Fred Ezeh, Abuja
The outbreak of COVID-19 pandemic has taught the world some lessons. For Nigeria, it exposed the covered rot and deficiencies in the country’s health care system, thus justifying political statements and successes that governments ascribed to themselves.
Huge financial and human resources, running in billions of naira have been invested in Nigeria’s health care system over the past years with little or nothing to show for it. Rather, government officials and members of the elite class, for lack of trust and confidence in the system, prefer to spend millions of dollars in search of medical care in developed countries.
But COVID-19 pandemic opened the eyes of the governments to years of failure in doing the needful as regards the health care system and its workers. This time, every health seeker, irrespective of social status was forced to patronise local medical services because global airspace was completely shut.
It thus reawakened the consciousness of Nigerian government to the need for increase human and infrastructural investment in the health care system in order to withstand the unexpected shock as was witnessed with the outbreak of coronavirus.
PTF first alarm
The Presidential Task Force (PTF) on COVID-19 was the first to raise the alarm about the infrastructural decadence as well as inadequate manpower in the health care system. It openly confessed that there was a huge rot in the Nigeria health care system, expressing the fear that the health care system may be overwhelmed by the pandemic.
PTF chairman, Boss Mustapha, is also the Secretary to the Government of the Federation (SGF). As early as March, he stressed the urgent for need for intervention from philanthropic Nigerians, corporate organizations, local and international donors to improve on the situation. He expressed shock at the level of rot and infrastructural decadence in the Nigeria’s health sector.
He was optimistic that COVID-19 pandemic will stir up serious discussions that would, perhaps, herald a greater improvement in human capacity and infrastructures that would boost the confidence and trust of health care seekers both at primary, secondary and tertiary health facilities. Currently, Nigeria has over 30 testing centres in testing and identification of positive cases.
Effects of coronavirus
President, Nigerian Medical Association (NMA), Dr Innocent Ujah, told Daily Sun that the negative effects of COVID-19 are not only evident in the health care system but the entire socioeconomic circle: «Thousands of people have lost their jobs and other sources of livelihood in Nigeria due to COVID-19. Thousands have also lost their lives across the world.
“It is a big challenge to us, though, we are not the only one. It is a global health crisis and the world is responding to it in different ways. Instructively, if developed countries of the world with sophisticated health care system can be brought down by COVID-19, then it shouldn’t be a surprise with what we see.”
He, however, renewed the commitment of NMA to the fight the pandemic: “We are always ready to work with government in responding to any public health crisis, not only during this COVID-19 pandemic but any other major public health crisis. But in return, government should be ready and show commitment and sincerity in their actions and relationship with us. Unfortunately, that is not being done.
“Some of our members in the frontline have not been paid their allowances, and that had, expectedly, affected their motivations. It shouldn’t be so at all. It is expected of government to wake up to its responsibilities and pay the health workers their allowances agreed upon. Even if the allowances are not penned down, it is natural that people who are fighting such a pandemic should be adequately motivated, financially and otherwise.”
He recalled his Ebola virus experience of 2014: “I was the Director General of Nigerian Institute for Medical Research (NIMR) in 2014 during the Ebola virus outbreak. Myself and my team initiated reward packages and did all we could then to motivate the frontline medical doctors and other health workers, and their total commitment to the course led to the success we achieved against Ebola in 2014.”
He regretted that there is no effective central coordination as regards the response to COVID-19: “I don’t see why some governors should go against the order of President Muhammadu Buhari.” He claimed that some governors, from their actions and utterances, do not believe in the President neither in the efficacy of the virus:
“That has birthed the discordant tunes in the fight against the pandemic. The President should direct governors to align with his vision so they can make remarkable progress.”
Politics of COVID-19
Many Nigerians believe strongly that politics has penetrated into the fight against COVID-19, hence their doubt and hesitation, in complying with the directives of the government. He said the politics of COVID-19 is not NMA’s business:
“Our commitment is to ensure the containment of the pandemic through the support of Nigerians and government. Nevertheless, there will always be politics in the affairs of men. But in this case of public health emergency, politics should take back seat so that science can drive the process. That is only way the pandemic can be contained and not being political about it.
“Imagine Governor Yahaya Bello of Kogi State insisting that there is no COVID-19 in the state when they are not testing people. That is absurd. He should have allowed for massive testing of samples in the state and if they return negative as he claimed, then we will reward him abundantly for his effective control and coordination.
“The position of his counterpart in Cross-River State, Prof Ben Ayade, as regards the fight is also funny. He was recently quoted to have said that use of facemask alone can protect the spread, not considering personal hygiene and others.”
He spoke on the situation in Kano State: “Remember what happened in Kano State when people began to die in hundreds on daily basis? Governor Abdullahi Ganduje said they were mysterious deaths. But verbal autopsy conducted by a team sent to the state by the Federal Government pointed to coronavirus.
“It was a tragic situation in Kano then. People were falling and dying on daily basis like pack of cards. It was same case in Yobe and Jigawa states. Hundreds were dying everyday as a result of undetected and untreated COVID-19. This is because those states never believed in the efficacy of the coronavirus.
“Nevertheless, I really appreciate Lagos State Government for its efforts to contain the spread of COVlD-l9. It was because they understood the situation and had taken the necessary steps towards the containment.”
Funding healthcare system
Ujah registered his displeasure with the poor financial commitment of states and federal government to the funding of health care services. His suggestion:
“I have made case for the establishment of the National Bank for Health several times and I will continue to do that. In Nigeria, there are specialised banks for industry, agriculture and others. It is important that we also establish a bank for health. It will encourage people to access loans to build state-of-the-art hospitals in different locations in Nigeria.
“In developed countries of the world, there are such facilities that help in funding healthcare system. They give loans at low interest rate for state-of-the-art hospitals to be built and equipped with state-of-the-art facilities for quality and affordable health care services in different fields.”
He expressed fear that brain drain particularly in medical system will get worst if government fails to intervene as quickly as possible: “Many people may think it was because of remuneration but it is beyond that. Working conditions, facilities and opportunities are not there. Imagine that people are trained, and they know what to do but the facilities are not there. Government at all levels need to equip the hospitals with modern health care facilities.
“I read in the dailies that most foreign trained doctors have, repeatedly, accused NMA and Medical and Dental Council of Nigeria (MDCN) of not being insincere in their examination and accreditation process. That is is not true. Interestingly, neither the NMA nor MDCN conducts the examination. They only supervise and coordinate the examination. It is experts, professors and consultants from different teaching hospitals that conduct the examination.
“Annually, we have avalanche of foreign trained Nigerian doctors coming to fight for the limited space in Nigeria’s health care system. Unfortunately, many of them wish to jump into practice on return, but it is not done that way anywhere in the world. They would, first, be subjected to examinations to test their knowledge.
“The responsibility of NMA or MDCN is to reaccredit their certificates after they might have passed the examination convincingly. Medicine is a course to protect lives. Every foreign trained Nigerian doctor must pass through the process before he or she could be allowed to operate in Nigeria.
“I am a Professor of Obstetrics and gynaecology. If I relocate to UK or US for the purposes of practice, I must be subjected to their examinations and passed convincingly before I am granted permit to practice.”