Features
The Challenges Of Nigeria’s Healthcare System
On Oct. l, 20 1 0, dignitaries from countries across the world converged on the Eagle Square in Abuja to celebrate Nigeria’s 50th independence anniversary.
However, the epoch-making event turned sour when two car bombs exploded some metres away from the square, leaving some people dead and others injured.
In the ensuing pandemonium, the casualties were ferried to hospitals with security patrol vans and private cars, including taxis, because of the dearth of ambulances.
The public-spirited acts of individuals and agencies such as the Nigerian chapter of Club 25, whose members regularly donate blood under the aegis of the National Blood Transfusion Service (NBTS), on that fateful day, were very commendable.
The NBTS’s doctrine of making available safe blood for transfusion saved the hospitals from the added trouble of looking for blood to treat the bomb victims.
Some observers, nonetheless, say that the Abuja bombing somewhat exposed some of the shortcomings in Nigeria’s emergency and health care systems.
Mrs Ladidi Bulus, a nurse at Garki Hospital in Abuja, says that the incident exposed some deficiencies in Nigerian emergency services, adding that inadequate ambulances are usually stationed at public events.
“Most of the well-equipped ambulances are privately owned. Therefore, the people who are predisposed to use them are those who are willing to pay the fees,” she says.
Dr Badejo Olawage, a surgeon at the National Hospital in Abuja, says that another major problem has to do with the actions of well-meaning but ignorant bystanders in crisis situations.
“These people sometimes cause more damage to patients when they attempt to administer first aid.
“Outside those in medical schools and first aid clubs in schools, the average Nigerian is not knowledgeable about basic first aid practices,” he says.
Olawage expatiates that knowledge of first aid issues is very essential in a community because “when attempting to save a life, whatever a person does in the first few minutes can be very important” .
The surgeon, however, concedes that the country’s health system is experiencing some structural changes.
Sharing similar sentiments, Dr Ibrahim Oloriegbe, the Executive Secretary of the Health Reform Foundation of Nigeria (HERFON), says that Nigeria is currently undergoing some epidemiological transition.
He says that there is a perceptible change in disease burden from communicable to non- communicable diseases. Oloriegbe, however, insists that over 50 per cent of all non-communicable diseases are due to poor or sedentary lifestyles of the people, including drug and alcohol abuse, bad diet, low stress management and lack of exercise.
He says that Nigeria is also saddled with coping with the effects of demographic transition, which is evident in increasing number of older persons and decreasing child mortality.
Observers say that diseases and health conditions such as HIV and AIDS, malaria, diabetes, hypertension and hypotension have been oversh-etching the country’s health care system.
For instance in 2005, former President Olusegun Obasanjo noted that HIV and AIDS, malaria, tuberculosis and child and maternal health problems had cost the country so much.
“However, it is less well understood that diseases such as heart disease, stroke, cancer and diabetes already have a significant impact on our country and that by 2015; it is projected that these diseases will be a leading cause of deaths in Nigeria.
“Most of the diseases are preventable and they are undermining our efforts to increase life expectancy and economic growth,” Obasanjo said.
Dr Olusegun Ajuwon, a former Chief Medical Director of the National Hospital, shares similar sentiments.
He says that medical conditions such as obesity are fast becoming a global menace, adding that Nigeria is not immune to the emergent health problem.
Ajuwon says that the lifestyle of the average Nigerian has appreciably changed because of the advent of jobs that require less physical activity and a habit of eating whatever is available because of busy work schedules.
“Nigerians believe that issues like obesity, diabetes and kidney failure are alien to the country; so, they are not as aware of them as they are of other diseases,” he says.
“It is now up to the government to deploy more resources toward the prevention and treatment of these diseases,” he adds.
However, Nigeria’s revised health policy document states that preventable diseases account for 70 per cent of the country’s disease burden and identifies poverty as a major cause of the development.
Observers say that poverty has been a major factor behind rural-urban migrations in Nigeria, as many of the rural dwellers migrate to cities in search of better living conditions.
Dr Orne de Idris, the National President of the Nigerian Medical Associations (NMA), says that there are several health issues stemming from urbanisation.
“Apart from the highly topical issue of climate change, a rising population in the cities will have adverse effects on public health.
“There are not enough trained physicians in localised areas because they have no guarantee of compensation,” he says.
Besides, Prof. Shima Gyoh, a retired Permanent Secretary of the Federal Ministry of Health, says that the increasing population of Nigeria is exerting a lot of pressure on all its social services.
Gyoh, nonetheless, stresses the need for a health care system that focuses on preventive measures, rather than curative measures.
He says that the public expenditure on health is currently less than eight U.S. dollars (NI, 200) per capita, a far cry from the 34 U.S. dollars per capita recommended internationally .
This, in essence, means that Nigerian hospitals have very little resources for maintenance and running curative services because they spend over 80 per cent of their income on the salaries of their personnel.
The infrastructure deficit in hospitals and the poor working conditions of medical doctors have been part of the bane of the country’s health care system, says Dr Charles Cudjoe, the National President of the Guild of Medical Directors (GMD).
He says that the doctors often go on strike because of these two problems, adding, however, that the doctors usually call of the strikes whenever the income aspect of the problems is resolved.
“As a result, the infrastructure of the health sector has continued to deteriorate, while the pay of doctors has improved,” Cudjoe says.
This explains the rationale behind HERFON’s decision this year to focus its attention on persuading political parties to place health on the front burner of their manifestoes in the lead up to the April elections.
The Foundation has been calling on political parties to be more specific about the health care delivery plans they intend to put in place to guide the electorate in deciding and voting on the issues.
As part of efforts to meet the Millennium Development Goals (MDGs), Nigeria has recorded some feats in reducing maternal mortality.
Gyoh says that the country achieved a 30-percent reduction in maternal mortality in 2003, adding, however, that the current progress is slow.
He says that the slow progress is mainly due to cultural myths, illiteracy, poverty, inadequate access to health services, stressing that these are compounded by inadequate water and electricity supply.
However, the country’s health sector will receive a boost this year, says the Minister of Health, Prof. Onyebuchi Chukwu.
He says that the Federal Government and the 36 state governments have agreed to dedicate 15 per cent of their annual budgets to the health sector from this year to 2015.
Also, President Goodluck Jonathan pledged while addressing the 16th session of the Joint Action Forum (JAF), that the Federal Executive Council, the National Council of States and other stakeholders were making efforts to further improve the country’s health care delivery system.
“We are determined to focus, not only on disease prevention, control and cure but also on the social, environmental, educational and economic factors that affect the health of our communities and population,” Jonathan said.
Olayemi Okeniyi, writes for News Agency of Nigeria (NAN).
Olayemi Okeniyi
From the fore going, the fight against drug trafficking should be treated as an international challenge with open collaboration, if the world leadership must win the fight!.
The circumstances or should I say the improvement on drug related activities are modifying and updating on daily basis. A close friend of mine in the United States of America who recently visited Jamaica, came with a lot of complicated information about drug trafficking and transaction. Being a qualified Nurse in US and on a visit to the Reggae Country (Jamaica), she said she was put aback when a man approached her and introduced himself as a Pharmacist. According to her, she immediately picked interest due to her professional background. To her, a business partner is birthed. But she was shocked to the narrows on learning that drug dealers or traffickers and subriquited Pharmacist in that Country. From her account, they ( The Jamaican Pharmacists), are the first set to people to meet and greet you at the Airport. No government or authority challenges them in the open due to the sophisticated nature of their transportation
Come to think of it, who would want to attack a Pharmacist on duty? Nigerians are not left out in the improvement on drug deal. A chat with a confident in the National Drug Law Enforcement Agency ( NDLEA) Rivers State Command, so revealed. The Officer draw my attention to the movement of Dispatch Riders. He said part of the reasons they ride with almost speed equivalent of the thunder lightning, is to meet up with the appointment of delivering hard drug consignment to a client of theirs. According to him, those guys popularly referred to as Yahoo Boys are the ones who now payroll dispatch riders so that they can deliver their consignment ( hard drugs) on schedule no matter the sort of traffic or weather condition. The fear of loosing rich clients and that of the unknown treatment that may come of the Boys, as the officer puts it, drives the Riders crazy thus the reason to speed even at the expense of their lives.
The account of a prominent Party Promoter, Wayne Anthony, as obtained online recently, also pointed out that ‘No Legislation Will Stop Clubbers From Doing Drugs’ Party promoter, Wayne Anthony, arrived in Ibiza, a Spanish Island in 1988, at the same time as dance music and the party drug ecstasy. Despite hallucinating badly enough to make him give up the lifestyle forever, he says laws will never stop clubbers taking drugs. “I don’t think you can control these things,” said former party promoter Wayne Anthony. He arrived in Ibiza in 1988 and began setting up club nights and raves in some of the island’s most iconic venues. In the years that followed, the sleepy Spanish island turned into a raver’s haven of clubbing and hedonism, with party drugs like ecstasy commonly found. “What Ibiza represented was this beautiful, hot island which was visually stunning and we knew you could party there quite legally,” said Wayne. “You didn’t have to look over your shoulder. You could just be as free as you possibly could be.”
That freedom came with a price. Along with the lavish clubs, all-day-benders and hot Spanish sun came drug cartels and crime. The city transformed into one the world’s most vibrant party capitals, “fuelled by a dangerous and lucrative drugs trade which drew as many criminals to its shores as it did party animals”. Wayne, one of the contributors to the documentary, spoke to Sky News ahead of its release.”I’m not going to sit here and say the cartels aren’t there. They are all there and they’ve been there from the ’90s,” said Wayne. But he said most people tried to ignore the organised crime going on around them. According to Wayne, clubbers usually took the approach of: “‘Give me 10 E’s . Behind the scenes of the filming of Ibiza Narcos with Wayne Anthony. Behind the scenes of the filming of Ibiza Narcos with Wayne Anthony. Hallucinating giant spiders Although he described the Balearic island as the “motherland”, it was eventually a bad experience with drugs that convinced Wayne it was time to leave Ibiza.
He’d been partying for days when he realised he’d taken too many drugs. A friend told him to drink cough medicine, dangerous advice that he now says could have killed him. “I saw the worst hallucination I’ve ever seen in all of my life. I ended up locking myself in the villa with all the shutters down. When he sobered up, he realised he had “come to the end” of his party life on the island. “I never looked back. I never took another drug. I got away from the club world.” ‘I don’t think you’re going to be able to stop it’ Despite his life-changing experience, he doesn’t think criminalising drugs is a good idea – or particularly effective. “If you’re old enough to vote for who’s going to be a world leader, if you’re old enough to put your name down on debt for 25 years, I feel like you should be old enough to govern what you put inside your own body, you know?” said Wayne.
Back to Nigeria, some illicit drugs worth over N30billion seized at Onne Port in Rivers State.
This blood chilling development forced the Federal Government to declare a state of emergency at the Onne Port, following what authorities described as repeated incidents of importation of dangerous cargo, including arms and ammunition through the said port. To this effect, the government said it was immediately implementing emergency protocols at Onne Port for the next three months by conducting thorough examinations of all suspected containers in the premises.
The Comptroller-General of Customs, Bashir Adeniyi, in charge of the port via a press conference, said it henceforth, unveiled the seizures of illicit goods by the Nigeria Customs Service, Area 2 Command, Onne in Eleme Local Government Area of Rivers State. In defence for his action, Adeniyi said the recurring incidents posed a threat to national security, adding that the health of citizens at the Onne Port is increasingly being used as a destination for dangerous and illicit cargo, describing it as a disturbing trend.
The customs boss stated, “Earlier today, I joined numerous stakeholders to take a significant step towards the cause of trade facilitation through the inauguration of upgraded facilities provided by the West Africa Container Terminal, Onne. “As I express delight that trade facilitation is getting traction in Onne Port, I cannot help but call your attention to a grave concern. This has to do with the repeated incidents of national security breaches unfolding in Onne Port. I appreciate your presence, as we all have a shared responsibility in safeguarding our national security. As we are all aware, the policy thrust of Mr President supports the re-energising of our business environment to drive faster import clearance and grow our capacity for exports, Our emphasis has been to promote initiatives that speak to Trade facilitation and economic development. “It is a matter of regret that criminal elements in the international supply chain are exploiting our pro-trade stance to commit atrocities bordering on national security breaches”.
“The attempts to test our will through the importation of dangerous cargo through this port has necessitated the declaration of a state of emergency in Onne Port, coming on the heels of a seizure of a huge cache of arms a couple of months ago. It is disheartening that perpetrators have not backed down on their illegal acts. Recent intelligence and seizures have revealed a disturbing trend; Onne Port is increasingly being used as a destination for dangerous and illicit cargo. The scale and nature of these illegal importations pose a significant threat to our national security and the health of our citizens. Today, we are here to showcase yet another series of significant seizures made by the diligent officers of the Area 2 Command. On display are twelve containers of illicit goods intercepted through a combination of intelligence gathering, inter-agency collaboration, and meticulous physical examination. Seizures on Display include: Three (3) x 40-feet containers: Containing 562,600 bottles of 100ml cough syrup with codeine and 3,150 pieces of chilly cutters, with a Paid Duty Value (DPV) of N4,716,573,846.
“Others are, three x 40-feet containers containing 380,000 bottles of 100ml cough syrup with codeine, 24,480,000 tablets of Royal Tramadol Hydrochloride, 5,350,000 tablets of Tapentadol and Carisoprodol, and other items, with a DPV of N17,432,506,000 were seized”.
According to the report, more seized items were, “Five (5) x 40-feet containers; Containing 892,400 bottles of 100ml cough syrup with codeine, 1,300,000 tablets of 50mg Really Extra Diclofenac, 7,250,000 tablets of 5mg Trodol Benzhexol, and other items, with a DPV of N8, 128,568,295,90. This very action of the Nigeria Customs Service, further complicated the hope of how soon the fight against drug trafficking could be brought to a halt owing to its high profile nature.
Another hair-raising report of the illicit drug deal has it that when NDLEA bursted a Snake-Guarded Shrine Used For Storing Illicit Drugs sometime ago in Edo State. This very news report was published in The Tide Newspaper on June 24, 2024. According to the report, NDLEA said its operatives uncovered a shrine, guarded by a snake, being used for storing illicit drugs, during an operation in Edo State. The Agency in a statement by its spokesperson, Femi Babafemi, added that its operatives discovered a specially constructed large hole in a wall, hidden behind wallpapers and fetish objects used for drug storage. It further noted that methamphetamine, Loud, Colorado and Arizona, all strong strains of cannabis with a total weight of 8.743kg among others, were recovered from the shrine.
To be cont’d
King Onunwor
The persistent clash between farmers and herders in Nigeria has been a longstanding issue. These conflicts, often, over resources like land and water, have led to loss of lives, destruction of property, displacement of large numbers of people, deep-seated mistrust between communities and insecurity. Herders, traditionally nomadic, move their livestock in search of grazing land and water. Farmers, on the other hand, require the same resources for their crops. This competition often leads to clashes, especially in areas where land is becoming increasingly scarce due to population growth, climate change, and environmental degradation. As these clashes intensify, there has been a growing call for sustainable solutions. Two weeks ago, President Bola Tinubu took a bold step towards tackling the issue by inaugurating the Presidential Committee on Implementation of Livestock Reforms and creating the Ministry of Livestock Development.
The committee which has the president as the chairman and the former Chairman of the Independent National Electoral Commission (INEC), Professor Attahiru Jega as the deputy chairman has the mandate to address obstacles to agricultural productivity and open up new opportunities which benefit farmers, herders, processors, and distributors in the livestock-farming value chain as well as propose recommendations aimed at fostering a peaceful co-existence between herders and farmers, ensuring the security and economic well-being of Nigerians.The establishment of the Ministry of Livestock Development was part of the recommendations of the National Livestock Reforms Committee. Part of the 21 recommendations submitted to the president include: “This agenda should include the establishment and resuscitation of grazing reserves as suggested by many experts and well-meaning Nigerians and other methods of land utilisation.
“Create the Ministry of Livestock Resources in line with practice in many other West African countries. In the alternative, Federal and State Governments should expand the scope of existing Departments of Livestock Production to address the broader needs of the industry,” among others. Experts in the agricultural sector have posited that the livestock industry can create millions of jobs directly in farming, processing, and distribution, and indirectly in related sectors like feed production, veterinary services, and marketing. It provides livelihoods for rural populations, helping to reduce poverty and improve the quality of life in rural areas. It also increases the Gross Domestic Product (GDP) and foreign exchange earnings through the exports of livestock and livestock products such as meat, dairy, wool and leather.
According to them, a well-funded livestock industry supports the growth of agro-processing sectors, such as meat packing, dairy processing, and leather manufacturing, adds value to raw products and creates additional economic activity as well as stimulates the development of supply chains, including logistics, packaging, and retail, contributing to broader economic growth. It enhances economic resilience by diversifying the agricultural sector and providing a buffer against crop failures or other agricultural shocks and many more. Some other agriculturists have also opined that the livestock industry in Nigeria is currently underdeveloped and that by the creation of the ministry of livestock development will open up the industry which will be a huge money spinner for Nigeria.
Reports have shown that a Livestock Ministry can play a pivotal role in mitigating conflicts between farmers and herders by implementing policies and programmes aimed at fostering coexistence and sustainable resource management. The Ministry can work towards clearly demarcating grazing routes and farming areas. This would reduce instances of trespassing and accidental crop destruction, a common flashpoint for conflict. While introducing rotational grazing systems can ensure that land is used sustainably, preventing overgrazing and land degradation, establishing water points and boreholes specifically for livestock can reduce competition for water resources. Similarly, promoting the development of pasturelands through reseeding and controlled burns can improve grazing conditions.
According to a veterinary doctor, Dr Andrew Obadiah, by providing training for herders on sustainable livestock practices and for farmers on conflict resolution, both parties can understand the importance of coexistence. He said that extension services of the ministry can offer advice on improving livestock health and productivity, reducing the need for large herds and extensive grazing. “Setting up local committees involving both farmers and herders to mediate disputes can provide a platform for dialogue and peaceful resolution. Encouraging community-based conflict early warning systems can help prevent clashes before they escalate”, he emphasised.For Mrs. Stella Ugwu, a farmer, having a ministry dedicated to the development of the livestock industry can help in diversifying income sources for both farmers and herders and in turn reduce dependence on land.
”For instance, promoting agro-pastoralism can provide farmers with livestock and herders with agricultural produce”, she explained, adding that providing incentives for adopting sustainable practices, such as subsidies for fodder production or crop insurance, can ease economic pressures. Ugwu was however of the opinion that the creation of a new ministry to handle livestock affairs was uncalled for, since the job can effectively be done by the Technical and Service Department of the Federal Ministry of Agriculture and food security and its equivalent on the states level.In some countries, the establishment of a Livestock Ministry or similar bodies has shown promising results. For example, Ethiopia’s Ministry of Agriculture includes a dedicated department for livestock which has successfully implemented programmes to improve pastoral livelihoods and reduce conflicts.
In Kenya, the establishment of the National Drought Management Authority has helped manage resources better, thus reducing clashes between herders and farmers during dry seasons.The president of Miyetti Allah Cattle Breeders Association of Nigeria (MACBAN), Othman Ngelzarma, sees the Ministry of Livestock Development achieving the same feat for Nigeria in the near future. He told newsmen that, “MACBAN expresses its deepest appreciation to the Federal Government for creating a ministry of livestock to unlock the trillion-naira livestock economy and create qualitative and productive jobs across the value chain to improve the Nigerian economy. With this development, MACBAN believes the hope of the Nigerian pastoralists is now achieved under the Renewed Hope Agenda.
However, the Middle Belt Forum took a different view of the proposed Ministry of Livestock Development, saying it was not enough to sustainably resolve the decades-long farmers-herders crisis in the country. According to the National President of the association, Mr. Bitrus Pogu, what is needed to end the perennial farmers/herders clashes is a deliberate action by regulatory bodies and the government to stop criminal elements from carrying out deadly attacks on innocent Nigerians, mainly farmers. Hear him: “If the reason for creating the Ministry is to stop clashes, I think it is wrong because all of these attacks and killings that are happening have nothing to do with conflicts between farmers and herders. “Farmers have never connived at any given time to go and attack herders, but rather, criminals who happen to be Fulani gang up and attack farmers, kill, maim and chase them out of their ancestral homes.
“Then, the Fulani will come and occupy them. So, it is more about invasion, criminality, and terrorism. And the majority of those they hire to do these evils are not even those who have cattle. So, a deliberate action has to be taken by the government against the perpetrators, which will address the criminality.” Mr. Pogu suggested that the government should adopt ranching for productivity and enduring peace between the pastoralists and farmers in particular and the entire country in general.While the establishment of a Livestock Ministry presents a viable solution, it is not without challenges. Funding constraints, bureaucratic inefficiencies, and corruption can hamper its effectiveness. Additionally, deeply ingrained cultural practices and mistrust between farmers and herders can be difficult to overcome.
Critics argue that without a holistic approach that includes land reform, climate change adaptation, and broader economic development, a Livestock Ministry alone may not be sufficient. Therefore, it must work in tandem with other governmental and non-governmental bodies to ensure comprehensive solutions. “A dedicated Livestock Ministry, with its focus on sustainable resource management, conflict resolution, and economic incentives, offers a promising avenue to address the root causes of these clashes. However, its success depends on effective implementation, adequate funding, and the cooperation of all stakeholders involved. With the right strategies and commitment, devoid of any political or selfish interest, it can play a crucial role in fostering peace and prosperity in affected regions”, they advised.
Calista Ezeaku
