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Dipo Famakinwa: Victim Of A Sick Nation, Diseased Healthcare System By Bayo Oluwasanmi

April 24, 2017

The news of the demise of Dipo Famakinwa swamped the social media. He was the Director General of the Development Agenda for Western Nigeria (DAWN) Commission. Famakinwa died last Friday at a Lagos hospital before he could be ferried abroad for better treatment. Since the news broke out, the outpouring of condolence on the social media flows around you like a river and you could easily abandon yourself to the current. It was a testimonial to his character, vision, work ethics, and love for people. 

The sudden departure of our friend is a sober reminder that “for everything, there is a season.” What a great loss to the Yoruba Nation and public service. It's hard to contemplate the unimaginable pain of losing him. Far better to mourn death, is to celebrate the life that was lived. This should now be the rallying cry to the memory of such an amazing life. He was a good man. He was an honest and trusted steward. He was amiable, approachable, and humble. He was a consummate professional. All we can really take with us at the end of our journey in this world is what we have given away. Famakinwa gave his all.

The state of our healthcare is a dystopian vision of how bad it would become in the future. A typical hospital ward in Nigeria is a dark, dormitory-style room with little or no equipment, scarce privacy, and miserable looking patients slumped two to a bed.  On a daily basis, many Nigerians like Famakinwa fall victims of cheap death caused by a sick nation and a diseased healthcare system. Nigeria is a big theater of mischief and combustible farce. A country that is ostentatiously inept where everything goes wrong. A country of an intricately planned fiasco. Nigeria is a big and pure comedic eye candy. According to the 2009 communique of the Nigerian National Health Conference, our healthcare system “remains weak as evidenced by the lack of coordination, fragmentation of services, dearth of resources, including drug and supplies, inadequate and decaying infrastructure, inequity in resources distribution, and access to care and very deplorable quality of care.”

The provision of healthcare in Nigeria is the responsibility of the federal, state, and local governments. The primary healthcare system is managed by the 774 local government areas with support from their ministries of health as well as private medical practitioners. Africa is home to 24 of the 26 countries with the fewest numbers of doctors per capita. The available statistics that I have show health institutions providing healthcare in Nigeria are 33,303 general hospitals, 20,278 primary health centers and posts, and 59 teaching hospitals and federal medical centers. 

About 55 percent of Nigeria's population lives in rural areas and only 45 percent live in the urban areas. About 70 percent of the healthcare is provided by private vendors and only 30 per cent by the government. Over 70 percent of drugs dispensed are substandard. Over half of the population live below the poverty line on less than $1 a day and cannot afford the high cost of medical care. In most of our public hospitals, one doctor attends to over 200 patients. In 2000, Nigeria could only boast of 39,000 medical doctors managing 150 million people. Our hospitals have no running water. According to WHO 2015 report, every year half a million babies die before they are one-month old due to lack of clean water and safe sanitation in hospitals. 

Lack of resources due to human-imposed catastrophes such as governmental corruption, diverts the much-needed funds from hospitals, schools of medicine in our universities for the training of doctors and other medical professionals into the pockets of our politicians. “Brain drain” also affects the availability of doctors in Nigeria who move to other countries offering better promise for a medical career. A staggering over 50 per cent of Nigerian-born medical doctors are working overseas. Low pay, poor working conditions, and hostility from employer (government) forced most Nigerian doctors to quit public service or to look for either private care providers or to look for opportunities abroad.

Inequitable distribution of service is endemic to our healthcare delivery. Millions of Nigerians are served by a handful of available physicians. It means the well-paid foreigners, corrupt government officials and politicians, and rich business people receive what little medical support is available. The rest poor like local farmers, taxi drivers, teachers, students, and the unemployed are denied access to healthcare because of its prohibitive cost. A majority of our people do not have access to a doctor to diagnose what's ailing them. And in most cases where they find a doctor, they're grossly misdiagnosed. Treatment becomes a shot in the dark. In desperation, people try any and all manners of reliefs or cures. 

Families whose loved ones die never know the cause of death. Our women facing birth complications rarely have access to trained doctors who can perform Cesarean sections. After days of obstructed labor, both mother and child would die. Nigeria is one of the countries with the highest infant and maternal mortality and morbidity rates, HIV, and high rates of preventable diseases such as malaria, cholera, meningitis. We're living through a glut of corrupt, irresponsible, backward, wicked, and “do nothing” legislators coupled with a government with no healthcare agenda to reform, restructure, and revamp the dilapidated state of our healthcare.  

The ruling class doesn't give a damn. They are not affected. With our looted money, they can buy the best medical treatment for their families in the best hospitals abroad. Their fluid approach to our comatose healthcare system undermines the foundation of a decent, humane, and civilized society. One would think the government would have acted on the recommendations of 2009 of the Nigerian National Conference on Health and similar recommendations from other medical professional bodies. Like all other recommendations, they are thrown into the garbage can. 

Neither the government nor the minister of health has the political will and policy clarity to transform the obsolete healthcare system. The tragedy is, the problem is not limited to healthcare alone. It's the same sad story in other sectors. Those in charge of Nigeria go about with a maddening air of sleepy-eyed beatitude “change is on the way.”  Where is the change?  When will the change take place? How long do we have to wait? We're not told. And no one is sure. No one cares!They simply moved on to enjoy their spoils of corruption. They lack the aptitude, the fortitude, the courage, the determination, and the ambition to spark or jolt change. Meanwhile, Nigerians continue to die in droves – needlessly and endlessly.

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