THE CHALLENGES OF MEDICAL INTERVENTION IN NIGERIAN HEALTH SECTOR

Health as defined by the World Health Organization (WHO) is a state of complete physical, mental, social and emotional well being of an individual. It is a vital aspect of living as the absence of it threatens the existence and survival of individuals, families, societies, nations and the world at large. The health sector is an aggregate of units within an economic system that provides curative, preventive, rehabilitative and palliative care. Challenges of medical intervention therefore implies conditions and factors which hinder the moves and smooth running of medicine and its paramedics in ensuring individual and societal well being.

The medical world today is relentless in actualising its goals and objectives through vaccination, environmental alteration (vector and intermediate host control,) education, legislation (legal actions, subsidies and taxes,) nutritional, maternal, neonatal and therapeutic interventions. Unfortunately, its pace has greatly been retarded (if not rendered unattainable) by challenges. Nigeria health sector, a vestige of poverty, disease, illiteracy and vice wreaking nation, has struggled under the clouds of life threatening diseases such as malaria, cholera, tuberculosis, diarrhea, HIV, pox and a host of others. Intermittent outbreaks of these diseases throw the nation in diaspora breeding stigmatization, segregation and high mortality of citizens.

The study by the Institute of Health Metrics and Evaluation (IHME) showed poor diet to be responsible for 72% of all deaths. This no doubt calls for great concern and attention. As man, a product of what he eats, drinks, inhales and thinks is prone to eating and drinking for quenching hunger, taste and satisfaction of pleasure which most often is detrimental to his health and wellbeing.

The prevalence of poverty has breed malnutrition which renders individuals susceptible to diseases and infections, while the poor wrestles with malnutrition, the rich is drown in gluttony. Some foods gladly eaten in Nigeria today cannot be given to dogs in the Western and developed countries of the world. The immense consumption of staples unwittingly shifts attention from other enriching foods that helps in keeping adequate and balance diet.

Stated in the constitution of the Federal Republic of Nigeria is the sole responsibility of the government to ensure the health and wellbeing of its citizens. Unfortunately, a look at the annual budget shows just 5% to 6% of the national budget allotted to the health sector, as opposed to the average (minimum) of 15% expected of any country that seeks to be called a developed and healthy nation or state. Instability and nonchalance of the government and its policies has crippled the intervening limbs of the health sector. A vivid example is the abandonment of the 500 Bed Specialist Hospital in Yenagoa, Bayelsa state for reasons yet unfathomable.

Nepotism, which results in recruitment of unskilled workers and the delay in payment of workers’ salaries by government which leads to incessant strike actions that cost lives and rendered many helpless, has also become a hard knock to crack. The importation of substandard and un-scrutinized goods (e.g. fairly used clothes) has put lives in grave danger of diseases and infections. Also, the rampancy of mushroom hospitals (registered by government assigned organizations and parastatals), exposing many to low quality health facilities and care, and opening wide the door to illegal health practices such as abortion, euthanasia and a host of others. The effect is obviously high crime and mortality rate.

Predominance of diverse religions, customs, traditions, cultures, values, beliefs etc has immensely instigated unawesome practices such as ritual killing, incisions, bethrotal of the girlchild, animal sacrifice (a threat to fauna), and negligence to life saving medical practices such as drug intake, blood transfusion, tissue/organ transplant etc. The prevalence of such naïve and dinosaurian practices in the 21st century, no doubt puts the growth of the health sector at snail pace.

Death resulting from conflicts, terrorism, suicide, murder and natural disasters such as flood, drought etc., is also on the rise; as those fortunate to escape such deaths are unavoidably rendered orphans, widows, homeless, disserted, disabled or threatened with worst health conditions. Abandonment of settlements, as people flee to other regions for safety, thereby leading to overcrowding and paving routes for outspread of diseases, congestions,  high crime rate and a host of threats to living and survival.

Poor hygiene in homes, communities, cities, industries, which create breeding grounds for bacteria, virus, fungus, indiscriminate disposal of  wastes and pollution of environment through bush burning, deforestation, automobile usage, volcanic eruption, etc. (releasing substances such as CO, SO₂, chlorofluorocarbons, excess CO₂ in the air) leading to depletion of ozone layer, global warming, greenhouse effects, acid rain, etc which ultimately shortens longevity.

Incessant migration of skilled medical personnel to other countries (Brain drain) to secure attractive salaries and for other ulterior motives has greatly diminished the efficiency and credibility of Nigerian health sector. Nigerians have little (if not no faith) in the health centres and facilities. The leaders take the lead by travelling far and wide the globe seeking medical attention and quality health care in exchange for huge sums of Nairas.

The stealthy acts and dispositions of infected persons, such that the hands of medical practitioners cannot reach them (to avoid being quarantined) and their deliberate acts of spreading  diseases is not only a challenge but also a threat to medical intervention in Nigeria.

According to the National Drug Law Enforcement Agency (NDLEA), Nigeria has the highest number of drug related convicts worldwide. Such a humiliating declaration shows recklessness on the part of citizens. The taking of drugs without the consent of skilled and experienced medical practitioner has landed many in hospitals and early graveyards. Ranging from alcohols, pharmaceutical and hard drugs like heroin, cocaine, etc., the abuse of these substances causes adverse effects suffered by their abusers or dealers, which in turn demeans and renders useless, the struggles of medicine in ensuring a healhy Nation.

Above all, the greatest enemies weakening and thwarting the interventions of medicine in a nation such as Nigeria are: ignorance, apathy, illiteracy and pessimism in its citizens. This alarming mental attitude begets and sustains other challenges combating the health sector. Little or no attention to rid these challenges has made every effort of the health sector as flogging a dead horse. All hands therefore must be on deck to circumvent the aforementioned challenges. Appointed ministers, commissioners, directors of health must seek selfless ways at the primary to tertiary levels. ‘A problem known,’ they say ‘is half solved.’ Collective effort is required in ensuring the peace and wellbeing of all, as a healthy Nation remains a wealthy Nation.

© Victoria Olabisi, 2018