Wednesday, 12 November 2008

Why organise a conference on Nigerian health….in London?

This piece was first publised on the
BMJ blog

by ike anya and chikwe ihekweazu
A quiet milestone passed in May this year, when Nigerians marked nine years of unbroken civilian government, the longest period in the 48 years since independence. A year earlier, the peaceful handover of power from one civilian president to another was another significant milestone. This period has coincided with an era of unprecedented high oil prices, Nigeria’s major source of income.

The past nine years of relative peace and democratic governance have seen changes in the economy with steady growth, large reduction in external debt, and structural reforms of the financial and telecommunications sectors.

Apart from increased access to mobile phones, these changes have had little impact on the lives of ordinary Nigerians.

From a health perspective, there are still many challenges. The health systems are weak, immunisation coverage is poor, and prospects of achieving the Millennium Development Goals (MDGS) are remote.

With a population of an estimated 140 million, improving health in Nigeria is a key step towards achieving global health goals like eradicating polio, achieving the Millennium Developmental Goals (MDGs), preparing for pandemic flu and achieving universal access to antiretrovirals for HIV/AIDS.

Perhaps because of our large population, Nigerians can be found all over the world. Meeting Nigerians working in public health at international conferences and meetings was the stimulus for founding the Nigerian Public Health Network a few years ago. The network now consists of over a hundred members working all over the world, including in Nigeria; and in our electronic conversations, it emerged that there were a large number of initiatives aiming to improve health in Nigeria, a broad range of expertise and skills, and a keen interest in engaging in the onerous task of improving health in Nigeria.

The large number of Nigerian health professionals working abroad and the reasons for this are well known. Our study of three graduating classes from a Nigerian medical school indicated that nearly half were living abroad ten years after graduation, with the majority based in the UK, the US and Ireland. While a handful of colleagues keep seeking opportunities to work in Nigeria, many have become disillusioned with Nigeria, frustrated by bureaucracy of engagement.

On our frequent visits back to Nigeria, we also sought to engage with policy makers who often spoke of their hopes of engaging the vast health diaspora. Their attempts to do this yielded little fruit as colleagues often returned to Nigeria in small teams for medical missions all over the country with little cohesion in planning or implementation.

A number of UK institutions and donor organizations are also active in Nigeria. Money, energy and air miles are spent in efforts to support Nigeria in providing health for her people.

With all these in mind, we felt that it would be important to bring together these groups to understand policy initiatives and the priorities of the Nigerian government and where each group can help. We felt it was time to start working together, as Nigerian health professionals in the UK and elsewhere and with our friends and partners. It was time to pull together from the same end of the rope.

Why has health slipped down the order of priorities in Nigeria?

Is this a sustainable state of affairs for the country with the largest population on the African continent, the 8th largest crude oil producer in the world?

Most importantly; what can we do about it?

To answer these important questions we have called a conference

Nigeria: Partnership for Health

which will hold at UCL, London on 22 November.

This is being convened by the Nigerian Public Health Network, in association with the Medical Association of Nigerian Specialists and General Practitioners, the Tropical Health and Education Trust, University College London and AfricaRecruit.

Together, perhaps we can spark the drive to awaken the sleeping giant. Perhaps Nigeria can avoid being the last country to eradicate polio. Perhaps we can improve on our health sector ranking as the 187th out of 191 by WHO. Perhaps we can ask why our politicians have to be flown abroad for the slightest ailments and why our healthcare workers continue to leave. Perhaps this conference can help put these difficult questions on the table, and suggest a credible, pragmatic way forward. Perhaps we can achieve a re-energised Nigerian health workforce in the diaspora together with our friends and partners ready to re-engage with Nigeria. should be there...details @

This piece was first publised on the BMJ blog

Wednesday, 5 November 2008

MANSAG meets in Birmingham

The Medical Association of Nigerian Specialists and General Practitioners in the British Isles recently held its 19th MANSAG Autumn Conference held in Darwin & Wedgwood Suite, Novotel Hotel , Broad Street, Birmingham from 17th -19th October 2008 under the guidance of Mr Ike Nwachukwu, the Chair of the Local Organising Chairman.

Running an organisation like this is never easy...Y
et over the years MANSAG has stood tall to the challenges it has faced,holding a scientific conference and meeting every year since 1997....every year!

This year was no different. Nigerian doctors working in the UK came together to deliberate on the theme
"Ethnic Minority Health Issues". We heard about health issues of particular relevance to us....Fibroid, hypertension, mental health issues....Each session led to vibrant discussions...

....But this was not just about lectures! We sat together for lunch, had the opportunity to network and form new relationships...get to know colleagues that have been in the profession through the good and bad times. One of the defining moments of the re-launching of the MANSAG mentorship programme aiming to offer support and guidance to junior doctors within their area of specialist interest as they develop their career. But the truly great thing is that this is being driven by young Nigerian of whom...Dr Nkem Onyeador was elected as the Welfare and Social Secretary.

A key challenge facing the organisation that protects the interests of Nigerian doctors in the UK is how to attract more Nigerian doctors, especially younger colleagues to join. Why do some of us remain disengaged in an era of "change we can believe in". The President of MANSAG; Dr Stanley Okolo and his executive deserve our respect for not dropping the ball...and keeping the organisation strong and vibrant against the odds. As they plan for their transition ...there was a discussion on the name as a disincentive for younger colleagues and if it could be adapted to be representative of the reality of the day.

But finally the weekend would not be truly Nigerian without a good party to end the day... and good it was. Our colleagues in the West Midlands Zonal Chapter of MANSAG pulled out all the stops to produce an evening that will remain in our memories for a while yet.

At the end of the left fulfilled with an experience of high quality science, cameradie of colleagues, and motivation of new mentors...what more can one ask for?

More pictures can be found

.....can't wait for next year

photo credits
Chinyere Onyeaka

Saturday, 1 November 2008

Medical Mission taken to another scale

In many online forums there have been discussions, often heated about the value of so called "medical missions" to Nigeria by Nigerian medical professionals living in the so called "Diaspora".

Find in Vanguard...and Sun a report about medical missions taken to another level when the Anambra Association in the USA, (ASA-USA) recently went home with over 54 medical professionals in the fields of general surgery, gynecology, ophthalmology, internal medicine, family medicine, pharmacy. pediatrics, nursing, and anesthesiology, and spent over $800,000 worth of medications on its mission to the state. They have been at this for a while as reported here.

This group also is planning on building an "ultra-modern" hospital in the state as reported here by the Vanguard.

Patients waiting to be seen...
Patient being seen...

Delegation received by Governor Obi...

The jury is still out on the value of medical missions....and maybe these discussions are flawed. Some problems such as chronic surgical conditions such as cataracts where patients can be prepared for the arrival of a surgical team are ideal for missions. However, for chronic medical conditions, it is of little value for a diagnosis of diabetes for instance to be made by colleagues on a medical mission when there is little availale in sustainable healthcare to provide long term care...

However...bottomline maybe is that in all we do we should also include a capacity building element for colleagues on the front lines as well as an advocacy component for better healthcare provision by those whose responsibility it is to provide healthcare.

To those that commit their time, energy and resources to do the little that they can do....we say thank you, as there are many others out there, that really don't care about the country from where they got a medical education....virtually for free.

What do you think about medical missions?