Time to Rebuild The Nigerian Healthcare System
Sustainable development could be defined as development that meets the needs of the present without compromising the ability of future generations to meet their own needs.
An article published in the journal of Pharmacy and BioAllied sciences (J Pharm BioAllied Sci. 2011 Oct-Dec; 3(4): 470–478.), concluded that ‘The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well-grounded in routine surveillance and medical intelligence as the backbone of the health sector is necessary, besides adequate management couple with strong leadership principles’ (Welcome, M.O 2011).
What is the state of healthcare provision in Nigeria?
From my experience, the healthcare system in Nigeria is declining. In the 80’s I was privileged to use the University Medical centre at UNN for my primary healthcare needs. We had an organised primary healthcare system, where we did not have to pay at the point of care. My parent was a staff of the University, which meant I was entitled to free primary healthcare at the point of need. My experience with the University Medical Centre as a child growing up in Nigeria could be likened to my experience using the GP surgery in the UK.
We had our favourite family doctor who knew every member of the family. There was a functioning emergency service, although we had one ambulance, it served the purpose of ‘fetching’ the on-call doctor in good time and transporting sick patients from point A to B in times of emergency.
There was a pharmacy attached to the medical centre and even as a child I could notice that the pharmacy did not stock all essential drugs for malaria treatment. We had to buy our injection ampules, syringes, etc. from a private pharmacy nearby. I’m not sure why we could not stock the pharmacy attached to the medical centre, even if we had to pay for our pharmaceutical needs. Walking down to the private pharmacy was a time-wasting venture and I think stocking the pharmacy attached to the medical centre with essential medicines could have been a source of income generation for the medical centre.
I had a few overnight admissions in the private ward, malaria treatment often goes with ‘drip’ infusion which could last for up to 12 hours, so I had a few ‘sleep overs’ in the ward, of course I got the private ward and I received excellent nursing care from the nurses on duty. There was always a doctor on call as well.
So why am I telling this story, last year I went to a private healthcare facility in Nigeria, and the care I received was worse than what I got in a public healthcare centre over 30 years ago.
Recently, I read an article where a gentle man narrated how he lost his wife because there was no ambulance in a Nigerian teaching hospital to transport her from point A to B; the patient who had breathing difficulties gave up the ghost on the way to another hospital via public transport.
So, are we improving our healthcare system or are we going from bad to worse?
A pensioner residing in Nigeria narrated her experience with a US trained Ophthalmologists in Nigeria and I was shocked to learn that, in 2020 some medical practitioners hide the name of the medicine they recommend for their patients.
Some clinicians refuse to discuss disease prognosis with their patients. Why on earth should a pensioner with glaucoma visit a private eye clinic in Nigeria and the ophthalmologist would complete all the eye tests without communicating or discussing his/her findings; the patient was not told to continue or stop her eye drop, the patient was not told if her glaucoma was getting worse or better. Why are we always quick to charge thousands of naira for consultation fee but we are very slow in engaging with patients to improve medication compliance and concordance?
Nigerian healthcare professionals should up their game towards providing excellent patient centred care. If you have set up a private practice in Nigeria, you need to offer the same service you offered your patients in the UK and USA. Be the change you want to see. You also have a duty of care to improve the healthcare system in Nigeria and this should start from how you treat your own patients behind closed doors.
On the COVID-19 pandemic issue in Nigeria, it amazes me how some religious leaders who thrive in peddling misinformation and conspiracy theories have brain washed their gullible followers in Nigeria. Imagine what it feels like hearing a full-grown educated man say ‘COVID-19 is a scam’. These are people with access to internet, data and google. They listen to the news; they see the frequent updates from the NCDC and yet they still believe COVID-19 is a scam just because their ‘daddy’ told them so.
How did we lose all sense of reasoning and why are so many people against the practice of preventive measures, respiratory hygiene and hand hygiene? I have heard about a certain Governor in Nigeria who goes around saying there is no COVID-19 in his state. If we have such people in leadership positions, what then is the fate of the common man on the street?
This is the time for us to begin to look inwards, we are recording increasing number of deaths due to COVID-19 on a daily basis; more and more people are also testing positive. We have to take the preventive measures seriously and we have to develop strategies to improve our healthcare system.
We need to hold our leaders accountable and demand for a practical strategy that would afford us a functional healthcare system though the provision of Universal Health coverage ‘peri/ post’ COVID-19 pandemic.