At the 43rd Conference of the West African College of Surgeons, the president made the usual hollow promises befitting a politician. It is surprising that he yielded to the same temptation that entraps most politicians. At this rate, this president risks to be remembered for his promises were, as he then was, mighty; but his performance, as he is now, nothing (Shakespeare – Henry VIII (Act 4). The ignominious epithet of King Charles II, by the English poet, Lord Rochester (1647-80): “Here lies a great and mighty man [sic], whose promises none relied on; he said many a foolish thing and did very few wise ones” [sic] may some day ring true for Obasanjo, when the appeal to our Doctors in the Diaspora comes to nought.
The president ventured into a nugatory and equally bewildering appeal that seems innocuous on the surface but complex when examined closely. He entreated our doctors practising in foreign countries to return home because the conditions that necessitated their departure no longer exists. That, in part may be true. In essence, it is as inaccurate for doctors as it is for other professionals. The appeal in itself is an admission of conditions that necessitated the exodus to foreign countries. So, what are the ‘conditions’ that he had in mind? Many professionals are all too aware of them. It would have been helpful, if the president attempted enumerating these conditions and at the same time afforded the concomitant endeavour his administration has embarked to eliminate them. There is an underlying approval that the president sees nothing wrong in the exodus. In fact, it is inconsistent of him to recall these professionals when at his Atlanta Presidential Dialogue, he did not disparage them and that was honourable of him.
This appeal is not only disjointed, it is as broad as the ‘conditions’ to which references were made. This is a president that is incapable of understanding basic fundamentals of problem solving. He may well be adept at the big picture. But, he portrays an impression of a traveller who cares less about the compass needed for his journey. This is the same problem with him as an itinerant president, who was busy visiting foreign capitals at the expense of taxpayers for the illusive foreign investors and debt forgiveness. His extensive travels do not seem to be commensurate with the inward flow of foreign investments or debt forgiveness and there is no evidence to show that the inflow of foreign investments is a direct result of the time he spent in his executive aircraft.
So what does he mean by the so-called conditions to which he alluded? Is it that Sani Abacha is dead? That is no news. Could they be the abounding opportunities in our thriving economy? That is a fallacy. Is it the selflessness of our leaders, which is worthy of emulation? That is a tall Order. Could it be that the president has suddenly realised after almost four years of wasteful ventures that our hospitals are now substandard; doctors, pharmacists and nurses are sometimes owed their contracted remunerations for months; patients die unnecessarily; the hygiene at some hospitals is abysmal; patients are exorbitantly charged for blood plasma; doctors lack sophisticated equipments for their work; the infrastructures of hospitals have collapsed; training, research and development are not funded by either the State or Federal Government; the Federal Ministry of Health is dysfunctional to the extent that the president publicly rebuked one of his past health ministers. The list is endless and it is disingenuous to entice these doctors to return home, at least for now.
This president must appreciate that unless his government provides an enabling structural environment for these highly competent Nigerians, his awareness of the lingering impression that health care facilities are in a state of decay is inadequate; his claim that his administration has improved the state of hospitals in the country is little and too late; that most hospitals that were once mere consulting clinics and high dungeon of past glories are now quintessential is a misrepresentation. Like what he discovered of our roads, where Billions of Naira have been gulped and there is nothing to show for the repairs, our hospitals may also astound him.
The problem here is that our leaders do not have the slightest understanding of the deplorable state of our national infrastructures. So, when the president said that the Federal Government of Nigeria has, on its part, begun the process of refurbishing and re-equipping our hospitals, what does he mean? Why has it taken this long for his administration to understand the exigency that our health delivery sector needs the funds allocated to construct a Stadium in Abuja?
In the good tidings of his announcement, he saw a need to introduce the ethnicity equation. Is it necessary to inform us of the geographical locations of the hospitals? Imagine, eight teaching hospitals located in the six geo-political zones of the country will be rehabilitated to international standards in diagnostics therapeutics, while others will follow in subsequent phases. Let someone tell this man that this is a nation of over 100 million people and his token is arid. Why is the president talking about eight hospitals and why the promise that others will follow? Does he not know that a promise is comfort to a fool? Is this president taking us for a ride or what? Well, others do. Why not him as well?
It is clear that this government has nether a medium or long-term health care strategy for this nation. Neither does it consider the sector deserves as much funding as was spent on buying military guns that now flood our streets and constantly used in armed robberies and political assassinations. As we do not face an impending war – that is to suggest Cameroon is not going to invade us pre-emptively over Bakassi as the current US president is adamant on invading Iraqi, health care delivery and education ought to be the priorities of this government instead of wasting money seeking foreign investors to come and build sweat factories.
But, why would this administration concern itself over health delivery? After all, it was only recently the Vice President went to Spain for a ‘rest’ and medical examination and he is not alone in that venture. Pius Anyim has recently returned from Germany for the same reason; Ghali N’abba, the House of Representatives Leader could not make the London Cromwell Hospital, he sent a relative – all expenses paid from national coffers. So, tell me, which of our national leaders does not manufacture an excuse to attend a foreign hospital? Ibrahim Babangida did it and many State Governors are doing the same. Why do we expect an improvement in a local facility that is beneath their custom? For as long as our leaders are attended abroad, there will be no commitments to improve our Health Service.
Now, let us consider why these doctors must reject the president’s appeal. Who in his right mind would want to exchange his Stethoscope for an environment that denies excellence and not only embraces mediocrity but also rewards it? Who in his right mind would want to convert the steadiness and development of a career that feeds not only his immediate family; even an entire village can benefit from remunerations paid no later than the contractual dates. This is not only about money. Hawthorne in his hierarchy of needs has made clear that there are other needs aside from money that are satisfying. I am not pretending that I am unclear about that.
But who wants to work in a rudderless sector that has no long term planning and if it does, every new minister clearly does not follow the plans of his predecessors. What about the financial improprieties of our officials for which many Doctors and Civil servants are equally blamed in the adventures? If the financial transactions of our health ministries, both at the State and Federal levels were audited, the Auditor General’s report would ring familiar. Therefore, no one in his right mind should advise doctors or other professionals to return home. After all home is where the heart is and it can be made in any part of this global village.
There is little to be gained from criticising the president who was probably ill advised to make the namby-pamby appeal without making one or two suggestions. Firstly, the president should keep encouraging those of our doctors and other professionals to utilise the opportunities in their host countries to the benefit of ours. I am aware of his endeavours in NIDO, which seems to have been hijacked by operatives that are less dynamic for the purpose of the organisation both in the US and UK. There are several doctors and others, who organise endless charitable trips back home for delivery of free books and medicine. These are the Nigerians that are worthy of national honours and not people that have contributed in one way or the other to bring the nation into its present state. The president should give national awards to those Nigerians in the Diaspora who benefit rural areas with free books and health care deliveries arranged from their host countries.
Secondly, it is now time for the government to look into Private – Public Finance Initiatives (PFI). This is a venture in which the government participates with the private sector to make public enterprise more efficient. I need to sound a warning here. The experience of PFI is open to gross abuse by Lawyers, Accountants and Management Consultants; if PFI is ever considered, we should learn from the mistakes made in the United Kingdom, so that we do not end up enriching a few individuals or their organisations and impoverish the nation. Nonetheless, Doctors in the Diaspora should be given incentives such as tax breaks to set up not for profit hospitals, for which there are many Non Governmental Organisations to support the ventures.
In closing, I must admit that Obasanjo meant well that our nation cannot develop when her sons and daughters outside her shores are unwilling to return to build the nation. Equally, I submit that there are enough professionals on the ground and it is not the number that is deficient. It is the foresight, corruption, lack of training, equitable reward and bad leadership in our system that keep many professionals abroad. This government should continue its consultations and encouragement of those in the Diaspora and at the same time, it must attend to other urgent matters of nation building.