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COVID-19: Incredible neglect of health sector

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As more Nigerians including political leaders are testing positive and embarking on and coming out of self-isolation, the lockdown ordered by the Federal Government is beginning to reveal in clear disbelief the abysmal and decadent state of Nigeria’s healthcare system. The days ahead will show that despite the sacrifices of health workers, the long decades of willful neglect and needless politicisation of healthcare delivery systems are going to haunt this country in a most calamitous manner. This is terribly disheartening for a country with some of the best human resources in the health sector – even in a global context.
 
Nothing explains this precarious state of our health sector as the preparation for the Coronavirus Disease (COVID-19). In the wake of the index case, Nigeria moved from denial to empty promises and now to panic mode nurtured by a litany of inadequacies we attempt to cover up. Apart from Lagos State, whose pro-active and responsive administration has set the pace for the management of the spread of the Coronavirus disease, even the Federal Government has demonstrated its familiar costly tardiness and fire-brigade approach to crises, by refusing to promptly act the way a responsible leadership does. There has been a credible report of how the Nigeria’s president “failed to take action in vital weeks,” a prelude to the present uncertainty in the land the president failed to address well last night in an address. 
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Although there have been fantastic private sector support, exemplary leadership from some administrators and overwhelming sacrifices from medical personnel, scary statistics pointing to a bleak future, stare Nigeria in the face. Experts and analysts speculate that like Iran, Italy, Spain, the United States of America, Nigeria may continue to witness a harvest of rising cases of people testing positive and worst scenarios. That is already happening and indeed the statistics say it all. 
 
As at Monday, Nigeria with an estimated population of 200 million has the following COVID-19 update: Only about 5, 000 tested, 323 confirmed cases, 85 discharged, 10 deaths, and testing centres in only a few states and the Federal Capital Territory. 
 
The tragic consequence of all this is that no one is immune from the pestilential effect of the virus. Influence, wealth, position and status cannot prevent the privileged from being affected. This fact is an invaluable lesson to Nigerian politicians who have made foreign hospitals their tourist haven for routine medical check-up. Public officers cannot go abroad for medical care because the same countries where their choice hospitals are located have also been devastated by COVID-19. Everyone is restricted to their tents.
 
More tragic is the budgetary allocation for health, which further reflects an unwillingness to make things work. While the 2020 proposed health budget of N427.30 billion is a marginal increase in the 2019 budget of N424.03 billion, when compared to budgets of other key development sectors (defence, education and health), health has the lowest. At 4.14 per cent of the entire budget, health has an allocation that is a far cry from the N1.985 trillion allocated defence, which is 19.23 per cent of the national budget. Curiously, a draft of the review already sent to the National Assembly doesn’t show any promise as health and education have also been slashed.
 

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Just as the Coronavirus disease has exposed age-long neglect of the healthcare delivery system, so also has it revealed lessons to be learnt. First, it is a lesson in patriotism. There is a way the patronage of local facilities can boost morale and improve the capacity of professionals. Had our public officials and their families been patronising public local health facilities there would have been some steady infrastructural development in, and management of, the health sector. Thus, it is a lesson on the wisdom in building resourceful hospitals and health facilities as a matter of necessity for the people. 
 
Second, it is a lesson on the need to invest in the management of the over-all wellness of citizens. While we channel resources and finances into investment in the science and narratives of control, influence and power, we forget to do the same for care, solicitude and respect for human dignity.

Another aspect of the neglect in the health sector is the relegation of certain other aspects of healthcare, namely mental health. Given the apparently lack of awareness of the import of wholesome health, there is the misconception that healthcare pertains only to somatic afflictions and diseases. Nigerians are yet to come to terms with the all-encompassing nature of health to include emotional stability, mental wellness, peaceful co-existence and even wholesome spirituality. As a result, they are less appreciative of the role of psychiatrists, psychologists, psychotherapists, mental health experts and counsellors. 
 
With the ongoing global scourge of the Coronavirus disease, its unpredictability, seeming incurability and its attendant suspense, it stands to reason that mental health challenges would be situations Nigeria will contend with. There are indications from mental health professionals that exasperation, boredom, tedium and monotony that would arise from the lockdown would lead to cases of traumatic stress disorders, depression and even suicidal tendencies. Already a finance minister in Germany allegedly committed suicide over the possible financial implications of COVID-19 on his country’s economy.
 

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It is for this reason that this newspaper calls for greater harmony amongst professionals catering to health and wellness. Proper enlightenment about mental health as a category of wholesome health should be given its rightful place in healthcare delivery system in the country. Stakeholders in the health sector should also establish facilities and regulate the practice of mental healthcare. One way of getting about this is to de-stigmatise mental health disorders as spiritual afflictions that must be managed by religious leaders and other categories of untrained caregivers.  
 
While we support the proposals of experts who call for the acceleration of the importation of our medical needs since between 50 and 70 per cent of our medical needs are imported, this newspaper believes that this can only be a short-term palliative to the menace of COVID-19. As the COVID-19 pandemic has revealed to us, Nigeria is caught unawares owing to its dependence on importation from countries that are also locked down. A more steady approach to qualitative and viable healthcare delivery system would be a long-lasting solution that puts the country on guard. 
 
To this end, Nigeria needs more investment in, and increased local manufacturing capacities. This must come through deliberate expansion of local production capabilities for raw materials and finished medical and pharmaceutical products. Furthermore, the Federal Government should, as a matter of policy, mandate specific research efforts for the production of local medicines for this and future epidemics. This mandate should also challenge the Nigerian universities and Nigerian Academy of Science (NAS) to initiate, promote and facilitate sundry research efforts in anticipation of epidemics. Specifically, as a congregation of the highest level of experts in the natural sciences, the NAS should deploy its expertise in finding home-grown solution to problems such as this. 
 
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