector, if they were addressed as the donations rolled in. By way of refreshing our memory, may I quote a portion of the column as follows: “Be that as it may, the crux of my concern here is what happens to the various equipment donated post-COVID-19, if we manage and are lucky to survive it? Who is taking stock of the equipment now and for the future? What is the maintenance plan for the equipment, both currently and in the future? Those developing faults now or are suffering from one defect or the other among the equipment, or those already mishandled, who is repairing them? Or, as characteristic of us, are we just packing them aside for ultimate disposal or for some smart elements to steal and sell as scrap? If only for accountability, what happens to the equipment donations jointly made to the federal and the state governments in their respective domains?
“For that equipment that we are procuring directly, is there any negotiated future trade in place for their latest brands? Beyond the emergency training we are doing now, is there any capacity development plan after the crisis? How are we proposing to bridge the gap of personnel after the crash programme we are running now? What are the forecasts for energy requirement for the equipment donated or purchased at their final destinations? What protective measures are being planned to forestall cannibalisation and vandalism of the equipment? As at date, it is the fact that most of the equipment, ranging from beds, ventilators and others, are residing in temporary structures all over the nation. What is the compass for the permanent residence of the equipment? Are we planning to remodel the existing structures in the different parts of the nation so as to comfortably accommodate the equipment; or we are planning to erect new structures that are customised for the purpose of these modern equipment?
“What happens to all the abandoned public buildings belonging to the Federal Government all over the federation running into thousands, which can be upgraded to a state-of-the-art medical facility to care for specific or general ailments? The same thing goes for the states. These and many more enquiries must be made for proper planning. The truth is that we cannot afford not to take maximum advantage of the opportunity COVID-19 has provided us. Government at various levels needs to put on their thinking caps in this direction. We need to earnestly start planning against all these, otherwise, the equipment, apart from ending up in the museum of various states and agencies where, eventually, they will rot, might equally find themselves into private hands, nay, hospitals. We must not be found in this kind of quandary or quagmire again in future. The Yoruba say: Ina esisi kii jo ni leemeji (you don’t suffer an accidental burn twice from the same source). A most important thing to do is building our capacity to re-invent this array of equipment by way of reverse engineering.
“It is my hope, therefore, that, with proper planning, we will succeed in building on these emergency achievements. We cannot afford to return to the state of decay our health facilities were prior to and up till these COVID-19-propelled interventions. Our universities can be funded to work on this as we cannot, all the time, be at the mercy of the Elon Musks, Jack Mas and Bill Gates of this world and their local counterparts whenever there is a crisis.”
The whole essence of my intervention then was to alert Nigerian leaders on the need to take proactive measures to rescue the healthcare sector of the country. Sadly, this is not to be heeded, as not only was the opportunity wasted, the situation of the healthcare sector in the country degenerated more. Nobody needs any further evidence for this assertion than the recent medical trip of Nigeria’s President to the United Kingdom and the recent strike by resident doctors. None of the issues raised in the piece has been countenanced, much less addressed. If I may ask again, where is the donated equipment? In which and what shape are the items? Who has the inventory? Where are the newly purchased ones, if at all, are they supplied? Are they up to specifications? Who audited them? Who can unveil the maintenance strategy put in place between then and now to us? Where are the new hospitals or the refurbished ones? Where is the sustainable capacity development scheme in place? I am sure there is no energy programme in place for the sensitive and sophisticated equipment. Where are the billions appropriated to the task force? Who is in possession of the various huge sums donated? Who will tell us what the fund has been used for? Where is the audited account published for public consumption? I am, just like other Nigerians, still in the dark about all these.
Apart from the issues of the conditions of service still plaguing health workers, lack of appropriate equipment to practise and work is still daunting; the environment in which they operate is still deplorable and abominable.
What is obvious, therefore, is that the country has not progressed a bit in terms of heathcare facilities. The healthcare sector of the country is not dissimilar to the situation of security in the country. Things continue to fall apart. Again, this brings to the fore the docile nature of Nigerians. I have always contended and am still largely of the view that Nigerians are ever passive in their affairs. Since that period when the various donations were made and now, Nigerians appear to have forgotten about the issue. They are largely muted, even in a matter of this nature that affects their lives. Can you imagine how many patients were stranded in the hospitals during the recent strike? Do we know the multitude of avoidable deaths that occurred during the period? Nigerians, like their leaders, care not about this, otherwise how do you explain the silence in the face of these deaths? For how long is life going to be meaningless to Nigerians? I have chosen not to forget those life-threatening issues and, therefore, through this medium, awaken Nigerians from their slumber. Nigerians must demand answers to all the issues raised above. Nigerians need to carry out their own audit and monitoring of the donations.
We must ensure the donations work for us as calibrated. For how long would the impunity last? Again, due to the failure of the healthcare system in the country, the current trend is the influx of medical expatriates to the country, some even below the quality of Nigerian medical personnel. The only edge these expatriates have over their Nigerian counterparts is the ability to mobilize modern medical equipment than their local counterparts. The sad news is that, in a whole lot of circumstances, they even operate by way of tele medicine.
All they do is to engage local technicians to operate the equipment while reporting on the result, particularly the interpretation of the outcome of the diagnosis is done offshore. In addition, they consult from abroad in the nature of medicine without borders. As much as this is necessary at times, it must not be a smart way of avoiding or side-tracking the local regulations in terms of practice of medicine. These foreign medical experts are not registered with the local boards and neither do they have attestation of their competence ascertained. The locals must not be allowed to be dwarfed easily this way.
In as much as I will not discourage the influx of these medical personnel into the country, I will advocate that it is not sufficient to license them and allow them to operate without conditions. They must be made to ensure transfer of skills where applicable. A package needs to be developed that will compel the medical expatriates to transfer skills gradually to the locals. This can be done by subjugating their operations to that of Nigerian personnel, and those flying in to carry out procedure, to equally specify the procedure and steps they are engaging in.
All these will aid the transfer of skills to the locals and improve the healthcare delivery of the country. It is, therefore, my invitation to Nigerians to ‘on their mic’ in respect of the various issues discussed above. Without probity and accountability, good governance will continue to elude the nation. Every sector must be held accountable at all times. This is my simple plea. A word is enough for the wise!