Ebonyi State Government: Immunize to Save the Nigerian Child!

Some of the common childhood killer diseases are pneumonia, measles, malnutrition, neonatal tetanus and tuberculosis. They are all avoidable and can be prevented through immunization and provision of nutritional supplements like Vitamin A. Other vaccine-preventable diseases include polio, whooping cough, hepatitis, diphtheria and neonatal tetanus.  Polio may have low mortality rate but can be very debilitating and prevents children and by extension societies from achieving their full potentials. 

Nigeria is one of the 3 countries in the world that is yet to eradicate polio virus; the other two are Afghanistan and Pakistan. Nigeria also one of the highest infant and under-five mortality rates globally. The federal government has made commitment to intensify efforts to eradicate polio in the country possibly by 2015. During National Immunization Plus Days (NIPDs), states provide counterpart funds to ensure the distribution and administration of vaccines to children in their homes or schools. This activity helps to provide herd immunity and protect the child from the vaccine-preventable diseases. It has been demonstrated to save lives of many children in Nigeria.

Our attention has been drawn to the non-participation of Ebonyi State in the on-going National Immunization Plus Days. The state is allegedly not interested in providing counterpart funding to facilitate the NIPD process. We are very concerned by this development as it would make Ebonyi children vulnerable to childhood killer diseases. It may also reverse the gains made so far in the effort of the Government of Nigeria to eradicate polio in the country. Although cases of polio are predominant in the northern part of the country, relocation of people from the crisis-ridden northeast to other parts of the country makes every state vulnerable.

More so, Ebonyi State has the highest cases of childhood malnutrition and performs low in many other health indices in the Southeast. Most of the residents of the state live in rural areas many of which lack access to orthodox health service delivery. Failure to participate in the NIPD will prevent many Nigerian children resident in Ebonyi State from getting immunized. This, in our opinion, is most unfair to the innocent children and dis-service to the country. 

We strongly encourage the Government of Ebonyi State to reconsider its position and act swiftly to save the children. We also call on the Minister of Health, Professor Onyebuchi Chukwu; who incidentally hails from the state; the State House of Assembly, National Assembly and all well-meaning Nigerians to prevail on the governor to do the needful as soon as possible in the interest of the country.  The human right of the Nigerian Child resident in Ebonyi State is being trampled upon by the state government. Time to ACT is NOW! May God bless the Federal Republic of Nigeria.

Health Equity Nigeria (HEN) is a coalition of youth-led organizations in Nigeria. We believe that every Nigerian should have access to best possible quality of preventive and curative health care services no matter where the person lives or socioeconomic status. We use various media platforms to advocate for improved health access to ensure health equity in Nigeria.

Signed:

Dr Laz Ude Eze, MPH, CPH

Executive Team Lead,

Health Equity Nigeria

Tweet us @healthequityng

Industrial Disputes in the Nigerian Health Sector: A Need to check the Rising Trend

This piece was first published in June 2009 edition of The Health Advocate, the magazine of the Nigerian Medical Association (NMA). 

Labour unions exist in every sector of the economy and are recognized worldwide as a platform through which workers seek to improve their general well being as well as that of the society. The health sector is not left out as we have the Nigerian Medical Association for medical doctors, Nigerian Dental Association for dentists, National Association of Nigerian Nurses and Midwives, Medical and Health Workers Union of Nigeria, Pharmaceutical Society of Nigeria, Nigerian Association of Physiotherapists among others. The primary goal of these labour unions in the health sector is to ensure the welfare of her members which would eventually result into better services at the various health institutions.

In fact, industrial disputes are inevitable as it is normal to have employers and their employees take different positions on policies or matters bothering on the welfare of the later. What is important is for such disputes to be resolved timely and amicably through dialogue and mutual respect. Unfortunately, this has not been the case in recent times in the Nigerian health sector. Even when agreements are reached, government at times does not implement them and in some instances suspend or abrogate policies emanating there from. 

As I write, the entire health workforce in Ebonyi State University Teaching Hospital are on the eleventh week of an indefinite strike action over the failure of the hospital management and state government to implement an agreement to improve staff welfare and provide adequate facilities in the hospital. The resident doctors in same hospital had embarked on strike for three weeks over same issue last September and were also forced to down tools for four days in February this year over the state of insecurity in the same hospital. In a related development, doctors under the employment of Lagos State government went on strike twice within the last the last six months; their counterparts in Anambra State had just suspended an almost eight month old strike a few months ago. Edo State doctors also had dispute with the state government over an alleged outrageous taxation imposed on private hospitals in the state.

Furthermore, resident doctors in Federal Medical Centre, Abeokuta reportedly downed tools because of an arrest of one of their colleagues by an anti-graft agency while on duty post. Doctors in Ladoke Akintola University Teaching Hospital, Oshogbo have also embarked on strike on at least two occasions within the last couple of years. In Abia State University Teaching Hospital, Aba, resident doctors were also on strike over the failure of the state government to implement the consolidated tertiary institutions salary scale (CONTISS). It could be recalled that a few years ago, doctors in the same hospital downed tools over an alleged physical assault on their colleague by a spouse of one of the political top shots in the state. Also in Oyo and Imo State, some health workers in the state were recently reported to be on strike. I could go on and on.

As if the above were not enough, the federal government inaction over the restoration of MSS/MSSS she unilaterally suspended about eleven years ago compelled the National Executive Council (NEC) of NMA to issue a 28 working the ultimatum to do so or face a nationwide withdrawal of services by doctors. But for the success of the negotiations between NMA and FG, Nigeria with her terrible health indices would have been left without the services of doctors for some time. However, only the timely implementation of the agreement would completely avert an industrial action.

The upsurge of industrial disputes and withdrawal of services by health workers is so alarming and not expected in any society with a people-oriented, responsible and responsive government. The contributions of Nigerian doctors and other health workers to national development cannot be over emphasized despite poor remunerations and unconducive working environment. Without sounding immodest, no other sector or group of workers make as much sacrifice like health workers. When people go to a health institution for care, they would of course want to be attended to by well trained and up-to-date health professionals with appropriate diagnostic and therapeutic equipment and also in good time, anything short of this is not acceptable. Ironically, same people criticize health workers when they withdraw services to compel the government to make the hospitals better equipped and more conducive for patients care. 

Nigerian doctors are very diligent, dedicated and go extra mile to care for their patients. We contribute money and sometimes donate blood to save our patients, even when the patient’s relatives may have abandoned them. This situation is commonly encountered in paediatrics department where children usually present as emergency with life threatening ailments and severe financial constraints on the part of the parents. I am sure that doctors detest withdrawal of services. NMA rarely go on strike. This is recently demonstrated in Ebonyi State where the state chapter of NMA despite the unacceptable treatment of her colleagues in the teaching hospital and sustained provocations by political jobbers in the state refused to be compelled to embark on statewide withdrawal of services. Similarly, the National Executive Council of NMA recently suspended her planned withdrawal of services to allow the federal government act on their agreement over restoration of MSS/MSSS.

It should be noted that the health sector alone cannot thrive when other sectors are also torn apart by regular industrial disputes, therefore, government must equally meet the demands of the Nigerian Labour Congress, Academic Staff Union of Universities, Nigerian Union of Teachers, NUPENG/PENGASSAN, etc to move the nation forward.

Nevertheless, the ugly consequences such as loss of lives resulting from industrial disputes in the health sector are unquantifiable. Also, the adverse effects of the strikes in the education and other sectors on manpower and socioeconomic development of the nation are better imagined. The persistence of these regular industrial actions would not only undermine the efforts to improve the nation’s health indices but would also make the achievement of the Seven-point agenda, Vision 20-20 or the UN millennium development goals a wild goose chase. 

In conclusion, prevention is better than cure; therefore, industrial action of any form should be avoided especially in the health sector. This can only be possible if government at various levels demonstrate strong political will by improving the situation of health in Nigeria through motivation of health workers, provision of modern diagnostic and therapeutic facilities in the hospitals as well as providing a qualitative and affordable education at all levels; to say the least.

A Need for Improved Healthcare Delivery in Ohaozara

This piece was written and shared in Forum for Ohozara Progressives in March 2013

Ndi ibe anyi ekene m unu (my people I greet you),

I plead with you to make out time and go through this piece.

I’m very concerned about the situation of healthcare delivery in Ohaozara. I grew up in my hometown Okposi and have always spent some days with my parents at home every year. My friends and relatives use the health centers and hospitals within Ohaozara and share their experiences. The situation at this time is that most of the healthcare facilities in our area do not have the capacity to manage medical emergencies. They also lack the capacity to treat some common curable health conditions in our area. The implication is that every one of us is at risk of dying from a treatable medical emergency or having complications/disabilities from curable diseases.   Why did I say everyone when all of us don’t live at home? An emergency can happen when one visits home.  It may happen to our loved ones. This is 21^st Century; we need health facilities that should be able to comfortable treat most of the common diseases experienced in our area. Don’t you think so? 

On Saturday, April 30, 2011; exactly 5days after my friends and I founded Okposi Education Initiative, my childhood friend, Ukpa Nwankwo had a road traffic accident and died the following day. I always shed tears on his birthdays and death days; it was one of my most traumatic experiences.  More so, my parents travel to Abakaliki treat conditions that any of the General Hospitals in our area would have been able to handle if they are functioning optimally. We have been losing many of our loved ones to highly preventable and curable health conditions. We can’t continue that way. 

Many individuals and groups have carried out free medical outreaches from time to time. It’s very good, we need more of that and I pray that God continue to bless them. However, the gains of such programs cannot be sustained if the healthcare system remains very weak. Apart from lack of modern facilities in our health centers and hospitals, the number of health workers is grossly inadequate. Lack of supportive supervision and capacity building trainings for the available workers also contributes greatly to the poor quality of health services in Ohaozara. If I’m asked to name one factor that is responsible for this, I will say it is LACK OF POLITICAL WILL. Therefore, our LGA s and more importantly the state government need to demonstrate strong political will in this regard.

I commend the efforts of dedicated health workers in our area who do their best under the challenging circumstance to do their job. The efforts of individuals and groups that carry out free medical outreach in our communities are also pleasing and commendable. (I’ve been involved in a couple). From my interaction with lots of folks, I observed that many people are as frustrated as I am. But it’s not enough to lament about the problem and do nothing. The question now is what are we doing about it? What do we intend to do about it?

 I must mention that through the efforts of one of our illustrious sons, Dr Nkata Chuku, Ohaozara and Onicha LGAs were selected to be part of the 5 LGAs where Global Fund Health System Strengthening projects are being implemented. I was part of the implementing team of the project in Ohaozara and Ezza South when it started in 2011 and Ohaozara LGA did very well in doing what was required of it to support the project. However, the idea is to use the 10 health centers in the local government to serve as a model of what government should replicate in the rest. I hope our LGAs and Ebonyi state government will do the needful. 

Over the last couple of years, I’ve been undergoing postgraduate training in health policy, global health and health systems management. But I wouldn’t be fulfilled if I don’t use whatever knowledge and skill I’ve acquired for the benefit of my community. I’ve decided to start an advocacy and treatment support program for indigent people (especially widows) in Okposi living with hypertension (with possible expansion to other communities). I will be making a presentation about this in 2 weeks time during the Clinton Global Initiative (CGIU) meeting at Washington University, St Louis in United States. Using the platform of my NGO – HAPPYNigeria, I hope to implement this beginning from the end of this year. We would also use the opportunity to draw attention of government and development partners to the health needs of our people. I seek everyone’s support in this. 

I would also want everyone to brainstorm what we as a people should do to improve the standard of hospitals and quality of healthcare in Ohaozara nation. I will want us to continue to have conversation on this. Please feel free to share your thoughts.  God bless you.