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Nigeria: Making The Medical Mess More Muddling?

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By Bala Ibrahim.

In Nigeria, the medical situation has long been as confusing as it is problematic. The worrying or disturbing nature of Nigeria’s medical centers was one time used amongst the reasons for a military coup, when, on the 31st December, 1983, some concerned military officers ousted the democratically elected government of President Shehu Shagari, and installed General Muhammadu Buhari as Head of state.

One of the reasons given by the military officers then, as announced by their mouthpiece, the late Gen. Sani Abacha was that, the country’s hospitals had become mere consulting clinics. “Our economy has been hopelessly mismanaged; we have become a debtor and beggar nation… health services are in shambles, as our hospitals are reduced to mere consulting clinics without drugs, water and equipment.”

Nearly forty years on, with both Buhari and Abacha having taken control of the steering of leadership of the country, the situation seems to have only moved from frying pan to fire.

Current statistics show that health institutions rendering health care in Nigeria are less than 35,000. In fact the exact statistics puts the figures at 33,303 General Hospitals, 20,278 primary health centers and posts, and 59 Teaching hospital and Federal medical centers. This is for a country with a government approved population of 211,996,970 people.

Contrary to the World Health Organization’s recommendation of 1 Doctor to 1000 patients, the Nigeria Medical Association, NMA, is saying there are only 40,000 Doctors to cater for the country’s population. I am not good with Maths, so forgive me, but by my calculations, it means the Doctor/Patient ratio in Nigeria is almost 1 to 5,300. In the US the ratio is 26 doctors per 10,000 people and 28 in the UK. Therefore one needs not task his brain to understand the reason behind the long waiting hours suffered by patients seeking to see a doctor in Nigeria.

But despite these glaring shortfall, which is increasingly putting the position of the medics in more mess, Nigeria seems unperturbed by the plight of the few doctors, who are constantly going on strikes because of poor infrastructure and low pays in public hospitals.

To make matters worse, pursuant to the latest crisis that has put the Resident doctors in the country’s state-run hospitals on strike for almost a month now, and amid a resurgence of coronavirus infections, there are unpleasant remarks coming from those that ought to be more circumspect at a time like this.

According to the Minister of Labour, Dr. Chris Ngige, a medical doctor by training, Nigeria has too many doctors and is not suffering from a “brain drain”.

These remarks were made on a TV station on Wednesday, in response to the widely reported recruitment exercise conducted on behalf of the Saudi Arabia health ministry. Ngige argued that it is normal for a country with a surplus of goods and services to export them.

It is estimated that no fewer than 500 Nigerian medical doctors participated in the exercise, with all of them expressing extreme optimism to leave their country due to frustration.

Many observers blame chronic underfunding and the placement of incompetent and insensitive people in charge of the state of the healthcare system.

Dr. Osagie Emmanuel Ehanire is the current Nigeria’s minister of health, but a Wikipedia search of his biography, shows that with the exception of place of birth, which shows that he was born on 4 November 1946 in Warri Town, Warri South Local Government Area of Delta State, everything about him is as foreign as the American Oval office.

According to the Wikipedia, after his primary education, Ehanire attended Government College Ibadan in Oyo State for his West African School Certificate, where he excelled at his Higher School Certificate examination. Ehanire went on to study Medicine at Ludwig Maximilian University of Munich in Germany, qualifying as a Surgeon. He went on to the Teaching Hospital of the University of Duisburg and Essen and to the BG Accident Hospital in Duisburg, Germany for his post graduate education. In 1976, he attended the Royal College of Surgeons in Ireland where he obtained a postgraduate Diploma in Anaesthetics. He got his Board Certification in both General Surgery and Orthopaedic Trauma Surgery at the Medical Board of North Rhine Westphalia in Dusseldorf, Germany. In 1984, he became a Fellow of West African College of Surgeons.

Ehanire worked in Germany as a Resident Anesthesiologist, Resident Vascular Surgeon and Resident General Surgeon in Thoracic Surgery at various hospitals. He also served as Clinical Instructor, Fracture Internal Fixation Course at BG Accident Hospital in Duisburg, Germany. On his return to Nigeria in 1982, he worked at the University of Benin Teaching Hospital as Senior Registrar in the Department of Surgery (Orthopaedic Surgery), a position he held until 1984. Between 1985 and 1990, he joined the Shell Petroleum Development Company Hospital as a Divisional Consultant Surgeon. He also served at various times on the Medical Review Board of Edo State Hospital Management Board.

Above shows that probably apart from the mandatory NYSC, the minister had not done any medical training in Nigeria. How then can he understand the anger and anguish of those going through the frustrsting training system in Nigeria?

Yes, unless the aim is to turn Nigeria into a poor training ground for doctors, and muddle more the mess of the medics, the government must wake up and smell the coffee, by changing the tone and theme of the talks. They should move from the language of threat to those of temptation.

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