Fresh Battle for Better Hospitals

The deplorable state of public hospitals in Nigeria has always been a major source of worry. But when human rights lawyer, Femi Falana filed a suit at a Federal High Court seeking an order to compel the Federal Government to equip public hospitals, he opened a new vista in the battle for better hospitals. DAVIDSON IRIEKPEN writes

Two weeks ago, Human rights lawyer, Femi Falana filed a suit against the federal government (FG) at the Federal High Court in Ikeja seeking to compel the FG to equip public hospitals in the country. Falana, in the documents obtained by THISDAY, argued that government has failed to ensure that there are adequate medical and health facilities for all Nigerians. He wants the FG to take necessary measures to protect the health of the people and ensure that they receive medical attention when they are sick.

He claimed that only few public officers are allowed to receive medical treatment at public expense in foreign hospitals whenever they are sick and that the public hospitals and health centres patronised by the majority of Nigerians are neither equipped nor staffed.

According to the human rights lawyer, “Many public officers are taken abroad for medical treatment at public expense from time to time and top public officers and private citizens who can afford overseas medical attention now travel to the United Arab Emirates, Saudi Arabia and India for medical check up and treatment while millions of poor Nigerian citizens die of preventable diseases in the local hospitals because they cannot afford the exorbitant costs of medical treatment in foreign hospitals.” He contended that Nigerians doctors, pharmacists and nurses who left the country due to the neglect of the health sector by the government, man several foreign hospitals patronised by privileged Nigerians.

The applicant also argued that contrary to its obligations under the law and in spite of the abundant resources of the country, the federal government has refused to equip public hospitals and medical centres located in Lagos and other the various parts of the country and that many countries that are less endowed than Nigeria have well equipped hospitals with qualified specialists many of whom are Nigerians.

He averred that the 469 members of the National Assembly have just demanded for increase in their allowances to N47 million per House of Representatives member and N60 million per Senator per quarter and that in the 2010 Appropriation Act, the defendant has budgeted N57 billion for entertainment and N27 billion for travels by members of the National Assembly. He noted that the FG also proposed N6.6 billion for the celebration of the country’s 50th Independence anniversary on October 1, 2010.

While many Nigerians are anxiously waiting to see how the case would go, Falana’s lamentation is not new to Nigerians. For sometime now, many analysts have been wondering when the deplorable state of the country’s healthcare would improve if those in government who are supposed to ensure that the country’s hospitals are well equipped and functional can at the slightest opportunity, jet out to seek medical attention abroad for even minor ailments.

It has been argued that the sustainability and viability of a country’s economic and social growth depend largely on a vibrant healthcare sector and that no country can maintain a steady economic growth in the absence of an adequate healthcare system. Yet, poor healthcare has remained an issue in the country. While Nigeria is believed to have a birth rate of 40.6 births per 1000, the infant mortality rate is 98.8 deaths per thousand live births with a life expectancy of 46.7 years.
Recently, Governor Liyel Imoke of Cross River State was rushed abroad for medical attention after an accident at the Obudu Ranch Resort. Before the trip, he was flown to a hospital in Abuja where doctors recommended his treatment abroad.

Last year, former Governor of Jigawa state, Senator Saminu Turaki was involved in an auto-crash and was flown to Singapore for further medical care. Turaki was involved in the auto-crash on his way to Abuja from Birnin Kebbi where he had attended a wedding ceremony. As soon as the accident occurred, the former governor was admitted at the Intensive Care Unit (ICU) of the National Hospital, Abuja. But he was later flown to Singapore, which had always been his preference. Not many Nigerians were happy to hear the news. After all, the man ruled Jigawa for eight years and was in charge of billions of naira, some of which he could have invested in a world class hospital,.

As Governor of Katsina State for eight years, late President Umaru Musa Yar’Adua also sat on billions of naira, but he constantly visited foreign hospitals. And as President, he made about four trips abroad for medical treatment. The last was on November 23, 2009 when he was admitted at King Faisal Specialist Hospital in Jeddah, Saudi Arabia for acute pericarditis. All through this period, no extraordinary effort was made to improve the country’s hospitals.

As a result of sustained decay in the country’s health sector, seeking medical assistance abroad is now a necessity for the wealthy. Last year, while the wife of the Speaker of the House of Representatives, Dimeji Bankole, gave birth to a baby girl in a Ghanaian hospital, the wife of the governor of Bauchi State, Isa Yuguda gave birth in America.
Incidentally, these are public officers who have the power to ensure that standard hospitals are built and equipped in their respective domains. But they could not entrust the delivery of their babies into the care of any Nigerian hospital. This is because they do not have confidence in the country’s hospitals.

Many observers have argued that the frequent trips abroad by those who are supposed to help refocus attention on the sorry state of the country’s healthcare delivery system do not give hope to others in the country that something is being done. They wonder what the poor would be going through if those in power do not have confidence in the country’s healthcare sector.
While for the wealthy, the alternative is to seek medical attention for chronic and severe ailments in foreign countries, the masses who have no choice or means, are left at the mercy of the near comatose 53 tertiary health institutions, 23 federal medical centres, 37 teaching hospitals and over a thousand general hospitals in the country.

Unfortunately, the sorry state of the country’s health institutions seems to have defied all forms of government intervention. In the twilight of the President Olusegun Obasanjo regime, he initiated a N17 billion equipment standardisation scheme. The intervention was aimed at upgrading the state of public teaching hospitals. About eight teaching hospitals benefited from the intervention programme. However, some of the equipment said to have been installed through the intervention are said to be malfunctioning already. Years after, nothing seems to have changed.

In spite of the annual budgetary allocations to the health sector at the federal and state levels, infrastructure and healthcare delivery remain paralysed in the country. In 2008, N89.45 billion was appropriated at the federal level for the health sector. A break down of this appropriation shows that N29.12billion was meant to take care of some 700 capital projects. By the close of that year, about N11.344 billion of that sum was returned as unspent fund. In addition to this, N138.17 billion allocation and N161.8 billion proposed allocation for 2009 and 2010 respectively grossly fell short of the World Health Organisation (WHO)’s recommendation that 11 per cent of a country’s budget should be dedicated to its health sector. At the state and local government levels, billions of naira has also been allocated to the health sector but the monies tend to end up in private pockets and accounts.

In the developed countries of the world, the sanctity of human life is given priority and that is why they have the best hospitals in the world. Also, they have the best health insurance schemes and have so much confidence in their healthcare system. So, nobody; whether a pauper or a president needs to travel abroad for treatment except for alternative medicine in China or India.

Contrary to WHO’s standards, the doctor-patient ratio of a doctor to 3000 persons is exceeded. In Nigeria, a doctor attends to more than 4000 patients; the country has the highest poliomyelitis burden in the world and it also records one of the worst maternal mortality rates in the world. Medical researchers are almost non-existent and many doctors who practice in government hospitals have no grants to attend capacity building courses abroad. The statistics are pathetic and undoubtedly scary.

The continued stagnation of the healthcare sector in Nigeria is of great social and economic consequence. Access to quality healthcare is either limited in Nigeria or non-existent with staggering financial burden to families and the nation. While the prevalence of fake drugs and substandard products are compounding the problems, the AIDS epidemic and unhealthy lifestyles of many individuals are making matters worse.

Milicent Obajinmi, a senior staff in the radiography department of UCH says the mammography machine installed in the hospital in 2005 is yet to be calibrated. The cassettes meant to complement the equipment are not compatible. Also, the erratic power supply to the hospital is adversely affecting the equipment.

Lamenting the state of the teaching hospitals, Francis Faduyile, former chairman, Association of Resident Doctors, LUTH chapter, recently said public health facilities are “almost in a pathetic state. We don’t have up-to-date equipment. In advanced countries, a lot of treatments are not invasive, that is, you don’t need to cut or traumatise a patient. The equipment for non-invasive surgeries is not available to our medical personnel in Nigeria. The federal government has been upgrading some teaching hospitals but it is not enough. It is a far cry from what is needed. Some of the available equipment spoil easily. There is no power supply. Power is a major issue and medical personnel are not well motivated.”

Also, in an interview he granted a national magazine recently, Chief Medical Director (CMD) of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Professor Olusanya Adejuyigbe, wondered what manner of a country would continually run a big institution such as a teaching hospital on generator. Adejuyigbe who is a professor of paediatric surgery said, “A hospital that runs on generators cannot get to where it should be. Everybody knows how much we buy a litre of diesel in this country. In other countries, teaching hospitals are on national grid. We should be able to do that here.”

This seems to be the bottom-line in Falana’s recent suit; the FG needs to do better. With the suit, the legal luminary has opened a new vista in the battle for better hospitals in Nigeria. The outcome of the suit would no doubt become a watershed in efforts to give Nigerians better healthcare services.
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