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Doctor’s Spectacle: National Insecurity In The Face of Fragile Health System

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By Dr Khalid Sunusi Kani

Do you know that “one-third of more than 700 health facilities in Northeast Nigeria, have been destroyed as a result of insurgency”? I was shocked the first time I laid my hands on the report released by the World Health Organisation (WHO) in the year 2016. Hmmmm, na wa woo! We don die…

Nigerians are vanishing from earth daily, not because of our negligence but as a result of the cluelessness of those responsible for safeguarding our lives and properties. Citizens are forcefully ejected from their heritage homes and blatantly separated from their loved ones. Our shelters are not safe, some were put ablaze by some mischievous personalities, the so-called “bandits, militants and Boko Haram.” Health Personnel are gradually evacuating from the areas where insurgency is on the rise. This is the architectural written description of the predicament of common people in Nigeria. These events have resulted in an abrupt change in the front pages of our newspapers to a near-death announcing space. If the present situation that we are living witnesses today continue, it will be very worrisome if care is not taken.

In the context of poor security, public health interventions and the delivery of healthcare to the individual are more difficult to perform and less likely to succeed than in the context of security. Violence – including the threat of violence – in such contexts results in injury, death, psychological harm, impaired development or deprivation. Insecurity therefore, potentially has a double impact on people’s lives and well-being; this is the reality of everyday life for many millions of people in Nigeria.

High insecurity, difficult terrain and lack of health workers, medicines, equipment and basic amenities such as safe water are making access to essential, life-saving healthcare services extremely difficult for people in these conflict-affected areas.

The rate at which the insecurity is going like a bat out of hell is very alarming. It has resulted in an indiscriminate geometric increase in the number of Internally Displaced Persons and Refugees in our country. Numerous researchers have shown the inextricable relationship between Maternal Motarlity, Under Five Mortality, and Malnutrition among Children with the insurgency. Insecurity worsens the health condition by causing numerous commotions and disturbances in the normal physiological and mental health of the indigenous people of the affected areas.

Hmmm, as I’m writing with my ink at this point, my heart is silently bleeding profusely, fully aware of the dilapidated health system that has been in existence for decades even before the worsening of the security situation. And could you imagine how the situation would be when augmented with the rascal behaviour of bandits, Boko Haram and Niger-Delta Militants? It would be just like adding salt to the wound. That simply defines the current condition in our country – “Insecurity In The Face Of Fragile Health System.”

There was a story of a pregnant woman with a poor financial background in Zamfara State, living in one of the Local Government Areas with the highest attacks by the bandits. She had an Intrauterine Fetal Death(IUFD), which means the baby died inside her womb, a few weeks before reaching her Expected Date of Delivery (EDD). However, this tragedy is related to the inability to access healthcare from the nearby Primary Health Care facility in their residential. The health workers were all transferred to other health facilities and most of all, they were not willing to stay in the village as a result of the perpetual kidnapping of their colleagues in the danger zones. That’s how she nearly spent nine months without attending Antenatal Care (ANC) clinic. Had it been the village is secured, it would have been a different narration. Unfortunately, she is presently depressed and placed on antidepressants and regular follow-up with the psychiatric clinic at a tertiary medical centre.

Truly, in a secured society, pregnant women would be able to attend ANC, and health workers could tackle preventable causes of poor maternal and perinatal mortality through early detection of dangerous signs of pregnancy and subsequently help the women to deliver safely without any complications. This sympathising story is one in a million; just a tip of an iceberg. That’s how insecurity continues to affect mothers and children in IDP camps. Hundreds are dying as a result of poor environmental sanitation in the camps as inhabitants of these camps keep battling with deadly infectious diseases, all as a result of insecurity in my country.

Nevertheless, the Nigerian Government has the greatest role and responsibility to play in securing the lives and wealth of its citizens. People’s security has been described as “a basic value because it is an essential requirement or condition of a successful and fulfilling existence; it liberates people (both physically and mentally) to get on with the business of building their lives without undue fear of those around them … It is also peace of mind: liberation from the anxiety and apprehension associated with fear of those who are in a position to harm us.”

The above mentioned description of personal security runs parallel to the “narrow” concept of human security described in the Human security report 2005: “it is about protecting individuals and communities from any form of political violence.” Given that the definition of health encompasses a state of complete physical, mental and social well-being, it is both logical and intuitive that people’s security, whether viewed collectively or at an individual level, is necessary but not sufficient for their health.

With the above mentioned assertions, we would be able to believe that we need health for peace, and as well, we need peace for health. Nevertheless, Government must do the needful to renew its strategic approach in bringing to an end, this unhealthy Humanitarian disaster that has made our healthcare to be severely destroyed. Yes, We Can collectively bring it to an end!

Dr Khalid Sunusi Kani is a Medical Doctor| Public Health Advocate| Public Affairs Analyst.
Drkano01@yahoo.com

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