Tuesday, 29 June 2010

A round-up of health news stories out of Nigeria

Following health news out of Nigeria is always interesting as one finds the good, bad and the simply absurd. Find here a cross section of recent stories.

"The sector, hitherto in a state of prostration, slumped into a coma with very severe untold consequences on the health of ordinary citizen’s especially sick infants and children, pregnant women and the bed ridden in the society." Intimidating challenges facing the health care sector in Nigeria as resident doctors go on strike. Details in the Daily Independent.

"I want you to do three things for me. One, you should forgive me, secondly you should take care of our children and thirdly you should pray for me." Read about how medical emergencies are dealt with at Mallam Aminu Kano Teaching Hospital in Sunday Trust.

"National Hospital has failed us - FCT Minister." Well if that is the case with our National Hospital, what of the rest of the health care system? Details in Vanguard

"Government give prostitutes in Abuja 48hours to leave the city" If only life was as simple as that! Our new Minister for the FCT is throwing his weight around without doing the requisite thinking. In life and in what country has he heard that the oldest profession in the world has been eradicated by a ministerial ban? Come to your senses honourable minister! Details in the Daily Independent.

Finally - Lagos State Government has set July 1 for the full enforcement of road traffic laws and regulations guiding motorcycle taxi (Okada) operation, and it will be illegal from that date for school children, pregnant women, and women with babies strapped to their backs to use this mode of transport...again details in the Daily Independent

The new rule says "Nobody below 18 years should ride on motorcycle"

Friday, 25 June 2010

Stories of hope and despair: A personal perspective of Primary Health Care in Nigeria

When we recently called on you, our readers to send us your accounts of encounters with the health sector in our country, we were not quite sure what to expect. But the piece below took us completely by surprise. This beautifully written account of the primary health care system in Nigeria from the perspectives of government, private and corporate sponsors is an eye-opener to the challenges AND hopes of our health sector. Enjoy, send it round, and send in your own posts!

Stories of hope and despair: A personal perspective of Primary Health Care in Nigeria

By Olufemi Sunmonu, M.D

I am a physician practising in the UK.  Born in Nigeria, but I have lived most of my adult life abroad in pursuit of a better education (with pleas from my parents, urging me to return to Nigeria when I was finished, growing fainter each year).  Sometime in the last 2 years I decided on a new direction within healthcare.  I had heard a lot about the state of healthcare in Nigeria, (especially how much worse things were now, compared to the state of affairs 30 years ago) but the only encounters I could remember were as a child being chased around a hospital room by large needle-wielding nurses.   As an adult all I could go on were the anecdotal tales from home that ranged from the comical to the horrific, the most disturbing being the almost quarterly reports of unexpected and undiagnosed deaths amongst friends and family back home.  

So in March 2010, I decided to go see for myself and took a three-week trip to Nigeria. I visited some rural and urban clinics in Abuja, Port-Harcourt, and Eruwa. My first stop was Dutse Makaranta, a satellite town about 40 minutes outside Abuja and home to a few thousand workers who commute to the city to make a living.  It is a hillside town composed of semi derelict houses and shacks with up to five people sharing a bedroom.  The town is flanked on one side by uninhabitable mountain terrain and enclosed on the other by the only paved road I could see.  The Dutse Makaranta primary health centre is located on the other side of the road, highly visible to the entire town.

My first impressions were mixed; there was no discernible path leading up to the facility (not really a major issue except you never expect to be walking across rocks, sand and trash to get to your doctor). Generally, the wards were clean but almost all the equipment was in need of maintenance.  I was greeted by a friendly midwife who offered to check my blood pressure.  I would like to preface the next part of this by saying I was informed that this was a slow day to visit the clinic.  There was no one else present; no doctors, no nurses, no community health workers, no pharmacist, no lab technician.  I was assured that these people did indeed exist but I could not get a firm answer on WHEN they would be around. 

I can comfortably attribute the midwife's presence to a newly rolled-out Midwife Service Scheme which has a strict compliance regime enforced by field officers. The Scheme itself (of which an outline is beyond the scope of this blog) is a testament to the commitment of the practitioners I met, who have a clear view to improving the state of healthcare in under-served communities.  Unfortunately, the narrowness of the scheme's scope means that you have an excellent midwifery service at a local clinic where there is no guarantee of the presence of a doctor, nurse, or pharmacist.

Eruwa, a quiet rural Community in Oyo State is home to the Awojobi Clinic; my next stop.  About a 5 hours drive from Lagos, the clinic was located off a main road seemingly in the middle of nowhere.  However, on my arrival, the waiting area was full of patients.  With 56 beds, it is more of a hospital than a clinic. It is run by Dr Awojobi, a home-grown surgeon who trained at University College hospital Ibadan and deferred the opportunity to spend a year abroad because of his belief (which he reiterated fervently when we met) that Nigerians can solve their problems with little or no external help.  Of note is that Dr Awojobi has been running this clinic for over 25 years.  He is the only doctor, his wife is the radiographer, there are 2 Registered nurses, 10 community health workers and the rest are secondary school leavers trained on the job to do specific tasks. The clinic itself is a testament to the self-reliance that he sees in his countrymen.  To overcome the problem of an erratic and sometimes non-existent water supply, they built a series of water reservoirs to collect rainwater and satisfy hospital water requirements for 4 months out of the year during the dry season. 

Other low cost innovations include solar panels to power lighting and minor equipment (Diesel consumption is now down to a gallon a day), large windows to maximise natural light use, A coal furnace using corn cob husks from local farmers to power the autoclave (locally manufactured from a household gas cylinder) and to distill water, and a manually operated hematocrit centrifuge fashioned from the rear wheel of a bicycle, locally manufactured intravenous fluids at 10% of the market cost (UCH Ibadan used to produce all of its own  intravenous fluids in the 70’s).  They even built an industrial size washing machine powered by a small diesel generator. I would like to point out that all these innovations were made possible by the contributions of the local community, friends and family.  Dr Awojobi sees roughly 600 new patients a month.  Most workers have multiple roles (X-ray tech, porter, handyman). Salaries are decided upon by consensus amongst workers and all employees are included in consultations on what to do with profits (if any).  This was undoubtedly one of the most impressive standalone systems I’d come across thus far; an unassuming rural clinic which employs principles of sustainability found in any global social enterprise: maintaining a low cost base, stakeholder engagement, maximising efficiency, innovation and transparency.

My final stop was Obio Clinic in Port Harcourt, Rivers State.  Here, I found hope.  The Obio clinic is a facility that not too long ago was essentially non-functional.  With the implementation of various initiatives, it serves as a model-in-progress of health care delivery as it should be.

The clinic is one of 27 that are being supported by Shell Petroleum Development Company in the South of Nigeria.  I am well aware of the scepticism with which the involvement of an oil company will be greeted with, but I would ask that we set this aside in order to examine this health care model. The clinic is essentially a partnership between the local government, private enterprises and the local community.  The clinic is owned by the government, which also employs and pays the staff as with any other community health centre (Dutse Makaranta in Abuja, for example).  A health insurance scheme has been implemented in this community by partnering with Health Care International, and the community is represented in this partnership by the inclusion of a respected local leader who is fully involved as a member of the health advisory board. But what does all this translate into on the ground? The clinic has a fully stocked pharmacy and a drug/reagent revolving fund where drugs and other essential supplies are replenished with capitation monies paid to the hospital as part of the community health insurance arrangement.  Staff members are motivated and fully engaged in their practice as they are paid on time and provided with necessary training and support.  There is a constant supply of electricity and running water.  The premises are immaculate due to systems put in place to inspect and maintain them regularly. Innovative solutions such as an oxygen concentrator, and reagents that do not require refrigeration are utilised. With the use of burnt brick and internal wall tiling, the external and internal walls are virtually maintenance-free as they do not require painting or repainting. Frequent meetings of the advisory board ensure that there is transparency and oversight. I can already hear the howls of “but they are using shell money to survive”. Granted there was an initial cost that had to be fronted by a private company, but this would not have been necessary if some of the mechanisms I have described were implemented in the first place.  The focus should be more on the utilisation of private sector processes and not the money.  The Company plans to exit this scheme shortly as it should be able to run independently with the delivery system that’s been put in place. 

My little expedition is admittedly a tiny window into the state of primary health care in Nigeria, but I did come away feeling more knowledgeable about some of the problems it faces. We have problems related to access, cost and quality that are unique to our continent, and as such we need innovative approaches to resolve them.  
I saw that innovations with alternative energy can help with some of our infrastructure dilemmas we face, and the pooling of risk (such as in private health insurance schemes) can significantly reduce or eliminate the issue of cost.  However, without the judicious management of resources these efforts will be essentially fruitless.   My hope is that anyone thinking about healthcare in Nigeria approaches it comprehensively, and thinks not only about preventing and treating illness but also about infrastructure (and its maintenance), creating community stakeholders, health promotion, consumer attitudes and the quality of the care being provided and how it can be safeguarded, as well as the management of people and resources.

None of this is rocket science, but it sounds suspiciously like a business and like any failing business, healthcare in Nigeria, it is in need of reform.  In doing my part to address some of these issues, I will be working with the sustainable health foundation, a Non Governmental Organisation committed to sustainably improving healthcare in under-served communities in Nigeria.

Thanks Femi for this - We all have a role to play - individuals, the private sector and governments. There are too many challenges to solve, and they cannot be solved without a collaborative effort that involves all stakeholders.................aluta

Monday, 21 June 2010

Medical missions with a difference

All over the USA and UK, the annual mobilisation of Nigerians to donate towards "Medical Missions"is in full swing. 

The fund raising of the Anambra State Association, USA is in full swing. They raise hundreds of thousands of dollars each year and spend time in several health facilities in Anambra State. From Nimo, to Oko, to Ogbaru...they will be all over Anambra State, supporting existing health facilities. What we find unique in these missions is the broad spectrum of medical professionals involved. In addition to the routine list of doctors, nurses and pharmacists, they have on their teams counsellors, data managers, fundraisers, and even engineers recognising the broad nature of our health care challenges. In 2008 we blogged about their mission. We challenged them on the capacity building and advocacy aspects of their missions. We challenged them to confront Governor Obi with the scenes they found in the hospitals, and what could be provided as institutional solutions.

The long term goal of medical missions should be to make missions unnecessary!

At another recent fund raiser; a dinner held in New Jersey, Professor Akinnaso who attended the event reports that the New Jersey chapter of the Association of Nigerian Physicians in the Americas is planning its next mission where they will be  "Improving healthcare in Nigeria, one person at a time". At the dinner,  a speech by Dr. Ferdinand Ofodile, who is a clinical Professor of Surgery at Columbia University and Chief of Plastic Surgery at Harlem Hospital in New York compared the Nigerian health system to a foreigner's first impression of  Murtala Muhammed International Airport, where "chaos and urban decay come flying at visitors like paper scraps in a windstorm". He went on to say that...
"If we want things to change, we in the Diaspora can no longer wait for the people at home. We must take the lead. We must be engaged in sufficient numbers and we must be prepared for the long haul...
Committing to doing this is no small matter. Nigerian doctors on medical missions have often paid with their lives. Last year the tragic story of Dr Enyi Okereke comes to mind. This colleague was, until his untimely death on 25 November, 2008, the Chairman of the ANPA New Jersey Chapter. He was in Enugu in Eastern Nigeria preparing to participate in a arthroscopic seminar with a team of colleagues at the University of Nigeria Teaching Hospital when he suddenly took ill, and there was not even the most basic functional resuscitation equipment available to save his life. He had been appointed to the Penn Faculty in 1993 where he was an assistant Professor of orthopedics and the Chief of Foot and Ankle Services at the University of Pennsylvania, Philadelphia, USA. His death was a loss to his family, the teaching hospital, Nigeria. Everyone loses because we have failed to do the basics.

Dr Kpaduwa the President of the Association of Nigerian Physicians in the Americas described the incident graphically. ..
In fact it was on one of these selfless services to our nation, in Enugu awaiting the seminar on arthroscopic surgery that death cruelly snatched him (Enyi) away from us.   He was first carried down to the lobby of the hotel that he was staying at when the heart attack struck.  A taxi was flagged down to carry him to the nearest hospital.  There are no emergency response systems in Enugu, no ambulances, no paramedics to administer crucial first aid to a heart attack victim.  There was no emergency room to act as second response; no clot busters' in the hospital, and no cardiac catheterization lab for crucial diagnoses.  Our friend was aware of these inadequacies.  He had to call for help.  He picked up his phone and called his dear wife, who was thousands of miles away.  He must have seen the worst case scenario coming." 

If this can happen to Enyi - what hope do we or any of our family members have when confronted with medical emergencies in Nigeria.

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. But also, I wonder if we are missing a trick with missions. The natural instinct that we all have is to try and solve problems ourselves. Organising a health care system to truly serve the people is a complex problem (as we are learning from the USA). The solution, lies to a large extent in the government's commitment and capacity to organise the system to serve the people. We challenge our colleagues to spend as much effort to advocate to the governments as they spend in directly providing care. Let us seek access and offer not just clinical services but expertise in management and leadership. Let competent Nigerians from all over the world speak up, show our governments and the world the state of affairs on the front-lines of our health care facilities.

This is the key to the success of the world's largest medical NGO - MSF. They have a dual role that they take as seriously as the other...firstly providing emergency medical assistance to populations in danger and to act as a witness, speaking out, in private or in public about the plight of populations in danger.

We can and should do both!

What do you think about medical missions?

Monday, 14 June 2010

Three major issues at the 63rd World Health Assembly

As described in a previous post - the 63rd World Health Assembly has just concluded in Geneva. Despite the 7 journalists that were part of the Nigerian delegation, very little has been reported in the Nigerian press. We therefore summarise the three most important issues discussed.

Three issues that caused the most furore at the Assembly was the issue of health worker migration, counterfeit drugs and the methods of electing a new Director General for the WHO.

Starting with the later ...

The WHA has been discussing rotation (no not only our PDP has this dilemma!). It has been discussing the possibility of rotating the post of Director-General among WHO’s regions since 2007.

Two schools of thought exist - one says that personal and professional qualities required to perform fully and effectively the functions of chief technical and administrative officer of the organization should be the overriding consideration, and another says no... a regional rotation of the post is the way to go!.

The Regional Committee for Africa strongly supported the principle of rotation of the post of Director-General among the regions. The full report can be found here. Vanguard's Sola Ogundipe who was part of Nigeria's official delegation to the WHA reported this as Nigeria, Others, to Vie for WHO's DG Seat. Well, I must confess this is one area, with 11 years of PDP in power that we have a lot of experience in, and the African delegation may well tap into this. Indeed we might offer to redeploy the entire Board of Trustees of PDP to fight this noble battle.

The other major issue that animated the Assembly was the draft global code of practice for the international recruitment of health personnel.

The debate on international health worker recruitment and its impact on health systems has been intense in recent years. The WHA had previously noted with concern that "highly trained and skilled health personnel from the developing countries continue to emigrate at an increasing rate to certain countries", thereby weakening health systems in their countries of origin, and requested the Director-General to develop a code of practice on the international recruitment of health personnel in consultation with Member States and all relevant partners. In response, the Secretariat initiated a global consultation process in order to produce a draft code as a priority activity and as part of its agenda to strengthen health systems based on primary health care.  This draft code was considered and most of the debate at the Assembly was mostly around the inclusion of the term


Most of our friends in "receiver" countries resisted the use of this term as this will presumably put them in a rather difficult situation if they were seen not to be abiding by the requirements of the code.

Also, while most "receiver" countries seem to have come to terms with the apparent "no brainer" that they will have to make some serious contributions to "donor" countries, they absolutely resisted any attempts to suggest that they should pay some reparations for historical unethical recruitment. The full paper considered by the WHA can be accessed here.

The third area that dominated discussions and one in which the Nigerian delegation showed leadership on was the area of of counterfeit drugs.  Counterfeiting is growing in complexity and scale, and Nigeria's NAFDAC has made some progress in confronting this and keeping it in the public focus. Nigeria's WHA delegate told delegates, "only last year we lost 84 children in Nigeria due to fraudulent practices in some countries. It is lives we are talking about"

But finally some good news for us in Nigeria....the WHO "approved a three-year plan to eradicate polio on Friday, bringing a two-decade battle to a critical juncture as funding falls short and the disease is on a surprising upturn," as reported in the Wall Street Journal. According to the newspaper, the plan "calls for spending of $2.6 billion over the next three years to run polio vaccination programs that will focus on Nigeria, India and several other countries world-wide where polio remains deeply rooted."

Photo credit - Vanguard Press

Saturday, 12 June 2010

Visit your mortuary

Death is always a difficult topic. Yet, it is the inevitable end of all of us. Death is part of life's journey built together in units of time. But today let's challenge ourselves a bit with what happens immediately after death. Over the past few years I have on a couple of occasions had cause to visit a loved one in a mortuary immediately after death, and those memories have hounded me. The trauma and anxiety of death in the family is intense and excruciating, but having to see a loved one in the sordid conditions we refer to as mortuaries in Nigeria makes it exponentially worse - believe me - you will never forget when you visit one.

This piece in the Daily Champion provided a reminder, describing the conditions at Isolo General Hospital Mortuary in Lagos where, in addition to the sordid conditions, mass burials of unidentified and unclaimed corpses occur regularly because facilities cannot hold and preserve the numerous corpses, that are depostied there for up to 20 a day. The piece also reminds of the incredibly powerful words of Nelson Mandela;
"one can tell how a country treats its citizens by looking at the way it treats its prisoners."
In addition to deaths from apparently natural causes, there are the reports of increasing executions of "armed robbers" by our law enforcement agencies. In a December 2009 report on the BBC, the chief medical director of the University of Nigeria Teaching Hospital; Dr Anthony Mbah, said ;
Our  mortuary is overflowing - with corpses brought in by the police.
"We have between 70 and 80 bodies right now... and about three weeks ago, there was a mass burial of some other corpses," he said.
I think back to the heroic death of Okonkwo in Chinua Achebe's epic "Things Fall Apart"  - a warrior who identified with his people, and a symbol of the tragic demise of a great people. I wonder about the extra pain it would have caused to his people if he had to been kept for weeks in the University of Nigeria Teaching Hospital Mortuary - one of the "benefits" of the modernisation our societies have gone through since his times. What a paradox of development...

Please find the courage to visit your local mortuary. Engage with its challenges. If you don't, nobody will and one day we will all end up there. Painful but inevitable. 

Thursday, 10 June 2010

Helpless over Lassa

We have on several occasions blogged about repeated episodes of Lassa fever in Nigeria, and the lack of progress on a coherent national approach in response to these outbreaks. We have advocated on several occasions for a federal agency that controls and monitors  infectious and chronic diseases, as modelled on the Centre for Disease Control (CDC) in the US, or the Health Protection Agency (HPA) in the UK, European Centre for Disease Control in the EU or the National Institute for Communicable Disease in South Africa etc. We have cried out every time there is another press conference held in response to a new outbreak, and the setting up yet another task force.

We are open to suggestions on what else we can do, because this is really not rocket science! How do we get out government to be interested in a programme that will not involve large infrastructure contracts? How?

Well....here is another report for you!

Daily Trust: A recent outbreak of Lassa fever killed seventeen people in Kebbi State. According to officials of the state Ministry of Health, they became aware of the disease when a test conducted by the Lagos University Teaching Hospital (LUTH)  confirmed it as Lassa fever. It is said to be currently prevalent in three local government areas of Kebbi State: Augie, Birnin Kebbi and Kalgo. Out of the seventeen fatal cases, the highest (9 confirmed cases) occurred in Birnin Kebbi.

But then, a recent article caught our attention....

The short article appeared in the CDC's Emerging Infectious Disease journal, and featured a "case series" report of Lassa fever in Nigeria titled "Lassa Fever, Nigeria, 2005–2008". And guess who was somewhere in the middle of the list of co-authors - no other than our present Minister of Health, Professor Christian Onyebuchi Chukwu.

In addition to the threat of emerging infectious diseases, outbreaks of the "old" disease such as cholera, cerebrospinal meningitis, measles, and yellow fever occur regularly in Nigeria. While we might have been socialized to believe that this is a normal part of life, this most definitely should not be the case. All these diseases combine to cause high morbidity, and mortality in the population. The one thing they all have in common, is that they are all entirely preventable by established means, and have been for several years.

While we invest considerable resources in the modernisation of our teaching hospitals, we need to remember the not so glamorous infectious diseases. Surveillance, outbreak investigation and control are public health functions representing the first link in a chain of activities aimed at countering infectious viral and bacterial agents. Prevention often involves simple means to interrupt the transmission process of an infectious agent. For these activities to be successful, we must think of them now...or we will pay the price later.

Professor Chukwu will you buck the trend? 

Maybe just maybe the interest shown in this area, through the publication above, is indicative of a deep understanding of the complexities of infectious disease control. We are hopeful.  

Phote credit - Vanguard Newspapers

Monday, 7 June 2010

Our Honourable Minister - Welcome to Nigeria

When we read the below quote in our Honourable Minister of Health's speech to the recent World Health Assembly, we were worried, uncertain whether this was naivety or ignorance of the complexity of the health problems on hand in Nigeria. But, we were also worried that he might have simply read a script given to him by colleagues at the Federal Ministry of Health, without being aware of all the facts.

This is the direct quote from the Minister of Health's speech which you can read in detail here.
...on the issue of the outbreak of epidemics in Nigeria in the recent past. We have effectively contained these outbreaks and put measures in place to ensure prevention of future outbreaks. 
Then, just in the last week immediately after his speech at the WHA.

Daily Trust reports an outbreak of cholera in Abuja - Yes cholera! Yes Abuja!. But wait, read on for the Local Government Chairman's response - he immediately sent additional drugs to the affected community in order to control the epidemic. Drugs? for Cholera?

Leadership reports an outbreak of Meningitis in Kaduna. The response? - The commissioner said that 130,000 doses of vaccines donated by the Federal Government and other donor agencies were being used to contain the situation.

Thisday reports that three people died from food poisoning in Ekiti. The Oluyin of Iyin-Ekiti, Oba Ademola Ajakaiye is quoted to have advised his people as follows: "I want to advise our people to be mindful of what they eat"!

Then by the end of the week, several media bodies including the BBC carried the story that more than 100 children had died of lead poisoning in Nigeria in recent weeks. The number had been rising since March, when residents started digging illegally for gold in areas with high concentrations of lead. The deaths were discovered during the country's annual immunisation programme when officials realised that there were virtually no children in several remote villages!

Dear Professor Chukwu. This is our reality! It might not have been obvious to you while working at the Ebonyi State University Teaching Hospital in Abakiliki - but in our Nigeria, outbreaks caused by all sorts of infectious and non-infectious agents are an on-going challenge. They have not been "contained" (despite what your colleagues in our Federal Ministry of Health might tell you). Sir, we propose you consider the idea of a National Centre for Disease Control that will concentrate the expertise scattered around the country to prevent, manage and control outbreaks. There are models around the world but we recommend you look at the website of the National Institute of Communicable Disease of South Africa - or maybe arrange a visit.

We look forward to a better week and your next speech Sir.... Welcome to Nigeria!

Friday, 4 June 2010

Mimiko - An Ex-Commissioner of Health as Governor

I do not know how many ex-commissioners of health have turned out to be governors of their states in our contemporary democratic history in Nigeria, but it was a delight to read of the emergence of Dr. Olusegun Mimiko through the courts as the Governor of Ondo State.

Most Nigerians do not want to be reminded of previous physicians in governance of states as exemplified by Dr Peter Odili in Rivers State and Dr Chimaroke Nnamani in Enugu State. (Read previous blog on them here). Dr Odili is remembered more for the private air-ambulance he bought for his exclusive use while he was Governor of Nigeria's richest state, while Senator Nnamani is alleged to have found the means within his humble salary as governor to fund the building of a private teaching hospital  "Renaissance University Teaching Hospital".

Dr. Olusegun Mimiko is a medical doctor who graduated from the University of Ife, and has worked in different health settings for much of his professional life.  Between 1980 and 1981, he was a House Officer at the General Hospital, Ado-Ekiti. He had a stint with the Nigerian Naval College (NNS Onura), Onne, Port Harcourt, between 1981 and 1982, from where he returned to  Ondo State as Medical Officer in the General  Hospital, Ondo, in 1982. From late 1983 to 1984, Dr. Mimiko had his initial taste of private medical practice by working at different times as a Medical Officer at Apagun Clinic, Yaba, Lagos; and as Acting Medical Director, Alleluyah Hospital, Oshodi, Lagos. He returned to public service for another year between April 1984 and February 1985 before finally going into full private medical practice with the setting up of the MONA MEDICLINIC with headquarters at Ondo. Read more here.

Dr. Mimiko was appointed Commissioner for Health and Social Services in January 1992  and his tenure was terminated by a military coup d’etat.
His two major achievements of that era are projects and programmes (NOT BUILDINGS); 

1. The Pharmacy Shop System under which 24-hour pharmacy services were being provided in the main hospitals around the State.

2. Accident and Emergency Centres in some of the State Hospitals in the then Ondo State (now Ondo and Ekiti States).

After the 1999 governorship election in Ondo State, Dr. Mimiko was again appointed Commissioner for Health in the State. In this case we identified his major achievements as the Millennium Eye Centre, Akure....

(maybe readers from this part of our country can feedback on how these are working today)

Now Dr Mimiko is Governor!

Reports are emerging of innovations in health service delivery in Ondo State. The Daily Independent reports on the Abiye, or Safe Motherhood, Project piloted (piloted!) in Ifedore Local Government Area of the state. Under the project, pregnant women, right from day they register their pregnancy are attached to a team of medical personnel, and a doctor for close monitoring. She is given a mobile phone loaded with credit on the bill of the state government, thus enabling her to seek and receive consistent and constant medical attention anywhere she may be even in the remotest part of the village.

Also the Daily Champion reports on Mimiko's new law in Ondo State to enforce the reporting of deaths of pregnant women during childbirth by making non-reporting to the appropriate authorities a criminal act punishable under the law in Ondo State.

Compare this to Chief Theodore Orji in Abia State who says he is spending N500 million partnering with an Indian firm to build specialist hospitals in Aba!...which will then be run  purely on a commercial basis! Well what can we say but hail the Ochendo Ibeku, Utuagbaigwe of Ngwaland and Ohazurume of Abia South as a remarkable Governor for his State! 

Dr Mimiko has a unique opportunity to set the pace for health, and health care planning and delivery at the State Government level in Nigeria. Let us watch and see if he will take this unique opportunity in showing his colleagues how to make a real difference in the lives of ordinary Nigerians.

Wednesday, 2 June 2010

Huge Nigerian delegation at the World Health Assembly

If we can assume that the number of Nigerians that attended the recent Sixty-third World Health Assembly (WHA) that took place between the 17 - 21 of March 2010 is indicative of the priority given to health in the Nigerian polity, then we should be excited, very excited. The WHA is the annual meeting of Ministers of Health from all UN member states to agree on policy for the next year for the WHO. It will probably be the only WHA our Minister of Health gets to attend unless....

Anyways ....as usual our  Honourable Minister of Health, Prof. Christian Onyebuchi Chukwu addressed the 63rd Session of the World Health Assembly.

Photo Credit - Vanguard Newspapers

He basically reported that ...

1. Our president is dead and we have a new president...

2. On polio eradication we have made progress, but we are not there yet, but we are optimistic...

3. On the outbreak of epidemics in Nigeria in the recent past. We have effectively contained these outbreaks and put measures in place to ensure prevention of future outbreaks...

4. Nigeria is fully prepared for the Influenza A H1N1 virus out-break that has affected a large number of countries world-wide...

5. Nigeria is working hard to be on-track for the achievement of the Millennium Development Goals...

6. Abuja the Federal Capital City is now a tobacco free city and many more cities are becoming tobacco free too...

7. We today have the most robust Malaria Control programme in the whole World...

8. Nigeria is on course to eradicate the Guinea worm Disease...

9 . Nigeria brings to this Assembly with a draft resolution on fake and counterfeit drugs in order to sanitize the chaotic drug distribution challenge...

10. We have a new plan: the National Strategic Health Development Plan (NSHDP)!

11. Finally, we thank  our development partners and...

12.  God bless you all.

 (Full address on the FMOH website).

Fellow Nigerians will be reassured that our interests were well represented at the Assembly as we had the fourth largest delegation (30 people!). Only China (ok... its them), Spain (European Presidency now), and Thailand (not a red shirt between them) had more people present. With 6 members of the press in the delegation one would expect extensive coverage in the press, debates etc...Well if you have seem any...let us know! I found one - Sola Ogundipe of the Vanguard Press - here.

Find below the full list of our noble country men who represented our interests (thank God there was no health crisis in Nigeria that week!). The full list of Nigeria and all other country's if you wish to verify this is available at the WHA website here.

Chef de délégation - Professor C.O.O. Chukwu Minister of Health

Dr M.I. Uhomoibhi, Ambassador, Permanent Representative, Geneva
Mr L. Awute, Permanent Secretary
Dr M.M. Lecky, Director, Health Planning, Research and Statistics
Dr M. Anibueze, Head, Department of Public Health
Dr P.N. Momah, Head, Department of Family Health
Professor P. Orhii, Director-General, National Agency, Food and Drug Administration and Control
Professor J. Idoko, Director-General, National Agency for Control of AIDS/HIV
Dr M.A. Pate, Executive Director, National Primary Health Care Development Agency
Dr H.E.M. Akpan, Chief Consultant, Epidemiologist
Mrs C.O. Yahaya, Minister, Permanent Mission, Geneva
Mr A. Jidda, First Secretary, Ministry of Foreign Affairs
Dr N.R.C. Azodoh, Assistant Director, MDGs/Resource Mobilization
Dr T. Avbayeru, Assistant Director, Multilateral
Mrs C. Ibekwe, Legal Adviser
Dr S. Ahmed, Technical Assistant
Dr A. Ikpeazu, Director Programme Coordination
Mr A. Adamu, National Primary Health Care Development Agency
Mr H.U. Yusufu, Director, Narcotics and Controlled Substances, Chairman, Federal Task Force on Counterfeit Drugs
Mr B.A. Usman, Senior Counsellor, Permanent Mission, Geneva
Mr A.G. Azubuike, Special Assistant
Mr E.A. Abanida, National Primary Health Care Development Agency
Mrs M. Makanjuola, Nigerian TV Authority, Health Correspondent
Mr S. Mohammed, Cameraman, Federal Ministry of Health
Mr G. Odemwinigie, Radio Nigeria
Mr N.L. Chukwu, Guardian Newspaper
Ms B. Akingbehin, News Agency of Nigeria
Mr S. Ogundipe, Vanguard Newspaper
Dr H.N. Yahaya, Chairman, NPHCDA Board
Mr C.A. Muanya, Guardian Newspaper
Mr E.T. Katsina-Alu, NAFDAC

The struggle as we say....continues!