“Health Is Waste”, They Say!

by L.Chinedu Arizona-Ogwu

Nigerians are worried over ostensible reluctance of the aspiring politicians. Their inability to tell the people what they have to offer when the whole country goes to polling boots to elect them into offices, this year, is one pain. They are yet to spell out how, if at all, they plan to make their individual and collective conduct democratic and accountable and their fund management transparent. Most importantly, they have still to tell the people what they have on offer to rid governance of the ills such as corruption, nepotism, abuse of power, etc. Overall, the politicians need to realize that their strength ultimately rests with the support of the people and their support will be short-lived if they decide not to take the people into confidence. As for us, the ordinary citizens of Nigeria; we are in favour of political governance by elected representatives of the people, as opposed to the rule by appointed government. However, at the same time, we want our elected representatives to be accountable to the Nigerian people.

All these notorieties notwithstanding, their famous trademarks have been their broken promises. The promises of good governance had never been materialized. The successive regime had made promises on numerous occasions to better the lots of the people but they could not curb corruption and tackle economic-loots from powerful people serving in the government. These abuses are still rampant and we have yet to see positive changes.

About 15% of Nigerians are doctors not favoured by local employment opportunities, but after all wangles were opportune to secure employment across the shores to head medical teams abroad whereas the remaining 85% of Nigerian citizens usually get significant portion of their income lavished on medical bills every month, leaving them and their family often very little to scrape through. .Those of them that use government hospitals and facilities, discover that nothing is free these days, despite government announcement on megaphones that “there is free medication “.If you want good doctors, you have to pay money. The doctors at these facilities just write you up medicine without a thorough diagnosis, leaving the patient very insecure about their health status. And what about the medicine..? Now we have to bring our own injections and other medicines to the hospital for the doctor to administer it. What is the use of these hospitals if the patients cannot afford private hospital services, and are left wanting? I find it extremely difficult to manage my budget, when such a large chunk of it goes to medical treatments every month.

We keep hearing and reading that the Health Ministry is building bigger and better hospitals in every city, and yet I wonder why they just don’t improve the services and hospital care in existing ones. The quality of physician and nursing care in some of these government— run health facilities is no better than veterinarian services. Sometimes, the staff is incredibly rude and hostile. Recently, when my wife experienced such behavior from a staff nurse, she gently inquired from her as to the reason behind her actions. After some time, the nurse explained that the labour recruiting company who had employed and brought them then changed all the terms of their employment contracts. Their salaries were re-adjusted downward, their housing conditions were pitiful, and they were often not paid for months in a row. That’s why some nurses took it out on the patients. They just think that all Nigerians are like that.

I’ve got to agree with some doubting “thomases” on one thing, and that is our ministerial obsession with numbers. Just the other day I read the following in a national daily:” As part of an ambitious N3 billion plans to expand the National health care facilities, Minister of Health signed a number of agreements that include the building of three major hospitals. Among the new projects are 200-bed hospitals in Asokoro area of the FCT at a cost of N204 million, and two 100-bed hospitals at a cost of N1173 million in Maidugari on the Lake Chad Basin and at Kpansia in the Bayelsa area of the Niger Delta region. Part of the money would be used to install computer systems in some 50 hospitals and 300 health care centers. The ministry, according to the report, has started work on building accommodation for nurses at an overall cost of N370 million.

There are over 320 government and private hospitals in Nigeria with 46,840 beds. To this should be added nearly 4,000 clinics owned and operated by Nigerians and foreigners. Hospitals in Nigeria — both governmental and private — currently employ over 31,402 doctors, 6,218 of them Nigerians.

These hospitals also employ some 66,493 nurses and pharmacies. Nigeria currently provides a hospital bed for every 457 people and a doctor for every 673 people. These new projects come within the framework of the Ministry of Health’s efforts to provide the best health care service to Nigeria citizens and expatriates in every part of Nigeria.

Small countries like Malta takes pride in its medical history and services and earned its reputation for healthcare and recuperation after caring for patients in the First World War. The country’s nursing and hygiene care was once considered the most advanced in Europe and its medical faculty at the University of Malta is one of the oldest. Malta has a public healthcare system, known as the government healthcare service, as well as a thriving private healthcare system. Employers and employees pay national insurance contributions towards their healthcare costs but since the health services suffer cash flow problems and long queues for operations many residents are opting for private health insurance (or paying upfront) to see GPs and specialists privately. The island has government-run health centres offering primary health care services as well as specialized health services like immunization, speech therapy, dental services, antenatal and postnatal clinics, well baby clinics, diabetes clinics, and paediatric clinics.

Flexible spending accounts, which have given Nigerian workers a small dose of relief from the rising cost of health care, are about to become a little less lucrative, thanks to few governors in the likeness of Rt. Hon. Chibuike Amaechi; a Governor in Rivers State, where consumers have been able to use the tax-exempt accounts to pay for doctor’s visits, medical care and all manners of medicine. They’ll no longer be able to buy most over-the-counter medications unless they have a doctor’s prescription. That’s right: If you want to buy aspirin, a stomach remedy or allergy medication, you’ll have to pay at the pharmacy with cash, and won’t be able to use verbal pricing – unless you get a prescription. Talk about a headache! What this will do is send people to their doctors for the most minor ailments, either to get prescriptions for over-the-counter medications or for stronger ones that in many cases are probably unnecessary. That’s going to bog down already-busy doctors’ offices, creating more paperwork for them as well as pharmacies. Higher costs, passed on to consumers, are inevitable – ironic because health care inflation was one of the reasons the Rivers State Government passed that bill.

It is shameful that whereas there is no record of any foreign dignitary that has died in Nigeria seeking medical attention, our rulers have made a virtue out of dying in foreign lands. It is a question of prestige and class! Curiously, despite their penchant for secrecy, our officials overlook the fact that foreign security agents could use the “treatment” procedure to extract vital official information from patients or plant chips in them for remote spying purposes. We call for a halt to this national elite pastime of medical tourism abroad by public officials blinded by primitive self-interest.

Not anymore! Following the advent of military politicians and political soldiers at the centre stage of our body politic, the health sec

tor, like other aspects of the nation’s public life, became soulless. All the things for which our public health institutions were once held in awe are atrophying or decaying. Almost all the teaching hospitals are embarrassing versions of their old selves. Most of the roads within the hospital complexes, once well-paved and well lit are now riddled with deep pot holes and the street lights abandoned. Surgical theatres often lack electricity supply or running water. The morgues rely more on embalmment than refrigeration, owing to prolonged power failure. As a result, public confidence in the teaching hospital, especially among the well-heeled elite, has evaporated. The former giant of the Sub-Saharan are now giant of embarrassment.

Obsolete equipment is the norm. Many specialists have immigrated to friendlier countries, where they will find professional fulfillment. Other staff who have stayed behind are frustrated. Patients are required to buy their own drugs, even plasters, syringes, dressings and gloves. Whenever the hospital provides, one dressing pack is used for two patients instead of one. If the atmosphere in the wards is unconducive, the specialized services for which the teaching hospitals were known have also become virtually non-existent. For instance, for some two decades now, most of the centres have been unable to treat kidney complaints because the renal dialysis equipment is out of order.

Government officials often use medical excuses as a cover to siphon funds from the public treasury into their private accounts abroad. More lamentable is the fact that they do not seem to copy any good thing from those foreign countries where they love to gallivant in the name of medical treatment. Even when, as has become evident, some of them with genuine serious health cases die abroad, thereby making the nation incur high costs in hospital bills and air transport of their remains back home, Nigerian leaders have refused to learn. They refuse to accept the fact that the huge financial resources being carted abroad for trivial medical treatment can conveniently provide most of the medical needs of the nation and create employment for Nigerians.

It is an ominous development that the government is proposing an increase in user fees at public hospitals, doing away with crucial free services and raising the prices of an array of tests and services that users already pay for. While these proposals are yet to be approved by the health ministry, it is said to be in line with the decision by the previous interim regime to grant autonomy to public hospitals.
Across the world there is more or less a policy consensus that health care is a common good and not a market commodity and that state expenditure in public health care has far-reaching redistributive effects. According to the World Health Organisation, more than 100 million people across the world slide into ever deeper poverty every year as a result of out-of-pocket expenditures on health care for a family member. Given this reality, providing free universal health care in a country like Nigeria could have a tremendous positive impact of preventing tens of thousands of families from sliding deeper into poverty and debt as a result of a single disease or accident. What this also implies is that when families that live marginally above or on the poverty line have access to free health care, they have more resources to divert towards better nutrition and better education for their children, both of which are keystones of economic development.

It is no wonder that almost all developed countries of the world ensure free universal access to quality health care to their citizens, though significant sections of the citizenry could very well afford to pay for healthcare services. In fact, the lack of such universal healthcare services is also evident from the plight of the United States — one of the wealthiest economies in the world — where 47 million people reportedly have no access to health care because of the prohibitive costs involved, and are mired deeper and deeper into debt and poverty when they incur heavy expenditure on healthcare.

It is very disheartening that this country has gone this bad. Enough is enough. The citizens of this country have suffered enough lack of good Medical facilities, Good schools, good roads, good housing, Electricity, portable Water and so no and so forth. Why can’t the hospitals they go be replicated here in this country? Why must they go out for treatment? What happens with the rest of Nigerians who die of “COMMON” malaria for lack drugs in the so call hospital? Where will the rest of the people of this country go to when they are sick? Are the rest of us less important or valueless to this nation? Should it only be their children and themselves that are important in this country and that they should have the best of everything (Medical treatment abroad, school abroad, drink water from abroad, wear designers’ clothes from abroad, drive the best cars manufactured abroad, shoes from Italy, Beds/other furniture from Abroad, Live in the finest and choicest house/location in the country, Holiday abroad, break laws without respect to constituted authority, etc).In Okada land of Edo state was once a hospital that was built by a philanthropic Nigerian, but was rubbished by the Military Politicians so as to siphon money out in the name “medical check up abroad”.

While public sector health care in Nigeria is indeed in a shambles, rife with corruption and neglect, this cannot be a good excuse to restrict health care rather than institutionalize reforms which ensure more accountability and better services. We see it fit to oppose, in the harshest possible terms, what can only be the government’s first step to harness its central responsibility in providing universal free health care to its citizens by introducing the concept of user fees in health care. If Nigeria’s health system is not considered this time, a Nigerian who cannot afford a better health services, may one day, die of easy-cure sickness; it could be your relation, because you are not near just because you didn’t put up a befitting health facility when you were opportune to head a government.

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1 comment

'Biodun Ajayi February 10, 2011 - 12:29 pm

Politics has become money-making business here in Nigeria. The main aim of political office-holding is washed into the cistern just to make way for siphoning public fund; abandoning ordinary citizens to disease-threat. Even the foreign medicines meant to cure those with TB, were taken away from them for the richer and those in power-corridor. No wonder Pfizer were allowed to test-run animal medicine on the innocent Nigerians in Kano. We need changes!


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