By Muyiwa Adetiba
An old friend died of prostate complications on Sunday. He died in the US. While every death diminishes humanity, every death abroad diminishes the country and every preventable death points an accusing finger at our health care system. Yomi Ismael’s death to me represented all of these. I have known Yomi for about four decades and he was always so full of life. He always seemed to have a joke for every situation. I am glad I did not see him bed-ridden or tongue tied so I can always keep that bubbly, jovial image of him. His death is raw in its suddenness and it hurts. So raw that you still feel like lashing out at our health system for his lack of timely awareness; his need to go abroad for treatment; the dearth and growing exodus of qualified medical personnel from our country which makes going abroad for surgery almost inevitable.
There is no year that we don’t have at least one medical doctors’ strike. There is no year that we don’t have a strike from the joint health workers union. Many of the strikes are self-serving but coated, like the pills they dispense, in ways the populace can swallow. In any case, each strike worsens the already dire situation. But nobody cares; least of all the people who sit on the two sides of the negotiating table. Palliatives are offered and accepted until the next strike. And so problems are inherited by one administration, made worse, and passed on to the next administration. And so our hospitals become consulting clinics, and when the consultants leave out of frustration, become diagnostic centres and when the machines break down, become emergency wards and when the interns leave, become mortuaries. A Fela’s song says: ‘Uniform na cloth na tailor dey sew am.’ Meaning that it is not the uniform (building) that matters. Hospitals are mere buildings until they are equipped with life-saving machines and well trained personnel. Mortuaries are also buildings that serve a different kind of purpose. They are designed to take the products or if you like, the failures of hospitals. One is therefore designed to preserve lives while the other is designed to preserve lifeless bodies. The more the former fails in its duty, the more the latter enjoys increased patronage. Every responsible country seeks to work more on the former so that the latter takes care of only the inevitable. This unfortunately, is not the case in Nigeria where the hospitals are scoring more deaths than lives. Unfortunate because the Health Minister is a Professor of medicine and we expected he would make a difference. He was also a former president of the Medical Association.
Under his watch, the stagnation of the health sector continues. So does the exodus of doctors. It is estimated that about five thousand medical doctors leave our country every year. The figure keeps rising. Many go because of the work environment. Many go in order to have post graduate training. Some go because they are in a cul-de-sac and completely de-motivated. They all leave a place where there is a doctor to four thousand people for a place where there is a doctor to a hundred or so people. They leave the desperately sick for the indulgent sick. They leave a place that has sown in terms of training but do not know how to reap for a place that is reaping bountifully from that which it did not sow. They leave their roots with their seeds–our future leaders–to replant in alien, sometimes hostile soil. And when they leave, they deplete us. They diminish us. They take away some of our pride as a nation.
A couple of months ago, I got a call from someone I had helped from time to time in the past. He wanted a meeting. Sensing that it was to solicit for more financial help, I urged him to make his request over the phone. He was an enterprising young man who had fallen on hard times due to a medical challenge that had handicapped his movement. I used that as a reason for him not to exert himself but he politely insisted on a meeting. We met. It was about his daughter, a bright girl who finished medical school in flying colours two years ago. He had sought my help then to get her a good hospital for her internship. It is part of the irony of our country that we don’t have enough doctors yet we are lackadaisical about the practical training of the ones who successfully complete medical schools. Every year, it is a struggle for these young graduates to secure places for internship. Every year, it is also a struggle for those who want to add value to their professional lives to get a place for post graduate, specialist training. It really does not help that the young people who choose the medical profession have to contend with different bottle necks all the way starting with their admission into medical schools.
Anyway, this young, bright girl now doing her youth service had sized up the situation and had decided her best option was to go abroad. She had sat for the local, preparatory exam and had passed in flying colours. She now needed assistance for ticket and to pay for the foreign exam. She had also, she said, been assured of work. Her request, through her dad, put me in a dilemma. I am aware that very few foreign students pass the intended exam at first sitting and the picture she had painted would not be that rosy. But it’s hard not to admit that the odds of her climbing the hurdles and having a more fulfilling professional life thereafter, were better in the UK provided she remained focused. But then the chances of her getting married to a foreigner would also be very high. This could be a permanent loss not only to the country, but also to her physically challenged dad. Should I encourage this separation that might not be in the long term best interest of her family? Should I assist her knowing she would be yet another doctor gone from our shores? But should I deny a bright, ambitious girl from chasing her rainbow? I told her dad to give me time.
Meanwhile, my appeal to those with the wherewithal to set up hospitals is to please do something. Having functional hospitals is a win-win situation for everybody. Churches can help and this is how. It is the harvest season again for Christians. Some buoyant parishes raise up to 150 or 200 million Naira during harvest. Five of such parishes can set up a good hospital that will employ some of our fleeing doctors. Let’s save lives even as we save souls.