Monday, 30 August 2010

Conference announcement - Nigeria: Partnership for Health II

Since the very successful first Nigeria: Partnership for Health Conference in 2008, we have received several enquiries about when the next conference will take place.

It is our pleasure to invite you to the next  Nigeria: Partnership for Health II Conference in London on November 6th 2010





We have another fascinating line up of 8 speakers who have driven change in the Nigerian health sector. They will be sharing with us their experiences on issues from public health policy, to clinical care. The theme for this year's conference is:

"Moving to sustainable collaboration"

This year's conference will focus on how sustainable collaboration between Nigerian health professionals working in the West, and Nigerian health institutions can lead to health gains for the Nigerian people. We will seek to highlight what we are doing to engage with the major health issues facing us both in preventive and curative medicine. This will include activity by government, non-governmental organisations, the private sector and individuals. We will feed back on progress since the last conference in 2008, both in terms of progress we have made and progress made by other partners at the conference. 

The conference will focus on the initiation process of setting up sustainable collaborations, as well as the challenges faced in growing and sustaining them.  These collaborative projects or partnerships will be related to clinical care, research, health policy formulation, training or teaching.

The overarching goal of this conference is to continue the work started at the 2008 conference; building enthusiasm and confidence in opportunities in the Nigerian health sector, nurturing new relationships and inspiring action. It will be an opportunity for us to learn from others that have initiated links, partnerships and networks, and share our diverse experience on how these have worked. Through this conference, we want to create a forum for the exchange of ideas that can change attitudes, lives and ultimately, Nigeria; a community of enthusiasts to engage with ideas and each other. 

Date: 

November 6 2010 - 9 am 


Venue: 
Royal College of Obstetricians and Gynecologists

27 Sussex Place,
Regent's Park,
London,
NW1 4RG.

Early Bird Registration: £40.00



Speakers include
• TBC Professor CO Chukwu – Honourable Minister of Health of Federal Republic of Nigeria
• Dr Aliko Ahmed  – President of the Nigerian Public Health Foundation
• Dr Liz Tayler – Senior Health Adviser for Africa, Department for International Development
• Dr Muhammad Ali Pate – Executive Director, Nigeria Primary Health care Development Agency
• Lord Nigel Crisp  –  Former Chief Executive, National Health Service
• Dr Ugo Okoli – Project Adviser to the Midwives Services Scheme (NPHCDA)
• Dr Dilly Anumba  – President Medical Association of Nigerians across Great Britain
• Dr Agomuo – CMD Federal Neuropsychiatric Hospital Enugu 
• Dr. Seyi Oyesola – Former CMD of the Delta State University Teaching Hospital Oghara
• Gbenga Olatunji  – Market Development Manager for Johnson & Johnson West Africa
• Dr Folabi Ogunlesi – Chief Executive Vesta Healthcare Partners


The Keynote address will be delivered by Professor Shima Gyoh


Professor Shima Gyoh is the Professor of Surgery at the College of Health Sciences, Benue State University, Makurdi. He trained in the UK,  worked clinically for several years and retired as Permanent Secretary of the Ministry of Health — the highest career position for civil servants in Nigeria. He was the Chairman of the Nigerian Medical and Dental Council for several years. Professor Gyoh is currently on the board of Population Services International (PSI) and also serves on the board of the Society for Family Health (SFH). Recently he led on the health subgroup for the Vision 20 2020 document.




There will be four workshops on setting up sustainable collaboration in the following realms. 

Sustainable collaborations in health research
Sustainable collaborations in public health policy
Sustainable collaborations in clinical care
Sustainable collaborations between NGOs





Register here! (Places are limited to available space)
Details at www.nigeriahealth.org

Friday, 27 August 2010

Shell, FHI and NACA collaborate on HIV/AIDS in the Niger Delta

One great thing about going for conferences is the fascinating people you meet. One such person I met at the last International Conference on AIDS in Vienna was Dr Babatunde Fakunle, the Regional Community Health Manager of  The Shell Petroleum Development Company (SPDC) of Nigeria. Tunde took me through the work he is doing for Shell in the communities they work in, mostly in the Niger Delta. I have not been privy to these projects, but the passion with which Tunde spoke about his work and the involvement of the host communities in driving this was infectious. I ended up spending several hours with him, exploring how Shell and corporate Nigeria can partner with government and non-governmental organisations to engage with the health sector in Nigeria. We lamented together about the poor leadership in the public health sector and the lost opportunities after 50 years of nationhood.

In the midst of all the negative stories coming out of our health sector, I stumbled upon this story, on the website of the National Agency for the Control of AIDS (NACA) titled - NACA and SPDC Sign NiDAR INiger Delta AIDS Response Project) Plus MoU. I thought this must be Tunde! 

The SPDC of Nigeria Ltd and Family Health International (FHI) had signed an agreement to extend their NiDAR to 10 more hospitals bringing it to a total of 15 supported hospitals in Bayelsa, Delta, Edo, Rivers and Abia states. At the signing ceremony were the Managing Director of SPDC and Country Chair, Shell Nigeria Mutiu Sunmonu, as well as the acting Country Director of FHI Dr. Robert Chiegli, and the Director General of NACA, Prof. John Idoko.


They all talked about the success of the model. So I wrote to Tunde, asking what his model was ?

Tunde wrote back saying...
“The NiDAR Plus project approach places communities in the driver’s seat, which will encourage government institutions, NGOs, and other services providers to build capacities in primary health care including the formation of partnerships and supportive networks.” The extended programme, known as NiDAR Plus will include Malaria control and Child Survival services. It will also strengthen the health care system and infrastructure in the Niger Delta, and help to improve collaboration among public and private sector stakeholders on health issues. Through the new programme, SPDC and FHI also hope to increase awareness about HIV/AIDS, maternal, neonatal and child health services, especially among people living with HIV, families and community members. SPDC is contributing funds and logistics, security and transportation support and medical staff supervision while FHI provides expertise. The two establishments are working closely with NACA and the various State Agency for Control of AIDS to deliver the programme. NiDAR Plus will run for two years. 
Then Tunde directed me to the Global Business Coalition Award for Collective Partnership which the NiDAR project won as the best-in-class for partnership. He asked me to go and visit the projects in the Niger Delta!

Ah How I would love to spend a few days around the creeks in the Delta. I remembered the days I would drive from Owerri to Port Harcout for the slightest of reasons. The days spent hanging out at the House Officers quarters of UPTH (University of Port Harcourt). Those good old days. Now the thought of either Owerri or Port Harcourt fills one with trepidation. How have we allowed this to happen to our country? 

But I promised Tunde that I will come...and I will...but Ill keep the timing to myself...for obvious reasons :)..

Reflecting on our discussions, my lesson is that  we must get beyond the divide between the public, NGO and private sectors and find innovative mechanisms to bring them altogether to work in the best interest of our people. We need the oversight of the public sector, the compassion and drive of NGO folk and the innovation and management capacity in the private sector. I submit that it is our inability to bring these areas of expertise together that has led to the stagnation in the health sector. 






Wednesday, 25 August 2010

Patients suffer as Nigerian healthcare workers continue strikes; who cares?

This piece is contributed by Chima Onoka. Chima is a friend and colleague. In this honest piece he contributes his thoughts about the ongoing strike that has paralysed public tertiary centres across Nigeria. I wonder how many other colleagues are thinking the same. As we remain quiet...and watch our hospitals deteriorate further, I cannot help but to agonise about Franz Fannon's famous quote 


 “Every spectator is either a coward or a traitor”. 


Patients suffer as Nigerian healthcare workers continue strikes; who cares?
Chima Onoka

Just about a month ago, at about 11pm, I saw a dishevelled pregnant woman outside the gate of one of the tertiary hospitals in the South East region of Nigeria. She was standing – arms at her hips, and her husband - running up and about!

What was wrong?  She was in labour. No one told her that the hospital she was registered at for Antenatal Care, the big hospital with consultants, resident doctors and ‘necessary equipment’ was shut down. The gatemen did not allow her into the premises because resident doctors had shut down the hospital – they were on strike to protest about delays in payment of wages that were 5 months in arrears! And of course – they move about monitoring the ‘SUCCESS’ of the strike. This woman had obviously agreed on the advice of many, including ‘health professionals’ and the government including MDG champions to leave traditional birth attendants, maternity homes and quacks to ensure delivery in the right kind of facility.

While I mused over the events leading to this and the gory sight before me, a big pick-up van pulled over at the bidding of the woman’s husband. The husband talked to the man who after a while, came out and aided the husband to move the woman-in-labour into the van. The next moment, they were off to God-knows-where.

No one really cares

Does the government care? 
Maybe they do but as far as this strike issue is concerned, no one can really say because they made a commitment to pay the new scale. It is however pertinent to note that many states have continued to say that they cannot pay, and that is quite straightforward. But, really, Can’t They Pay? The fuel that has continued to oil the fire of the strike and other strikes in the country is the ‘IRRESPONSIBLE’ manner in which our politicians deal with the resources of the country. Name it: from the house of reps, to many of the state governors (who their ‘subjects’ have to praise like gods – because they provided a borehole with money that belongs to the same people), to local government chairmen (whose only idea about why they are there, is to collect, share money and mobilize for the governors next election bid or else get replaced by a transition committee), to the state assembly men (who are there to receive money and approve everything that will facilitate they- or impeach anyone in the way of this ‘assignment’). I choose not to mention the senators and the honourable senate who sometime ago felt that one way of encouraging senators to be attending sittings is to increase the ‘sitting allowance.’

Do doctors care? 
I know a tertiary facility in the southeast region that for over 4 months sterilizes all materials in another hospital. So many things are wrong that affect patients and no one ever talks about a strike for these things that ‘affect patients’ – as long as they don’t affect the doctors ‘pockets’ negatively. Negatively I say because this chaos keeps the hospital in disorder, drives the patients away from the hospital – and into the waiting arms of the devouring private clinics, mostly owned or run by the same who ‘don’t mind’ the chaos in the public hospital. Maybe this is how private hospitals ‘complement’ in providing health services to the people.

Looking around, I think doctors don’t really care anymore and the generation is gone. There are many countries (low – middle income countries) where doctors earn a lot less, but we go to them from Nigeria for patients we cannot manage or have even contributed to their mismanagement. India comes to mind readily. I think those in Nigeria don’t care again except for one thing – their pockets – even if it takes the shedding of blood of ‘patients’ – the very reason why the doctor has the job, and salary in the first place.

Do the people care?
There is a nationwide strike in our tertiary care centres across the country and you will hardly read a word about it in our newspapers, hardly hear a word on radio, nor on TV. It is not part of the discussion, simply not on the agenda. As for the woman I saw, there is no one who cares! What doctors just demand for is the wages of those in developed countries. I laugh. Why? Most doctors in Nigeria have no idea about the existence of, and extent of application of ‘Performance Based Management’ of health workers that goes on in those countries and how it is linked with the engagement in service and flexibility of wages. Unfortunately too, our government is yet to see that the effective use of resources should demand that salary increases are channelled to improvement in performance and output. No one cares! After all, they don’t want to be monitored too.

Perhaps conscience and compassion are no longer part of the practice in a place where many don’t manage to eat two meals a day. The few amongst the health professionals who still have compassion should persist in their good work. Though the pocket is important, there is more to life than the pocket, and service to humanity especially in care for the poor, despite all odds is still a virtue. It is lawful and acceptable to make demands for better wages – but it is not expedient to do this at all cost – most of all things - the cost of lives.

As I ruminated over all these, all I could do at that time was to say a prayer for that woman – let her not join the list of 101 women who will die today in Nigeria because they are pregnant. If she does, she will only be remembered by the ‘care-less team’ government, politicians, and their new ‘care-less’ doctor compatriots as a ‘STATISTIC’ – one of the 1000/100,000 maternal deaths that they talk about – and for this lovely woman, the single unit of data she represents fails to call her name – she is dead - face unknown, family unknown, vision dead, children orphaned, husband widowed, a generation lost.

And for the hundreds who are currently dying from cholera in the North of Nigeria, the thousands who are rushing back to quacks, chemists, traditional birth attendants and to native concoctions or even to nothing, giving a deposit to their carpenters to start preparing their coffins – the strike rages and the new strikes are being planned.

Our new Minister of Health just had the usual political ‘reception at Afikpo’ this weekend, and our doctors are looking for ways to make additional money as they must be paid for the strike period – else – they go on another strike!

Sunday, 22 August 2010

Voter Registration vs Immunization cards: Missed opportunities in Nigeria

by ndubuisi edeoga


We are all still lamenting the use of our money for frivolous independence celebrations. Now we are stuck with the bill for the voter's registration touted to be the "MOST EXPENSIVE" in the world, see here.

Compare the cost of voter registration in India,one of the so-called emerging economies. According to a publication by Krishna Murthy, Chief Election Commissioner of India. The country’s cost per registered voter stands at $0.62, while the cost in Nigeria, voter registration estimates translates to a cost of N1, 292.3 ($8.6) per registered voter, the highest per capita cost for registering a voter anywhere in the world.

Voter registration is important for our future elections...absolutely important. However, the uncontrolled and excessive misuse of funds that could be allocated to other important aspects of nationhood has to be pointed out and addressed.

The process of voter registration could and should be linked to National ID card project as well as  the issuing of immunization cards to our children, driving licences or any other process of identifying people in our country.

I have often wondered why is there not much fanfare, anxiety, noise and large contracts going to the documentation and proof of immunization of our children. A friend of mine told me of how he moved from Nigeria to the USA and is in the process of registering his kids in a new school, and one of the requirements for enrolling his kids was to show proof of immunizations in the form of an immunization card. Well he had to navigate a lot of mountains just to get that. Meanwhile he is a doctor and had no records of immunising his children in Nigeria.

I then asked around all the ritzy, high class schools in Abuja, about any school that needed evidence of immunization before a child was registered to school.....no one asks....no one cares. These schools would proclaim that they provide as good an education as anywhere else in the world...and I do not doubt that they do. But how come they are not ensuring that their intended wards are safe, ready and alive for the future?

The blame lies at the feet of our leaders. The same leaders that are falling over themselves to spend our money on the most expensive voter registration in the world. The same leaders that would not spend any money on the "voter (read = immunization) registration" of our kids. I also blame us. Why are we not putting the same pressure that we put on government on voter registration on the immunisation records for our children?


Like we don't have enough problems already, measles is making a come back. According to this report, see here. Reported cases of measles in some parts of the country from 455 confirmed cases in 2009 to 4,771 as at yesterday.

We need to rethink our priorities. Lets start registering our kids, lets get a head count of how many kids are immunized, and lets start making sure that no one is left behind as we jostle for the voter registration windfall....

Wednesday, 18 August 2010

The Minister of Health, Resident doctors and strikes

Minister and Perm Sec of FMOH
Since resumption of office, the Minister of Health has faced challenges of industrial disharmony in the health sector, largely inherited, all protracted and mostly on issues relating to the payment of doctors. Presently, a strike by the Nigerian Association of Resident Doctors has paralysed tertiary care centres across the country. This has left Professor Onyebuchi Chukwu in a difficult situation, unable to focus on the future of the precarious health sector in Nigeria, he is being forced to fire-fight his way out of these strikes. Complicating matters even more is the fact that Professor Chukwu was himself an ex-president of NARD.

Now things are really getting out of hand...with reports like these in several newspapers.....

PMnews reports that activities in General Hospitals in Lagos State have been paralysed due to the inability of the Lagos State Government to pay the federal wages its doctors are demanding for. 

Doctors’ strike paralyses LAUTECH, Ekiti govt hospitals


From a letter sent round by NARD in Lagos state recently, the key issues being demanded by the National Association of Resident Doctors can be summarised as follows. 
  • They are protesting the non imlementation of the apparently hitherto mandatory one year overseas clinical attachment for resident doctors
  • They are demanding full payment of the January-May arrears of CONMESS within 21 days of the passage of the budget (i.e on or before Friday 19th Aug 2010) apparently agreed by the former Minister of Health and the Federal Government in the circular no SWC/S/04/s.410/ 220, dated 29th Sept 2009.
  • They insist that Ogun, Lagos, Oyo and Ekiti States which say that they cannot afford to implement CONMESS...must do so ..or else...
  • They are angry about the diminishing relativity in wages between doctors and other health workers, and demand that the FMOH should immediately constitute a committee to review wages within the health sector using appropriate and internationally acceptable yardsticks.
Reading between the lines suggests how deep our problems are. We have lost all confidence in our medical training. It is now the case that 50 years after independence, we conclude that a one year "overseas" attachment is critical for our training needs. There is apparently no shame felt or expressed in this statement. The demands by our senators has given credence to every demand for more wages in our country. The concept of federalism in our constitution and the right of state governments and their legislature to determine their wage structures is thrown to the winds whenever convenient....and "relativity"!...why is this so important? Is it important enough to abandon our patients to go on strike.

In the letter written by NARD, to which we are privy, not once is the patient mentioned. Not once are the state of our hospitals mentioned. No statement is made by NARD on what it is offering the Nigerian people. No commitment to serve. No commitment that when the saalaries are paid, that the work will be done. There is no empathy, no compassion - just fire and brimstone....

But then - our government has put us into this quagmire. After 50 years of independence I can bet that our Ministry of Health will join other Ministries in allocating millions of naira to celebratory books, seminars etc. What do we have to celebrate in our health sector. As with all these matters in our dear country, last week, our own Radio Nigeria reported that 2 committees have been inaugurated - one was a presidential committee and the other a ministerial committee.


1. A Presidential Committee to harmonize working relationships among health workers
 The 42 member committee (42!), headed by Justice Bello Abdullahi is to identify the root causes of disharmony among health workers, and professional groups in the sector, and to examine the negative impact of such problems on the healthcare delivery system. This is mandated to check the long standing rivalry and industrial disharmony existing among the professional groups in the sector.


2. A Ministerial Committee for the review of the residency programme in Nigeria.
The 11 member committee is mandated to review the residency programme in Nigeria including examine the proposed one year clinical attachment/training abroad for resident doctors.

The Lagos State Government has come out boldly to say that the package was worked out for federal doctors alone, and that the state government was not part of the agreement reached at the federal level therefore should not be forced to pay - I agree!


Commissioner for Health, Dr. Jide Idris, says that the Lagos State Government could not pay and would not be forced to do so. Idris stated that government would continue to support doctors who did not join the strike and had been working assiduously to meet the demands of the patient, saying that agitation of doctors in its hospitals for increment in salaries had become too frequent and worrisome, saying that they got increases in their salaries early this year. The state government has begun to employ the services of consultants to carry on the work of administering treatment to thousands of patients in the state’s public hospitals, which are generally inconsequential to meet the teeming needs of the people.
As doctors, we should be very careful not to lose the support of our patients, and we must be extremely careful not to use the power we have in society against the people we have sworn to serve. The "patient" must be central to our arguments and sacrosanct in our demands. We lose the patient we lose everything.

Granted, working conditions are difficult in many of our settings, and granted our Senators have lost all touch with reality by their demands, but must we follow them in this blind pursuit of self destruction.
Finally this issue of "relativity". Are we really better than the nurses and pharmacists etc...think about it!

In all that has been written in the press and even in the letter circulated by NARD, Professor Chukwu is described as a man with "uncommon integrity in his public and private life". I could not agree more. We must give him the opportunity to build a better future for our health sector rather than spend the last 8 months of his tenure negotiating salaries.

Thursday, 12 August 2010

Radio, bucket, and a bicycle - improving healthcare provision in Nigeria

by ndubuisi edeoga


I have been reading through Sonia Shah’s book "The Fever: How Malaria Has Ruled Humankind for 500,000 Years". She discussed a survey that was designed to collect data about the use of insecticide impregnated nets, and about what most people would want if given the choice in a rural setting (one of their options was insecticide impregnated nets). People's top choices were a radio, bucket and bicycle. Most people just need the simple things in life to be happy; the irony of Nigeria is that the funds for these simple things are allocated to complex things that end up not benefiting anyone.

Take for example the multiple cholera outbreaks in different parts of Nigeria, in Bauchi, Adamawa and Rivers States, and so many other mini outbreaks that we do not read about in the papers. The causes of these outbreaks which occur mostly in the rainy seasons can be traced directly to poor or non-existent portable clean water provision. We would rather spend billions on the independence celebration rather than spend the money on providing portable clean water for local communities in Nigeria.

Next year we would still have multiple cholera outbreaks, and we will still allocate billions to another independence celebration.

How do we break this cycle? I suggest that we as a society have to do a "root-cause-analysis", some people already know the answer, but to satisfy everyone we should still go ahead and do one. We should ask: what caused the cholera epidemic? poor hygiene?, lack of portable clean water?, water source too close to the sewer? Then we should ask: How can we stop it from happening again and again? We should then insist that our leaders make these changes as a condition for voting them into office. Water ...its that simple!




Most people just need a bucket!!!

Recently, 50 doctors and some consultants were said to have resigned their appointments with the Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Ogun State due to alleged poor remuneration, as well as their  non-conducive working environment. Well, who cares when the people that make the health care decisions can afford to travel out to the UK or wherever else they may chose for their health needs.

Then we should ask again ; how do we break this cycle of unending strikes, year in year out? Another root-cause-analysis!. We should ask: is the strike about  too many doctors?, or too few doctors?, is it really about the non - conducive work environment?, or poor remuneration?. Then we should ask: how can we stop these strikes?, (next year). Then, we should insist that our leaders make these changes or else......

The next elections are around the corner, hhmm…. maybe the money that would have been used to make the doctors work environment better and pay them better salaries are serving other needs, maybe the money meant for our boreholes/taps are serving other  needs, making posters, t-shirts, campaign buses, bullet proof election vehicles for the people that make the health care decisions....for us!

As the elections come closer, if our votes will count this time around, we hope to make changes in the people that make our health care decisions. Then....maybe we would be closer to getting our radios, buckets and even a bicycle.

Taking it a step further, a Lagos based lawyer Femi Falana sued the Nigerian government for its failure to adequately equip our hospitals. He went as far as requesting an injunction to stop government officials from using our resources to get personal medical care in other countries, while they have not worked hard enough to provide basic health care for their masses. I think the Nigeria masses should be joined in this suit, even if only for the significance to the international community.

The next time your neighbour, or loved ones dies from cholera, other forms of diarrheal diseases or any other preventable diseases that still kill only Nigerians, we know who to blame. The next time you go to hospital or you are admitted into a hospital and the doctors do not provide an adequate level of care, we know who to blame. Our president, governors, senators, representatives, councillors, local government chairmen or any other "elected" government official. We should make our voices heard. We have to engage with the political process.

Then, and only then we would be sure of getting our radios, buckets and who knows even a bicycle!

Tuesday, 10 August 2010

A new book by Professor Adetokunbo Lucas

If you read this blog, you have no excuse not to knowing Professor Adetokunbo Lucas. Professor Lucas needs no introduction, the picture on the right, taken about 5 years ago is one of my prized possessions. "Prof" is one of the most accomplished physicians Nigeria has produced, yet he also carries himself with humility that is sadly rare among our elite.


When Professor Lucas writes a book, you should read it! His new book is due to be launched on Monday the 23rd of August at the Sheraton in Abuja. 


The book is an autobiography in which Professor Lucas recounts major incidents in international health over the last 50 years. I can't wait to lay my hands on the book. Timing here is everything. As you might have heard, our government is reported to be about to spend millions of Naira to "celebrate" 50 years of our existence. I have not read the book yet but I know that Prof's book will no doubt be reflective of where we could have been as a nation after 50 years of independence. I am sure there will be nostalgia about the University College Ibadan and its unfulfilled promises, unfulfilled promises from the various policies he has helped draft for various governments. But Prof does not belong to Nigeria alone. His contributions really are to global health and his textbooks are read by medical students around the world. One thing Prof cannot be unfulfilled about, is the esteem in which his colleagues, peers, and students hold him. He truelly has had a career worth celebrating and this autobiography will definitely be worth reading!


In the profession...he is our own "FELA"! An every day hero!


Find an overview of the book below....




“IT WAS THE BEST OF TIMES: FROM LOCAL TO GLOBAL HEALTH”
Adetokunbo O. Lucas, OFR MD, DSc, FRCP, FFPH, FRCOG

The past few years have witnessed an expanded interest in international health, involving more organizations as well as much larger financial resources. This autobiography of Professor Adetokunbo O. Lucas recounts the background and life history of the author with particular reference to his involvement in and contributions to the development of global health. The book contains information and commentaries on major occurences in international health over the past 50 years. Viewed from a personal perspective, the book contains analysis and comments on key events that have expanded interest in various aspects of global health, and it also identifies threats and obstacles.

At the national level, the author was the first chairman of the Nigerian Medical Research Council (1973-75) and in 1984; he chaired the committee on national health policy which set the foundation of the nation’s health services. At the University of Ibadan, he developed a new approach to the teaching of public health. His personal research contributed new knowledge on the epidemiology of malaria, schistosominasis and other tropical infectious diseases.

The author has been closely associated with many major developments in global health. Notably, he directed the WHO Tropical Diseases Research programme (TDR) for a decade; the scientific advances that resulted from TDR have been credited for making significant contributions towards the elimination of leprosy, onchocerciasis and lymphatic filariasis.

Professor Lucas was a member of the Commission on Health Research for Development which, in 1990, reported a radical review of health research globally with strong recommendations about the need for countries to develop and strengthen Essential National Health Research. Follow up of the report led to the creation of two international organizations: Council on Health Research for Development (COHRED), and the Global Forum for Health Research (GFHR). Dr. Lucas was the first chairperson of the Foundation Council of GFHR when this new entity was founded in 1997 to promote international health research.  Other issues discussed in the book include new initiatives to promote public-private partnerships, the global solidarity for the control of tobacco, and the tragedy of high maternal mortality in developing countries and similar topics.  He has served in an advisory role to WHO, UNICEF and other international agencies as well as to the Rockefeller Foundation, Bill and Melinda Gates Foundation, Carnegie Corporation of New York and other organizations working in international health.

See you at the Sheraton on the 23rd of August!

Saturday, 7 August 2010

Falana sues FG over state of public hospitals

We are highlighting this article about Femi Falana's prosecution of our Federal Government, as it is of critical importance in our journey as a nation. We are 50 years into our existence, and most public hospitals in Nigeria have regressed over this period. Just like most Nigerians do not expect justice from their police stations, electricity in their homes or water from their taps...we have also learnt not to expect care from our hospitals. Can we let this be? It is easy to dismiss Femi Falana as just another maverick, but we need to sit back and think. Maybe we need to use the courts more innovatively, to hold our leaders accountable. Sometimes it is the arrogance of our so called "leaders", and the way they are able to access cutting edge health care in the West, while the very people they are there to serve and protect cannot even access the most basic antenatal care. Maybe one day we will join the dots on this story....
Falana is also seeking a perpetual injunction restraining government from taking any public officer abroad for medical treatment.  
Falana is seeking among others, a declaration that the failure or refusal to repair and equip public hospitals and medical centres in Nigeria constitutes a violation of the duty of the defendant to protect the health of Nigerians, and to ensure that they receive medical attention when they are sick, as required by Article 16(2) of the African Charter on Human and Peoples‘ Rights (Ratification and Enforcement) Act (CAP A9) Laws of the Federation of Nigeria, 2004.
The Applicant also argued that, “Contrary to its obligations under the law, and in spite of the abundant resources of the country, the Federal Government has refused to equip public hospitals and medical centres located in the country.
On the 4th of August Justice Adah sitting at the Federal High Court stated that he agreed with Mr Falana, that substituted service could be resorted to since it is a fundamental rights matter. The judge therefore ordered that all the processes in the case be served by the bailiff on the Federal Attorney-General through the Federal Ministry of Justice - a small initial victory, but a very significant one.


Mr Falana is seeking the following reliefs:

A. A DECLARATION that Nigerians are entitled to the best attainable state of physical and mental health guaranteed by Article 16(1) of the African Charter on Human and Peoples’ Rights (Ratification and Enforcement) Act (CAP A9) Laws of the Federation of Nigeria, 2004.

B. A DECLARATION that the failure or refusal to repair and equip public hospitals and medical centres in Nigeria constitutes a violation of the duty of the Defendant to protect the health of Nigerians and to ensure that they receive medical attention when they are sick as required by Article 16(2) of the African Charter on Human and Peoples’ Rights (Ratification and Enforcement) Act (CAP A9) Laws of the Federation of Nigeria, 2004.

C. A DECLARATION that the failure of the Respondent to save lives through the provision of adequate medical facilities is illegal and unconstitutional as it constitutes a threat to the Applicants fundamental right to life guaranteed by Section 33 of the 1999 Constitution and Article 2 of the African Charter on Human and Peoples’ Rights (Ratification and Enforcement) Act (CAP A9) Laws of the Federation of Nigeria, 2004.

D. A DECLARATION that the practice of having public officials treated at public expense in foreign hospitals is illegal as it violates the right of other Nigerians to equality before the law and equal right of access to the public property and services guaranteed by Articles 3 and 13 of the African Charter on Human and Peoples’ Rights (Ratification and Enforcement) Act (CAP A9) Laws of the Federation of Nigeria, 2004.

E. AN ORDER OF PERPETUAL INJUNCTION restraining the Defendant from taking any public officer to foreign hospitals for medical check up and/or treatment in any manner whatsoever and howsoever.

F. AN ORDER directing the Defendant to repair and equip Federal Government owned hospitals and medical centres to ensure that Nigerians receive adequate medical attention when they are sick forthwith.

Thursday, 5 August 2010

Bill Gates in Nigeria - lessons for us?

I have been following Bill Gates on Twitter for some time, and one recent "tweet" caught my eye.
"Incredible trip to Nigeria – determined and getting closer to eradicating polio. Government, partners and Nigerians are committed and inspiring"
Then I searched around a bit for more information on his trip to Nigeria....not too difficult! On his website you find the notes from his trip, as well as a film clip that shows him voicing his thoughts and vision for polio in Nigeria. Find an excerpt below.

"I spent most of my first day in Kano, one of the northern states most vulnerable to polio. I met with community leaders, visited a local health center and stopped in at an informal school where students study the Koran in Arabic. On the streets and almost everywhere else we went, I noticed so many young children around. Nigeria has more people by far than any other African country, and more than 40 percent of them are under the age of 15. That makes polio immunization a big challenge. Kano had just begun a campaign to immunize more than 6 million children under the age of five."

Find a the video here.

Now - I went back to read that tweet again - "Government, partners and Nigerians are committed and inspiring". How often have you heard that from anyone lately, Nigerian or foreign when referring to the work being done by the Nigerian Government? Something is happening in the deliverance of primary health care in Nigeria, and it might have something to do with the leadership of the National Primary Care Development Agency. We have previously written about the Executive Director who returned to Nigeria after working for the World Bank for several years. Recently, 6 new directors were appointed (some re-appointed) to take forward the vision of delivering the promises on polio and vaccine preventable diseases in childhood. Again what caught my eye in the newspaper article announcing this was the statement...
The new directors were appointed following their success at a recent public service recruitment interview and examination jointly organised by the Federal Civil Service Commission, Federal Character Commission, Governing Board of the Agency, Federal Ministry of Health and a Human Resources Consulting Firm.
Ha? This is happening in our own public sector? 


But let’s go back to Bill Gates and his commitment to public health in Nigeria. Apart from the amounts being spent on global projects and programmes that will eventually affect the health of the Nigerian people Bill Gates is spending millions of dollars directly on programmes in Nigeria. This has led me to wonder about all our millionaires. We hail and celebrate when they break into the list of the richest people on earth. They drive in convoys with police “protection” and fly around our dilapidated airports with their private jets. On the weekends, all the first class seats on British Airways flights out of Lagos or Abuja are regularly fully booked. How much have our millionaires given back to our health, education and social institutions and programmes? How can they sleep at night on all their wealth and drive past (or fly over) all those hospitals and schools all over our country. How do they feel when they see Bill Gates in Nigeria, caring for the same children they just drove past?

As we celebrate Bill Gates for his extraordinary career in building one the most successful companies, and thereby becoming the richest man in the world, let us consider what the biggest lesson in Bill Gates life is for us as Nigerians. I suggest that it is not what you will read in most cases studies for MBA programmes or many of the motivational books on the market.  I suggest that the biggest lesson in his life for us as Nigerians is not that he revolutionised the way we work with Microsoft products in our daily lives, or that he became extremely wealthy in the process, but in his promise that he will give almost all of it away in seeking solutions to the world’s biggest social problems....and God knows we have many in Nigeria.

In 2006, at the International Conference for AIDS in Toronto, Bill Gates made an appearance on the podium for the first time at one of these AIDS conferences. He announced his intention to give upthe day-to-day running of Microsoft, a company that has revolutionized our way of life, and devote the rest of life into work for his foundation: The Bill and Melinda Gates Foundation. It is now one of the largest funders of research into health issues in the world.  I could not help but think; in 10 years time Bill Gates might be remembered less for his role in the growth of information technology, and more for public health issues? What a story that will be.
Somone was in the process of redefining his legacy. Could Microsoft become a footnote in the Bill’s legacy?

Bill Gates writes of his experience in Nigeria in the Huffington Post.
Follow Bill Gates on Twitter here and follow Nigeria Health Watch on twitter here

Tuesday, 3 August 2010

NHW asks you for 2 favours!

Dear Friends of Nigeria Health Watch!

Recently we reflected on the blog, why we started it, and why we have continued. Like some of you that know us, the idea for this blog started at a conference Ike and I attended in Arusha, Tanzania - TEDGlobal in 2007. It was particularly inspired by a talk Ory Okolloh gave on a project called "Mzalendo - Eyes on the Kenyan Parliament". Ory explained their mission as:
"we built Mzalendo to demonstrate that there is only so much bemoaning you can do about your representation."  Mzalendo hopes to convince Kenyans - to engage with their MPs and current legislation.
At the time, we had no idea on the power of citizen journalism. But, we quickly learnt about powerful blogs and blog aggregators around the world, and how they are shaping our world. We are trying to do the same for our health sector in Nigeria; to hold ourselves and our leadership at different levels of our health sector accountable to the Nigerian people by making information and our informed opinion more widely available in the public space. We do not pretend to have a monopoly of wisdom on the issues, but health is the one issue that we have earned a right to write about.

We have recently revamped the face of the blog, added links to important Nigerian health related websites and made it easy to follow th blog by RSS, email, facebook and twitter. If you are receive this by email, check out the blog at Nigeria Health Watch.


Recently, a friend of ours asked us sternly - "What is your business model?" Well, maybe one will emerge in the future, but for now this is basically a labour of love. We hope it acts as a small…be it a very small contribution to the state of affairs of the health sector in Nigeria. Recently, when we struggled to keep the blog going - I received a reminder from a friend, on a statement made by Barack Obama during the US election campaign....
I am asking you to believe. Not just in my ability to bring about real change in Washington...I'm asking you to believe in YOURS." - 
We do therefore believe that by continuing to put critical health issues as it relates to Nigerians in the public space you can drive the change we seek in Nigeria. We believe that health has to be on the very top of the political agenda. We believe that our leadership has to articulate a vision for the Nigerian health sector, and be prepared to be held accountable for the delivery of that vision. We also know that the health sector is subject to significant information asymmetry i.e.- where one party has more information than the other about a transaction, therefore the ignorant party goes into the conversation from a position of weakness. This happens every day we face a mechanic with our car or a doctor with our illness. To redress this in-balance we seek to make as much information available to the Nigerian people on their health sector.


But to do this, we need your help!

Firstly send us your stories! Send us your stories on your engagement with our hospitals, clinics, or commissioners and ministers. Take pictures and videos on your phone. Share with Nigerians your experiences - joyous or painful on our health services. Please send these to chikwe@nigeriahealthwatch.com. (of course we will retain some editorial control and not publish any inappropriate material)

Secondly, share NHW on your social media networks, share by email, join the conversation on twitter and "like" us on facebook - re-tweet and link to our updates. You can follow us on twitter here and on facebook here

Join us in re-imagining the Nigerian health sector.

-   As Franz Fanon said: “Every spectator is either a coward or a traitor”....