Dr Rafiu Isamotu, is the Commissioner for Health in the State of Osun. In this interview with the duo of Nigerian NewsDirect’s Abimbola Abatta and Ayoola Florence, he speaks on the achievements of Governor Gboyega Oyetola’s administration in the Health sector and other sundry issues. Excerpt
What are the notable achievements that the Osun State health ministry can lay hold on to in the past two years?
Thank you so much. At the risk of being immodest, I think this administration led by Governor Gboyega Oyetola has laid on well in the area of health. As a matter of fact, when Mr Governor came on board, he made the health as the flagship of this administration. He believes in the dictum of health is wealth. Whatever you want to do, you want to go to school, construct roads, and all that, you must be healthy before you can do all that. Immediately he was inaugurated, sworn in, he set up a committee, Health Revitalisation Committee and Mr Governor himself was the chairman of the committee. I had the privilege of being the commissioner for health in the last administration. So, Mr Governor made me a member of that committee. The current Commissioner for Works, Engineer Oluremi Omowaye, was a member. The current Commissioner for Finance, Mr Bola Oyabamiji was there. The then Deputy Vice-Chancellor, University of Ibadan, Prof Aderintan was a member. Holistically, what we did was to look at where are the areas we have challenges and all that. We were so fortunate we won the grant, SOML. We came second in Nigeria. That was in 2018 from the smart survey that was done. There are some dramatic areas that they needed to look into. We came into governance to look at twenty million dollars grant. I do not think there has been any government that has embarked on that huge amount of work that we are doing. We are renovating and revitalising one PHC per ward in Osun simultaneously. We have three hundred and thirty-two wards in Osun. So, we are renovating three hundred and thirty-two primary health care centres. We have one thousand and twenty or thereabouts PHCs. Eight hundred and seventy-six are functional. Out of those that are functional, we are now renovating one per ward. There is no village, hamlet, town or city that does not belong to a political ward. So, invariably, our people at the grassroots level have been taken care of. Not only that, we made it what we call PHC under one roof according to WHO standards. What our people need at that level is not too much. We want our people to go to our health centres for them to be able to have their blood pressure checked. We want them to have their blood glucose monitored. We want our mothers, our wives who are pregnant to have basic antenatal done at that level. So, we will be able to use the stethoscope and all that. So, basic equipment that our people will need are what we have provided in those hospitals. We have equally provided drugs in those focal health centres that we have revitalised. Like I did mention earlier on, there is no state in Nigeria that has done that much. Moving away from there, at the secondary health care level, our biggest hospital in Osun is State Specialist hospital in Asubiaro here in Osogbo. As I speak to you, we’ve almost concluded, it will be about eighty percent completed. We are building 120-beds ward in Asubiaro. We are equally building 30-flat structure for our doctors. We want our doctors to be able to reside inside the hospital so that the idea of any doctor on call you have to send ambulance to find that place where that doctor lives. We want it to be a thing of the past. We are equally doing that. We have renovated our emergency department which has hitherto been destroyed by monkeys because of the proximity of that place to Osun groove. Laboratory, especially the blood bank has been renovated. The paediatric ward, maternity ward. We have a theatre there. That was the purpose for which it was built by the previous administration which has never been put to use. But we haven’t used it, yet it is in a state of disrepair. That has been equally repaired and renovated. That is the building that serves as the intensive care unit for our COVID activities in the State. Also, general hospital in Ejigbo and Ifetedo. Those who come from our state, they know the state of those two hospitals before the adventure of Mr Governor Adegboyega Oyetola. So, we have renovated our general hospital in Ejigbo and that of Ifetedo. We hope we would be able to include those two as part of the hospitals we commissioned as part of the two years anniversary. And of course benefit of hindsight. If we didn’t renovate general hospital in Ejigbo, we would have run into problems when we had the issues of returnees from Cote d’Ivoire from that axis. That was what served as our isolation centre then. The paediatric ward there was replaced to serve as an isolation centre, and we now have 130-bed isolation centre in Ejigbo. Of course, we are at the phase where the COVID-19 is exiting, not yet gone, but we do not use that place as our isolation centre now, but the kind of money that we have spent in that place is a money well-spent because we have actually renovated that place given a massive facelift and that of Ifetedo, as far as infrastructure is concerned. Look at other MDAs under health, especially our health insurance agency, OHIS, Mr Governor has given about four hundred million naira for people to campaign into premium for the vulnerable. Our people who are really really poor and cannot afford any health care… when pregnant women want to deliver it is free of charge. And of course, the treatment for any under-five child is equally free. So, that has been done. Mr Governor gave two brand new ambulances to Osun Ambulances in Asubiaro. One for emergency and one for us to have transfer to other hospitals and other towns. Of course, about few of our secondary health facilities were renovated. Staff clinic here in Secretariat and the staff clinic at the state Assembly. And of course government house clinic in the government house was equally renovated. Having spoken about that, for some time, now, we’ve found it difficult to retain our staff, especially doctors simply because we cannot pay as much as other states pay. So, when Mr Governor came in because he was part of the previous administration, he was the chief of staff then, he knew about the agitations of doctors as far as their pay was concerned. This has been the issue of revised Consolidated Medical Salary Structure (CONMESS) for doctors and consolidated health service scheme for other health categories. So, it was the idea of Mr Governor who said I want to pay them this certain percent consolidated salary scale for our health workers. We have started paying that from February. Of course, there is quite a lot of money to our doctors, nurses, pharmacies and all that. That was one of the achievements of Mr Governor. We couldn’t retain many of our doctors, our staff, especially consultants because we didn’t pay as much as neighbouring states that pay higher salary.
There have been hints that there may be a second wave of lockdown triggered by the Coronavirus pandemic. What is the ministry doing to avert another lockdown?
Well, in the first instance, nobody likes that because lockdown, even the first lockdown had adverse effects on our economy. Of course, if we had our ways, we would have done something else. However, that has been a very effective way of containing COVID-19. Even in the Western world, that was what they did. And of course, Mr. President Mohammad Buhari had to take action at the peak of the COVID-19 pandemic. Even before we had that general lockdown in the country, we in the State of Osun had imposed lockdown on our state. We believe that it will prevent people coming in from other states into our State because even the first index case was an imported case. So, if you are able to do that, it will go a long way in reducing the number of people that will have COVID-19. So, we knew it is a possibility of having another lockdown. But we are intensifying our efforts on our risk communication because people say prevention is better than cure. If we are able to enlighten our people that look, COVID-19 is still pretty much with us. It has not gone and basically what the NCDC guideline and what we told them is what we continued with. So basically our people need to mask up. Wear your face mask. Wash your hands regularly with soap and water. And of course, maintain social distancing. We will still let our people know that this has been really difficult. Simply because there are some folks who do not even believe in the authenticity of COVID-19. They don’t even believe that it exists. Even those who believe that there is COVID-19 they believe, that erroneous belief now, that COVID-19 has gone. It’s now pretty much difficult for us for that enforcement. If you go to Okefia now, Olaiya or anywhere to round up people and start imposing fines, the likelihood that people will revolt is there. So people will have what we call COVID fatigue. Everybody is tired about COVID-19. However, we do not let that one discourage us. We still continue with our risk communication. We still have our jingles on radios and TVs and of course, we continue with physical appearances in our news media both TVs and radios to let our people know that COVID-19 has not gone. It is still pretty much with us.
During the heat of the pandemic, do we have any Osun health workers who lost their lives?
No, to the glory of God, we did not lose any of our staff. However, we had a lot of our staff who had COVID-19 who tested positive. Doctors, nurses and other health workers. We did not treat our patients at the primary health care level. We thank God that we did not have that problem of staff who tested positive at PHC level. We have our isolation centres. One in Mercyland and one in Osogbo, OAUTHC Ile-Ife, we have one isolation centre there. So, majority of those who tested positive are people working in our isolation centres, and of course they are health essential workers who tested positive. But like I said, we thank God we did not lose any of our health workers.
President Mohammad Buhari approved that 40% of the health workers’ salaries should be paid. We gathered that essential health workers in Osun did not receive any form of payment. When will they be paid?
Well, that is the problem we have with our faulty federation. You know in Nigeria we practise federation, but it is not true federalism that we practise. A situation whereby, at the federal level, a decision is made for the state without taking cognisance the peculiar status of those States, those federating units. It is just like the issue of minimum wage. It has been approved by the federal government that all states should pay, not knowing that there are many states who cannot pay. In a true federalism, you will be able to pay according to your capacity, according to the money available to you. When the federal government did that, even before the federal government gave that blanket approval, we have been paying those who worked for us for COVID-19. We’ve been paying our staff. They are essentially our staff. Apart from their salaries, we paid them COVID-19 allowance for the job that they are doing. But it depends on their status. Consultants earn more than residents. Senior registrars earn more than registrars. So if we are able to do that based on what we have, we were not given any money to do that. And federal government said pay forty percent of their basic salary for COVID and all that. We have a situation whereby doctors who refused and told us that they will have nothing to do with COVID-19. And federal government want us to pay people. But we say no, if you have volunteered yourself, you have risked your life to help and attend to those who had COVID-19, we will pay you. I refuse to do so. Now, federal government came that regardless of whether you work for COVID-19 or not. We are still looking at it. But as I speak with you now, we only paid those who worked for us for COVID-19.
What are the challenges that this Osun health ministry has been confronted with since the assumption of office?
The challenge is not unconnected with paucity of funds. Quite a lot of things we would love to do but we’ve not been able to because of lack of funds. However, with that little delay, with the little money we have in the state, Mr Governor has been a hundred percent given us full cooperation as far as our needs are concerned. We want to employ more staff, but if I employ staff, we have to factor in even the recently agreed minimum wage, we’ll to factor that in. With the minimum wage, the state government assented to be paying at the end of this month that thirty thousand naira minimum wage. The bulk of the money, because of the approval and because of consolidated CONMESS that we have been paying our health workers and all that, we now have the issue of thirty percent together with it. That has taken a big chunk of the salary to our workers, especially the health workers. Even with that, the little money available to the state, we have been able to do that. I would have loved for us to now recruit more staff. But with the little money that we have, Mr. Governor has been able to assist us in that area, but as far as I am concerned as a medical doctor, because we really lack personnel in all our hospitals. Some of our hospitals cannot run two shifts simply because we do not have enough personnel to so do. As far as I am concerned, I know it cuts across, but that has been the major challenge to us. There are some consultants we would love to employ; we’ve not been able to, including some other categories of health workers. As far as we are concerned, anyone that works in the state government hospitals is important, even the cleaners are equally important as the surgeons that do surgery. So, we’ve not been able to get more staff, and of course, we want to replace our aging equipment and instruments. So everything still boils down to that paucity of funds. Mr Governor has equally assured us that we are going to do that. At least if we say we want to employ ten doctors, and according to the money we have, Mr Governor says you want ten doctors but I do not have money to pay for ten doctors, I have money to pay for seven doctors, we’ll accept it. Mr governor has assured us that we are going to employ more staff pretty much soon.
World Toilet Day 2020 is titled “Sustainable Sanitation and Climate Change.” Many households lack adequate toilet facilities because they are used to open defecation. How have you been sensitising the public on the import of open defecation?
In our state, we work in conjunction with some partners. UNICEF is championing a cause about open defecation. We have chosen three local governments. Number one is Ifedayo. That is the smallest local government where we have Oke-ila, Ora and others. And of course Odo-otin local government and Ayedaade. As I speak with you now, we’ve achieved the prevention of open defecation in Ifedayo local government with the help of UNICEF. Modern-day toilet facilities are being built everywhere. We have achieved that in that local government. We are still working on other local governments. This is the pet project of the first lady of the state, Alhaja Kafayat Oyetola. She is campaigning vigorously against open defecation in our state. We have been able to do that. Like I said, we want to start with three local governments. We’ve achieved hundred percent in one of them. But the remaining two, I cannot quote the percentage because I do not want to give you the wrong percentage. We know that public health effect of open defecation what it could cause, public health issues, we know the importance and we are making sure we are working assiduously to make the importance of doing so. There is campaigning in radios, print, and news media. We are working in conjunction with some partners especially UNICEF in building toilets for our people in the State.
During the course of the EndSARS protest, it was gathered that the Osun Health Insurance Scheme office was vandalised by some hoodlums, destroying properties worth millions of naira. What is the government doing in supporting the scheme in recovering the losses incurred during the protest?
Not only our health insurance office was vandalised and looted, but our central medical store is also in the same compound. That central medical store is where we kept our materials that we used for COVID-19 like PPE, hand sanitisers, face masks, thermometers, and drugs. It was massively looted and vandalised. Ditto for the health insurance office, so many computers, laptops, other electronic gadgets were carted away. But thank God I think they will have backup for about 90 percent of those things that were stolen. I don’t think we suffer so much about that. And of course our isolation centre in Mercyland. They removed all the television sets in that place, fridges, PPEs, some medical equipment. What they wanted to do with it, we don’t know. They actually removed the CCTV camera in that place. When they saw that it was a CCTV camera, they smashed it on the floor, but one of them thought this thing may still work, so they took it away. So it is really pathetic what youths. I won’t say youths, but those ones are criminals. They may not even be the one that participated in the protest because we warned our youths that of course it is their legitimate right if they want to protest, but it has never happened anywhere that you have an indefinite protest. It’s not done anywhere. You want to be protesting till the kingdom come. That was what happened. So, we have our own fair share of that. When the looting took place, Mr Governor gave seventy-two hours ultimatum to those who looted to bring the things they looted, not necessarily our own, but we were able to bring back twenty to twenty-two percent of the things that were looted. At least that is still something. A good number of the things that were looted have not been recovered. Those whose house looted items were found are now being prosecuted because Mr Governor had given them that ultimatum of seventy-two hours. You know some people participated in it not knowing the import of what they were doing. They just thought our friends are doing it, let’s join them. It was after that they asked why did I do it? It was those people that felt remorseful that brought the things they looted back. One of our isolation centres, the one in Mercyland, CACOVID gave us hundred beds of the bed-capacity. We have about one hundred and eighty beds. So what we did was to write to CACOVID and NCDC that the health centre you facilitated in building for us has been looted, and these are the items that have been carted away. Of course, it’s been built and given back to the state, they may want to replace those things. On our own, those things were just removed like that. Hospital beds were carried away. Those things that were carried away on our own we are replacing them.
Do you anything to say to our readers?
Number one, I will like to appreciate the governor of Osun Mr Gboyega Oyetola for all his cooperation and assistance towards my ministry. And of course, I thank my colleague, the Special Adviser to Mr Governor on public health, Pharmacist Dr Siji Olamiju for his comradeship. And of course all the permanent secretaries and all other staff of the ministry and other agencies in health. We appreciate them. But more importantly the people of the State of Osun that we have beautiful facilities. We want our people to use these beautiful facilities. There is no point in government in spending so much money in renovating and revitalising our hospitals for our people not to patronise them. So we want our people to use those hospitals and take ownership to see those hospitals as their own. People will say government hospitals. There is nothing like government hospital; it’s your hospital. It’s your own. Your money was used to build those hospitals and in renovating them. We want our people to take ownership of those hospitals to see it as their own because if you see it as your own, you will not do anything untoward to it. You will not let it to deteriorate. You will not want anything to be done to it to damage it. That’s what we want our people to do: to take ownership of those hospitals and patronise and use our facilities. Of course, people should take responsibility for their health.