HEALING THE ILLS IN THE NIGERIAN AILING HEALTH SYSTEM

Without mincing words, Nigerian health professionals are some of the best in the world. In Canada for instance, a Nigerian couple, both Pharmacists trained at Ahmadu Bello University, Zaria are blazing the trail in pharmaceutics. Between them, and their pharmaceutical company, they hold more than fifty chemotherapy patents. That’s not all. In President Barak Obama’s administration, a Nigerian professor of oncology from University of Ibadan, is in the United States President’s Health Advisory Committee. And who can forget Nigeria’s Medical Laboratory Scientists or Nurses in London, Riyadh, Amsterdam, Spain and the rest of the world. They are all among the best brains in the world and in the process, make us proud. No doubt, Nigeria has one of the best medical professionals globally. Unfortunately however, the nation’s health system back at home is one of the worst in the world. What a paradox! Something is definitely wrong.

I remember reading an article in the British Medical Journal several years ago. In the publication, Nigeria was presented as the African nation with the highest number of medical professionals in UK’s NHS and the writers made a case for the UK government to reach out to the Nigerian health ministries to design a working arrangement where the UK professionals would come back home to salvage the brain drain and help the sick that cannot afford to fly out of the country in search of best healthcare services available abroad.

Structurally, Nigeria has an original, perfect and realistic health system. The three tiers of health care service ensure that no matter the level an individual occupies in the economic stratosphere, there is an appreciable healthcare policy to benefit from. The system was designed to incorporate a vast, all-encompassing referral system that takes the sick from one level of the healthcare ladder to the next depending on the severity of the ailment and the competence of respective medical facilities to convincingly and satisfactorily handle the health challenge of the patient.

The first tier comprises the primary healthcare centers that are expected to take healthcare services to people at the grassroots.  Apart from that, they are also expected to handle antenatal cases, immunization, public health awareness and basic Medical Laboratory Services. Also, during emergencies, the primary healthcare centers are expected to give first aid services before referrals are made to secondary healthcare facilities in complicated health situations.

The secondary healthcare centers are equipped to handle some cases that are beyond the scope of primary healthcare centers. They ought to perform general surgeries but they must refer to tertiary healthcare centers that have the specialists and facilities to handle sophisticated cases that need specialist’s attention. These include but not limited to comprehensive Medical Laboratory Services, perfect nursing care, standard drugs etc. Unfortunately, over the years, this clear-cut, seamless flow in patients care has been distorted with attendant shift in the service equilibrium.

Tertiary health centers today are not well equipped to handle some basic primary healthcare procedures that even the primary healthcare centres would ordinarily provide. For instance, patients still die from tetanus in some Federal Teaching Hospitals. Inadequate attention to secondary health facilities by state governments means wrong hands run such facilities at the detriment of public health. This is a disservice to Nigerians and a breach of social trust by our leaders. Needless to talk about the primary healthcare centers which have long become breeding grounds for reptiles and other wild life.

It is sad to note that Nigeria ranks high among nations with high infant and maternal mortalities. Nigeria has the second largest HIV/AIDS burden in Africa. Outbreaks of communicable diseases such as cholera are still prevalent, just as nosocomial infections are daily on the increase as a result of poor conditions and inadequate facilities in the health facilities. Poliomyelitis which many countries have eradicated, still lives with us in Nigeria.

It is noteworthy that the healing system (Health System) itself needs healing. The health system in Nigeria is suffering from a chronic ailment that has made it difficult for it to deliver quality health to Nigerians. The major problem is that of politics.

We all know that politics is everywhere. Elsewhere, democracy, especially in the developed world enables the citizens to have and hear different opinions to develop sustainable policies. Political parties in power therefore have the noble responsibility of ensuring that the best hands are brought on board to deliver the goods and earn the trust and mandate of electorates. This is not the case in Nigeria where positions are shared to suit political loyalists thereby mortgaging quality for political recompense. When the president’s personal physician is made the minister of health and the governor’s doctor the health commissioner, to appease god fathers and godsons, then the health system will perpetually suffer. 

It is myopism to think that the best doctor must always be in charge of the nation’s health sector, forgetting the competence of other professionals like the health economists and administrators. Obasanjo-led administration brought a health economist and seasoned administrator on board as the minister of health who left with the accolades of the best health minister the country has ever produced. He ensured the upgrading of most tertiary hospitals; he instituted the National Health Insurance Scheme (NHIS), and was part of the process that led to the formation and establishment of the National Blood Transfusion Service (NBTS). He also ensured the transmogrification of NACA from a committee to a federal government agency.

Soon after the expiration of his tenure, surgeons, and other medical professionals were made ministers. They all have little or nothing to show for their various tenures in office apart from corruption allegations resulting in quantum failure of the system. This anomaly clearly shows that though the government knows who ought to be in charge, they’ve simply decided to do nothing since they rarely patronize the country’s healthcare system.

Inter- and intra-professional agitations, enmity and acrimony form another clog in the wheels of the Nigerian healthcare system. Nigerian medical team is divided against itself, and every member of the team sees the other as threat seeking to usurp the rights of others thus resulting in lizard’s territorialism mentality and other defense mechanisms. Pharmacists accuse doctors of taking their jobs insidiously, Physiotherapists are also grumbling just as Medical Laboratory Scientists and Pathologists at some hospitals are at each other’s jugular with daggers drawn. Booby traps are everywhere, each seeking the downfall of the other. This is not how a healing system should be like.

When Ben Carson (M.D.) separated the Siamese twins in Johns Hopkins, he could have presented himself as the master and brain behind the project. But he didn’t because over there, it’s an insane thing to do. Nigerian medical professionals in practice don’t believe in team work, all they currently seek is individual gratifications at the expense of the patients’ wellness. Resources are limited because even the ones so far released are not well utilized. There is no scale of preference; it’s each one to himself. When a bill is proposed or passed in the national assembly concerning the health sector, accusing fingers are pointed at different directions until such a bill is suffocated without implementation.

There are more sick people than before, prevention and treatment options are being stretched. There are focal outbreaks across the nation and very soon, the nation may have to contend with bioterrorism. A chaotic healthcare system cannot handle that!

Government can sort these issues out once-and-for-all. A leave can be borrowed from nations with efficient healthcare systems. A think -tank consult of internationally reputed health administrators could be assembled to diagnose this ailment ravaging the health system to avert the impending catastrophe. Unlike the impression that had been created, government must know that no health profession is bigger or more important than the other. Equity and justice must be the watch word. All hands must be on deck to attain the various international health targets to prevent the nation from being labeled as a threat to global quality health.

ADEYEYE ADETUNJI TAM.
NATIONAL PRO,
Association of Medical Laboratory Scientists of Nigeria (AMLSN)