Nigeria: Health and Agriculture Key, Says Kwara Governor Saraki

Patients waiting to be seen at clinic in Kwara State Nigeria
26 January 2013
interview

Ilorin — This interview was first done in 2009, when an AllAfrica team visited a rural health clinic and a farm in Kwara state and afterwards talked to then-Governor Bukola Saraki about rural development. We are revisiting that conversation now, because AllAfrica is exploring those issues in Nigeria in more depth this month and in the months to come. What the governor – now a senator from Kwara state – said then can help to benchmark how far Nigeria has come in the past three years and how far it still has to go. Excerpts:

You're a medical doctor who has become a politician. Has your professional background had an influence on what you do as governor?

We have the first state health insurance scheme in Nigeria. The design came partly from my medical background but more from experience, after being governor.

It is always easy for us to look at things like bricks and mortars and say, "I've built a hospital." People will come, there will be fanfare, and we cut tapes. As politicians and as leaders, we clap and say, "Oh, yes, we've done something." Everybody can point and say, "That building was commissioned by Governor Saraki". Building those clinics and hospitals, people can say we've sorted health care. And that's a mistake. But you only learn that from being here in this seat for a while.

We came in saying: we need more hospitals, we need more clinics, we need more drugs – and we do. But there is one thing I have learnt after being here for a while, which many people don't understand. Over years of neglect, the population has lost faith in medicine, in the sense that over the years the clinics are not there, the doctors are not there. They've gone to traditional medicine and other ways of trying to survive. So you first have to win their confidence and get them to come back.

The way to get them to come back is pretty much as if you are a marketing a new product. We decided to charge a nominal amount for insurance – 300 Naira ($U.S. 2) a year. So that's basically free. It's not a cost issue anymore. And we are providing care through clinics. After a year in the program, the community has started going back to those clinics, and as time goes on, they begin to act like consumers and demand better service - because they're paying for insurance. And that begins to bring back better health care.

We started off with 10 visits per month to those clinics. Now you are seeing about a 1000 visits. It is the same community, so what has happened over the last two years? Either they were going somewhere else or just staying at home and not getting better. So the community health insurance scheme enables those in the informal sector, who can't afford it, to begin to get primary health care. That's where we are getting the high infant and maternal mortality rates. It is these kinds of people you saw today at the rural areas, who can't afford health care, that we need to reach..

You have a lot of these rural hospitals, but most of the doctors are in the cities; they don't want to live in the rural areas. You have to give them incentives, and still sometimes they are not there. So on Monday the doctor is there; on Tuesday and Wednesday he is not there; on Thursday he turns up. After a while, it doesn't encourage people to have confidence in the reliability of health care service. What the community insurance has done is provide that reliability and affordability – and to spread more knowledge about health care in the community.

You're also investing in agriculture.

In Kwara our arference between poverty and getting someone out of the poverty bracket. So what we've done is encourage them via mechanization and providing credit.

And, more importantly, we need a new generation of farmers – young, qualified graduates who have moved to the cities and are roaming around looking for jobs in oil, banking, and engineering. Why? Because they don't see agriculture as a source of livelihood. Now we are trying to encourage them, and we did that in collaboration with   commercial farmers from Zimbabwe who came here and have employed young Nigerians. A Nigerian farmer's profile is: 60 years old, not well educated, not well exposed to new technology, can't walk up to a bank and raise credit. The new Nigerian farmer is much younger, is a graduate who can write a business plan. That begins to make the young chaps think, "Oh, so there are these kind of farmers that exist all over the world; farming is not archaic or rural". That changes their orientation. We have a school where we have a lot of young guys who now look at farming differently and think it could be a business.

With the commercial farmers, we hope that best practices will be transferred to small-scale farmers, and you begin to see that already. We believe that the commercial farmers are having a 'pull-up effect'. As they are getting better, the small-scale farmers will get better.

And also there is what we call agro-allied industries. For example, if you look at dairy, the more dairy production you have, the more demand you will have for maize, soya beans, and all the feed stock. If you have the agro-allied demand, you push demand for the small-scale farmers. If there is a market, it is easier for the banks to finance small-scale farmers.

That is not happening at the moment. The market is not there. Right now, the farmer is saying: when I harvest, I will go to the side road and put it there and pray that someone is going to buy it, or if things are bad I'm going to eat it myself. All these factors need to come together, and that is what we are doing here.

We also are doing a lot of land reform to provide more security for financial institutions. But the most important thing is creating the market. If we can create the market the sector will stand on its own.

Perhaps as many as half of Nigeria's small-scale farmers are women. What role do they play?

I believe that in the rural areas they are as active as the male farmers, and I believe that their role is pretty much the same as the male farmers. They need the same support to be able to produce higher yields.

In development organizations and among donors, public-private partnerships has become a big focus.

A lot of the things we are doing here are public-private partnerships. We are doing it in health, agriculture, sports, transport, aviation, even in the environment -- because in the sustainability of a lot of these schemes you need private sector partnership.

Without stable access to electricity, everything you're trying to do is harder.

Nigeria is notorious for its power problems - apart from Kwara. We have 24 hours [a day] here, because we invested heavily in transmission. We are the only state in the country today that has stable power. I've been around to see small guys who have barber salons that used to spend about 100,000 naira a month on diesel [to run generators]. I've seen wielders who used to do only five jobs a month because they had to wait for power; now they can do 25 jobs a month. You can see the impact on the economy. The hotels used to spend 10 million naira a month on diesel, now they spend up to a million. I got a letter from the principal of a school who wrote personally to say thank you, because he's got 6 extra million a month to invest in infrastructure.

The power is coming from Kainji hydroelectric dam. A lot of people talk about generation, generation, but it's not only generation. The problem is also transmission and distribution. Even with the low level of generation we have in the country, even for us in Kwara, for as long as the country can generate 3000 megawatts, because of the work we've invested in transmission and distribution, we maximize that and we get about 80 megawatts, and that's fine to keep the whole state with uninterrupted power. The only time we have problems is if the generation collapses to about 2000 megawatts. Then we drop to about 12 hours a day. But when you compare to other states, even at 3000 megawatts, they don't provide power because they don't have good transmission or distribution.

But from the amount the government is investing, I think it can only get better. Next year the government should be able to provide anything between 5 to 10,000 megawatts. I think that is enough to ensure most of the industries do not depend on diesel. It might not be enough for the expansion going forward.

But once you are doing 4,000-5,000 megawatts, it is going to impact the economy. The country spends one trillion naira yearly to import diesel. Once that goes, it will be tremendous.

Corruption is one of the main complaints of everyone. How do you confront it in Kwara?

First of all, we introduced a price intelligence unit, which has been in existence from day one. We try as much possible to review processes and try and get right prices on government work and projects. We also ensure transparency in our processes. People who are found wanting have had to face the law. I think it has to do with leadership as well. Once the guy at the top provides direction, everybody else follows. Also, we try to make the system more efficient. If it is more efficient, you succeed in removing the loop holes where corruption can thrive.

In Nigeria generally, do you see signs of improvement?

In ten years of democracy - I'm a second term governor - I've seen it getting better. The crop of governors now compared to the crop of governors before, you can see the difference. The crop of councilors at the local level definitely has gotten better. Accountability is improving. Nigerians themselves are becoming more active in the whole process, and I think by that process we are beginning to move in the right direction.

We have all the ingredients to make us a major player in the global economy. If we can run credible elections [in 2011] and further strengthen the belief of the people in elections then we begin to, finally, get what I call true patriotism, as we had in the 70s and 80s

In the [oil-producing] Niger Delta, there is definitely there is a need to give something directly to the communities in those areas. What is of great concern is that all that is produced there ends up somewhere and never gets down to the people.

But if we have a mechanism by which for every cent earned and every gallon produced there is a certain percentage that goes directly to the community - to develop the community - and the community is responsible for managing those funds, then you can't blame anybody else. I think that will bring a sense of ownership that is central to maintaining peace and order in those areas. The view is: why should we maintain peace and order? Nothing earned here is coming here anyway. We pump oil tomorrow or we don't pump, it doesn't make any difference to us. But if they are benefitting from the oil every day, then I think there will be that sense of ownership.

You mentioned leadership earlier. All over Nigeria, people complain about leadership. How do you see that issue?

I think one of the important aspects for those of us who find ourselves in positions of leadership is to understand that it is a trust. We must feel accountable. We must, as much as possible, serve the people that have elected us. How do I put their desires and their concerns ahead of everything else? Those are the key issues that are so important in leadership in Africa, in Nigeria and here in Kwara.

As a leader, you should have your own guidelines of what is right and what is wrong and set those standards. A leader must not get self-centered. I want to be remembered as someone who put the people first.

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Editorial Note: Before he was elected governor, Dr. Bukola Saraki was one of the individuals who provided start-up funding for AllAfrica.

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