Buhari’s ailment and sorry state of Nigerian health system
The question of whether Nigeria has adequate medical facilities and personnel to handle the growing health challenges of her population has again resurfaced following President Muhammadu Buhari’s trip out of the country to receive treatment for an ear infection. Apart from President Buhari, three members of his cabinet were reported ill and are currently seeking medical attention probably outside the country.
This development, especially President Buhari’s case, has nonetheless generated much controversy and criticisms from Nigerians. This is especially in the light of the President’s earlier promise to end medical tourism among Nigerians.
Buhari’s party All Progressives Congress (APC) had among others, promised during last year’s election to prioritise the reduction of the infant mortality rate by 2019 to 3 per cent, reduce maternal mortality by more than 70 per cent, reduce HIV/AIDs infection rate by 50 per cent and other infectious diseases by 75 per cent, improve life expectancy by additional 10 years on average through our national healthy living programme, increase the number of physicians from 19 per 1000 population to 50 per 1000, increase national health expenditure per person per annum to about N50,000 (from less than N10,000 currently).
The party also promised investing in cutting edge technology such as telemedicine in all major health centers in the country through active investment and partnership programs with the private sector, Provision of free ante-natal care for pregnant women, free health care for babies and children up to school going age and for the aged and free treatment for those afflicted with infectious diseases such as tuberculosis and HIV/AIDS, boosting the local manufacture of pharmaceuticals and make non-adulterated drugs readily available.
But a year after coming into power, Buhari’s government, some analysts have observed, has not been able to do the needful to use the surgical knife in rescuing the nation’s decaying healthcare system.
While many Nigerians have expected Buhari’s government to kick-start the immediate implementation of the provisions of revolutionary National Health Act, the best the government has done so far was setting up a committee to look into the Act and recommends way forward.
Some Nigerians are worried by the existence of such committee whose activities are shrouded in secrecy, since the popular belief in Nigeria is that if you want to kill a good idea, give it to a committee. Besides, the country’s successive governments have set up several committees in the past whose recommendations are gathering dust in government shelves.
Aside the delays that have held down the nation’s healthcare system, basic equipment and modern facilities are as scarce as water in the desert. The scenario has made most Nigerians to abandon the primary healthcare centres (PHCs) to find solutions for simple sicknesses like malaria in teaching hospitals. Aside being distracted from their research roles by constant harassments, these teaching hospitals have become mere consulting rooms where drugs and equipment are hardly available to solve health issues of those in need. Medical tourism has therefore taken over.
PHCs, which is supposed to be the bedrock of the country’s health care policy, is currently catering for less than 20 per cent of the potential patients. While most PHC facilities are in various state of disrepair, with equipment and infrastructure being either absent or obsolete, the referral system is almost non-existent.
The health services, based on PHC, include among other things: education concerning prevailing health problems and the methods of preventing and controlling them, promotion of food supply and proper nutrition, material and child care, including family planning, immunisation against the major infectious diseases, prevention and control of locally endemic and epidemic diseases and provision of essential drugs and supplies. The provision of health care at PHC level is largely the responsibility of local governments with the support of state ministries of health and within the overall national health policy.
Buhari’s government has, however, promised to revive PHCs by making at least 10,000 of them functional across the federation within a shortest period. Although a lot of stocktaking and monitoring of PHCs by the federal government have been going on, there has not been any reasonable financial backing to such PHCs revolution, even though the year is half-spent.
Earlier in the year, the medical community was shocked to learn that the President allocated a paltry 4.2 per cent of the national budget to the health sector. To some, the allocation flies flat, when compared with the Abuja Declaration held in Abuja where heads of state of African countries met and pledged to set a target of allocating at least 15 per cent of their annual budgets to improve the health sector about 16 years ago.
Former President of the Nigerian Medical Association, Dr Osahon Enabulele, is one person who is not happy with the President’s medical trip.
In an open letter widely circulated in the online media, Enabulele described president’s decision to go on a 10-day medical vacation to London as a mockery of the change mantra of his administration and that of the professional competence of Nigerian doctors.
President Muhammadu Buhari
“I am very constrained to state that this foreign medical trip flies in the face of the federal government’s earlier declaration of her resolve to halt the embarrassing phenomenon of outward medical tourism, which by the end of the year 2013, has led to a humongous capital flight of about $1 billion, particularly from expenses incurred by political and public office holders and their accompanying aides, whose foreign medical trips, most of which are unnecessary, were financed with tax payers’ resources,” Enabule said.
“Available records show that in last year (2015) alone, 637 medical doctors emigrated due largely to poor working conditions and health facilities, insecurity, unpredictable and poor funding of the Residency Training Programme, uncompetitive wages and job dissatisfaction,” he stated.