Ailing President and Nigerian Hospitals, By Martins Oloja

Even as we the people of Nigeria continue to pray for courage to ask the president’s men about the nature and extent of the reported presidential ailments we are told the president “has been recuperating from”, it is time to ask some questions. Suddenly, we need to examine why we actually need more prayer warriors and amazons to pray to the God of all grace to open the eyes of our leaders to seethe recurrent reproach called ‘presidential ailments’ as opportunities to improve the country’s healthcare delivery.

It is clear from our recent experiences that some unclean spirits have been lurking around the state house, Abuja always seeking which members of the presidential household to afflict. The strange presidential affliction was welcomed into the sprawling presidential palace, Abuja in 1997 but could not be noticed until the then Palestinean leader, Yasser Arafat visited us and our much dreaded leader then General Sani Abacha showed unusual robustness in public appearance with the visitor.

Before then, there were rumours of liver issues inside Aso Villa. But shortly after Arafat left, presidential ailment story was coloured by other stories of strange apples from far Asian countries delivered in some other rooms at the then presidential annex called Defence House in Maitama. It will be recalled then that a hospital for women and children the then First Lady, Mrs. Mariam Abachahad initiated in the Central Business District had reached an advanced stage but was not ready for commissioning. Behold, the then Women and Children Hospital was the one President Olusegun Obasanjo who was sworn in on May 29, 1999 changed into what is today known as National Hospital, Abuja. Which is today Nigeria’s apex hospital. But sadly the apex hospital was not equipped well enough for the presidential ailment that afflicted the amiable First Lady, Stella Obasanjo who had to travel to Spain for a surgery of urgent personal importance. We sadly lost her in Spain. And Obasanjo’s successor, Umaru Musa Yar’Aduawho we were later told had been cured of some strange illness as his medical file revealed to President Obasanjoby an Oxford University trained Professor of Medicine, had hardly got into the same Aso Villa when rumour mills became active again and it was said that the Katsina-born analytical chemistry lecturer was not so well, after all.
But the nation too was also being assured that that there was no cause for alarm until the then President Umaru Musa Yar’Adua was rushed to Saudi Arabia on November 23, 2009 where he was treated for ‘inflammation of tissue around the heart”. He was brought back home in the middle of the night after three months on February 23, 2010 and the citizens never saw their president alive again. He was buried on May 6, 2010 barely three years into his administration.

It was not on record that the death of Stella in Spain and paralysis of Yar’Adua in Saudi Arabia got the successor administration of President Goodluck Jonathan angry enough to pay special attention to Nigeria’s University Teaching and General Hospitals, let alone Federal Medical Centres beyond the normal budgetary allocations. Nor was the National Hospital, Abuja given special attention to stop or reduce medical trips abroad.

Then presidential ailment again afflicted the wife of President Goodluck Jonathan, Dame Patience Jonathan. Specifically, on February 17, 2013, the First Lady thousands of guests including 18 state governors graced a lavish thanksgiving party for God’s mercy upon her in a German hospital. Although she had previously denied being in a Germany, Mrs. Jonathan opened up at the day’s special service at the State House Chapel where she stunned worshippers that her medical condition was actually critical in the hospital. In her testimony, she said: “I actually died. I passed out for more than a week.

My intestine and tummy were opened…It was God Himself in His infinite mercy that said I would return to Nigeria. God woke me up after seven days.” She confessed that her doctors had, in fact, given up hope of survival though she did not specify her diagnosis. Her husband was in power while she too was in office for two years after this presidential ailment. And there was no presidential anger to set up a purpose driven committee to equip even one hospital well enough in Abuja to deliver Nigeria’s presidency from a new reproach called medical tourism to India, Saudi Arabia, South Africa, Egypt, let alone UK, U.S and Germany.

This is inexplicable. Curiously, there have been so many medical doctors that have been governors including Governors Olusegun Mimiko (Ondo state) and Dr. EmmanuelUduaghan (Delta state). Throughout his tenure, Dr Mimiko who established two hospitals for women and children in Akure and his home town Ondo would disturb even the United Nations with the din of this two hospitals he won several awards with. The hospitals cannot be more than mere consulting clinics elsewhere. Instead of building a world-class hospital in Ondo (state) as a reference point, Governor Mimiko established University of Medical Sciences in Ondo town. Not a bad idea, but it is still work in progress as there were two other not-so extraordinary Universities in Akungba and Okitipupa respectively that also need resources and attention to be 21st century universities. Was Governor Uduaghan credited with any world-class hospital in Delta state good enough to prevent medical tourism? The answer is blowing in the wind.

And now the denouement of the whole matter is that the current President is also still being reported as ailing president and he has not been able to attend three federal executive council meetings. Presidential ailment has set in and it was reported that he could not attend last Friday prayer meeting (Jum’at service) at the presidential villa. And so President MuhammaduBuhari who just returned from a 49-day medical vacation in the United Kingdom is not enjoying robust health that will enable him to face his responsibility to the people of Nigeria at the moment. Though the president’smen have assured us that “he is recuperating” and all is well. It is believed that the reputation managers only have faith in the words of God that, “let the weak say I am strong”. It is clear to the discerning citizens that the President who had hinted on the possibility of returning to hospital in U.K, may wish to see his UK doctors sooner than later. The anxiety in the polity at the weekend prompted the only Nobel laureate Nigeria has had, Professor Wole Soyinka to ask the President to declare the true state of his health, saying, “the president is a public property”.

But as we pray for the president and “wait for Godot” (apology to Samuel Becket)on the declaration of the true state of health of the president, it is also important to ask all the former presidents that ruled the country after General SaniAbacha why they have all failed the nation in the area of health-care delivery despite all the budgets and road maps of Nigeria Medical Associations since 1999. We also need to ask all the 36 states former and serving governors why they too have failed to act as “federalism ambassadors” the way Governor Godswill Akpabio did in Akwa Ibom state before leaving office in May 2015. The former governor of Akwa Ibom state now Senate minority leader had set up what medical experts believe could be a pace setter in health-care delivery – Ibom Multi-Specialty Hospital in Uyo. It is a work in progress but it is already noted as a difference maker from the way the multidimensional hospital is being equipped and managed by experts drawn from different parts of the world. This is the big dream that the federal government should have coveted and elevated.

In this country that is fast gaining notoriety as a land that under-develops and destroys its best and brightest, there are enough medical experts to manage its hospitals if they are equipped.

The Federal Government has only 20 teaching hospitals, 22 federal medical centres and 13 specialist hospitals, making a total of 55. In terms of access, this is grossly inadequate to serve a nation of about 181 million people even when most badly equipped states-owned hospitals are added. The private hospitals are many, but they equally lack the equipment, resources and personnel, and are mostly located in the cities.

As our population rapidly grew, the government neglected the emerging dynamics. According to the Nigerian Medical Association (NMA), there are 40,000 Nigerian medical doctors, but 19,000 out of them are practising abroad, while 70 per cent operate in “urban centres where only 30 per cent of the population reside.” This is a dismal ratio. As a result, the World Health Organisationclassifies Nigeria among the 44 per cent of nations that have less than one per cent of physicians-per-1000 population.

Facilities in the hospitals are obsolete, too. General Electric, a United States firm, said the other day that between 50 and 80 per cent of the equipment in Nigerian public hospitals, “are out of service.” Drugs are sometimes not available. This generates constant friction between government and doctors. Strikes bedevil the system at every turn. The result is chaos, such that the military, in the 1980s, described the hospitals as “mere consulting clinics.”

A few years ago, former President Olusegun Obasanjo awarded contracts to VAMED Engineering GmbH and Co kG of Vienna to renovate, computerise and modernise 12 Teaching Hospitals including the university Teaching Hospitals in Ibadan, Enugu, Zaria, Maiduguri and Idi-Araba in Lagos.. Some facilities there had become so run-down that they lost World Health Organization classification as centres of excellence for tropical medicine.

Within three years the Austrian firms carried out major infrastructural transformation of the teaching hospitals – until the Ministry of Health officials allegedly meddled, prompting the companies to stop work and go to court. The Senate, the upper chamber of Nigeria’s legislature, also became enmeshed in the controversy.The sudden suspension of renovation work at the academic hospitals came to light through the Court of Justice in Abuja, Nigeria’s federal capital, and the Senate.

News media reported that the Austrian companies had taken the Ministry of Health to court for breach of contract. The firms claimed in affidavits that they had won, through due process, two different types of contracts. The first contract, worth US$226 million, was for the complete rehabilitation and modernisation of 12 university teaching hospitals. The second contract was to upgrade 12 federal medical centres at a cost of US$65 million.
Today, we are worse off in spite of the budget for modern equipment for those centres. After the billions of naira spent on the project, it is clear that the problem is not money earmarked but how well spent for the common good.This is a story of another dream killed by the political class aided by the federal ministry of health. Who has been prosecuted on this? Who is asking questions on where rains began to beat us on health care?

Who cares about the University College Hospital (UCH) once reputed to be among the best four teaching hospitals in the Commonwealth?
This article that will continue next week is just to point out to the political class that in spite of the monumental failure in the area of health-care delivery since 1999, the need for modern hospitals we can patronise as hospitals is urgent. The idea of our president and governors being treated abroad is a reproach. What will poor citizens do?