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Nigerian health care critical

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By Denrele Animasaun

Resignation is what kills people. Once they’ve rejected resignation, humans gain the privilege of making humanity their footpath—Kouta Hirano

I am of an age when going to hospital was a common place, it was relatively stress free; you knew what to expect. Depending on your presentation, you either go to a clinic or one of the teaching hospitals. You were guaranteed timely and high quality intervention, access to efficient health professionals and  payment for treatment was affordable. Sadly, this is no longer the case. The Nigerian health care service both public and private are cut throats and under resourced and at times, inhumane.

We now have a multi tiered health care system according to one’s means or no treatment at all, because seeking treatment or not is now more of an option.

Health care is now a luxury than many cannot afford.

Almost twenty years ago, my dad had an accident and sustained multiple fractures that needed a leg cast and regular appointments at the orthopaedic units. My father has always been an inpatient patient, he does not like to be dependent on anyone but he knew he had to pay for treatment so that he can recover the use of foot. He regularly attended the fracture clinic and had his cast removed and recasted, for this he paid every step of the way, the nurse, the doctor, the cast materials, the administrator and so on. That was the way.

During that time, we heard of  horror stories, of  people faced with similar broken bones, for them, it is Hobson’s choice; to spend money they cannot afford monthly or have the limb amputated once and for all. Many chose the latter. This shouldn’t be, but this was they were faced with. It is unimaginable how many died of gangrene or secondary infection or life changing disabilities.

Some went the traditional healers route. They had their features broken and then recasted   (without anaesthetics) in the attempt to metaphysically recast the bones with potions. One can only imagine the outcome.

That was twenty years ago. So you would have thought things would have progressed for the better. No, it has got worse. By the way, my father’s broken leg was badly treated until we realised that despite changing the cast regularly, they failed to treat the skin and the bones. We had to treat him for rotting wounds and it took months to heal. He mobilises well but with the aid of a walking stick.

The story of  access or lack thereof, and the quality of treatment in healthcare is sadly, out of reach for many and it is definitely inadequate and it is causing needs deaths.

It is absolutely shocking and insensitive that, the minister for Labour and Employment, Dr. Chris Ngige, had the guts to say our scarce resoureces;doctors who may want to relocate overseas, should go right  ahead, according to him, Nigeria has enough medical personnel. Yes, he said it.

This man has either been ill informed or he is deluded or in denial  or all three.

I don’t know what part of Nigeria, this man lives in, but he is clueless  and not worthy of his portfolio. 1

Having said that,very rich people do no not access  local health care services. If they did, they would realise that: there are not enough medical manpower or resources.

Ngige , was responding to a question on brain drain and the deliberate recruitment of Nigerian doctors by foreign embassies in Nigeria to the detriment of the nation’s health sector. He should know, as a medical doctor himself, or so you would have thought. Guess the truth eluded him

According to the World Health Organization (WHO), Nigeria has one of the highest doctor to population ratio in Africa.  It is hard to believe isn’t but this is  a misnomer .

We know the bench mark in Sub-Saharan Africa is pegged so low ,so the figure is nothing to crow about.

READ ALSO: PCN strategises on maternal, child mortality rates reduction

What is the global recommendation for optimal health delivery?  Well, it is one doctor to 600 population.

According to  the Medical and Dental Council of Nigeria (MDCN),  there are about 72,000 nationally-registered Nigerian doctors, with only 35,000 practising in-country! So make of it what you will that is over 35,000 for 200 million Nigerians.

Assuming all the doctors stay and practice in Nigeria, which is definitely not the case. So how on earth did the minister come up with the surplus doctors and having no qualms of haemorrhaging doctors to overseas health services.

He said that there was nothing wrong with doctors leaving the country because,the remittance they, in turn, grow the economy, “No, I am not worried (about doctors leaving the country). We have surplus. If you have surplus, you export. It happened some years ago here. I was taught chemistry and biology by Indian teachers in my secondary school days.

“There are surplus in their country and we also have surplus in the medical profession in our country. I can tell you this. In my area, we have excess.

Serioursly,did he understand the question? He asked ,“Who said we don’t have enough doctors? We have more than enough. You can quote me. There is nothing wrong in them travelling out. When they go abroad, they earn money and send them back home here. Yes, we have foreign exchange earnings from them and not just oil.”

Can he tell why we have a high infant and maternal mortality rate? Why are people suffering more ill health or lowered mortality rate if Nigerians have enough health personnel that it can afford to haemorrhage essential health workers to other countries to the detriment of the health of 8ts population.  The reality is medics are leaving because of lack of opportunities and grinding poverty.

He simply, telling the improvised that there is no problem and that everything us fine and dandy because the ineptitude of subsequent administrations  lack of investment in prioritising health care and resources is not a problem! He seems to play down Nigerians resilience as a success and a resource for the government coffers. What an insult! We know that remittance of billions of dollars is what keeps Nigeria afloat. This arrogance of this minister knows no end, “Will you call that brain drain? I know a couple of them who practise abroad but set up medical centres back home. They have CAT scan, MRI scan which even the government cannot maintain. So, I don’t see any loss,” he said.

Yeah,so all these centres are privately own and are better sourced than the public health centre. It has cost implications, so if you are poor or unemployed or have no means ,it is out of reach of many.

This quite concerning, very concerning indeed. He has no clue on ensuring that the country grows its economy and provide employment for millions of Nigerians, talk less of safeguarding the health of the people.

The fact here is over decades, thousands of Nigerians have migrated due to inadequate, under resources and inequitable distribution of health care services and manpower. Access to health is more in urban areas than in villages and our reach places meaning health outcome is sadly unequal and health care workers tend to seek work in cities and towns(HRH Country Profile: Nigeria, WHO GHWA, 2008).

All habits are bad habits. (…) Madness does not come by breaking out, but by giving in; by settling down in some dirty, little, self-repeating circle of ideas; by being tamed.

G.K. Chesterton.

There is no failure except in no longer trying.

Elbert Hubbard

We are no Cuba but we could learn from its systems.

“In the years after Fidel Castro seized power in 1959, Cuba invested heavily in education and science, training tens of thousands of doctors, nurses, and scientists. As a result, Cuba, a country of 11.2 million people, today has 90,000 doctors, the most per capita in the world.

About 25,000 of these doctors, along with 30,000 Cuban nurses and other health professionals, are working in 67 countries around the world. They earn about $8.2 billion in revenue for the government, according to a recent article in Granma, the official paper of the Cuban Communist Party.

Cuba receives about $5,000 a month per doctor from Brazil, pays each doctor about $1,200, and banks the rest, said John Kirk, a professor of Latin American studies at Dalhousie University in Halifax, Canada, who has researched Cuba’s program of medical missions. Most of the doctors’ shares are deposited in their Cuban bank accounts, requiring them to return home to collect it.

“Cuba has too many doctors, so their main source of hard currency is to rent out medical services,” Kirk said.

Once close allies of Havana, Brazil and Venezuela have been engulfed in political and economic crises that will cause them to reduce their use of Cuban doctors in the coming years.

That may lead Cuba to redeploy some doctors to other parts of the world, including the Middle East. In Qatar, an oil-rich emirate about as far from Cuba geographically and culturally as any place in the world, the so-called Cuban Hospital is fully staffed by 400 Cuban doctors, nurses, and technicians.

Cuba’s dispatch of doctors not only generates revenue, it is also an exercise in soft power that allows the country to spread its influence around the globe.

“It’s a major contribution to the health of the world,” said Morales. “They made a big difference in fighting Ebola in Africa, in the aftermath of Hurricane Matthew in Haiti.”

Some Cuban doctors working overseas have defected to the United States, aided by a policy launched during the administration of George W. Bush that permitted Cuban medical personnel to go to the US with their spouses and children. In its last weeks in office, the Obama administration announced it was ending the program.

No foreign boots on Nigerian soil please.

Beware of Greeks bearing gifts. Future generations do not need the burden of servitude and debt.

The Minister of Defence, Mansur Dan-Ali, made an appeal on Wednesday at the 8th Moscow Conference on International Security.  The Federal Government has solicited the cooperation of Russia to eliminate the Boko Haram insurgents from Nigeria and the Lake Chad Basin countries. He promised that Nigeria would create the legal and environmental conditions to accelerate Russian investment in the country, expand trade and achieve better balance in the trade relationship.

This is worrying, Africa should not bear the brunt of our leaders ineptitude and greed. They are now selling the future generation’s birth rights to those who historically indentured and enslaved a continent.

VANGUARD

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