In Nigeria, the lack of improved healthcare facilities has led to high rate of medical tourism while the poor masses who cannot afford the resources for such medical travels become victims of poor health management. Few who leave school as doctors and nurses cannot concentrate to work at home; travelling to the West becomes a key in their plans, as the available opportunities are limited, due to lack of good healthcare facilities. Addressing these issues is most paramount as it is of great concern to global health. Nigeria, and most other African countries have the resources to assure their citizens of the best medical conditions in the world today. The inability of so many countries in Africa to improve healthcare and healthcare facilities is a major problem for global health security. The problem of our leaders and their cabinets to do tangible things at the level of global health is attributed to bad governance characterized by corruptive practices.
The problem with Nigeria is that corruption has become part and parcel of the country’s agenda. Corruption in Nigeria is like a cankerworm that has eaten into the bone marrows of the leaders of the Nigerian government. The amalgamation of the northern and southern protectorates in 1914 stands as a key historical moment that put Nigeria in the present cynical condition. The military governments destroyed Nigeria, and in a country that is made up of different ethnic groups, emancipation of ethnic and tribal strife becomes the order of the day. At the inception of democracy, people do not vote based on transparency or character of those seeking elective posts but tribal and ethnic interests. No matter how good you are, if you are not from my ethnic group or my zone, you are not qualified to have my vote. The poor masses suffer these anomalies more and poverty, marginalization, segregation and sectionalism rules Nigeria today.
This decay as seen in the discussion so far has caused Nigerians the loss of basic facilities that are prerequisites for making life bearable and for authentic human existence. There is decay in all facets of the Nigerian government; the education sector, health, personnel management, oil and gas sector, aviation and so on. This collapse has penetrated into the healthcare system in Nigeria, leaving its marks there. These negative marks can only be salvaged if people are ready to cooperate in fighting corruption. The Nigerian healthcare system has witnessed a gradual decline in recent years due to the inability of the government to provide the essential facilities that help in the better running of a healthcare system. In discussing improvement of healthcare facilities, it is important to note that healthcare and healthcare facilities are two complementary points. Looking at the decadence in healthcare facilities in Nigeria, it has to do with all the facets of healthcare, personnel management, good hospitals, emergency services, keeping data sensitivity, health pharmaceutical companies and so on. At the heart of the improvement of healthcare facilities in Nigeria and other developing countries is the importance of a well-equipped hospital. Since the oil relapse in Nigeria in the early 70s and 80s, instead of witnessing a considerable growth in the health system, a considerable decline in budgetary allocation to the health ministry has been noticed. Budgetary specification on the healthcare system in Nigeria hardly exceeds 3% of the overall national budgetary outlay. Primary attention cannot be given to healthcare improvement as politicians loot and embezzle billions of dollars from the national treasury without being charged for embezzlement.
Due to the negligible attention to healthcare system in Nigeria, there is an explosion of private health practitioners in Nigeria that has made the populace more vulnerable than ever. People now rely more on private healthcare systems than government provided health schemes. Since there is a demeaning attention toward healthcare system, most of the available places are either too costly or not functional. This leads to the pluralization of health care in Nigeria with so many getting into the business of patent medicine sellers in order to alleviate the health conditions of the poor. In some states, 75 percent of the healthcare facilities are provided by the private sector. Private medical practice is also on the increase in Nigeria; fewer medical doctors opt to work with the government. Some who work for the government also use the opportunity to manipulate patients by inducing them into visiting their private clinics instead of the government hospitals. Meanwhile, in their private clinics, they do not have the standard facilities needed for the treatment of that particular illness.
The practice of selling and buying medications without prescriptions in Chemist shops in Nigeria has become an opening for many dealers to extort money from the people. The intention originally was to help the poor but at this level, so many ill actions troop in and poor people are exploited. The healthcare system is porous, and the poor become more vulnerable. The doctors who invite them to their personal clinics exploit them, and when they cannot finance it, they purchase behind the counter medicine, where they are exploited all the more. It is important to note that all the payments made for the purchases are out of pocket payments as most times, you are expected to pay for the service before receiving the service. There are few hospitals in Nigeria where the health insurance scheme is active. The Federal ministry of health estimates that over 70 percent of healthcare payments are made out-of-pocket. I remember taking a young accident victim to the hospital for treatment and he was refused treatment until I made some deposits. For life to improve in Nigeria and other developing countries, healthcare facilities must be improved, beginning with the rehabilitation of our hospitals with the most recent and sophisticated healthcare facilities for sustainability of good health. Not just that, our pharmaceutical companies are to be upgraded too, to avoid fake and substandard drugs from entering the healthcare market. Poor quality drugs enter the healthcare market through the back door and this poses a big problem to healthcare security in Nigeria. The National Agency for Food and Drug Administration and Control (NAFDAC) in Nigeria has fought this ailment since 1993 and has actually helped to safeguard the lives of Nigerians through the constant war it wages against fake and substandard drugs and medications in the Nigerian healthcare market.
Another factor about the Nigeria health care system is the growing phenomenon of medical tourism and brain drain problems as byproducts of failing healthcare facilities and delivery in Nigeria. Nigeria and some other developing countries witness a massive embrace for medical treatments overseas. I remember a politician friend who made it clear to me that; “I cannot visit a Nigerian hospital for medical treatment, when I am sick,” and just as he told me, earlier this year, he told me that he is in United States for his routine checks. I remember asking him a question: “if my grandmother in the village is sick, can she make it to the United States too for treatment?” I cannot blame him for coming to the US on a medical trip because he has to take care of his health, but I blame people like him in the government who have not done enough to guarantee safety of life and properties for the poor masses.
The Nigeria of my dream is a Nigeria that is structured on mutual interdependence, love, justice and equity, a country laying its foundation on respect for human dignity, human needs and embellished with the protection of human rights. The poor masses have a life to protect, they have a right to live and this life should be protected. Provision of healthcare facilities is paramount in an effort to restore the dignity and empty life of the poverty-ridden people of Nigeria. Resources are to be distributed equally to all corners of the country, and special attention should be given to the rights of women in the far north who suffer in the hands of their husbands. Equity in health cannot be achieved if clear and conscious efforts to promote population health and to protect the welfare of all people do not become a political imperative. Fighting the Ebola virus and succeeding in that venture is an indication that the Nigerian government can conquer corruption to a reasonable extent if it decides to do that in order to hand over a better life to the ageing and a bright future to the young.
At the heart of the Millennium Development Goals (MDGs) are health related issues; hunger, child mortality, maternal health, HIV/AIDS and Malaria. The year is already half spent, though two thirds of the goals have not been realized. It is still not late because it is never late to save lives. Catholic Social teaching stresses the dignity of every human life and the universal common good. Our leaders need to stand up in the face of the present injustice to guarantee all citizens justice in all fairness. The rehabilitation of the lost glories of our hospitals, emancipated in an ethic of life flourishing, in a nation blessed with so many natural resources, equity will be achieved through distributive justice. All the rural villages neglected for so long will be given attention, and the health workers will begin to have a better attitude toward the sick entrusted to their care. The improvement of the financial strength of the Community health centers, and the early payment of medical health workers’ wages is a prerequisite to guarantee the lives of the poor masses that depend on their services for good life. The life of each one of us is unique; humans are created in the image and likeness of God. The life of every one of us in Nigeria is as important as the life of the president. May the government of Nigeria rise up to protect this Image of God through the provision of the essentials of healthcare and its facilities for the betterment of the citizens, especially the vulnerable populations in the society.
The Church’s teaching on liberation theology and option for the poor reminds us that: “it is important that numerous Christians, whose faith is clear and who are committed to live the Christian life in its fullness, become involved in the struggle for justice, freedom, and human dignity because of their love for their disinherited, oppressed, and persecuted brothers and sisters.” This is an invitation to fight for the common good of all, that those marginalized may be empowered again in their localities through the provision of affordable healthcare opportunities.
I call for a good medical insurance that will be accessible to all, both the rich and the poor alike, not what we had which covers only the rich without covering the poor in the society. By doing this, Nigeria will put the lives of its citizens first before every other thing, checkmating the excesses of some rich corrupt government officials who loot the collective basket of the nation.
I invite the Church to keep promoting the preferential option for the poor, where the government through the continuous knock on their doors from the leaders of the Church, will realize the necessity of upholding the rights of all the citizens, to good and adequate healthcare thereby, providing just means to see to the distributive efficiency of the health system. The Church should not relent, considering experiences of looting and corruption of the past; more young people should be trained in the Church owned hospitals so that they keep alleviating the hopelessness of the communities who have been forgotten by the government. Prayerfully, hoping on God who does not abandon his people, we hand over our leaders, asking for a change of heart and attitude from them in their leadership roles.