EZEONWUMELU: BLAME THE DOCTORS
I AM angry. I am ashamed to be a doctor in Nigeria. I must get it off my chest. I have been vituperating ever since I came back from India recently from medical tourism, they call it. This was a medical tourism forced on me by the Nigerian situation. It was not a pleasant choice by me.
I partly respond to the recent piece by Dr. Levi Obijiofor, captioned, “The death of public heath service” (The Guardian Friday April 15, 2011). He wasn't deep enough. There is still hope after death, especially sudden death. The dead could be resuscitated. But “burial” seems to put a total end to the dead. So retitle it “The burial of public heath service”. He was indeed very light about it. One may even begin to think that it is the fake drug sellers that are the problem with healthcare in Nigeria. They are not. The problem fully is with the doctors. Not even with the politicians or our leaders. Do not blame them. Blame the doctors.
Recently I was in India with my wife because we were referred there by the urologist we were seeing in Nigeria for kidney stones. She needed to have the stones laser-beamed and crushed and the tiny fragments passed out in the urine. He told us that the technology is not yet available in Nigeria save somewhere in Abuja, but he wasn't sure.
So we proceeded to India after assembling almost N2,000,000 (two million naira). (We will soon go back for the second and final part of the treatment). Further investigations were carried out to confirm the diagnoses and some of the stones were blasted and other treatments given, without any hassles. Over there in India we also came across many hapless Nigerians also on “medical tourism”.
You may ask, “What is my grouse with Nigerian doctors?” Simple: they still go to work and take salaries every month even when they know that things are not well with health service delivery in Nigeria. Why should they still be going to work, especially in the Teaching Hospitals and Federal Medical Centers, especially when they know what to do but can't do them simply because they do not have the equipments? When they know they are limited in helping their patients, why do they carry on as if things are okay?
In India, I was ashamed to be a doctor. I can't easily forget the Indian doctors' faces of wonder and amazement when they learnt we didn't have the technology for blasting kidney stones. They were further amazed that as late as 2008 my wife had to go under the urologist's surgical blade for bladder stones when the stones could easily have been laser-beamed.
In 1981 when I did my Housemanship I witnessed a surgical removal of kidney stones. The urologist then assured us that in a year or two from then surgical removal of stones would be history as he was sure Nigeria would have acquired the technology to blast stones thenceforth. This is 2011, 30 years after, and the technology is not yet in sight. Yet this same urologist was to become a CMD at some teaching hospital. Why did he not use his office to make one of the Teaching Hospitals especially the one where he was CMD a “Urology Centre of Excellence”. What was his handicap? Was it funds? Were they not allocated funds? My wife's urologist derisively said his private clinic is better equipped than the teaching hospital he works in.
The President of Nigeria, who is not a medical doctor, is not to know that Nigeria does not have the technology to blast stones. The doctors know. The CMDs know. The Ministers of Health know. Doctors have always been the leaders of the medical teams in the hospitals. That is why you must blame the doctors. They must be held accountable. I told my wife's urologist that he should have resigned except they procure the equipment for him and he just stared at me incredulously as if I was out of my mind. I told him that if he was a specialist of repute and threatened to resign, the hospital will take notice and do something. Our doctors are too comfortable with mediocrity.
I won't also let my colleagues at the private end off the hook either. They would rather buy the best cars (multiples) or build the most expansive houses or acquire chieftaincy titles or do multiple burial ceremonies for their long dead grandparents; and will more likely run sole proprietor clinics and hospitals than to team up together and invest in high tech health facilities that can rival those in India. Indian doctors run simple lives. Here we pursue vanities.
Somebody somewhere will now shout infrastructures, electricity, maintenance of the facilities etc. That these are the responsibilities of government and if they are not there the doctors cannot do much. I agree but the reason Nigeria is in a mess right now is that every body is passing the buck. We must accept that health care delivery is the way it is today because the doctors have allowed it to be so. Is it when there is a Surgeon General that it will come to life? What have the Health Ministers been doing? What have the CMDs been doing? What have the Consultants been doing? During the time of equipping the Teaching Hospitals as Centres of Excellence, wasn't there a urologist somewhere that would have also demanded a urology centre of excellence? No, not one of them did that. Instead I was forced to go to India on medical tourism I never planned for nor financially equipped.
Yes, I am angry and I hold my colleagues responsible for quietly and tacitly burying public health service in Nigeria.
• Dr. Ezeonwumelu lives in Port Harcourt, Rivers State.