By Enyeribe Ejiogu
In the 57 years that Nigeria has been independent, it has had issues and faced challenges in the health sector. During the colonial era and in the first few years after 1960, the health sector was better organized and functioned very well, up to 1975.
During the colonial era, the health sector functioned in a beautiful way, and the present disruptions caused by multiple strikes were alien to it. But trouble began when the then military government headed by the then head of state, General Olusegun Obasanjo, sacked doctors who embarked on strike to press for improved funding for revitalizing needed healthcare infrastructure that had begun to crumble in the face of budgetary cutbacks by the military government. The doctors had at the time also sought improved funding from the government to sustain the equally important and robust training programme designed and bequeathed to the country by the colonial administration, for the production of a successor generation of knowledgeable health care professionals. Rather than listen to reason, the military government summarily sacked almost one generation of knowledgeable and experienced healthcare professionals, many of who simply left the country, unleashing the first wave of brain drain in the health sector. That is why today, in Saudi Arabia, US, Britain, Canada and some other countries you fine brilliant Nigerians working in healthcare facilities patronized by many of Nigeria’s elite, including the present political leadership.
As Nigeria marks the 57th anniversary, Sunday Sun spoke with Dr. Andrew Ukegbu, who is a consultant public health physician at the Federal Medical Centre, Umuahia, Abia State, to share his views on what he considers the biggest health challenge that Nigeria has had to grapple with over the last five decades. Please read on…
In terms of disease burden, before 1990, the health challenges of infections and parasitic diseases were a big headache. But that is not to say that the non-communicable diseases were not a problem. Until that year, we had to contend mainly with communicable diseases such infections and parasitic diseases. These constituted about 80 to 90 per cent of the disease burden in the country. But in the last decade or so, we began to witness a change in the disease pattern.
Nigeria like every other middle income nation, there is a growing change in lifestyle and consumption patterns, increasing environmental pollution and other negatives of urbanization. We are now having a mixture of communicable and non-communicable diseases, in the ratio of 60 per cent to 40 per cent. But the worrisome discovery is the rapid rise in the incidence and prevalence of non-communicable diseases, such as heart and kidney disease, cancers of different kinds. The reasons as I indicated earlier include change in lifestyle, eating habits and lack of exercise. In the past when most of our parents were farmers and ate fresh natural foods, vegetables, and consumed foods that had reasonable amount of fibre and used good quality natural palm oil without colouring and additives like the kind of “palm oil” sold in the market these days. You now find that a lot of people of the present generation now eat fast foods and other junks, do not exercise, move from air-conditioned bedrooms to air-conditioned cars to air-conditioned offices and often end up in air-conditioned mortuaries. You find that there is increased incidence of hypertension and diabetes, which often result in kidney disease. You also find more and more people are resorting to the use of alcohol based concoctions that are marketed as herbal medicine. There is nothing essentially wrong with herbal medicine, because our forefathers used true herbal medicines in their days, but what you these days are herbal preparations of questionable efficacy.
Improperly managed urbanisation and industrialization and the environmental pollution resulting from these development have also contributed to the worsening of the country’s disease profile; that is why we are increasingly moving from communicable to non-communication diseases as cigarette smoking and consumption of alcoholic drinks, especially among the youths, rises rapidly. Squally, there is increase in the use of narcotics and other drugs that are being abused. As result, mortality and morbidity continue to increase.
If you look at the statistics based on the number of admissions in hospitals, you find that there is trend towards increase in non-communicable diseases. As of today, advances in medical science have made the country better able to tackle the incidence of communicable disease such as HIV, Ebola, Lasss Fever, hepatitis, malaria, typhoid, diarrhea, dysentery, cholera, etc.
The real headache is not that there is increase in non-communicable diseases and other modern diseases, the concern is that Nigeria is not really prepared to tackle what I believe will be an avalanche of non-communicable diseases in the near future. Clearly, we lack the capacity to deal with what will happen. It is a very big challenge. We lack the manpower and the appropriate facilities to provide requisite services.
More troublesome is that the people are not very much aware of how to recognize when these diseases manifest because there is general tendency to report late to the hospitals to see doctors when they experience certain symptoms. There is high incidence self-medication. Major organ diseases require early intervention which begins from seeing a doctor early. Most major diseases can be treated or adequately managed when they are discovered early.
But the problem is that in several cases the patients come late to the hospital, after they have done the rounds of self-medication and under-going prayer sessions in so-called spiritual centres whether Christian or Islamic. Therefore, by the time the appropriate diagnosis is done and treatment is commenced, you find that the problem has gone far and almost to the point where medical intervention will not be effective and thereby leading to death.
That is why today, a school of thought believes that the greatest health challenge confronting the country is the rapid rise in non-communicable diseases. Added to this is the very poor funding situation we see in the country’s health sector which is in turn leading to abject lack of adequate manpower to handle the health problems we are seeing in the country. Of course, there is the issue of corruption in the management of the country’s financial resources.