Dr. Wale Omole is a medical practitioner of over 30 years and the Zonal Chairman of the Association General and Private Medical Practitioners of Nigeria (AGPMPN) who adores the ideals and principles of the late social critic and humanitarian Dr. Tai Solarin. He is the Coordinator of Tai Solarin’s Foundation and the only known person still keeping the ideals and principle of Tai Solarin going. Recently the Foundation celebrated the anniversary of the death of the late social critic where Dr. Omole wore the regalia of Dr. Tai Solarin to remind Nigerians what he stood for in his life time.
In this Interview with Olusesan Laoye Dr. Omole frowned at the decay of medical institutions in the country, Nigeria’s environmental situation causing series of illness and the negligence of Nigerian government of the health care delivery system. Excerpts
As a medical practitioner what is your perspective of the health care delivery system generally in Nigeria?
To be frank with you, the health care delivery system in Nigeria is nothing to write home about. It is in a bad state and this has been going on for decades without solution being found to put it in good shape. Let us look at it this way, if Nigeria’s health care is good, why should the president of Nigeria go abroad for treatment? It is not the president alone, virtually all those in government and the National Assembly including the rich, don’t stay in Nigeria for medical treatment. This has shown that the country’s health system is bad and that the government cares less about putting it right.
I believe that if our hospitals especially the Teaching hospitals are working optimally with the required needed equipment and modern day facilities and machines, all these people mentioned and even the president of the country would not go abroad to seek medical attention . I feel very sad that despite the well qualified medical personnel in all fields here in Nigeria, our people still travel to ruin our foreign exchange for medical treatment.
Nigeria has the best brains and medical experts and that is why they are regarded and respected all over the world there is no country in the world today that you will not find Nigerians playing important role in the medical system of that country, but here in their own country they are relegated to the background due to poor funding of our hospitals, where they are supposed to be and put in the best they now offer other countries. These doctors abroad I must tell you are those qualified here in Nigeria before they went abroad.
Honestly some of us are not happy with the ways thing are medically in Nigeria and this is the fault of our governments. Adequate funds are not provided for health and the little available is not well utilized due to corruption.
What then do you have to say to the noise being made by states governments about providing this and providing that as regards the health care system in their respective states?
We cannot rule out the facts that some of them are trying, but the bottom line is that they still don’t budget enough for health to be able to cater for the needs in their various hospitals. If you go to many state hospitals they are very bad. Doctors there don’t have good gadgets to work with. Some state hospitals are horrible. The toga of free health, free everything is just to show off. As far as people are concerned there is nothing free in the hospitals.
Coming down to the teaching hospitals they all suffer the same thing. They lack modern day facilities that are befitting of teaching hospitals. You see in other climes of the world, their leaders don’t go outside their countries for medical treatment because they fund their hospitals adequately. You can imagine, the governors who say they provide facilities in their state hospitals going abroad for treatment when they have minor ailment which doctors in Nigeria are capable of attending to.
Doctors in Nigeria are better than some of the doctors treating them abroad, but for the mere fact that they already have the mindset that if they go outside the country they would be well taken care of, they travel out with even the resources which they should have used to develop their hospitals. Let me however acknowledge this, Lagos state government is tying and I can say it is the best I can see that is very serious about health care delivery. Despite this, the state still need to improve on the standard already set which is commendable.
What serious effect do you think all you have enumerated as the short comings in the nation’s health care is causing the country?
The country is losing a lot. Apart from the hazards which all these are causing the citizens, it is also affecting the country in terms of brain drain. Many Nigerian doctors as I said earlier have gone out of the country to where they can effectively practice their professions. They are not leaving the country just because of money. It is a fact that Nigerian doctors are not well paid but they go out because they have no facilities to work with and because the jobs are not provided for them.
Again, the issue of unemployment has cut across every profession in Nigeria. The medical profession is seriously affected as well. Some of our young doctors don’t get jobs. Government is no longer offering jobs despite the fact that there is shortage of manpower in Nigerian hospitals. You see if not because of the private hospitals we have in the country, majority of them could have been roaming the streets without jobs. But the point is that the private hospitals that are giving out jobs to these young doctors cannot accommodate all of them.
Nigerians should be grateful that we have dutiful doctors and directors in the private hospitals that are capable of handling serious and critical health issues. If not for the private health institutions, the situation would have worse.
Don’t you think that we should be more concerned about preventing illness and diseases by taking good care of our environment to reduce the cost of medical treatments?
Let us face the fact; Nigeria has the worse environment in the world. Our environment is so bad that even government that is supposed to take care of it is lacking in its responsibilities. I agree with you that if we have clean environment, the rate which Nigerians are falling ill would be drastically reduced. The bad environment we have in this country is also putting more work pressure on the doctors and other health personnel. I can say that because of different kinds of infections that Nigerians are exposed to as a result of dirty unhygienic environment, a lot of money are spent on anti-biotic.
Our environments are unkempt, especially, our markets where the food we buy are exposed to infections. Honestly most of the things we buy outside are contaminated. Corn, suya, cucumber, carrots, and water melons and other food items are infected. If not the fact that we boil some of them the rate of infection could have been unpardonable. We are wasting money on antibiotic, some of the anti-biotic cause kidney problem.
The issue of Antibiotic you mentioned now reminds me of the cry by Nigerians that a lot of anti-biotic tablets are counterfeit; how do you identify fake drugs?
There is no doubt about it; we have a lot of fake drugs in Nigeria because other countries have turned Nigeria to a dumping ground. All sorts of drugs are imported to the country and some of these drugs deceive doctors. Even those who have NAFDAC numbers could be fake because they can forge NAFDAC numbers because in Nigeria nothing is impossible.
What efforts do you think can help to curb manufacturing and importations of fake drugs into the country?
The best option is to set up a parallel regulatory body that would be purely formed by the Pharmaceutical Society of Nigeria. I think if the pharmaceutical body is allowed to handle importation of drugs, it would reduce the number of fake drugs entering the country. Nigerian pharmacists have been complaining about the rate all kinds of drugs are coming to Nigeria. One is not saying that the pharmacist in NAFDAC are not good, the work load is too much for them and if a parallel body is set up that would handle drug importation , NAFDAC would still carry out its functions and it would relief the body of a lot being done now.
Again, I must say that governments too have a big role to play for good drugs to be provided. As a matter of fact, our pharmacists should be encouraged to produce the drugs we use in Nigeria. Adequate finance should be given to them because the
controlling body would set up a regulatory organ that would make sure that good drugs are produced.
Government should as well provide funds for research. Most of the lecturers in our universities are very brilliant, but because of poor funding for researches they are just there. If they have money they would be able to research into drugs that would take care of many ailments in the country and there would be no need for mass
importations of drugs into Nigeria.
What about the money in the nation’s budget concerning health?
We all know that health is one of the areas that are not adequately provided for by all tiers of governments in the country. Although they always say that they allocate good money from the budget to health, but the money has never gone to the right places meant for it. The money always goes to the wrong hands. Even people in the ministry would start deductions and by the time it gets to where it would be used, it would no longer be sufficient for the purpose they are meant to serve.
That is why the teaching hospitals are not well funded because contracts for health projects are not given to the right people but those that would do the bidding of those in government. Honestly, I am not happy about the state of our teaching hospitals and if not because of private medical practitioners in the country, we would have been in serious health crisis in Nigeria. It is the private practitioner that are covering up and filling the gap
Recently there was problem over the health insurance scheme in Nigeria, do you think the policy is going on well and how do you think the system could be effective to cover ordinary people because it appears that only working class people are benefitting from it?
The scheme is not well handled by appropriate authorities. The scheme has been hijacked by some people who have nothing to do with the policy and this is what is causing problem and disaffections among those who are to be direct beneficiaries of the policy.
What is happening is that the HMOs amass wealth through the scheme while the providers are being cheated. Other health personnel who are to benefit are neglected as well, Nurses, radiographers, lab technicians are set aside in the scheme which is not supposed to be so. The health scheme when you come to think of it is not beneficial and profitable to the doctors because the tariff is determined by the HMOs. With what is happening the scheme should be redesigned so that all stakeholders would enjoy it and no one would be left out or feel cheated as the situation is now.
To also make the scheme work, the bottom line is that more money should be allocated to health. Good health is vital and important for the country to develop, because if the citizens are not physically, mentally and otherwise fit, they won’t be able to function very well in the discharge of their duties and responsibilities to the country and this would be a big setback. In other countries of the world especially America and Europe, their governments don’t play with the health of their citizens.
How would you describe the recognitions now given to alternative medicine and the patronage the practitioners get by Nigerians who believe that this is cheaper than the orthodox medicine?
The problem in this country is that the governments encourage them but alternative medicine cannot be compared to the orthodox one. Medicines administered by medically trained doctors have been tested and it has measures which cannot be abused. Prescriptions are made based on the quantity of medicines needed for a particular ailment which if followed strictly as prescribed by medical practitioners it is not hazardous and cannot lead to overdose.
In the case of herbal medicine, there is no proper dosage and often leads to overdose and dangerous to the users. I always laugh when I see some herbal doctors trying to equate themselves with medically trained doctors without realizing that we are miles apart. They do this just because of the recognitions accorded them by the government and some ignorant people looking for cheap alternatives to their ailments
What then is the way forward for the improvement of our health care delivery system?
I believe that the way forward is for the government, to formulate new and proper health care delivery policy that would be effective from primary, secondary and the tertiary levels. Private medical practitioner who are rendering great service to the country should be motivated and encouraged by the government because like I said before, if not for their efforts, the situation of our health care would been worse than what we have now. I will also want the government to provide funds for research and our pharmacists should be encouraged to manufacture drugs here in large quantity that would not give room for importation of drugs.
You see in the USA, they don’t allow drugs from other countries. We can do that as well in Nigeria because we have well trained pharmacists who are up to the task of making us self-reliant in drug manufacturing. Government should put up conducive environment for our pharmacists to be well and fully engaged, there would be employment for young pharmacist to work in the pharmaceutical companies