James Egbuchulam
15 June 2009
Lagos — It is mandatory for countries including Nigeria to achieve the Millennium Development Goals by 2015. One of these objectives is the attainment of adequate and affordable healthcare for the citizens. These peasants toil day and night for their daily bread and they pay their taxes. They also pledge to Nigeria ?my country?to uphold her honour and glory??. But what is the present status of their healthcare, and who will rescue them from their predicament?
The constitution of the Federal Republic of Nigeria provides in section seventeen, subsection three ?c? and ?h? that: the state shall direct its policy towards ensuring that, there are adequate medical and health facilities for all persons. And that evolution and promotion of family life should be encouraged.
Inadequate as these provisions may be, they presuppose that medical and healthcare facilities should be at the disposal of all Nigerians for their well being and longevity. But the truth is that many people in the urban and rural communities who are living from hand to mouth are not enjoying healthcare delivery. Even where the structural facilities exist, effective medical personnel and affordable drugs constitute traumatic headache. The consequence is that sick people are deserting the medical clinics and receiving cheaper and concessional services from other sources. The complaint is that the quality of medical services is no longer the same, and that cost of drugs in government hospitals are relatively high.
Another observation is that private medical practitioners are charging exorbitant fees even when their experiences are below maturity. Perhaps they are looking for the resources to modernize their own hospitals or indirectly bleeding their helpless patients with the syringe of brain drain. Another school of thought portends that since the older generation of medical doctors retired from service or left the shores of this country in search of greener pastures the hospitals and medical services have lost their luster.
A patient complained that some of today?s doctors rather than listen and interact with you, they write faster than magistrates as you narrate your ailment. Then they give you prescription for which you pay heavily, to obtain fake and ineffective drugs.
It was not long ago when certain provisions of the medical private practice were relaxed to give members of the Nigeria Medical Association reasonable opportunity to render humanitarian services, to save lives. But some of them have seen it from the business perspective in the quest for materialism.
Yet the sick population are daily seeking remedy against sickness such as stds, typhoid and malaria. But the government is not quiet. It usually projects and expends huge appropriation in the health sector, annually. Perhaps this reveals government's consciousness of the expectation by the World Bank that a good portion of the Abacha loot refunded by Switzerland few years ago should be channeled to healthcare.
But the question arises: Are the people benefiting form the huge amount appropriated by the Federal Government towards healthcare? It is obvious that more medical schools are being accredited and more general hospitals are being converted to teaching hospitals by some state governments but the fact remains that the average citizen is still fighting a losing battle against endemic sickness such as malaria. What an Irony!
Unlike AIDS, malaria is curable but well over 100 years since it killed early missionaries in Nigeria the plasmodium parasite is still claiming lives daily in large numbers. In fact it constitutes the greatest health hazard in Africa?s most populous nation.
Unfortunately the end is not in sight because today malaria is the nucleus of medical business, providing cash boom to multi-nationals, local pharmaceutical companies and others. They all team up to sustain their business, and pray that malaria should never be eradicated. It is true that this mosquito ?bred monster has develop strong resistance to drugs, even the recently popularized ACT brands , and our dogwoyaro, but what about efficiency and potency? A certain anti-malaria drug costing about N600 which gave me over six months immunity some years ago, proved ineffective recently even at a higher cost of N1,200.
Infact it was like a beverage to the malaria parasites which gulped it, clean and jerk! The same goes for other types of drugs which the manufacturers in India, China ,Indonesia, Nigeria and other places have over-diluted and adulterated. Hence a tablet or capsule which is said contain 500 mg of ciprofloxacin or sulfamethoxazole might just have only 10mg or less of the said potent substance. If it is faked then it contains mere white chalk or dust or some other substance injurious to the human kidney or liver. But how do these substandard and fake drugs get into licensed Pharmacy stores who are serviced by Sales Agents? Here lies the crisis of our Health system. God save us!
Unfortunately the drug manufacturers are not helping the situation. Rather their exploitation dragnets have cut across the country with drugs whose potency and costs are questionable. Infact some of them have re-packaged old tablets such as chloroquine and branded it another name, in other to maximize profit. This explains why the new malaria drugs cost between five hundred and above one thousand Naira per dose. And for the average Nigerian family, student, youth Corper or applicant it is catastrophic! What is not in doubt is that these manufacturers are not supportive of the Roll-back malaria campaign.
Otherwise why should a dose of malaria drug cost about one thousand Nair? But Kudos must go to the Micro-soft inventor, Mr. Bill Gates who visited Nigeria recently. In 2005 he began funding research into malaria vaccine, which was scheduled to be completed in 2011. But my fear is that the multi-nationals who are feeding fat from the farmland of malaria would not want it exterminated by vaccine. Any wonder they introduced and emphasize on mosquito ?treated nets, which have hardly made noticeable impact. It definitely cannot provide solution to our malaria palaver in rural or urban Nigeria. In May 2009 the Minister of health, Prof. Babatunde Olatimehimn was at Kano state campaign against malaria at which treated- nets were distributed. He lamented the ravaging effect of malaria on the populace. Evidently health is on the priority list of the government but the experience of the end users suggest otherwise. Therefore a three-pronged approach should be employed to make healthcare more relevant and beneficial to the people. From the perspective of the federal, to the state and to the local government tiers of authority. Let a monitoring committee of stakeholders be constituted to observe the implementation of government health programmes. General hospitals and health centers should be left to carry out the functions for which they were originally conceived while medical schools needing teaching hospitals should build their own. The state governments should establish and refurbish general hospitals and make them community-friendly, while it behooves the local government councils to improve on the status of their health centres. To say that most local government councils have neglected health care would be an understatement. The fact is that in many rural communities today healthcare delivery is an after thought and aberration!
This has given rise to the question: has orthodox medicine failed us! Perhaps this explains why most rural dwellers are going back to prayer houses and lives are lost owing to wrong diagnosis, neglect, and inferior medication by quarks. The prayer houses seek for the intervention of the Holy Spirit while the patent medicine dealers combine assorted drugs for quick relief. Obviously these approaches to healthcare are primitive and do not always proffer solution or succor.
But in a situation where the patient is helpless, where there is no medicare or government subsidy even for the costly malaria drugs, has he any choice? Let this situation challenge the stakeholders to make healthcare delivery a reality and not a dilemma. Let adequate provision be made for effective healthcare delivery to benefit the young and old, school children, mothers and everybody! It would not be an excuse to blame dishonesty, mismanagement or to divert healthcare appropriation to other needs. Let an effective and efficient implementation committee be set up to monitor the situation of healthcare decay and expose the lapses, the inadequacies, the apologies. This way our hope for healthy living and our march towards 2015 for the millennium development goal would have been a reality.
-Egbuchulam wrote from Lagos
Be the first to Write a Comment!
Copyright © 2009 This Day. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com). To contact the copyright holder directly for corrections — or for permission to republish or make other authorized use of this material, click here.
AllAfrica aggregates and indexes content from over 125 African news organizations, plus more than 200 other sources, who are responsible for their own reporting and views. Articles and commentaries that identify allAfrica.com as the publisher are produced or commissioned by AllAfrica.
