The Problems In Nigeria's Health Sector (3)
I have received a lot responses from my readers with respect to my last articles under this subject matter. I want to state clearly here that the health sector is like the human body.All the parts are important and there is no way the hand will tell the eyes that they are not important and vice versa. However,we should be aware that every system has a central control unit which though other parts are important but that central part is more important than others.
This reminds me of the words of comrade Napoleon that says that all animals are equal but some are more equal than others. In the human body,the brain is the center of all activities in the body while in the computer system,the CPU is the center of all activities. A medical doctor is at the center of the health sector.Each profession has its own contributions to the health sector hence every profession is important but we should never forget that for us to work as a team,there must be a team leader,assistants etc. Problems arise in an organisation when the components do not their roles and their limits.
In one of the books of Professor Ben Carson,he warned new doctors never to look down on nurses because they have outlived many doctors in the hospital hence they have acquired a lot of skills from many doctors in the hospital. Ben Carson still went further to attribute part of his success in the 1987 separation of the binder twins to a nurse working with him. I personally learned a lot from nurses as a house officer.I have many of them as my friends till today. The problem in our health sector can be likened to an incident that occurred in the days of David in the bible.
The book of 1st Samuel chapter 30 narrated a story of how the Amalekites invaded Ziklag,a territory under David's kingdom. The Amelekites carried everybody there away including the two wives of David(Ahinoam and Abigail).When David and his men reached there they were all confused and bitter. The bible said that they all lifted their voices and wept,until they had no power to weep.
David who was the king then was as confused as any other citizen in that part of the kingdom. Remember that David and his men were not there when the Amalekites invaded Ziklag and nobody informed them while the attack was ongoing.Guess the next reaction of the people there,verse 6 said that David was greatly distressed;for the people spoke of stoning him.The question I will ask here is why must the people plan stoning him even when his two beloved wives and children were also affected?
The above scenario is exactly what is happening in our health sector today. The doctors( represented as David)are more affected than other health workers(the men with David and other citizens whose wives and children were also taken into captivity) in the neglect of the health sector by the government. This week,one of the cleaners in our hospitals shouted involuntarily while cleaning the floor:why must I work like an elephant but eat like an ant?
That singular statement touched me. See the health sector that our government is supposed to channel huge resources to,instead our leaders are busy bringing down the health sector by their obnoxious policies as concerns the salary packages of the health workers.Tell me any reason why a worker in the oil company or a politician will be earning more than a health workers?In terms of risk,the health worker has direct contact with patients suffering from Pulmonary Tuberculosis,Lassa fever,Hiv-Aids,Ebola-virus etc and they can easily contract these infections in the process of treating their patients.What insurance does the government have for them?
What we hear today is this political leader is flown abroad for a mild headache. I thank God that some of them will still die abroad. Nigerian economy is now adjudged the largest in the continent,the question then is how does that reflect in the lives of the citizens?Come to our hospitals nowadays,patients die due to their inability to buy the prescribed medications. We talk about medical tourism abroad,what is the difference between the health workers we have in Nigeria and those in abroad?
There is basically no difference in terms of human capital development,but when you come to the use of sophisticated and the state-of -the art equipment,you will find a big difference between what we have here and what is obtainable abroad. As a house officer I got to learn that when you are on call,you are not supposed to sleep both in the day and night.Tell me the quality of one's cognitive capacity when one does not sleep for 48 hours because the system(my oga at the top) has made it to be so and if by mistake you sleep during that 48 hours and there is an unattended case,you will answer a query.
Every civil servant knows that answering a query may be followed by suspension or outright dismissal. I tried to complain but my superiors told me that I should thank God that I did not do my house job a year earlier in that I would have been on call on daily basis.They still went on to tell me the story of a senior registrar in internal medicine who was on a weekend call,he overworked himself to the extent that he fainted on his way to collect his laptop from his car and he was immediately rushed to the same Accident and Emergency unit where he had been treating his patients.
Surprisingly,my superiors who were telling me these stories seemed to be very comfortable with the situation.That reminds me of my days in the University of Nigeria,Enugu campus.One day I went to lay my complaint to the authorities on why the school library should be sited adjacent to the school hall which can as well be rented out to other individuals and companies for all sorts of functions.I made that move because I reasoned that a library should be sited in a noiseless zone.How stupid I was not to understand that in Nigeria,blessed are those that suffer,the person that attended to my complaint told me pointblank that I should not come to the office again and that if I was tired of studying that my course,I should apply for a change of course.
He went further to tell me that the likes of Peter Odili,Chris Nigige,Chimaroke Nnamani,Sullivan Chime etc passed through the same campus that I should go and tell my parents that I was tired of my present course. Having been convinced beyond any reasonable doubts,I thanked him with all humility and left his office to go and continue other business of the day.Why must Nigerians rejoice with suffering?Also in our health sector,tell me any reason why a work that is meant for at least 5 people should be done by one person with no compensation?
It is very annoying that our JOHESU brothers who were pursuing the same rats with us suddenly made a volte-face and are now claiming that our hands are like that of the rats. The current salary packages for all health workers,medical doctors inclusive, can best be described as peanuts when compared to the risks involved.I know many health workers that have had needle pricks while injecting or drawing blood from HIV positive and Hepatitis B and C positive patients,my question is what medical insurance does our wicked government have for them?
Go to Arv(anti-retroviral) clinics and see health workers queuing up to collect their medications as part of post exposure prophylaxis(pep) when our corrupt politicians are busy amassing wealth. This was exactly what Major Kaduna Nzeogwu tried to fight earlier but Nigerians brought in tribal sentiments to his moves. Till tomorrow,Nzeogwu remains my role model because he was a disciplined soldier .Many of his friends described him as a non philandering teetotaller.
All I am saying is that the pay packages of all our health workers must be increased and a functional insurance be granted to the health workers.In America,how many people are struggling for leadership positions. They have fewer number of aspirants because virtually everybody is comfortable with the government.
However,coming to Nigeria,thousands will come out for a post because the winner must take it all hence nobody wants to be left out. Let the government inject reasonable amount of money into the health sector and employ more workers,this bigotry in our health sector will die a natural death as Obasanjo said that Sharia would die a natural death during his regime.
It annoys me today that our people go to India and China for medical tourism.Every tertiary hospitals must have at least three CT and MRI scanning machines to be working at least morning,after noon and night shifts with enough radiographers and radiologists to cover adequately for the shifts.
Our Accident and Emergency Units must live up to their names not the one a patient will be rushed to the hospital, either the person holding the key of the store to the oxygen cylinders will not be available or there is no oxygen in the cylinders.I don't want to talk about a situation where a surgeon starts a complicated surgery with light powdered by electricity but ends up with torch lights from phones.
The accreditation and re-accreditation teams of hospitals should be visiting hospitals unannounced if they are really serious with what they are doing unless the Chief medical directors and heads of units will continue the present, the more you look the less you see pattern of re-accreditation.
DR PAUL JOHN