Ailing presidents, rickety hospitals and unhealthy citizens
As I was saying last week within the context of “ailing presidents and Nigerian hospitals”, I have been unable to find any reasons why our leaders have failed and continue to fail the nation so woefully in the area of healthcare delivery system despite the fact that some of them have died in office during prolonged illnesses. Three of them now being referred to as the ‘three musketeers’ met in Minna, capital of Niger state last week in connection with the incumbent president that is generally believed to be ill.
In fact, the chief host of the Mission to Minna, General Ibrahim Babangida, was captured in the photograph released, in this regard, as a sick former head of state. He was seen on “walking aids”.Latest report on him (IBB) was that he just returned from Switzerland where he too was treated for an undisclosed ailment. In 1989, he took ill in office and announced to the nation that he was going to treat radiculopathy in an American hospital in Paris, France. As it was recalled last week, one of the musketeers, former president Olusegun Obasanjo too lost his wife in office. The amiable Stella died in a Spanish hospital during a cosmetic surgery. We lost a head of state, General Sani Abacha in office in 1998 during a brief but concealed illness. President Umaru Musa Yar’Adua also died in office. Some sources said he actually died in a Saudi Arabian hospital in 2010 and the body was artfully brought home to save the reproachful face of a nation. It is no longer a secret that the incumbent president Muhammadu Buhari, the lion, is ill. The only curiosity that has continued to baffle the nation is why these presidential ailments have not triggered anger that would have led to massive investment in equipping even a few hospitals where the presidents, governors, ministers and citizens can be treated in a nation of more than 180 million people. This article is therefore another clarion call on those who aspire to contest elections in 2019 to remember healthcare delivery to citizens as a matter of priority. And during campaigns that will take off soon, they should be able to cite the shame that has been associated with our ailing leaders and their spouses that have died abroad and are being treated inside the state house by foreign doctors. And more important is unknown number of citizens that have died in the country because of poor healthcare facilities. This is indeed a reproach that must be removed as a matter of priority from 2019. It seems that there is nothing that can be done now as any moment after reading this; the nation may be told that the president has either returned to Germany or United Kingdom for further treatment of his undisclosed ailments.
Capitalism & Healthcare:
It is has been argued that capitalism has no place in health care provision. This explains why government-run health care is still in vogue in France, England, Canada, Cuba, etc. The WHO health- care delivery model, has consistently demonstrated how results can be better achieved with limited resources. With a life expectancy of 78 years, it spends just four per cent of the United States annual health outlay of $2.4 trillion ($7,900 per person) to outperform developing nations and be at par with the developed economies.
Nigeria ranks dead last on almost all health-care indices. Malaria alone accounts for 30 per cent of childhood deaths in the country, with 25 per cent of deaths in children under-1, 11 per cent of maternal deaths, and 60 per cent of all out-patient visits to hospitals. This is clearly insufferable. Apart from the loss in man-hours, the financial cost is huge, standing at N132 billion for treatment and prevention on an annual basis, according to the Federal Ministry of Health. Yet, Cuba despite all odds eradicated malaria from its shores since 1967.
Not only does Nigeria have one of the highest infant and maternal mortality rates in the world, the country also harbours 3.4 million HIV sufferers, going by WHO estimates. WHO said 200,000 Nigerians died from AIDS-related complications in 2012. This has made many to put their fate in the hands of quacks all over the place. Consequently, Nigerians who can afford it troop abroad for medical treatment. Statistics from the FMoH state that for the past few years, Nigerians have been spending a whopping $500 million annually on medical treatment overseas, with India, the top destination, raking in $260 million of that amount from our ailing citizens. But there is a major problem for those who cannot treat themselves, whether at home or abroad.
So, what really works and what doesn’t? There are several models, depending on the environment and the political will of leadership. Sweden, for instance, is leading the world in allowing private companies to run public hospitals, a model that was refused for National Hospital, Abuja under President Obasanjo. But government picks the bill in Sweden. In 1970, Oman tweaked its convoluted programme, increasing government investment. This has reduced maternal mortality and improved system performance. Britain’s National Health Service, which started in 1948, is worth studying. More than 90 per cent of the British population are on the NHS, but medical treatment is free for the citizens. This is paid for through tax. The United States has a mixed system, with most employers sponsoring health insurers for their staff. But the US government insures the poor (Medicaid), the elderly, veterans, federal employees and
Congressmen (Medicare), while state government-run programmes insure other public employees.
However, amid these different models, health experts always recommend the one in Cuba nurtured under legendary Fidel Castro that America demonized for so long. In spite of debilitating US economic sanctions and limited funding, Cuba guarantees free medical treatment for all of its nationals. Its consultorio system, based on research, depends heavily on preventive care. Most diseases are nipped in the bud before they can spread through a neighbourhood treatment and assessment programme in which doctors live close to the people. Illnesses that can’t be cured at this level are referred to the 444 polyclinics that work under medical practitioners trained inside Cuba.
This has worked to a telling effect. At a time New York City had 43,000 AIDS cases, Cuba had just 200. There, measles was eradicated in 1983, meningitis (1989), diphtheria (1979), polio (1962) and rubella (1995). Cuba exports 29,000 doctors to 69 nations around the world, including the US, and 22,000 students from different countries are studying medicine on free scholarships there. In 2014, Margaret Chan, WHO Director-General, praised it, saying, “We sincerely hope that all of the world’s inhabitants will have access to quality medical services, as they do in Cuba.”
As a starting point, the Nigeria’s National Health Act 2014, should be implemented. The law prescribes “not less than one per cent from the Consolidated Revenue” to fund health in the country, while state governments and local governments are to provide counterpart funding. The money generated is to be deployed in providing free health care for women, children under-five and those aged 65 and above. What is needed to implement this is a healthy, committed and angry leadership.
The National Health Insurance Scheme, established under Act 35 of 1999, should be reviewed and be made to attract membership as pooled resources benefit a health system. Above all, the government and stakeholders should take a critical look at how to reform, fund and equip the system for optimal performance.
Nigerian-trained medical doctors are daily making waves abroad. At the 2011 annual convention of the National Association of Black Journalists NABJ in Philadelphia, Ambassador Andrew Young, former Mayor of Atlanta and former US Permanent Representative to the UN, well-known as Obasanjo’s friend, told me in an interview published in this newspaper that in Atlanta alone, there were then 2000 registered Nigerian doctors.What is more,Dr. Funmi Olapade a Chicago, US based Nigerian medical doctor was awarded the MacArthur Genius Award the other day. Dr. Olapade graduated from University College Hospital Ibadan, Nigeria. Dr. Olapade is just one among many Nigerian professionals who are in foreign countries not because they do not love their country but because their country is not ready for modern medical science. For instance, UCH where Dr. Olopade trained is no longer a medical centre of excellence.
Besides, in November last year, there was a report about a United State-based Nigerian Surgeon, Dr. Oluyinka Olutoye, who achieved a remarkable feat by performing a rare and successful surgical operation on an unborn baby with tumour in the mother’s womb.
Professor Olutoye of Texas Children’s Hospital, alongside his surgeon partner carried out the delicate surgery on a 23 weeks old foetus who was removed from the mother’s womb, operated upon and returned to the womb to heal and continue to grow until the baby girl was born at 36 weeks.
Dr. Olutoye’s success has made headlines in the US. The Nigerian Government congratulated him without any report of how medical conditions would be improved upon at home. A statement by the Senior Special Assistant to the President on Foreign Affairs and Diaspora, Hon. AbikeDabiri-Erewa, felicitated with Dr.Olutoye on behalf of the President and people of Nigeria.According to the statement, President MuhammaduBuhari received the news of the unique feat with excitement and fulfillment and looking forward to meeting with him soonest.To complement that, Dabiri-Erewa said something familiar since 1999 that Nigeria was working on a National Diaspora Policy guideline geared towards regulating all engagements with all Nigerians in the Diaspora.
Dr. Olutoye is a Co-Director of the Texas Children’s Fetal Center and fetal surgery team member, as well as a general paediatric surgeon in USA.
He (Olutoye) received his medical degree from Obafemi Awolowo University in Ile-Ife, Nigeria, in 1988 and his PhD in anatomy from Virginia Commonwealth University in Richmond, VA, in 1996.
He completed his residency in general surgery at the Medical College of Virginia Hospitals, Virginia Commonwealth University, and his fellowship in paediatric surgery at The Children’s Hospital of Philadelphia and the University Of Pennsylvania School Of Medicine in Philadelphia.
When will we have well equipped medical centres of excellence such as the ones where Professor Olutoye was trained?
Next week, we will read the correlation between the neglect of history of one of the pioneer brain powers that built UCH, the late Dr. Samuel Manuwa and the collapse of the country’s healthcare delivery system.
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