We have plans to improve Nigeria’s health sector–Minister
The Honourable Minister of Health, Professor Isaac Adewole recently visited the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos and afterwards had a press conference/interview section with journalists. Daily Times LARA ADEJORO was there. Excerpts.
You went to the Accident and Emergency unit of LUTH and said patients should be evacuated within 24 hours. You also saw some indigent patients and asked LUTH management to absorb the cost of managing such patients. Is that a directive or an advice?
I think it is important to appreciate the management of LUTH for the ongoing renovation in the facility. It’s not easy to maintain, renovate and rehabilitate. I commend them for the independent power supply. I must also commend the Chief Medical Director for reactivating the water treatment plant that was abandoned for 25 years. The A & E unit is the face of the hospital and no one will give you credit if you fail to respond to emergencies on time and what I saw at LUTH was congestion. When the emergency room is congested, the facility cannot absorb new cases. That’s why I gave a directive that LUTH should evacuate their patients within 24 hours. In other words, once you give first aid treatment, move them out to the wards or discharge them if they are stable so as to create spaces for new cases. We cannot also deny poor Nigerians treatment, so those who are poor should enjoy our services. But, we are appealing to Nigerians to be truthful because we can’t take care of everybody for now, free of charge. Until the system of insurance scheme or a form of health levy is put in place that will create the resources to take care of everybody.
What are your plans to improve the National Health Insurance Scheme (NHIS) and your primary objectives for the Primary Healthcare (PHC) system?
The poverty indicators in Nigeria show that 57 per cent of Nigerians are poor. That implies that 100 million of almost 180 million Nigerians are poor and that’s massive. We intend to reach them by providing basic care through the PHCs. When we came on board, the first thing we recognised is that there’s chronic under-funding of the Nigeria medicine. When you look at the 2013 data released from the World Bank, Nigeria has the least contribution to the health sector from government spending in Africa. We are even behind South Sudan in terms of the percentage of the GDP devoted to health. On PHCs, there are about 30, 000 PHCs in the country and only 20 per cent are working. Some are uncompleted, some are dilapidated, some are overgrown with weeds but what we will do is that, we will make 10, 000 of the 30, 000 functional, we will have one PHC per ward. Though, it’s not a new idea but the strong determination to implement it is new. When we reach this 10, 000 places, we will be reaching 100 million Nigerians and as an advocate of the poor, we want to give them free care. We have submitted the proposal to the presidency and the proposal has been sent to two independent reviewers that we don’t even know. This administration would not want to start a project and back track. We will have a retreat with World Bank this weekend to ensure that beyond 2017, the PHCs continue to function. After April 9, we will repackage the proposal and submit to the FG. In 3 months from May 1, we want to revitalise 110 PHCs on the basis of one per a senatorial district and we will have an extra one for Fuka village in Niger state where the current Lassa fever outbreak started. When I visited the village, the PHC wasn’t functioning and I gave a directive that the PHC should be rehabilitated and it’s almost near completion. We hope to commission it next month.
What’s the stand of the country on Lassa fever outbreak?
Lassa fever has been with us. There’s always an outbreak every year and I call it a national embarrassment because we have what it takes to make sure it doesn’t happen. However, we have put up a committee to develop a plan and we want to ensure that after this current outbreak, it won’t come back again. We are also worried that the case fatality this year is high. Usually, about 10 per cent of people with Lassa fever will die but this year, we have lost about 60 per cent of those who tested positive to lassa. We want to make sure our laboratories are working so that we can test and treat them nearer home instead of taking them over on a six hour journey either Kano or Ebonyi to Irrua. We want to ensure there’s a lab in the hot spot areas and the treatment facility and we’ll be able to prevent lassa.
What are you doing to increase the country’s health budget?
It is the country that should be fighting for me. I shouldn’t be the one agitating for better funding. The media should fight for us. The people of Nigeria should demand for a bigger slice of the budget because when the nation is healthy, we can produce in a productive manner and the economy will thrive. The media should analyse the budget, look into the budget appropriation in other countries and make a case for us objectively. It is difficult for me as a Minister to fight for myself.
In the past few years, the health sector has not been performing optimally and there’s an expectation that there needs to be a reformation in terms of the output. So, what are your plans to revamp the health sector?
We recognise the health sector is not performing optimally and there are quite a number of ways to make sure it functions. The first thing is to put in money in the health sector. Secondly, it’s to improve the morale of the health workers and thirdly, to reposition the system. Not everybody in LUTH should come to LUTH. Those with diarrhoea or skin rash should go to the PHC; those with something serious should go to the General Hospital. Only the serious ones should come to LUTH because it has highly trained people who should spend more time with you when you need their attention and that’s why we are trying to reposition the system. Once that is done, we will begin to see improvement and enjoy better satisfaction. The health system will change when we implement the structure we are putting in place.
There has been call and need for more radiotherapy machines in Nigeria due to the number of people who need the services, yet we have just two machines functioning. What’s your take on this?
The truth of the matter is, we need at least 140 radiotherapy machines in Nigeria but we have 7 or 8 and only 2 or 3 will work because they are over-used and they break down frequently. We need more machines and we’re working on it. We are talking with International Atomic Energy Agency. There’s a programme that will help us establish more radiotherapy machines. We are talking to many organisations, we believe this will happen. Our plan is to really reactivate the centres. And it is not just machines we need, we also need to train the people that will use the machines and to make sure each of the centre has more than one machine, so that when one machine breaks down, the other will work. The better and longer solution is to talk to Nigerians because 40 per cent of cancer can be prevented, 40 per cent can be cured when diagnosed early and some, when they come early can be treated by surgery. Nigerians need to improve on their lifestyles and go for regular check-ups. By so doing, we will reduce the number of people who present with late cancers.
There has been incessant strike actions and disharmony in the health sector. What will you do to abate this?
I think it is a usual family problem. The family quarrels over money, position and who leads but the message is that, as a member of the family, we will resolve it in a way that will not hurt Nigerians. Without the patient, there will be no hospital and the patient does not come to see a leader but to receive treatment or seek advice. So, we will give treatment first and quarrel later but what we do is quarrel first and then, the patient runs away. We will keep on preaching to ourselves and we’ll get it right.
