NIGERIA @ 55
The Nigerian health sector is one which had been embroiled in one controversy or the other over the years. It is either the medical professionals are at logger heads with one another over who should head the hospital or they are at daggers drawn with the government over salaries or monetization benefits or even going on strick for reasons of insecurity.
No doubt, these acts have unleashed serious hardships, sometimes irreversible co consequences to the citizenry. It has also led many to seek alternative to the public healthcare centres to privately owned ones, it has caused medical tourism to flourish beyond imaginable measures while others have resorted to traditional medicine.
Despite all odds, the sector, according to the Chairman, Nigeria Medical Association, Rivers State, Dr Fubara Green, when compared to its gloomy ratings in the past has not fared badly.
Green said, “the health sector is struggling to survive, we are under alog of pressure, but we are getting there”.
Green admitted however that there were deflicreneies, in terms of manpowers materials, funds, and even personnel “but we have being improving and taking cane of our patients and over 95 per cent of them survive, so we are trying”.
He recalled two eases involving the Kogi State governor Capt Idris Wada, who had fractures from and auto accident and was treated in Nigeria, and former governor of Akwa Ibom State now Senator Godswill Akpabio who also had an accident with a mild concoction, was treated here, “there are both doing well”.
He further said, “there are many cases which we had operated upon that were rejected outside the country and they survived. So its not a totally bad situation”.
He stated however that though medical tourism cannot be stopped, “because you cant tell people how and where to spend their money”, it can be reduced if the conditions of healthcare delivery were improved.
Commenting on the areas of need, the NMA boss said manpower was critical, saying that the dearth of manpower to maintain medical equipment was worrisome. In his words, “we need maintenance personnel, we need biomedical engineers to man even the very simple machines we have in our hospitals Green, a consultant surgeon, lamented that a patient who had gun-shot would could not be operated on due to the non-functionality of a machine that could be used to locate the exact position of the bullet.
He also listed manpower deficiency as one of the challenges preventing the health sector from achieving greater success. “We need doctors, nurses, laboratory scientists and other medical professionals in the sector, right now we have one doctor to 3,500-4,000 patients whereas, WHO has said it should be I doctor to 600 patients he said.
Another area of difficiency he noted was the insensitivity of security agents to emergencies. He explained that a medical doctor could be delay, for hours on the road if he tries to get out of traffic congestion to attend to an emergency. He narrated an incident where a renouned surgeon in his hurry to attend to a gun-short patient at Briatewaite Memorial Specialist Hospital, decided to drive one-way due to heavy traffic was to support the healthcare givers to attend to emergencies, if I am rushing to attend to an emergency the road should be clear for me, that was why many years ago NMA asked that doctors should be given a special plate number colour, but people kicked against it saying we will abuse it, but look at the abuse of sirens in the state”, he stated.
“The response to emergency care is a global phenomenon not peculiar to doctors,” he added.
Green also mentioned the misinformation of Nigerians by Nollyhood. He observed that Nollyhood depict medical scene in very bad light, adding that often times the actions they take in emergencies in the movies are wrong and people tend to carry out those actions in real life situations.
Furthermore, he stated that Nigerians need to develop an informed emergency response culture and not fall back to the old traditional ways, explaining that the past administration had the foresight, but could not follow through due to lack of financial backing.
Another difficiency he noted was lack of political willpower to enforce policies. The health care delivery system in Nigeria has been divided into primary, secondary and tertiary.
He said this laudable policy though would only be effective if it would be followed through in practice. He said the first port of call for all health issues was the primary healthcare facility, which he said was not the case in Nigeria.
He pointed out that for this reason, the referral system, which he said was a panacea for a successful healthcare delivery was jeopardized.
Another salient deficency, he noted, was the lack of discipline in the sector, decrying the non-autonomy of the state-owned hospitals and political interference in the system.“We have asked the government to make BMSH autonomous, it’s a tertiary hospital, a tertiary hospital should stand on its own, it should have its own board rather than going through the prevailing long processes before any policy can be implemented or a disciplinary action to be taken for that matter. If BMSH had its own board some of the indiscipline that we have in the system will be taken care of”.
He also listed funding as a deficiency plaguing the health sector in the state.
He described funding as grossly inadequate and appealed for at least the implementation of the 15 per cent of the annual state budgets as stipulated by World Health Organization.
Still reeling off the inadequacies in the sector he said, “some of the medical personnel working in our hospitals have never gone for self or sponsored capacity development safe for the Doctors Continuous Education organised by NMA.
Training is a big pillar in promoting healthcare delivery services.
Structural and equipment deficiencies also adequate health care delivery system.
On the way forward he recommended that a focused attention should be given to the health sector, adding, “we call on those who manage our resources to look at the health sector more sincerely and appropriate the funds as recommended by WHO”.