By Alex Enemanna
Nigeria the largest nation in the Black race is no doubt bleeding under the heavy weight of dearth in infrastructure virtually in all areas of our national life – education, health, transport, agriculture, security, social amenities at al but of utmost concern to this writer in this catalogue of national challenges is the rot that has pervaded the health sector. Unarguably, there exists a telepathic bond between health and life, which is man’s greatest asset. An unhealthy health sector is a direct attack on the fundamental human right to life and a violation of the UN universal declaration on human rights 1948. Sadly, the outbreak of COVID-19 in the global community and general and Nigeria in particular has not only exposed how fragile and precarious the sector is but has stuck a knife in the very heart of the dwindling life expectancy in our country.
While it is easy for any discerning mind to decipher the fact that it was sheer luck and divinity that saved our country from implosion in terms of fatality rate following the outbreak, others may gloat and thumb their chest in the wrong assumption that Nigeria has hit a breakthrough in medical research that accorded it an advantage over some Western countries that had a bounty harvest of deaths from the new virus. Interestingly, the penchant for our elite to embark on health pilgrimage in Europe, America and Asia at the slightest opportunity has not abated even as the number one man in our land and President, Muhammadu Buhari continues to be the loudest voice in the campaign for foreign medical trip while back home our medical facilities openly advertises perennial neglect and a sector in limbo.
Suffice to say that while the rich and affluent can afford medical bills in choice locations across the world, an overwhelming majority of Nigerians who are not sure where their next meal will come from have largely remained at the receiving end of the inability of relevant authorities to solve issues of public health in the country. While most countries, including supposedly ‘small countries’ in Africa have recorded a visible breakthrough in overcoming peripheral health concerns such as infectious diseases, control of vector some disease, maternal mortality, infant mortality, malaria, HIV/AIDS, poor sanitation and hygiene, disease surveillance, non-communicable diseases and road traffic injuries, a research by Faisal Muhammad, Research Assistant, Department of Public Health, Daffodil International University Dhaka, Jamil Hassan Abdulkareem, Lecturer Department of Environmental Health, New Gate College of Health Technology, Minna Niger State and ABM Alauddin Chowdhury, Assistant Professor Department of Public Health, Daffodil International University, Dhaka reveals that these have unabatedly remained at the front burner in the list of diseases that on hourly basis fell our people with utter viciousness.
Again, is Nigeria prepared to handle epidemic outbreak? There are legion of pointers that the country has a long way to go in mustering the needed war chest both in finances, equipment, research, structure and pharmaceutical stamina in subduing a major outbreak. For decades, diseases such as Lassa Fever, cholera, Cerebrospinal Meningitis, yellow fever, measles, etcetera have continued to expose the vulnerability of our health system with numerous lives they have claimed across the country with the North being on the lead. This is in addition to the long list of ‘strange’ diseases often reported in the country. In March this year, about 284 persons were said to have been hospitalized following a ‘strange’ disease outbreak in Kano.
According to reports, the victims were rushed to a primary healthcare centre after passing excessive blood urine and vomiting. Expectedly, no fewer than 10 fatalities were recorded from that one incident alone. In November 2020, a ‘strange’ disease later discovered to be Yellow Fever killed about 22 persons in Ika North-East local government area of Delta state. While it goes to say that the inability of government to identify what these so called strange diseases are, the same way criminal elements killing our people for fun across the country have been branded ‘unknown gunmen’ government’s response to these ailments have not gone beyond reducing the number of actual casualties in apparent effort to subdue tension, deodorize themselves while claiming to be ‘on top of the situation’.
The acute shortage of manpower in the sector as a result of poor welfare package for medical personnel again places our country miles away from being prepared to handle the slightest of pandemic outbreak. According to a 2019 Aljazeera report, brain drain impacts healthcare sector on the account of mass exodus of our doctors to overseas in search of better work conditions and pay. The report says about 2,000 doctors left the country few years ago. Added to this is intense wooing of Nigeria’s greatest medical talents by authorities of Saudi Arabia and UK. The desire of Nigerian doctors to work abroad cannot be extricated from the frustrating low budgeting for the sector, put at only four percent of the country’s budget. In the US, annual healthcare threshold for one person is $10,000 while in Nigeria, it is just $6. Again, the issue of security concerns where doctors are mindless being abducted right from their places of work by unpatriotic criminal naturally sends fear and apprehension in their minds, singling them out as endangered species in a nation already battling shortage of qualified doctors.
According to a poll conducted by NOI Polls in partnership with Nigerian Health Watch in 2017, it was discovered that most doctors seek work abroad. Implicatively, most patriots stand the risk of being under-served in their quest for affordable, efficient and accessible healthcare service. According for Prof. Isaac Adewole, former Minister of Health, there is one doctor per 5,000 people in Nigeria compared with the World Health Organisation (WHO) recommendation of one doctor per 600 people. The issue of constant strike arising from inability of government to meet up with medical unions’ demands for better work environment, enhanced welfare and effective service delivery is not something to glory in.
Again, the fragility of our health sector crystallizes in the reported shortage of beds in isolation centres as a result of the overwhelming number of cases of COVID-19 which dwarfed the country’s capacity. That about 25,000 health workers were hurriedly trained for infection response implies that if peradventure a similar outbreak occurs in the future, there will be need to bridge the gap by adopting the fire brigade approach. This is not the trademark of a country prepared to deal with any possible serious outbreak. The amplified demand for COVID-19 vaccine not commensurate with production capacity of manufacturing countries has put Nigeria in the long queue of nations waiting like the proverbial patient dog, with a very minimal option for home-grown solution. As earlier highlighted, our large dependence on foreign interventions to solve our domestic health problems calls for genuine concern. Can’t we equip our research institutions, make grants available and commission a team of professionals to broker a roadmap towards home-grown solutions? A consumer nation who relies on the research milestone of others is not a quintessential example of combat-ready nation in cases of disease outbreak.
Lastly, there must be a concerted effort to reposition the country’s healthcare system to compete favourably in providing answers to contemporary health questions. The future generations will not remember President Muhammadu Buhari for how many countries he has visited in search of improved healthcare service for himself with our common patrimony but how many medical institutions he equips, how many healthcare centres he constructs, how much he incentivizes medical practice in the country as well as how much he reduces the growing desire by Nigerians to embark on medical tourism outside the shores of our land. There is never a better time to demonstrate that we are reasonably prepared to guarantee the minimum level of healthcare for citizens than now.
Enemanna, an Abuja-based journalist, writes from [email protected]
