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Crushing the poor in Nigeria

By Helen Ovbiagele

UNTIL our government tackles health issues seriously, we cannot lay claims to being a developing country, because our health system has been steadily sliding since independence.‘Patients groan as UCH hikes fees’ is a pointer that our government is insensitive to the health needs and interests of the masses.

“What’s this government trying to do?” a colleague asked when she read the piece. “Are they trying to get rid of the poor in the land? Increasing fees in a government health institution which is mainly patronized by the masses is very insensitive.” “You feel the UCH authorities shouldn’t have increased their fees?”

I asked. “They shouldn’t, even though the chief information officer and head, Public Relations Department of the hospital is alleged to have pointed out to journalists that the new fees are still low, compared to the fees payable in other medical establishments. Theirs is the foremost teaching hospital in the country, so, they have enough experience to know the state of the pockets of those who patronize them.  It’s mostly the poor who go to government health institutions.

The rich go to private hospitals in the country, or go abroad. Government hospitals should work towards a time when they will offer free services to the poor, and meanwhile they should collect low charges in order to encourage patients to come to them.” “But in this article the P.R. department gives seemingly valid reasons why the fees have to go up.”Increased fees ‘We spend about six million on diesel every month to power our generators.

If there’s little or marginal increase in our fees, it is to serve Nigerians better’, he was alleged to have said. Also, on the surface these increased fees may seem low, compared with some other hospitals where you have to make a deposit of fifteen thousand naira before you’re admitted. ‘The hospital, last week, announced an upward review in the admission, feeding, laboratory, X-ray fees and others by 50 per cent.

The admission fee rose from N300 per day to Nl,000, and feeding dues from N450 to N600,’ the newspaper article said.However, when you think of the state of the nation and the plight of the masses, many of whom are unemployed, to pay out one thousand naira for each day a patient is on admission, is not reasonable, especially for an extensive stay. No-one chooses to be ill to the extent of being given admission in a hospital, and these people are coming from a background where they either live in the family house, or, pay around two thousand naira a month, at most, for accommodation. One month’s stay at UCH would cost N30,000, or even N31, 000 if it’s a month of 31 days.

How many families can afford that? Some homes survive on the wife’s petty trade and the children hawking on the streets.  The cost of feeding at UCH rose from N450 a day to N600 a day. This seems fair where you can spend more than that at a fast food joint at a go, but the fast food of many people in the low income, or no income group, is roasted or boiled maize and some groundnuts or pear, shared with another family member. That six hundred naira could be managed for a pot of soup.

Those who can afford to buy a newspaper would get impatient reading this, because they can’t imagine a life in which one thousand naira a day is too much to pay for a service. You need to get close to the those living in abject poverty (and there are many in this country) to understand their condition. In any setting, health is important to every body, and things which would enhance good health for citizens, should be a priority with any responsible government – clean drinking water, clean environment, good roads, etc. And when people fall sick, they should be entitled to affordable or free medical services in government health institutions.

What are our taxes being used for? If you’re in paid employment, tax is deducted forcibly before you’re paid your salary. We should see our money at work.One cannot really blame the UCH for increasing its fees. The blame for the increase should be laid squarely at the door of the government.   If they vote enough money to run our health institutions, their hospitals will not need to pass on the cost of increased bills to the patients. Let the various tiers of government take health issues seriously and make adequate provision for our citizens.

It isn’t too much for us to aim at improving our health services to such great heights that they compare favourably well with the services the rich go to get from health institutions abroad. Let our rulers not say that because they can afford
to fly themselves and members of their families abroad to treat the most minor ailment, they shouldn’t be bothered about our health system. The report the other month, that legislators had to take funds from Health and Education to provide money for repairing federal roads, shows that we’re still not getting health issues right. We should add to funds for Health, not take from it.

An acquaintance told of how she tripped and fell while crossing the road while on vacation in Britain. She was dazed from the fall and she had some deep wounds. An ambulance appeared in a matter of minutes and she was whisked to the nearest hospital where he was attended to immediately.   She was asked to stay overnight for continued bservation, but she declined. She was then asked to return two days later for her condition to be assessed.   What was her bill for these services? Nothing.

As a visitor, she wasn’t entitled to the National Health System free medical service, but the law permits free treatment of visitors who suddenly take violently ill on the street e.g. fainting, accidents, etc. The same thing obtains in the U..S.A. where medical services are terribly expensive. They won’t allow you to die out there on the street. Any hospital you’re taken to, government or private, is obliged to attend to you free of charge; though not for extensive treatment of a medical condition which was there before the accident. If a visitor takes ill on the streets of Nigeria, there’s no provision by our government for free treatment anywhere. Unless good Samaritans come to the person’s aid, he’s likely to kick the bucket right out there.

Successive governments, since independence, have not been able to provide adequate and affordable health services for Nigerians. One wonders why. Where are the health experts?


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