Activist and distinguished consultant public health physician, Dr. Ossai Edmund Ndudi in this interview with Sunday Sun speaks on the COVID-19 pandemic and how not to joke with the deadly disease, the challenge before the government and issues surrounding 2023 and emergence of a Nigerian president of Igbo extraction, among others. Excerpt:
What is your candid assessment of the COVID-19 pandemic response by the Federal Government?
Comparison may be a source of discontentment. Remember, this is a novel virus. Again, the virus has mesmerized even the wonderful health systems of developed countries. Everyone is counting losses, high and low-income countries alike. I think the Federal Government has tried. But there is room for improvement. It has been a trying time for NCDC, but we should thank God the agency has been established. Remember NCDC once informed us that initially samples were sent to South Africa for the COVID test. There may be some issues in the kits since we are yet to meet up with our projected number of tests for each day. Perhaps, the fact that the world was under siege the same time is something of note. Even the United States at a point in time was in short supply of PPEs. So, we should see this as a global problem and learn the essential lessons from this experience. Now, when we talk of the government remember that state governments are there also. So, collectively, the three levels of government in Nigeria have not done enough. The first matter is our level of preparedness. This again is a function of the health system in which case it was poor. I think we learnt people were locking down and we joined the bandwagon. That time of lockdown was the time to adequately prepare the health system, but we failed in that approach. When the present government of Ebonyi State saw that Lassa fever is a problem in the state, the government made the necessary moves to position the state in fighting the disease. That is the way to go. So, what we have now is that the triple disease burden in Nigeria is still there then came the COVID pandemic. The people withdrew from health facilities and worse still died from other causes of death other than COVID. Remember that as we were all frightened by COVID-19, Lassa fever continued to kill our citizens. Then the issue of palliatives was not well handled, but remember we lack the means to do that like the advanced economies. I think the Federal Government did not manage the case of Chinese doctors very well. In matters like that it could have been better to factor in the opinion of the Nigerian Medical Association since it was a sensitive matter. We have already made nonsense of the local government system and the results are evident. I think the Lagos State government deserves commendation, but the same cannot be said of other states. The United States bears the greatest burden of the COVID-19 pandemic, but they also make it known that they have conducted the highest number of tests. This is the same time one of the states in Nigeria has conducted only a single test. That is amazing. So, you see there are many issues in this subject. NCDC has asked the states to make available some specific number of beds in the isolation/treatment centres, but how many are eager to work in tandem with the NCDC. To an extent, the federal system of governance in Nigeria did not help us in this fight against COVID-19. In any case, I think the government at all levels was able to mobilize and sensitize the people about COVID-19 within a short period of tie. I think the government should be commended for that. This is part of the good lessons we have to carry over to post-COVID.
Have we learnt the lessons?
It is very early to answer in the affirmative to this question. God forbid if we do not learn lessons from this COVID experience. However, from what is happening now, it is obvious the system cannot be the same again. There was a very fine comment in this regard by the Governor of Akwa Ibom State. I agree with him completely. This should be the turning point.
But some Nigerians think that the COVID-19 issue is mere deception and not true?
Deception for what purpose and to achieve what? It is unfair for anyone to think in this direction. More than 90,000 Americans have died due to COVID-19 and we are still thinking otherwise. The Chief of Staff to Mr. President died because of COVID-19 and someone is still chanting deception. An Emir has died and a member of Plateau State House of Assembly has also died from COVID-19. I think it is crazy for anyone to think so. In any case we should be grateful to God that we are not witnessing enormous mortality from COVID-19, but that is not an excuse to be complacent or reason in the absurd. NCDC has said that 80 per cent of our cases are without symptoms. In situations like this, I do not know whether to ascribe it to complete ignorance or lack of trust on the government. For whatever reason I think such thoughts are out of place. Somehow I think we should learn to play politics during the period of politics and face governance once the period of electioneering is over. The politicians should understand this and the citizens should be consciously aware of that too. It will help us to grow as a nation. Because any failure is strictly not that of the government, but the nation as a whole.
As a medical doctor, how good is our health sector?
Our health system could be described as weak and this has manifested in our response to this pandemic. We should know that only the Federal Government is making some efforts in the area of healthcare. Most of our state governments do not attach premium to healthcare and forget about the local government system, they are nowhere when it comes to health service delivery. Remembering that comment of the governor of Akwa Ibom State, we are hopeful the story will change post-COVID.
What is your advice to government on how to secure the post-COVID era
The post-COVID era is not only for the government, it should be for us all. Our health system is weak, we have several doctors, including specialists that are unemployed yet the same government subsidizes medical education. The whole thing does not add up. I watched AIT news one day and the Hon. Minister of State for Petroleum laid the foundation stone of a five-star hospital in Bayelsa State to be built by AGIP and partners. The news said similar hospital will be built in all the geo-political zones. That should be one of our responses for post-COVID. The Federal Government should go a step further in its commitment to healthcare. Bearing in mind that health is on the concurrent list, the various state governments should wake up in the area of healthcare. Then most importantly all our local governments should have a medical officer of health in their employment. This is already the case in Lagos, Delta, and Rivers, other states should follow suit. One of the lessons of COVID is the need to invest in healthcare and also public health. An expert committee has already been set up in this regard by the government made up of distinguished academics. I hope the government takes their recommendations seriously. I think that will go a long way in improving the system.
What is the way forward?
The way forward is for all to work together for the good health of all Nigerians. You can see the goodwill from influential Nigerians and big companies to the government in support of the COVID war. That is great and perhaps we may have to go that way again. The Catholic Church said they have 425 health facilities and all are to serve as treatment/isolation centres in various parts of the country. ThisDay newspapers made available their dome for the care of people affected with the disease. NNPC and Central Bank have concluded plans to take care of Nigerians returning from other countries during the 14-day isolation period. The owner of AIT was admitted at the University of Abuja Teaching Hospital for COVID-19 treatment. You see INEC donating its vehicles to NCDC. The National Primary Health Care Development Agency seconding their members of staff to NCDC. The issue of Almajiri has taken a new turn. There is now the production of home-made sanitizers. Face masks are now produced at Calabar. Some individuals in Aba are now producing PPEs. There have been several innovations in the process of handwashing with emphasis on not turning a tap. These observations are great and they are capable of energizing the system post-COVID. I count them as good deeds. They are indications that things are bound to change in Nigeria for good. Running water is an essential commodity in most of our public health facilities in Nigeria. This should change in post-COVID Nigeria. Can there be increased investment in healthcare by the private sector in Nigeria? One way to improve our health service delivery is to reduce or put a stop to medical tourism. This could be realized through private investment in healthcare. Remember the AGIP foundation laying ceremony of a five-star hospital in Bayelsa State. That is the way to go. I also expect medical doctors especially those that are working outside Nigeria to also invest in healthcare in Nigeria. I do not see the setting up of five-star hospitals to be the business of government. However, there is nothing wrong in establishing amenity wards in our various teaching hospitals. This is already existing at LUTH and UCH Ibadan. Other teaching hospitals should learn from that experience. I will be glad to see a Nigerian President being treated in a Nigerian hospital by Nigerians. This may go a long way in reinforcing confidence in the health system. Remember when the son of the president was treated in a private hospital in Abuja, it was a turning point. Once this private investment in healthcare is realized, it will have multiplier effects. Certainly, medical doctors will be well paid and then the idea of specialist physicians being jobless will be a thing of the past. Imagine medical education in Nigeria is free yet after graduation, these same doctors remain at home for years with no placement for internship. This is wrong. With the increasing number of medical schools in Nigeria, it is obvious not all our doctors will practice in Nigeria. There will continually be need for doctors in the developed countries and the conditions of service are not the same as what we have here. However, let our doctors not leave Nigeria out of frustration. You need to see the number of medical doctors applying to leave Nigeria on a yearly basis. The effects of COVID have brought to the fore the importance of health workers as soldiers of war and bear in mind it is a global experience. COVID is not all about healthcare. What about food sufficiency? Can we invest more in rice production? I thank God for the rice revolution as seen in Ebonyi State today. Other states have some food or cash crops they could grow in abundance, they should maximize that. The North has been doing very well when it comes to agriculture. You can go and buy a phone now and you will know it is a different experience altogether. This idea of importing all things including toothpicks cannot help anyone. We cannot be producing these number of graduates every year and import all things and expect to move forward. In this context, almost all countries of the world were affected so I think the lessons are for all to learn. Necessity they say is the mother of inventions. We should start producing or manufacturing some essentials. INNOSON motors is a case in hand. That is where the issue of power supply comes in. It is of prime importance in the Nigeria we are dreaming of. The government has a prominent role in this direction. The government and other agencies should now invest in research in our various institutions. Someone mentioned the number of research institutes in Nigeria and I was amazed. This means we need to re-energize the system for better yields. I just hope that the post-COVID experience will be the desired catalyst for the building of a new Nigeria. For once we all were vulnerable and all of a sudden the home became the ultimate refuge. It is time to build the home.
Which political zone do you want the presidential position to go to in 2023?
The politicians will be in a better position to speak on this matter. One of the uncertainties of the moment is to predict the Nigerian politician. Somehow they know how to reach out to one another and have an agreement. The problem is whether the agreement suits the man in the street. However, if you view from the side of fairness and equity, one may be tempted to say it should go to the Southeast or Northeast geo-political zones. Perhaps if one takes into cognizance that the current president is from the North then you may favour the Southeast geo-political zone. I think that the Southeast geo-political zone should present its case properly to the other geo-political zones and win their support rather than insisting on it as a matter of right. I believe that power belongs to God and that is indisputable. President Goodluck Jonathan is from Bayelsa State. How many local government areas are in Bayelsa? Yet he won a national election to be President of Nigeria. Thus I see things differently from others most times. Again, this 2023 is part of the post-COVID era. Perhaps, Nigerians may see things differently during the elections of 2023. Time will tell. God bless Nigeria.