2022: Expert calls for holistic approach to revamp Nigeria’s health sector

Abimbola Abatta

… Harps on legislation for political leaders to utilise home brand

The Federal Government has been charged on the need to adopt a holistic approach to revamp the deteriorating health sector.

The government was equally tasked to implement legislation to ensure that political leaders make use of home brand in terms of health care delivery.

A health expert, Consultant and Infectious Disease Physician at Babcock University Teaching Hospital, Dr Charles John Elikwu, disclosed the above on Monday while highlighting the expectations from the government in the New Year.

Dr Elikwu, who emphasised that the Nigerian health sector needs to be overhauled, averred that Nigeria has all the human and natural resources needed to be one of the leading countries in the world.

He, however, cited corruption and selfishness as some of the factors escalating the problems of the health sector.

According to him, the government must set up a committee to study the effective and efficient health care delivery models in developed countries, adding that a holistic approach to the healthcare system will bring about infrastructure.

He also opined that the present government can put in place successful structures which subsequent governments can build upon to create a ripple effect on the transformation of the health sector.

His words, “The problems in the health system of Nigeria, just as our other basic problems, are as old as the country. They have been there for a long time. Looking at it both as a professional and believer in God, when the foundation is wrong, what can the righteous do? However, we all really desire to see a better country and in the New Year, we hope that things are going to be better.

“Nigeria has all the human and natural resources needed to be one of the leading countries in the world. Today, when Nigeria is referred to as Giant of Africa, it is like a mockery.

“The health sector needs a lot of overhauling, and we really need to learn. Even though we have had some health experts who have advised the government in the past, a number of things has been politicised in this country. But we will still keep advising the government to take on the advice from experts.

“In the health sector, there is inter-professional rivalry. We have so many professionals who are supposed to work together for the common good, but because of the inequality problems in the country, they are being distracted by fighting with each other. When they are doing something for a particular profession, other professions will want it to be escalated to them.

“This means the government really needs to do what we call a holistic approach. And to get a holistic approach, the government must be ready to set up a committee. And perhaps from the National Assembly or so, we may decide which model to follow. Is it the UK, American, Chinese or Israeli model? The government should send their representatives to any of these countries to study how the health sector is working there.

“The problem is corruption and politics. Corruption is such a great monster that has eaten deep into every fiber of our national lives. It is like a malignant disease. How many Nigerians are patriotic today? Most people are only concerned about what they will gain as a person before they will move start looking at collective benefits.

“During the time of former President Olusegun Obasanjo, it was said that at least one hospital per geopolitical zone will be upgraded to a centre of excellence. This doesn’t mean we will only have these six upgraded hospitals forever, but we should start from somewhere.

“So, even if they cannot start the project all at once across the 6 geopolitical zones, we are one country; the government can decide to start from one. For instance, the government could start from Aminu Kano Teaching Hospital, Kano State or University College Hospital, Ibadan. Wherever it is, the government should start from somewhere.

“There must also be legislation that our political leaders should make use of our home brand in terms of health. The National Orientation Agency has always laid emphasis on home brand, but what about the health sector? If the health system is not good enough to take care of our leaders, can we say it is good enough to take care of the ordinary citizen of the country?

“So, back to what I said earlier, the government should look at the model it’ll like to adopt. It is not compulsory to follow the American or UK model hundred per cent. We should study these models and come up with a hybrid sort of thing. We can see how we can adapt them to our local use, something that will work, and it must be backed up with appropriate legislation.

“If we don’t have leadership by example when it comes to utilisation of the health services, then we are still joking. When our leaders are to go for check up, and they are have to travel to some other countries, and those countries, you don’t hear their leaders going to other countries for medical checkup. They are always treated in their own countries. For instance, the US president can go to any hospital in any of the 50 states for medical treatment. And it was an intentional thing in these countries.”

He maintained that “we need to start by identifying models that we want to pattern ours after. We need to come to our political arena to decide and give it the legislative power, things that will make it work.

“The government can never be committed to making our health care service a first class one when our leaders are travelling out of the country for treatment. Of course, if they can afford it, they can go to other countries.

“We are not saying they should put a draconian rule because this is a democracy. But the truth of the matter is that even those countries that they run to, they also have citizens there. Why do the citizens believe in their health care system? It is because everything has been put in place. Health care personnel who are highly competent and professional are there. And in those countries, we have a number of Nigerians who are leading in some of their hospitals.”

Responding to the question that paying too much attention to the COVID-19 pandemic has been regarded by some as a disservice to other infectious diseases, he said “As a health professional, I can tell you confidently that it is not about what is less important. It is good to prioritise, but the Covid 19 pandemic we are having at the moment, and that we call it pandemic.

“Nigeria is not standing alone. It is a problem worldwide, and no country is an Island. In fact, there is no other time that countries of the world are more connected than this current age. Is it in terms of air travels, even aside the internet, as you and I are talking, a number of international flights are landing right there at the Muritala International Airport, and a lot are also leaving.

“Even right now that the air travels have been restricted there’s still some travelling. People still travel here and there. So the nature of Covid 19 being an infection that is transmitted through the respiratory root makes it peculiar, and this is not the first time the world would be in a situation like this. It is only looking more terrible so to say because in those times, the population of the world is not like this because every day, every month, every year, every country, every nation, the whole world is growing; there’s population explosion.

“So in 1918, there was a flu pandemic caused by another virus called Influenza A virus. If you check Google, at the beginning of this virus, people brought in some pictures of people back in 1918 using scarves to cover their mouths and noses, and some people are making this diction that ‘nothing is new under the heaven’. We keep recycling, and that is not the only time.

“We’ve had pandemic from time to time, and with Covid 19, it is a Coronavirus that has that has a high propensity for transmission. That is when one person is infected, that person can infect up to three or four person at a time. It is rapidly spreading. The mortality resulting from Covid 19 relatively may not be much compared to the death you’ll have if it’s Lassa fever. So in that case, we can say Lassa fever may likely kill, but thank God, those ones like Lassa fever and Ebola are not being transmitted in the respiratory root.

“If the same Lassa fever is to change and we have a variant (we’re taking of variant with Covid 19 like omicron), we are talking of mutation in genetics, and it produces another variant that can be transmitted through the respiratory root that means the whole world is in soup. However, Lassa fever is transmitted only by contact with infected body fluid from an infected person, maybe the vomit or the stool of that person and so on and so forth.

“So when it comes to infectious diseases, they are all important in their own line, but it requires a preventive approach that is peculiar to it on its own merit. There has been a lot of criticism, even some people are comparing it with malaria. Malaria is still killing, and it has killed many more people which is true. But the nature of the pandemic is such that we still need to address it.

“We won’t fold our hands. If we don’t do anything, probably Covid 19 would have been more devastating than it is in Nigeria. Also, when it comes to COVID 19, there is what we say Africa versus the rest of the world.

“At the beginning of the pandemic, there was this saying that dead bodies will litter the ground in Africa, but it has not played out. That means it is leaving some questions for research in the future. Are there some things in our genetic makeup as blacks because of some numbers of the infectious diseases that we have been exposed to as blacks?

“Infectious diseases are usually interpretated with poor economic situation. Infectious germ is all over the world, but in some countries of the world, there is nothing like malaria. If they see a single case of malaria in the UK or in the European Union or in the US, it’s reportable. They would flag it and quickly swing into action with measures to mitigate it. Whereas if a child is born today Nigeria, as the child grows, he will have one or two episodes of malaria. It will not be serious as an adult because malaria has been part of the child while the baby was still in the womb of the mother. But this malaria that we just brush aside by taking a rest for one or two days and we are okay, it can kill an adult who just flies in from the UK if you don’t treat the person properly.

“When it comes to infectious diseases, we in the health sector know some may be deadlier than others, but this one that is rapidly spreading, are we going to fold our hands and let as many people to be infected? And the more people are infected, then the more those that are prone to severe ailment of COVID 19 increase, and the more death we will have.

“This also comes down to the fact that when we have a holistic approach to our healthcare system, we put in place infrastructure. Through our own Nigeria Center for Disease Control (NCDC), we can say in terms of disease surveillance and mitigation prevention, we are doing better now.

“If you remember when we had the Ebola outbreak in the West Africa, and it flew over to Nigeria briefly, thank God we got over it through that expatriate who came in and landed in a private hospital in Obalende and from there, some people got infected. That’s how it entered Nigeria.

“Since that time, the NCDC has been doing well, and some of the infrastructure that has been put in place have been expanded upon. The government has upgraded them, and also at the beginning of this Covid 19. In terma of diagnosis now, we have a number of laboratories that are capable of diagnosing not just Covid 19, but Ebola or Lassa because they tried to use Ebola to build on it.

“Sometime last year, the WHO also praised Nigeria. Nigeria was listed as number four among countries that have a well coordinated preventive approach to Covid 19. That also translated to the Director General of the NCDC then who is now an assistant director general to the WHO. But as I said, NCDC is just a small parastatal of the entire ministry of health.

“There is still a lot of things that need to be put in place, that need to be restructured internationally for our health system to progress. If you check the NCDC site, you’ll discover that the NCDC is still giving regular update about even Lassa fever, Covid 19, and even cholera. Since the middle of last year, we have been having cholera outbreak in some places, and the NCDC has been updating Nigerians, giving them information that will help them prevent it because they all have their different approaches.

“Why are we still talking about cholera in Nigeria in this day and age? Cholera is a water associated, food associated infection due to poor hygiene condition. In Nigeria of today, how many people have access to potable water?

“It goes even beyond the health ministry. When I was young in the primary school in those days, even though we don’t have water in our house, we go to places to look for water, and in those days you don’t get tap water, you must go to the stream because you need water for everything, and then they will educate people on how we can boil water, use a white cloth and filter it.

“Since that time, Nigerians have lost confidence even in the quality of our pipe borne water. In those days, you will open a pipe borne water and you’ll see earthworm coming out of it. We were often told not to drink directly from the tap.

“When I travelled to Germany, I was told I could drink water from the tap anywhere, any day, and anytime. That is an organised community. They have a quality assurance and everything it takes. Even if you’re just building your house, they have organised how you are to connect your water, among other things. And they are confident that you can open your tap water and drink from it.

“If you look at it, it is like we still have a long way to go, but we can start. The journey of a thousand mile begins with a step. We can start with a step in a positive direction and put in place successive structures that when this government is out of the place, another government comes in, and their politics does not dismantle the structure. They will rather keep on building on the structure so that we can have a better community and a better health sector for our people,” he concluded.