Two weeks ago, I had cause to take my son to a private hospital in Lagos. After a series of tests and scan, the doctors concluded that it was appendicitis. The hospital then invited two consultant surgeons who did an excellent job of removing the appendix. But the little snag was the cost. The surgery alone was N300,000 while the cost of tests and admission was about N100,000. No big deal, you might say. But how many Nigerians can afford this type of hospital bill to remove appendix? I understand that the cost wouldn’t be more than N80,000 at a general hospital in Lagos. But how committed are these general hospitals?
My latest experience sharply contrasted with a similar one when the same boy was admitted in the paediatrics department of the University Hospital of Wales, popularly called Heath Hospital, in 2007. Then, he was just one year old. He had high temperature but nothing was discovered after a series of tests, including a heart X-ray. To cut the long story short, we were discharged a few days after without any payment. In fact, the day we were asked to come back, we refused to go back because we felt the boy was okay. They called from the hospital a few minutes before time to remind us of the appointment. My wife and I took the child to the hospital for fear that we might be prosecuted for child abuse. And, intermittently, a nurse would visit to check how the child was faring. All these cost us nothing. Under the British National Health Service scheme, once you are in the UK for study for six months or more, you are treated as a resident and could get most of the health care free of charge. This includes your spouse and children under 16.
In Nigeria here, many of us either self-medicate or consult prayer warriors. A doctor friend told me the story of a patient who had appendicitis like my son. The parents went to a pharmacy to mix drugs. The illness worsened. When the boy died, they concluded that it was poison. But a post-mortem revealed that the boy died of a burst appendix. Many Nigerians have suffered a similar fate.
Sometimes, the problem is misdiagnosis. A good friend of mine, Dr. Athanasius Obiadazie, fell ill and was being treated of different things in Nigeria. When the illness got worse, he went to Manchester in April. That was where the real sickness was diagnosed. It turned out that he had lymphoma, a cancer of the lymphatic system. He returned to Nigeria to continue on chemotherapy. But it was too late. Last month, the man who was a consultant oral and maxillofacial surgeon at Ahmadu Bello University Teaching Hospital, Zaria, died. He has since been buried.
The late human rights lawyer and Senior Advocate of Nigeria, Chief Gani Fawehinmi, suffered the same fate. He was diagnosed with and treated of pneumonia in Nigeria but it was only when he got to London that it was discovered that he had cancer. By then, it was already late as the cancer had reached an advanced stage. Gani did not survive it.
This type of misdiagnosis occurs because most of our health centres lack the necessary well maintained equipment and high quality reagents and supplies to make the right diagnosis. In 2017, the President’s wife, Mrs. Aisha Buhari, decried the appalling state of the State House Clinic, Abuja. She had called the clinic to find out if the X-ray machine was working. She was told it was not working. She ended up using another hospital established by foreigners. Sometimes, the problem has to do with incompetent and poorly trained ‘experts.’
This is why many Nigerians who have the means travel abroad to treat even a slight headache. President Muhammadu Buhari is a typical example. The United Kingdom, United States and India are destinations of choice. Annually, Nigerians spend not less than $1 billion on medical tourism.
Patients are not the only ones going abroad. Doctors are not left out. Out of about 80,000 Nigerian doctors registered with the Medical and Dental Council of Nigeria, about 35,000 of them are practising in Nigeria. The rest of them practise in such places as the US, UK, Canada, Australia, United Arab Emirates, Kuwait and Saudi Arabia. The other ones still in Nigeria are ready to move at any slight opportunity. Recently, health officials from Saudi Arabia, in conjunction with some recruitment consultants, came to recruit medical consultants and specialists from Nigeria. There had been similar recruitment exercises in the recent past by Saudi Arabia.
Consequently, the doctor-patient ratio in Nigeria is about 1:5,000. This is against the World Health Organisation’s recommendation of 1:600. Little wonder life expectancy in Nigeria is one of the lowest in the world. Recently, the FutureProofing Healthcare initiative’s Health System Sustainability index ranked Nigeria’s health care system as the fourth worst in Africa.
You do not blame the doctors. They are more appreciated abroad. Here in Nigeria, many of them cannot afford the simple luxuries of life. After spending six to seven years in training, they come out to receive peanuts as salary. Frequently, members of the National Association of Resident Doctors (NARD) and even the Nigerian Medical Association (NMA) engage the government in a running battle over working conditions. NARD members have gone on strike many times. Their demands include, among others, improved hazard allowance, life insurance or death-in-service benefits for their families, payment of arrears of salaries owed them in federal and state tertiary health institutions, etc.
Government should take more than a cursory interest in the country’s health care system. The average allocation for health care in the nation’s budget is less than 5 per cent. This year, it slightly improved to about 7 per cent of the entire budget. That is a step in the right direction. But it is not yet up to the 15 per cent of the annual budget, which African countries agreed upon in Abuja in 2001. Good enough, the Federal Government recently increased the hazard allowance of doctors in the services of the federal hospitals and medical centres from N5,000 to between N32,000 and N40,000. Other health workers like nurses and laboratory workers had theirs reviewed to between N15,000 and N34,000. NARD, has, however, disagreed with the new rate. It wants some more.
Nevertheless, let’s be always hopeful. The other day, the African Export-Import Bank (Afreximbank) commenced the construction of the estimated $300 million African Medical Centre of Excellence (AMCE) in Abuja. The bank is implementing the project in conjunction with the Federal Government of Nigeria, King’s College Hospital, London, the Christie Hospital, Manchester, and the University of Wisconsin Teaching Hospital, United States. The 500-bed AMCE is expected to provide world-class medical facility for Africa and hence reduce the outflow of patients from the continent. It will provide services in areas such as cardiology, haematology and oncology.
This is the type of thing we want in Nigeria. If we have two or three of this medical centre of excellence, our medical travel to India or London or New York will drastically reduce. Government should prioritise health because a healthy nation is a wealthy nation.
Compliments of the season!
Re: Evaluating national anti-corruption strategy
Casmir, the war against corruption in Nigeria is very cumbersome. It’s a war that requires absolute self discipline and willpower on the part of the citizens. On the part of the Government, it requires elimination of hypocrisy. This is why today we have sexual abuse, bribery and unnecessary frustrations in different public offices. The Government is most often the culprit. Religion, ethnicity and federal character requirements are ingredients that fuel up this cancer. Any organization that cannot afford a disciplined and determined head can’t fight corruption no matter the weapons at its disposal.
– Pharm. Okwuchukwu Njike, +234 803 885 4922
Dear Casy, talking about anti-corruption crusade under this dispensation amounts to deleterious insult on the intelligence of the silent, helpless, ‘sidon look’, but very large population of upright Nigerians. Corruption has graduated from ENDEMIC to PANDEMIC pedestal where those that drive the fight are very glib and lackadaisical for the reasons that:- (1)selectivity in the prosecution of alleged villains: (2) kid-gloving in the prosecution of the alleged but ‘anointed’ villains; (3) rhetoric and sophistry; are the bane! All the setting up of all the NACS and its component IMCs of this world are mere window-dressing exercises that end up in ‘dogon turanci’. Happy Christmas to you and family my dear brother!
– Steve Okoye, Awka, 08036630731
Casmir, as a nation we are not short of policies or strategies on how to achieve this or that. What we lack is sincerity of purpose and the will of execution by a gang of mischievous, hypocritical leaders who are hell-bent on destroying this nation via their corrupt tendencies which they hand over to their children and children’s children as an inheritance. No national strategy will work until we do away with the practise of an individual owning 10-20 properties and 30 cars in a poverty stricken society like ours. Can we improve the score card? Yes we can but only if we reduce our greed (contentment is great gain) and lust for wealth and material possessions. A realisation of the fact that it is ‘all vanity upon vanity’ will help in this regard. Where there is a will, there is a way. A common resolve on our part to do away with proceeds of corruption and not celebrate convicted and society known corrupt politicians will usher in a new era. Righteousness exalts a nation but the ‘sin of corruption’ is a reproach. Merry Christmas and happy New Year to you, your family and management of the Sun!
– Mike, Mushin, Lagos, +2348161114572
Dear Casmir, the anti corruption war should start from the social institutions such as the home, education and religion. The media should hammer at good parental upbringing and sermons should desist from preaching greed.
– Cletus Frenchman, Enugu, +234 909 538 5215
The corruption fight remains a ruse in Nigeria because of lack of transparency in its approach. Government’s failure to ensure the independence of the leadership and operation of its anti-corruption agencies is deliberate. Government setting itself throws up more than 70 percent of corruption-laden persons and cases. And when the same government is the judge or presides over the very cases that involve the government, where then lies the principle of fair-hearing? Unless there’s sincerity of purpose on the part of government, we may continually be burdened with the present ‘all noise signifying nothing’ but has rather unchained corruption that now swims in a state of multiplicity.
-Edet Essien Esq. Cal. South, 08037952470
Dear Casy, until the twin evil that is killing Nigeria – the evil of leadership and the idiotic followership – are sorted out, Nigeria can’t function as a country. Nigeria has lost its leadership to crooks and evil men since 2015 under Buhari. Buhari hasn’t come to develop Nigeria. He has come to Fulanise and Islamise us. Nobody is fighting corruption.
-E ze Chima, +2347036225495