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Editorial

Brain-Drain: Nigeria’s teeming population challenged by health sector’s man-power crisis

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Dearth of professionals in Nigeria’s critical  sectors have been growing at disturbing height. The trend has hit the  health sector so hard that the problems associated with huge deficits in man-power have worsened to a profile of deep crises, requiring urgent attention. Poor conditions of service and the lamentable apparent perpetual passive concern of the Government to the defective issues challenging the sectors have constituted grounds of dissatisfaction for health professionals. The expression of displeasure with grievances taking the form of incessant industrial actions have never changed the narratives of the disposition of the Government to the sector. Today, the profile of public health system in the Country still remains unsavoury. Strike by health professionals under the employment of the Government over the years, became a redundant feature of the sector, while the critical issues of concern remain largely unaddressed.

As more health professionals grew to develop dissatisfaction over the system, losing hope on same for the years of irresponsive disposition of the Government, the resort of many have been settled on fleeing the Country for greeener pastures. The phenomenon which has grown to be known as “brain-drain” has left Nigeria’s health sector deserted of health professionals. The profile of the upside records of Nigerian trained health professionals leaving the Country yearly have been worrisome, just as several thousands are on the look for their move out of the Country, for greener pastures.

The Nigerian Medical Association (NMA) on Monday, 04, April, 2022, disclosed that no less than 9,000 medical doctors fled the Country for greener pastures in two years. Their destination were noted to be largely the United Kingdom, United States of America and Canada. Statistics of records since the period of concern (2016 and 2018) have left the health care system with only 4.7% of specialists to manage Nigerians’ health concerns – development experts have lamented to have left negative impacts for health management in the Country. The rippling effects of the deficiencies have seen the Country losing billions to medical tourism.

In lamentation, NMA President, Professor Innocent Ujah, at the NMA’s maiden annual lecture tagged: “Brain Drain and Medical Tourism: The Twin Evil in Nigeria’s Health System,” had disclosed that over $1 billion was being spent yearly by Nigerians on medical tourism. He had decried the high emigration rate of doctors of Nigerian extraction to foreign nations, regretting a situation of health workforce crisis. The Don who had noted that human resources for health, which according to him, represented “one of the six pillars of a strong and efficient health system,” was critical to the improvement of health system, said the huge amount Nigerians were injecting into medical tourism has weakening effects on Nigeria’s economy. According to Ujah, the impacts of the ugly phenomenon on the economy, include reduction of funding and investment in the health sector, widening infrastructural deficits and the growing distrust in the Nigerian health system by the Nigerian public.

“According to the World Health Organization (WHO), sub-Saharan Africa has about 3 per cent of the world’s health workers while it accounts for 24 per cent of the global burden of disease. Nigeria has a doctor-to-population ratio of about 1: 4,000-5,000 which falls far short of the WHO recommended doctor-to-population ratio of 1:600. Nigeria is still grappling with disturbingly poor health indices. The Nigerian health sector today groans under the devastating impact of huge human capital flight which now manifests as brain drain.

“The twin monster of brain drain and medical tourism seems to have a bi-directional relationship, which implies that one will lead to the other and vice-versa. It is because of the devastating consequences of this twin evil on the health system efficiency and effectiveness and the urgent need for solutions and action that inspired the theme for this maiden NMA Annual Lecture tagged, ‘Brain Drain and Medical Tourism: The Twin evil in Nigeria’s Health System.’  The burning desire of NMA to proactively confront the many challenges of healthcare delivery in Nigeria must be sustained using evidence-based constructive engagement, high-level advocacy and understanding to achieve quality healthcare for our people so as to reduce the unacceptably high morbidity and mortality. This national discourse on brain drain and medical tourism is, therefore, inevitable at this time,” he was quoted.

The impacts of these trends are, by no small means, inimical for a nation under the stress of population explosion. The paradox of alarming dearth of health professionals in the Country, amidst population explosion is worrisome. On Monday, 1st, August, 2022, at a press briefing in Lafia, the Nasarawa State capital, during the 23rd Annual National Scientific Conference tagged, ‘Covid 19 Experience: Expanding The Role of Health System Pharmacists,’ the National Chairman of the Association of Hospital and Administrative Pharmacists of Nigeria, Olabode Ogunjemiyo, mentioned that poor service conditions were responsible for the brain-drain in the health sector. He pointed out that between January and July 2022, over 200 pharmacists had left the country to foreign lands in search of greener pastures. He was quoted, “Poor condition of service is the reason for brain drain in the health sector. Since the year began, over 200 pharmacists have left the country in search for greener pastures. And in order to check the trend, the federal and state governments need to set aside substantial resources to upgrade all our health centres and improve on our welfare packages.”

The realities before the Country is such that demand a responsive health system. The growing population, reflecting an explosive dimension, would only require that there be conscious investment in the health system for a robust architecture to cater for the demands of a population growing in such dimension. The poor commitment of the Government to the challenges of the health sector has been lamentable, apparently reflecting insensitivity to the demands from the sector pari-passu the realities of a growing population.

Commitment of huge investments to revitalise the public health system of the Country is a necessity before the Government to fulfil. The Government must live up to the expectations of developing a virile health system responsive to the demands of the Nigerian population.

As observed, large population is a source of national strength, however, in as much as such remains a potential power, it could also serve as debilitating factor. The expression of the later, finds reflection where a huge percentage of the population is saturated with unhealthy persons, who, a bad health system is unresponsive to addressing their health challenges.

To save the Country from unmanageable health crises, the Government must rise to the demands of reconfiguring the public health system of the Country. The demands for such, require nothing but an overarching concentration and deliberate commitment to the necessity of developing a responsive health system, correspondingly suitable to the realities of the growing complex population, and the challenges associated with same as health is concerned.

The troubles of the sector, which have left it unattractive and unsavoury for practitioners, must be addressed to avert the heat of looming crises which rising dearth of professionals is portending. Addressing the various issues relating to poor conditions of service, creating by the desertion for greener pastures, a vacuum brewing an alarming man-power crisis in the sector, is a necessity that must be addressed concertedly with much alacrity.

Editorial

Endless turnaround maintenance of Port Harcourt Refinery

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Since 2021 when the turnaround maintenance of the Port Harcourt Refinery started, there have been heaps of failed promises of the production commencement date.

First, it was former Minister of State for Petroleum, Timipre Sylva promising severally of commencement of productions of Port Harcourt Refinery, but these promises never came to limelight till he resigned for political calling.

Next was the Managing Director of Port Harcourt Refinery, Ahmed Dikko who at a time said the turnaround maintenance was 98 percent completed and would have commenced operations in December 2023. That promise again was unfulfilled.

The Group Managing Director of Nigerian National Petroleum Company Limited (NNPC Ltd), Mele Kyari equally said that Port Harcourt Refinery would start production in two weeks time, that elapsed in April, 2024. April has come and gone.

The Head, Corporate Communications of NNPC Ltd, Olufemi Soneye was also quoted to have said that the reason for non-commencement of operations of the Port Harcourt Refinery was regulatory and compliance tests. As it seems, all efforts to restart the operations of the Port Harcourt Refinery and by extension other refineries, have been futile.

Political watchers have adduced poor management, corruption, sabotage and lack of political will as some of the problems confronting smooth operations of our refineries. They particularly accused those benefitting from importation of petroleum products as being responsible for the non-functionality of the four refineries in Nigeria.

Political will, of course, plays a major role in shaping directions the policies go. Political will in this instance translates to good leadership, and in this case, the buck stops at the table of the Federal Government, particularly the President, who doubles as the Minister of Petroleum.

Petroleum being the mainstay of the country’s economy should be given all the attention it deserves. The reason being that virtually everything in the country is tied to the petroleum products situation.

Since the announcement of the removal of fuel subsidy on May 29th, 2023 by President Tinubu on assumption of office, life has not been the same in Nigeria. Cost of living has  risen astronomically, consequent upon the hike in price of petroleum products.

In the midst of plenty, courtesy of the abundant human and material resources, Nigeria is still often described as the poverty capital of the world. What an irony! Turnaround maintenance of the refineries subsists without end. Every hope is now placed on the Dangote Refinery, a private outfit. While the diesel price slash is commendable, how on earth will a single private entity take the whole country to Eldorado?

We cannot regulate what we do not produce, this is a natural principle that cannot be contravened. We only pray that Port Harcourt Refinery comes on stream someday.

We look forward to that time. Our position is that Government agencies saddled with the responsibility of providing fuel and other petroleum products to Nigeria must do their work and justify their pay.

This onerous task is mandatory and statutory to them and shall amount to disservice if they fail. Our prayer is not for them to fail, but that they fulfil their vows and make the country great for the overall interest of all.

Tecnimont, the Italian company undertaking the $1.5 billion rehabilitation project of the Port Harcourt Refinery has through its Local Managing Director, Gian Fabio Del Cioppo pledged to fulfil the terms of contract, so as far as we are concerned, there is nothing stopping the country from achieving the target of the turnaround maintenance project.

The only clog would of course be lack of political will, which we know could be cultivated. So let all hands be put on deck to achieve results.

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Editorial

Gas explosions: Nigeria and its avoidable tragedies 

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Nigerians die daily for reasons  so avoidable it would make  a 19th century peasant weep.  The deaths are often a product of systemic wickedness, nonchalance, and greed. Too often have gas explosions claimed the lives of Nigerians untimely. Whether it is the leaders refusing to enforce the checks and balances for personal gain, or citizens selling defective gas cylinders, it all balls down to a collective aversion for kindness.

The internet is rife with news of this tragedy occurring in a Sisyphean cycle. Jolted by the cries of the populace, the leaders promise reprieve, release press statements and in the weeks that follow, little to nothing happens. “One must imagine Sisyphus happy,” Camus wrote. Unfortunately, our Nigerian dead imagine nothing.

While people relaxed from their labour, were preparing for the Workers Day celebrations, nine people including a pregnant woman were injured in Tuesday’s gas cylinder explosion at Alaba Lane, Alayabiagba Community of Ajegunle-Apapa, Lagos.

“The fire explosion started around 1:30 pm and immediately, two tricycles were burnt, school children coming back from school were affected. A particular young man was seriously affected as his body was peeling off, but rushed to the Gbagada General Hospital,” according to reports.

The usual suspect is, of course, negligence, as the Director of Lagos State Fire and Rescue Service, Margaret Adeseye, puts it: “preliminary investigation revealed that several various gas cylinders traded within the neighbourhood have one triggered from a susceptible leakage leading to the snapping of a high tension cable and resultant Fire.”

The explosion razed down “four commercial tricycles, six lock-up shops, a bungalow part of properties, while salvaging adjoining structures including a major fuel service station.” Children were hurt, the future of the nation plunged, as usual into avoidable misfortune.

The way out is through. The press releases are wonderful PR statements but they do not bring back the dead, as was the case in Ogun State recently where a truck explosion cost the nation another life. The leaders must enforce the checks and balances put in place. The law is no decoration.

We mustn’t wait until a politician’s family member is involved in a tragic gas accident before “banning” (as is the default response of the Nigerian leadership). The leaders must realise that such misfortunes are contagious, and money is hardly a bulwark against 3rd degree burns in a nation where all its doctors are fleeing.

Renewed Hope requires renewed action. This is all that Nigerians ask of its leaders. All agencies responsible for monitoring trucks, cylinders need to work together to defeat this peculiar evil. Like COVID-19, gas explosions are no respecter of persons.

Of course, citizens too must do their part and resist the allure of profit over the death of others. A society without empathy is headed for a dystopia. It will not matter the price of petrol or electricity tariff, if all that matters is the pursuit of super profit at the expense of one’s neighbour. We owe it to the dead to live fully and graciously. To escape, as we should, avoidable tragedies.

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Editorial

Nigeria must act now to mitigate flood disasters

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As the rainy season looms ahead, a palpable sense of concern grips the nation.The recent cautionary message from the                      Federal Government to 31 state governors  regarding the looming threat of floods from April to November serves as a wake-up call, demanding swift and concerted action from both state and federal authorities.

Presented by Minister of Water Resources and Sanitation Joseph Utsev, the 2024 Annual Flood Outlook paints a bleak picture, underscoring the urgent need for preemptive measures. It is not merely an emphasising advisory; it is a resounding call to arms.

The spectre of past flood calamities in Kano, Taraba, Lagos, and other states still haunts our collective memory.

The haunting images of devastated homes, displaced families, and shattered livelihoods serve as poignant reminders of the human toll exacted by our complacency.

It is imperative that we glean lessons from these tragedies and take proactive steps to forestall the impending catastrophe.

The warning issued by the Federal Government is crystal clear: floods are imminent, and the time to act is now.

The Nigeria Hydrological Services Agency’s classification of 148 local government areas across 29 states, including Lagos, Kano, and Delta, as high flood-risk zones emphasising the gravity of the situation.

Every moment of inaction heightens the risk to countless lives and properties. State governors, local authorities, and relevant agencies must set aside differences and collaborate effectively to implement robust flood preparedness and mitigation measures.

From infrastructure reinforcement to early warning systems and community awareness campaigns, a comprehensive approach is imperative to safeguard vulnerable communities.

As responsible stewards of our nation’s welfare, we cannot afford to be caught off guard. Let us heed the warning, unite in purpose, and proactively address this looming threat.

The cost of inaction is too grave to contemplate, and the time to act decisively is now. This is not a drill.

The minister’s revelation that 31 states face high flood risks, while all 36 states and the Federal Capital Territory will experience moderate flooding, demands immediate attention and collective action.

“The high flood-risk states are Adamawa, Akwa Ibom, Anambra, Bauchi, Bayelsa, Benue, Borno, Cross River, Delta, Ebonyi, Edo, Imo, Jigawa, Kaduna, Kano, Katsina, Kebbi, Kogi, Kwara, Lagos, Nasarawa, Niger, Ogun, Ondo, Osun, Oyo, Plateau, Rivers, Sokoto, Taraba, Yobe,” the Minister said.

We cannot afford to wait until the waters rise and lives are lost. The time to act is now. It’s imperative that federal and state governments, agencies, and local communities join forces to mitigate the impact of floods.

This requires a coordinated response, including public awareness campaigns, infrastructure upgrades, emergency preparedness plans, and investment in flood mitigation projects.

The future of our nation depends on it. Let us heed the warning and take proactive steps to build a more resilient Nigeria, where lives and properties are protected from the ravages of flooding. The clock is ticking; let us act now to avoid a catastrophe.

While 31 states face high flood risks, the remaining five states must also be proactive in their preparations. It’s not enough to simply warn residents to relocate from flood-prone areas; state governments must provide safe and conducive spaces for relocation, complete with essential services like relief materials, healthcare, and security.

This will help mitigate the trauma faced by displaced families. Citizens, too, have a critical role to play. They must be willing to relocate from their homes and comfort zones to prevent avoidable deaths and losses. The stark reality is that flood disasters are devastating, as seen in 2023 when 45 lives were lost, 171,545 persons displaced, and 22,666 homes partially damaged, with 5,358 others completely destroyed.

The economic toll was equally staggering, with a $4.6 billion bill that significantly dented Nigeria’s GDP. Let us learn from the past and take collective responsibility for flood preparedness. State and federal governments, agencies, and citizens must work together to build a more resilient nation, where lives and properties are protected from the ravages of flooding. The time to act is now.

In 2022, flooding claimed 662 citizens; 2.43 million others were displaced and 3,174 were injured nationwide, per NEMA.

The financial losses were estimated at $9.12 billion by the Federal Government, and by a United Nations agency at $7 billion. A UN report stated that food insecurity was aggravated in the country as 569,000 hectares of farmland were destroyed by the flood.

According to the then Minister of Water Resources, Suleiman Adamu, 178 LGAs in 32 states were declared “highly probable flood risk states.”

Although climate change remains a global concern, leading to flash floods, droughts, forest fires, and cyclones, the government must not make excuses.

They need to take lessons from previous floodings and replace their nonchalance with strategic actions and campaigns. They must do all they can to avoid the repetition of losses of lives and properties.

The citizens must play their part by clearing drainage in their vicinity, cultivating good waste disposal and environmentally friendly culture. To entrench this, the government must place strict surveillance and enforce stiff penalties against erring residents.

State governments should demolish structures erected on flood paths to enable rainwater to drain appropriately.

NGOs in the environmental niche should activate campaigns distilled in local languages through the media to prepare citizens for the flood.

The federal and state governments should be proactive in the deployment of ecological funds to provide guardrails against natural disasters. This must be used for pre-emptive measures like building bridges, desilting rivers, evacuating canals and drainage, and building dams and levees. The dams would help preserve excess rainfall to irrigate farmland during the dry season.

The government must fully embrace its onerous duty to safeguard lives and properties.

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