(32): Re: Misdiagnosing patients in the Nigerian healthcare system

The article last week on the above subject attracts a lot of attention, and I would like to share one of the reactions that provided another perspective, sent  by Dr Suleiman BM (mbskt@yahoo.co.uk ). Jameel

 

I decided to take some time out of my busy schedule to contribute on this important topic. First of all, I am a medical doctor. Wholly trained in Nigeria by the Nigerian educational and health system. I am a Pediatrician. Secondly, I have been a hospital administrator as a CMAC from February 2009 to Sept 2012. Thirdly I have been involved in the training of medical students during my fellowship years between 2003 and 2007. I hold two fellowships of the National Postgraduate Medical College of Nigeria and the West African Postgraduate Medical College.

The problem of misdiagnosis happens all over the world, no doubt. We are however more aware of our own immediate surroundings. If one is in the field of public health, he will recognise that virtually all African countries and most Asian countries have weak health systems and are therefore battling these problems.

One issue I have observed during my time as a resident doctor is the “quality” of students being admitted to study medicine. When the student is admitted because of who he knows, not merit, the result will surely be what we are now experiencing. But as a hospital administrator, I will tell you we see the quality of the products being churned out as house officers from our universities. Yes, I agree that the standards have fallen. But many are still good.

 

The bad ones are still few and with adequate supervision, you can polish most of them. Medicine is an apprenticeship programme. After you get the knowledge, you need to work with an experienced senior doctor to get the needed skills to practice adequately. That is where most of our governments have gotten it wrong when young graduates are allowed to function and practice alone without supervision. We do need to get back to the drawing board on the issue of adequate experience and on the job training.

We should not forget that all medical equipment are now essentially computers. One thing that is common with all computers is that they are shut down, not switched off. One big issue we face as administrators in provision of equipments in the hospital is constant breakdown because they are switched off many times a day by PHCN.

 

The health service sector cannot work in isolation. If power is not improved upon, we should forget about getting state of the art hospitals that are affordable. Go to Redington and Lagoon hospitals in Lagos. They are state of the art, but not affordable to generality of Nigerians. Have you ever wondered why hotel fare is more expensive in Abuja than in London? The government needs to generate power for us to progress; otherwise, progress will remain a dream.

However, more than 70% of cases presented to hospitals can be diagnosed by the bedside with minimal investigations. To me, the most important issue we need to address is with all of us Nigerians… attitude. We talk of empathy in healthcare sector as against sympathy. I was at the Nigerian High Commission in London on Monday. I saw a small Nigeria within London. Even the community surrounding the commission has not changed our ‘ways’.

We all need to work on our attitudes and love our brothers more than ourselves. I believe there is a hadith (saying of prophet Muhammad, upon whom be peace) related to that; “None of you is a believer until he loves for his brother what he loves for himself”, otherwise “your iman [belief] is not complete”. All health workers in particular need to change our attitude for our system to move forward.

I don’t know how many of us have been to a typical general hospital set up in Nigeria. I have worked in general hospital Katsina outpatient department as a young inexperienced doctor. I was presented with one hundred and fifty patients to see in one day. Even today, go and do a study in any general hospital. The story has not changed. I left general hospital because I could not cope with the work without cheating the system. I was feared for my iman. It is impossible for any doctor, no matter how good, to treat even hundred patients properly within one working day.

Like I said earlier, this is just a contribution, introducing the tip of the iceberg of the problems bedevilling the Nigerian health care delivery system. My advice, however, to all of us that feel we can contribute to the system is to go back home and see what we can do. I am in the UK for a master’s study. I will go back insha Allah when I finish. Some of us have decided we will remain in Nigeria and see what little difference we can make. And we can really do a lot.

(31): Misdiagnosing patients in the Nigerian healthcare system

After writing a piece in this column entitled “new hospitals, new corruption, new challenges”, the article elicited one of the highest responses, and many of the readers shared their experiences with me via email. One of the key issues that they drew my attention to was the issue of misdiagnosing the illnesses of patients, but once they travel to either Egypt, India or UK, they are told that, they have been wrongly diagnosed, and within a week or so after treatment they become normal. To address the reasons behind this problem, I have invited Dr Jaliya Braimah (jaliyaadda@hotmail.co.uk), a highly experienced medical doctor in Manchester with a comparative understanding of Nigerian and UK healthcare systems as a guest columnist. The original title of his article was “Reasons behind Misdiagnosis of Patients’ illnesses in the Healthcare systems of Nigeria”. Enjoy. Jameel

It is universally accepted that no healthcare (HC) sector in the world is spared the unfortunate issue of making a wrong diagnosis of diseases afflicting patients under its care. Although this article is on Nigeria, it should not be seen as purely an issue peculiar to the Nigerian HC system alone. However in developed countries at least, such events are the exceptions and whenever they occur, they are thoroughly investigated, lessons learnt from the mistakes and recompense given to victims where appropriate. There is no evidence at the moment that such investigations are a normal practice in Nigeria.

The main reason for writing this article is to highlight a few of the important reasons behind our doctors’ inability to make the correct diagnosis of diseases in Nigeria. For ease of discussion, I’ll like to separate this under three sections i.e. the ‘Doctors factors’, the ‘facilities factors’ and the ‘Patients factors’ although these three do overlap extensively.

Doctors’ factors

Nigerian universities have historically produced and still continue to produce some of the best medical graduates in the world. However, the recent economic/political climate has meant that the standard of training has become progressively worse. Overcrowding in our medical schools leading to very low teacher student ratio has resulted in sub-optimal training in most places. This has a direct impact on the quality of the graduates with increasing numbers becoming less able to attain the minimum standard required to cope with life as doctors. This phenomenon is true for both the undergraduate and post-graduate trainings. As a consequence the patients suffer. For example every case of fever is then treated as typhoid/malaria despite evidence to the contrary.

The 2^nd most important reason for misdiagnosis is what I call the ‘I know it all syndrome’ where doctors find it impossible to simply say to a patient “I’m sorry I just do not know what is wrong with you”. Hence there is a failure to suggest referral to a colleague who may be better able to help. The old medical dictum of ‘First do no harm’ will remain relevant till the end of times! In fact, patients are better left alone with their illnesses than putting them through an intervention which may cause them more harm. In this regard the behaviour of this group of doctors is not any different from that of our traditional native ones (the Babalawos).

In addition, the art of making a correct diagnosis in Nigerian Hospitals depends largely only on physical examination of the patients at bed side because of limited lab/imaging support. No matter how well trained a doctor may be, if they find themselves in a hospital with little/no access to experienced colleagues, they will struggle to make correct diagnosis. This is the experience of many NYSC doctors who work (especially) in rural areas where cases often come in late and are therefore more complex to manage.

‘Facilities factors’

There is no doubting the fact that modern technological development has made a big impact on the tools available for investigating diseases more accurately. Except for a few centres, most of these tools are lacking in Nigerian hospitals. This is the reason why experience of using them is lacking which means doctors do not get trained to use them, hence the patient suffers as a consequence. It is also true that even in the few hospitals with these facilities, when patients undergo such investigations, the results are sometimes not interpreted correctly, thus emphasising the need to ask for help from more experienced colleagues.

‘Patients factors’

The fundamental reason why issues of poor diagnosis will persist for a long time is due to the largely uneducated nature of our population. This means that patients are not able to challenge any decisions made on their behalf because they perceive seeing a doctor as a privilege/favour rather than as a matter of constitutional rights! Doctors are seen as demi-gods who are to be worshipped as they can do no wrong.

Another factor to consider is the fact that the Nigerian society is one of the most unbalanced in the world in terms of the haves and the have-nots. This means that while our leaders are suffering from diseases of gluttony (like in Europe/US), the masses are still dying of essentially old fashioned largely preventable diseases of poverty. This is an area that needs to be remembered when treating patients from differing social classes.

Even among the elites, there is another problem which we need to be aware of. For example, how many of them will be happy (content) to be sent home only on paracetamol and the advice to drink lots of fluids and take some rest following a trivial (often viral) chest infection (such as flu) which by its very nature is self limiting? ‘Haba man no antibiotics and no injection(s) for oga?  chineke god’. The expectation to ‘do something’ sometimes adds to the pressure on doctors leading them to make diagnosis which will not stake up to scrutiny. Sometimes doing nothing is best medicine but a number of the “shakers and movers” of our society prefer to be given a medical label. The fear of some doctors losing their customers can be overwhelming. The overall effect of it all is that the Nigerian healthcare system is defined by the over medicalisation of the rich and powerful, and a lack of even the most basic care for the many more!

Finally in this short article, I’ve tried to highlight areas that I think many who work and use the health sector in Nigeria will recognise, but this is by no means an exhaustive discussion. What is also clear is that I’ve done the easy bit i.e. identifying some of the reasons for this phenomenon without delving into the more difficult area of proffering possible solutions. Perhaps this is best left for another day? Let me know what you think.

21:08

Newcastle upon Tyne

04/11/12

(30): Nigerian youth, education and entrepreneurship

Ten years ago during the National Youth service Corp in Shagamu, Ogun State; we were visited in the camp by the representatives of the National Directorate of Employment (NDE). During the visit they gave us a lecture on the importance of entrepreneurship, self reliance and employment opportunities.

It was a beautiful presentation that is needed to help the Nigerian youth. Then came the questions and answer session. I got an opportunity to ask a question. On receiving the microphone, I thanked the representatives, but also made the following observations. First of all, it is too late for this effort to be made at the NYSC camp, because the values they were trying to inculcate in us should have been done the moment we stepped into the university. Equally important, it seems, there is little understanding of the psychology of the Nigerian graduate.

I recalled that when you go to the hostel, a lot of students discuss how to become ambassadors, or work in such places like the Central Bank, NNPC, Ports Authority and other lucrative areas. In fact during our final year in the university, our then head of department was teaching a course on newspaper production, he told us that the department was considering recruiting Graduate Assistants, and he asked how many of us would be interested. To the shock of our teacher, only two people raised their hands. A typical Nigerian youth, lives in an elusive and imaginary world. Sometimes the nature of our upbringing does not help matters, because we have been raised to simply collect money from our parents and spend, without contributing anything in the management of the house or engaging in any useful activity outside the household. 

Many do not understand the real world, until they graduate, distribute their one page CV to friends, families and other associates, and yet nothing comes up. And with the 'Nigerian factor' or ‘long leg’, they realise that getting to NNPC or Central Bank is not an easy task, then they begin to scale down their ambition.

The population of unemployed youths is alarming, but to curtail this problem, parents, teachers and community leaders need to seriously think of how to transform the thinking of our youth into self reliance and entrepreneurship. Waiting for government to provide employment will simply compound our problems particularly looking at the state of the economy.

But today let us concentrate on university graduates who usually think of white-collar jobs. It is important to target this group once they set their foot into the university. Courses like General Studies that universities offer should focus on entrepreneurship and help students to think of how they can use the knowledge they have acquired to provide employment for themselves. And in this age where information and communication technology make things easy, innovation and skill will not be too difficult to develop. The second strategy that can work is to use the undergraduate projects that students write, by motivating them to come up with topics that they can develop as life time projects, which they can then transform into a business after graduation.

The third option that can help is for the Corporate Affairs Commission to have a scheme that subsidises the registration of companies that can be developed into successful businesses by Nigerian graduates. This will help motivate young professionals to think of developing business ideas, whose beauty is not only about self reliance, but also providing employment to others.

Two years ago, I met a young Nigerian who studied a master’s degree in network engineering at Sheffield University. On return to Nigeria he immediately established a company, identified unemployed graduates in computer science and engaged them in the company. They developed a software that can be used to help doctors and hospital staff in handling patients, particularly queue management, record keeping etc. When we met earlier this year, he said “I left the UK unemployed, went to Nigeria and established a company, employed some graduates, now I have a job and a car, my sister has travelled to Dubai to do some shopping for my marriage, and I am here in the UK to purchase some materials needed for my business”. I saluted him and told him that he is my hero.

Our youth should understand that knowledge should not make us dependents on someone’s shoulders; rather it should make us independent such that we can serve as beacons of hope.

22:04

Newcastle upon Tyne

28/10/12

(29): Virtues of the first ten days of Dhul Hijja

As Muslims enter the 12^th month of Islamic Calendar, Dhul Hijja,the month when Hajj (pilgrimage) is performed, this column will focus on the virtues of the first ten days of this great month. Here is an edited version of a presentation on the virtues of these days by the late Islamic scholar, Shaykh Muhammad ibn Saleh, Al-Uthaymin, may Allah have mercy on him. -Jameel

The excellence of these 10 days have been mentioned in the Qur’an and the Sunnah. Allah says in the Qur’an: “By the dawn and by the ten nights …” [Al-Qur'an 89:1-2]

Ibn Kathir said that “the ten nights“ referred to here are the ten days of Dhul-Hijjah, and this opinion was also held by Ibn Abbas, Ibn az-Zubair, Mujahid and others. The Messenger of Allah, peace be upon him, said: “There are no deeds as excellent as those done in these ten days…” . The Messenger of Allah, upon whom be peace, said:“There are no other days that are as great as these in the sight of Allah, the Most Sublime. Nor are there any deeds more beloved to Allah than those that are done in these ten days. So increase in tahlil (to say la illaha illallah), takbir (to say allahu akbar) and tahmid (to say alhumdulillah).” [Reported by at-Tabarani in al-Mu'jum al-Kabir]

With regards to the noble companion Sa’id bin Jubair, when the days of Dhul-Hijjah began, he would strive to increase in good actions with great intensity until he was unable to increase anymore. [Reported by ad-Darimi]. Ibn Hajar says in Fath al-Bari: “The most apparent reason for the ten days of Dhul-Hijjah being distinguished in excellence is due to the assembly of the greatest acts of worship in this period, i.e. salawat (prayers), siyam (fasting), sadaqah (charity) and the Hajj (pilgrimage). In no other periods do these great deeds combine.”

In the last 10 days of Dhul -Hijja, It is highly recommended to perform the obligatory acts at their prescribed times (as early as possible) and to increase oneself in the superogatory acts, for indeed, this is what brings a person closer to their Lord. The Messenger of Allah, upon whom be peace, said: “Upon you is to increase in your prostration to Allah, for verily you do not prostrate to Allah with even one prostration, except that He raises you in degrees and decreases your sins because of it.” [Reported by Muslim]

Fasting – This has been mentioned as one of the acts of righteousness where Hanbada ibn Khalid reports on the authority of his wife who reports that some of the wives of the Prophet, peace be upon him, said, “The Prophet, upon whom be peace, would fast on the ninth of Dhul-Hijjah, the day of Ashura and three days in every month.” [Recorded by Ahmad, Abu Dawud, an-Nisa'i and others].
Imam an-Nawawi said that fasting in these ten days is extremely recommended. Saying allahu akbar, la illaha illallah and alhamdulillah – It is found in the aforementioned narration of Ibn ‘Umar: “So increase yourselves in saying la illaha illallah, allahu akbar and alhamdulillah.”

Imam al-Bukhari, may Allah have mercy on him, said:”Ibn ‘Umar and Abu Hurayrah, may Allah be pleased with them both, used to go out to the markets in the ten days saying the takbir causing the people to follow them in this action.”
He also said:”‘Umar ibn al-Khattab used to say the takbir in his mimbar in Mina, whereupon the people of the mosque hearing ‘Umar, would start to say the takbir as would the people in the markets until the whole of Mina was locked in glorifying Allah.”

Ibn ‘Umar used to say the takbir in Mina during these ten days and after prayers, whilst on his bed, in his tent, in his gathering and whilst walking. What is recommended is to say the takbir aloud due to the fact that ‘Umar ibn al-Khattab, his son and Abu Hurayrah used to do likewise, may Allah be pleased with them all.

Strive with us O Muslims in reviving this sunnah that has become lost in these times and it was almost forgotten, even amongst the people of righteousness and goodness all of which is unfortunately in opposition to what the best of generations were upon (preserving and maintaining the superogatory acts).

There are a number of ways of making takbir that have been narrated by the companions and their followers and from these ways is the following:

Allahu akbar, allahu akbar, allahu akbar kabirun.
Allahu akbar, allahu akbar, la ilaha illallah, wallahu akbar, wallahu akbar, wa lillahil hamd.
Allahu akbar, allahu akbar, allahu akbar, la ilaha illallah, wallahu akbar, allahu akbar wa lillahil hamd.

Equally important, fasting has been affirmed on the day of ‘Arafah, where it has been confirmed from the Prophet, peace be upon him, that he said regarding fasting on the day of ‘Arafah: “Be content with the fact that Allah will expiate for you your sins for the year before (the day of ‘Arafah) and the year after (the day of ‘Arafah).” [Reported by Muslim]

However, whoever is at ‘Arafah as a pilgrim then fasting is not expected of him, as the Prophet, peace be upon him, stopped at ‘Arafah to eat.

This edited version was culled from http://sunnahonline.com/library/hajj-umrah-and-the-islamic-calendar/182-superiority-of-the-first-ten-days-of-dhul-hijjah-the

15:29

Newcastle upon Tyne

21/10/12

(28): Volunteering, hardwork and success

Mentoring the younger generation of Nigerians should be a responsibility that each and every one of us should take. Change does not happen overnight, we have to work for it. It is in the light of this that today this column will pay tribute to a young Nigerian, whose name you may be hearing for the first time, but one who serves as an example for the youth of his age. This young man, still in his twenties, is no one other than Muhammad Fardeen Dodo, originally from Katsina state in north-western part of Nigeria.

Fardeen is a graduate of Agricultural Engineering from Bayero University, Kano, where he graduated with an upper second class honours degree in 2009. After his National Youth Service, and a couple of work experience, including a stint with Zenith Bank in Sokoto state, he secured a Petroleum Technology Development Fund scholarship, which brought him to northern England, to study a master’s degree in Renewable Energy, Enterprise and Management at Newcastle University.

I met Fardeen in December, 2011 when we were planning for the Annual General Meeting and Winter Conference for the Nigeria Muslim Forum, UK, together with other members of the Local Organising Committee such as Malam Sani Makarfi, a lecturer at Kaduna State University, currently pursuing his PhD; Dr Mukhtar Ahmad, a medical doctor, and Malam Abdullahi Bello, formerly of the Economic and Financial Crimes Commission, and currently a PhD student conducting a research on money laundering at the Newcastle Business School, Northumbria University.

Fardeen Dodo came forward as a volunteer for the planning of the conference. And this is the main point that motivated me to write about this young man. The culture of volunteering for a good cause is something we need to promote among the younger generation. Nothing is more valuable than time. A lot of the things that may require financial commitment can equally be achieved without spending a penny, if we can adopt the culture of volunteering. For a project to be successful, you need planning, expertise and resources, which means by getting some individuals to volunteer their time and expertise, you have potentially achieved more than 2/3 of the requirements; you only need to work for the remaining 1/3.

Another way of looking at it is: if for instance in a small locality there are ten university graduates, specialising in different fields like mathematics, chemistry, physics, biology, etc, should each of them volunteer just two hours of his time in a week between Monday and Friday to teach the secondary school students in that locality in order to help them pass their school certificate examination, it means you will have an average of four dedicated hours a day, covered by two volunteers.

Imagine the difference that will make in helping that small locality to engage the youth in the area and help them pass their examination, but also build a community of committed individuals. In short, one will even suggest that the few people in that area who have to employ a lesson teacher to do that same job can as well let their children join the same lesson, while a fund can be created where they can save the money they spend on lesson teachers to support the education of the less privileged in the society. A win-win situation.

Back to the subject of our discussion. Fardeen was never afraid to volunteer his time for a good cause. Within the one year that he has been in Newcastle, almost daily, he dedicated part of his time for a worthy project. He was involved in support for orphan projects, healthcare programmes, assisting new students, distributing publicity materials for events organised by different charities and organisations, website management, video/audio recordings, etc. In fact, the name Fardeen became associated with anything successful organised by different communities; and while volunteering his time, he never forgot the primary responsibility that brought him to Newcastle, which was his studies.

And to the delight of many, Fardeen did not excel in volunteering only, but as his programme came to an end, he graduated with distinction. What else than to thank almighty Allah for His bounties on this young man.

The lesson here for the younger generation is that you can’t plant laziness and expect to harvest success. My advice is that Mr Fardeen should remain focused, humble, hardworking, and try to pass on these rare qualities that he possesses to his peers. It is our prayer, that with such distinction he can hopefully secure another scholarship to pursue a doctoral degree. It is not easy to write about individuals, but for those who make a difference to others, we should be prepared to let our ink dry in helping their cause. What do you think?

 

00:17

Newcastle upon Tyne

14/10/2012

(27): Establishing a Nigeria-Saudi binational commission

So what is the solution to the Nigeria-Saudi Arabia diplomatic impasse? So many writers and pundits have written about it. To me what is happening regarding the female pilgrims is not surprising, even if the approach is difficult to justify. In April this year I visited Saudi Arabia, and on my return I wrote an article entitled “Child Abuse, Kano-Jeddah and Nigerian Muslims”.

At the end of that article I advocated for the establishment of a binational commission between Nigeria and Saudi Arabia in order to address some of the unfortunate abuses and crimes committed by some Nigerians in the holy land. These issues are not restricted to Saudi Arabia; you will find similar things in the United Kingdom, the United States and other places.

The relationship between Nigeria and Saudi Arabia is too important to be left to deteriorate. It is a relationship that is defined by faith, the most important human identity. To Nigerian Muslims, Saudi Arabia is second home, just like some Nigerians consider the UK and the US their most important destinations. This is not a problem that will be solved by threats, counter-threats or physical confrontation.

The entire issue, in my opinion, was caused by indiscipline, bad governance, corruption and ignorance. In summary, you can say that the problem is attitudinal. While some of these issues are internal and have to be addressed by Nigeria alone, others require a collective cooperation between Nigeria and Saudi Arabia; Nigeria has the largest Muslim population in Africa, Nigerian Muslims are among the most frequent visitors to Saudi Arabia for Umrah and Hajj; and medical tourism, trade relations are increasing by the day. Nigerian expatriates are everywhere in the Saudi economy, ranging from oil companies, medical doctors working in hospitals, nurses and university lecturers.

Key Saudi universities like the University of Madina, Ummul Qura University in Makkah and King Fahad University of Petroleum and Minerals are populated by a large number of Nigerian students. In fact, in different shops in Makkah, Madina and Jeddah many Saudis speak Hausa language fluently because of their interaction with Nigerians.

Countries like the US that have strong relationship with countries like Mexico due to the movement of people for economic and social purposes establish binational commissions in which officials from both countries meet regularly to find solution to their key concerns.

An example of that is the US-Mexico Binational Commission. In 2010, Alhaji Mahmud Yayale Ahmad led a delegation of Nigerians to sign an agreement forming the US-Nigeria Binational Commission with US Secretary of State Hillary Clinton. Since then, regular meetings have been taking place between US and Nigerian officials, the most recent being in June 2012.

Nigeria has similar agreement with South Africa, and recently some of the diplomatic rows between Nigeria and South Africa were addressed by the Nigeria-South Africa Binational Commission.

A binational commission is a strategic partnership established between two countries in which officials from both countries meet regularly to discuss and find ways of helping each other in areas of strategic interest. The agreement will decide how many times delegations from both countries should meet. The way it works is that key areas of interest between the two countries are identified, and working groups with representatives from both countries will be established.

Each working group will constitute some experts and senior government officials to discuss and find practical solutions to the problems affecting the two nations. As far as I know, no such commission exists between Nigeria and Saudi Arabia, and it is time to have one since Saudi Arabia is the most strategic partner of Nigeria in the Middle East.

With such a commission, and if taken with all seriousness, important issues like Hajj and other matters will not be left until the last minute, thereby creating unnecessary negative headlines. One can easily think of different areas of interest such as Hajj/Umrah, trade, education and employment.

But by far the most important issue to be addressed by the commission is the one that neither of the two countries speaks about openly, and that is Nigerians living in Saudi Arabia illegally, committing and spreading so many social vices, and finding ways to return to Saudi Arabia after they have been deported. Such binational commission can find ways in which serious rehabilitation programmes can be initiated so that on arrival in Nigeria, the deported people can be assimilated into the society.

The commission can also address the concerns of Nigerians on how they are treated by Saudi officials so that the dignity of every Nigerian is protected. A single step that provides solution is far better than unproductive noisemaking.

21:38
Newcastle upon Tyne
06/10/2012

(26): New hospitals, new corruption, new challenges

On Saturday 22^nd September, 2012, some members of the Nigeria Muslim Forum, UK attended the Annual General Meeting of Africa Healthcare Development Trust (AHDT), in Manchester. Both organisations are registered charities, and their entire members work voluntarily in order to contribute in one way or the other to the development of Nigeria. AHDT under the leadership of Dr Ibrahim Hassan Jalo, particularly focuses on healthcare intervention in rural areas, and providing training through partnership with Nigerian doctors and teaching hospitals.

One of the speakers at the meeting was a senior lecturer from the Faculty of Medicine at Ahmadu Bello University Zaria, Dr Aminu Bakari.  Dr Bakari’s presentation which dwells on the challenges of healthcare provision in Nigeria captivated the audience. It reveals why there is need for serious intervention in the Nigerian healthcare system. What particularly caught my attention in the presentation was what Dr Aminu described as “New hospitals” in Nigeria. These new hospitals which are springing up in different parts of the country are established by foreigners, and Indians seem to lead the way in establishing those hospitals.

There are several reasons why people should be concerned about those hospitals. First of all, how qualified are the medical doctors to practice in Nigeria? Secondly, which is equally worrying is that some of these hospitals are so quick to refer to even the most basic cases that can be handled by the local doctors to foreign countries. This is something that every concerned citizen should think about. The third reason is the horrible experience that Nigerians face when applying for visa, and on arrival at the foreign countries.

While the foreign doctors come and establish hospitals in Nigeria whether for business purposes or otherwise, the blame should lie in the door step of Nigerians, who from different accounts invite some of the doctors to establish hospitals in Nigeria. And if the foreign personal refuse to do their bidding, they threaten them with expulsion from Nigeria, or revocation of their visa.

In all this, it is not the corruption, or the medical tourism that is of major concern, the key issue is that human life is at stake. Many people lose their lives either because they have been given the wrong prescription, they have been treated by under qualified doctors, or cases have been referred abroad, and by the time they arrive the foreign country whether it is India, Egypt, Saudi Arabia, Germany, United Kingdom, it is too late to improve the situation.

But one thing I learnt from my interaction with medical doctors, whom I can confidently say constitute almost the highest percentage of settled professionals particularly in the UK, is that the problem of healthcare in Nigeria, is not necessarily about medicine itself. But about the attitude of healthcare officials.

One of the participants at the Africa Healthcare Development meeting, and a highly experienced consultant in the UK, Dr Bukar Wobi almost broke into tears as he was comparing the decay in the Nigerian healthcare system 30 years ago, and what obtains today. It was sad to hear that one of the State governments in Nigeria actually donates a meagre 100, 000 Naira to one of the teaching hospitals in the State even though, the teaching hospital is the main centre for healthcare intervention, not only for that state, but for the neighbouring states as well.

Although I am not a medical doctor by profession, but certainly if there is one area, that needs improvement, not only in the health profession, but in other areas as well, it is changing our attitude to work. What has been happening recently, in terms of the treatment of Nigerians in the hands of Saudi authorities, the treatment of Nigerians in South Africa, United Arab Emirates etc, is nothing but a reflection of our attitude. The lackadaisical attitude of both the leaders and the led has created an image of unserious nation, so rather than being angry when other countries treat us harshly, we should look inward and reflect. Let us think where we went wrong and take measures to address our shortcomings. But as long as we continue to shift the blame to others, the more we will continue to humiliate ourselves and our country.

 

Newcastle upon Tyne,

12:02

01/10/2012