Oluyombo Awojobi is an innovative primary care surgeon in Eruwa, Oyo State, Nigeria.Â His focus is on making basic and appropriate technology work in delivering care toÂ the bulk of Nigeria’s population, especially in rural areas.Â Below he has shared his thoughts on the weakness of the grandiose. We agree with his perspective and doubt whether six regional mega hospitals will help eliminate one of Nigeria’s main killers – malaria – in the near future.
Nigerians have a penchant to use the superlative in describing events, institutions and personalities. For example, the country is the GIANT of Africa, members of the national football team are the SUPER eagles, Lagos, the old capital is the centre OF EXCELLENCE and plans are afoot to make it a MEGA city. Being a petroleum exporting country, there are MEGA petrol stations. In religious circles, there are the MOST HOLINESS, the MOST REVD SENIOR APOSTLE PROPHET DR Abrahams, the head of an orthodox religious denomination has transformed from the SECRETARY to the PRESIDENT. When the old market is renovated, it becomes an ULTRAMODERN shopping plaza with no functioning toilets!!
The health sector is not left out. Over three decades ago, the teaching hospitals in the geopolitical zones became CENTRES OF EXCELLENCE in neurosciences, cardiovascular medicine/surgery, oncology and immunology. That was the golden era in medical practice in Nigeria when these public institutions were blazing the trail in open heart surgery, renal transplantation, Siamese twins separation etc.
With economic depression and corruption in high and low places, the decline set in until the advent of the third republic in 1999 when the civilian government initiated the Famed programme that would turn the teaching hospitals into world class centres and stem the outflow of Nigerians to foreign countries for medical care. A decade later, the teaching hospitals are still prostrate. In some, their laboratories and investigation units have been outsourced to private outfits.
Although the federal authorities had identified the challenge as that of poor work ethics and SURGICAL TURF PROTECTION, they seemed not to know how to set about rectifying it. The latest effort is headlined â€œGovt begins MEGA hospital projects in six zones.â€
â€œHealth Minister, Prof. Onyebuchi Chukwu, who inaugurated the panel, tasked the members to conduct a critical analysis of low private sector investment in high-end specialist hospitals and medical diagnostic centres in Nigeria.
â€œThey are also to identify and engage potential investors with a view to guiding them to develop business models and plans for the establishment of world-class hospitals in the country.
â€œThe team will also look into and propose an accreditation scheme that would ensure full compliance with global best practices in the operations of the proposed facilities.
â€œChukwu said: â€˜As many of you have observed, tertiary healthcare services in Nigeria have been largely in the domain of the public sector. However, inefficiency in resource management and service delivery, and the ever dwindling financial resources per capita for the health sector have made it difficult for many of the government-owned hospitals to keep up with global best practices
â€˜The associated failure to provide high-end medical services in many instances coupled with globalisation has resulted in loss of patients to medical tourism with its attendant capital flight from the economy further worsening the economic situation in the country.Â In the circumstances, it is obvious that government alone cannot provide all the facilities needed to provide adequate healthcare services to the teeming population, now at 167 million and still expanding. These issues have been a source of concern to the President who in his transformation agenda for the health sector has decided to engage the private sector under different models of Public Private Partnership.â€
The question that bothers me is â€œWhy should charity not begin at home?â€. In countries that are attracting Nigerians in medical tourism, the infrastructure (electricity and water supply) is solid as is relative security and services from top to bottom are rendered by dedicated and efficient staff.
Most major surgeries known to man are routinely performed in Nigerian hospitals â€“ mainly private, but out of the reach of most patients who are wary of the dedication of the specialists.
The other day at the maiden Free Medical/Health Outreach provided by Primus Super Specialty Hospital, (an Indian group) Abuja in collaboration with the Health and Human Services Secretariat of the Federal Capital Territory Administration (FCTA), the Indian High Commissioner in Nigeria was quoted as saying:
â€œThe Indian government has advised Nigeria, to improve on the standard of health care facilities in order to ease the difficulties faced by Nigerians who go abroad for medical attention.
â€œIt is difficult for a sick person to travel, and it is even more difficult when you are seriously sick to travel that distance, and it is only humane for us to endeavor to come closer to the patients as possible.â€ India is the country where most Nigerians travel to receive surgical care.
Three years are not too long as incubation period for the mega hospitals project. We will â€œSIDDON LOOKâ€.
With kind regards. Yombo Awojobi