Friday, 24 December 2010

At Christmas we are "Only As Strong As Our Weakest Point"

Dear Friends, 

What a year it has been. This year we have struggled on what to reflect on. We wondered whether to write on our 3rd Minister of Health in 4 years, or to mourn the death of our President after futile attempts at health care in Saudi Arabia while most of our people do not have access to the most basic care, or to again moan on why more women die in childbirth in Nigeria than almost any other country in the world, bar the conflict zones. But none of these seemed quite right. So I tempted fate and asked my friend; Patrick Anigbo to reflect on a very personal story that has given me more cause to think than any of the issues above. That our society, any society is only as strong as its weakest point....this is Paddy's story....enjoy, reflect, do. 

Merry Christmas! 

Only As Strong As Our Weakest Point
by Patrick Anigbo

This year my first child, a son we named Odinakanna (translated - it is in the hand of GOD), celebrated his 10th birthday. It has become custom, at least amongst my friends, to mark our children’s 10th birthday with some sort of fanfare – it is a milestone of some sort. And so it was that close family and friends organised for Odi a truly breath-taking day. Not even the spring downpour and the attendant travel chaos could put a dampener on proceedings.

Along with the merriment, it provided me with a chance to reflect on the year 2000 when he was born. For those of us in the IT Industry, the biggest con of our industry’s history was finally put to bed and millions of computers round the world did not burst into flames. As Head of IT at PentaHact, an organisation that provided quality care for individuals with learning disabilities, I had spent all of 30 minutes of our Y2K emergency summit a few months before, explaining to the board that as we were only a 10 year old company and do not have any IT systems older than that, the issues of the millennium bug simply did not exist for us. You see, it was important for me that the board did not send me on some wild goose chase for imaginary gremlins armed with expensive consultants. My wife, Ngozi, was expecting our first child and I had a baby room to prepare.

Thanks to modern technology, I knew he was male and, though this simplified the design to his room, blue based furnishings still had to be acquired, assembled and installed by the resident DIY expert – reluctantly. The prospect of being covered in blue paint in the name of giving the walls of the baby room a new lease of life was also looming in the horizon. So there simply was no time for idle speculation over bugs.

Anyone who has been blessed with child birth will tell you the joys of expectation that comes with the first child. It is about the only time you get most blokes actually attend the ante-natal classes of their own accord. In fact, I remember going to a whole session, though I remember very little of what the experience was all about now.

And then, after many a false alarm, the day arrives and you do just about the only other job blokes do in the whole process – get mother and baby to hospital in one piece. I remember our 2am dash to St. Thomas’ Hospital and then the endless wait. It was a Saturday and it showed. Everything was in slow motion. When Odi finally arrived, amidst all sorts of issues, there was no cry - total silence. That was the first sign I had that plan A had not exactly gone to form. And that began the most difficult year of my life. The baby room was not to welcome its resident till Christmas – 7 months later. The Intensive Care Baby Unit had that pleasure. Initially Odi was at St. Thomas’ Special Care Baby Unit (SCBU) and then on to the Ronnie McKeith Ward at Guy’s Hospital (now the stunning Evelina Children’s Hospital – first one in London in 100 years).

It was here that I got a first glimpse of how much value a great society puts on its weakest and most vulnerable. The attention and care Odi and the other children got at Ronnie Mac (as we fondly called it) bothered on saintly at times. Nurses worked from 7am to 7pm shifts creating an environment that sort to ease the intense suffering that little children were experiencing. They shared the rare moments of smiles from the children as well as the many moments of despair from us parents. It is no surprise that ten years later we will be sharing some part of our Christmas with Joe and Julie Nwanazia. Julie had quickly sussed out Odi’s parentage and being married to a Nigerian, she bonded with Ngozi on the ward and they have remained friends since. Ngozi sponsored their second boy in confirmation.

The efforts on the ward was supplemented immensely by that of the Ronald McDonald House at Guys & St Thomas’ who provided a home away from home to parents like us who faced months of uncertainty with their child as you waited for a final diagnosis.

I can honestly say that we got all the support possible for Odi and Ngozi who cared for him devotedly by his side. I had the dubious pleasure of having to carry on going to work to keep a roof for Odi to come home to. Once in a while, I get asked how it was for me. I almost always end up describing how it was for Odi and Ngozi as Odi in the first instance was of course having a tough time of it and I cannot think of any mother that would not have cracked in the face of the mother of all challenges and many did in Ronnie Mac including Ngozi who had some really tough moments and lots of tears.

From my perspective, it was the loneliest time of my life. My routine was simple. Wake up, get to work, then hospital and then back to an empty house. No baby’s cry, no nappy changes, no first milestones, no toddler telly. My colleagues were great. Later I realised that not many actually were quite aware of how serious things were. Through it all, I had to stay strong when in hospital to give strength to my son and Ngozi before going home to punch holes out of my walls in frustration.

I often ask myself why I was not shouting about it at the time. After much reflection, I can only conclude that prime amongst the reasons was my Nigerian background. I come from a culture that simply does not understand disability, especially learning disabilities, and attribute most of it to some mystical curse from years gone by. I had at least 2 attempts of relatives trying to present such theories to me in the midst of our struggles and that simply made me clam up. It cheapened our struggles in a perverse way. It was pretty clear very quickly that all we would get from our Nigerian community was pity and that was, quite frankly, the last thing anyone needed in our situation. We needed practical help and support from people who knew what they were doing.

This carried itself into my workplace where I should have been more forthcoming about the situation but instead I felt more comfortable in picking one or two people to confide in. On reflection, this added to the loneliness.

One of the happiest days of my life was the day Odi came home. It was significant for me as I had been living with the real prospect that my boy would not make it to his room that I had spent all my effort preparing for him. Through the years we have had all sorts of issues to deal with but it got easier once he was given a diagnosis in 2001 – Cerebral Palsy – Four –Limb Quadriplegia which is the most severe type. It takes a while to diagnose brain injuries in children as you have to wait for the brain to develop to be able to see the extent of the damage.

At 10 years old, Odi goes to a special school and learns skills every day. He gets 24 hour care and has gradually grown to enjoy life beyond his limitations. This is down to the society he was born into. Recently a friend had similar troubles in Lagos and it became clear very quickly that trying to manage circumstances this complex was not a remote possibility in Nigeria and the family have left and relocated. This is an indictment on all of us – The Nigerian Society. We are blessed with riches but currently have leaders that are poor in spirit.

All these years I have lived with the knowledge that if Odi had been born in Nigeria he would not be alive today.  Despite our resources both within and outside government, you will hardly hear a word spoken about health care, about care for the disabled, for the frail, for the mentally ill in our society. Children die in Nigeria of diseases no one else in the world is dying from. We cry a bit, moan a lot and shrug it off as the will of God.  Children loose the opportunity to live, to aspire, to happiness, because we prefer to look the other side. 

I have recently worked with different groups of Nigerians at FGCE Project Hope, TEDxEuston and Enugu Old Skool and know that we are a people that are very rich in spirit and have people who carry this spirit with them more than most. While they have shown me that there are still a few such people in our society, I believe there are a lot more, standing on the fence, hoping that by some miracle, our country will get better. 

In a recent effort, Enugu Old Skool members worldwide went on a drive to provide Christmas cheer to lots of children in Homes and Orphanages in London, Lagos, Abuja, Enugu and Jos as well as contributing to a Charity for children in Southern Africa, Msizi Africa. They did not argue about “zoning” or “resource allocation” or “rotation” or any of the grandiose terms our politicians use to get us fired up against each other. These Nigerians just went out and did what they had to do for the children that are our future. They are building up Nigeria every day and leading our politicians by example. They are my heroes this Christmas; Let us continue to build a better society. 

So my Christmas wish is this; I hope you like this article. When Odi turned 10, I wrote a little about him and got lots of likes and comments from my dear friends and these were really nice. But we need to go beyond this now.

We need to get over the inertia of thinking that we cannot make a difference. We need to use the tools at our disposal - Facebook, Twitter and all the social networks to mobilise for good causes and to go beyond just clicking on "like" visit our local schools, orphanages, care homes and hospitals.  But not just visiting with old clothes alone but sitting down with the leaders at these institutions and asking what we can do to support, then going out and doing it. We will also have to engage with the political process, ensure we ask our politicians the hard questions on the things that matter to us. 

Do not sit back and cry for Odi or send us emails, or post comments of empathy. Give yourself to our society in the spirit of what Christmas really stands for. Engage with the challenges that face our society.....our future and the future of our children will be one we our action or inaction.  

 enjoy, reflect, do.......and not just for Christmas!

But, do have a Merry Christmas!

Wednesday, 22 December 2010

Bringing our health data to life!

For a long time, our leaders have taken Nigerians for a ride, quoting astronomical amounts of money for delivering nothing. One major reason for this is that we had no way of knowing more than they told us. We relied on NTA News to tell us what our Government was doing with our funds....and we have all learnt how effectivet that is. But thanks to blogs, Twitter, Facebook and wikileaks...things are changing, and I suspect our country will never be the same. The first example of this was while NTA tried to deceive the public with its quietude reporting of the Independence day celebrations, images of the bomb blasts in Abuja were being viewed all over the world.

One more tool has just been added to our armoury of holding our leaders accountable.

An amazing phenomenon is spreading around the world. People are finding ways to present data in ways that make them more accessible to people, enabling them to use this as advocacy tools. One man that has become a folk hero is Professor Hans Rosling whose  TED Talk has received one of the most views ever. He founded a website called Gapminder that is literarily revolutionising our relationship with data. With software that brings data to life, we can follow our development (or lack of it) over time. This map below will show how we have done in terms of one of the most widely accepted indices of development; life expectancy. It not only shows how badly Nigeria (dark blue) has done measured against Brazil, India and Malaysia, it also shows within that how badly we did in the dark military yeas of the Babaginda/Abacha regimes. This is the new power of data. Next time I see our Minister of Health - this is what I will show him. You should too!

Now something amazing is also happening in Nigeria with the The Nigerian LGA GEodemographic Classification System and profiler (NIGECS) . This geodemographic classification system is an attempt to simplify a large and complex body of information about people, where and how they live, work or recreate.

At present, the Nigerian LGA classification system encapsulates spatially referenced datasets for the year 2006 sourced from the National Bureau of Statistics (NBS) for each of the 774 LGAs in the country. NIGECS is the first interactive repository for geographical and statistical information about the 774 LGAs in Nigeria. Find some of the health data below - showing access to public hospitals in 2006. You can immediately see the inequities in access in the country and one would expect a government to use this data to plan for the provision of health care in the country.

The beauty of this tool is that once your data is geographically referenced, you can change the data and produce maps needed to understand how our country is evolving.

This website has been put together by Dr Adegbola Ojo who has a PhD in Geography from the University of Sheffield. Dr Ojo is Lead Consultant in Development Studies, Informatics and ICT at the African Higher Education and Research Observatory (AFRIHERO), Sheffield, U.K. He is also Lead Consultant at Global Strategic Services and Training (GlossTra), Sheffield, and a researcher at the Head Office of Skills for Justice, Sheffield, U.K.

If I were the Minister of National Planning - I would camp outside Dr Adegbola's home until he comes home even if it takes paying him the humble salary of a distinguished senator. I would do everything it get him to deploy his expertise in the service of our country...

This will probably not happen, as our leaders prefer that we stay in the dark....

Saturday, 18 December 2010

Thank you to three extraordinary senior colleagues

As part of the Second Nigeria: Partnership for Health Conference that held in London on the 6th of November, the Public Health Foundation of Nigeria recognised the contributions of 3 extraordinary colleagues in the health sector in Nigeria. We recognised these senior colleagues not only for their pioneering work and their leadership but for the integrity they have maintained in their years of service to the motherland.

There is no other way to put it - these are our heroes and our role models. They stand for the values that we hold dear; integrity, excellence and a commitment to public service so rare in our country today. They have inspired and continue to inspire us. When they speak, you feel the pain in their voices on the state of affairs in our health sector today. But all hope is not lost. We will pick up the pieces and strive to build on the their legacies. 

Professor Shima K. Gyoh is a graduate of Newcastle University, Officer of the Federal Republic, Professor of Surgery and Board member, Society for Family Health and Population Services International.

He is an accomplished civil servant whose helmsmanship at the Federal Ministry of Health saw unprecedented improvements in health indicators in Nigeria working with Dr Olikoye Ransome Kuti in the glory days of the Ministry of Health. Professor Gyoh is a national leader in medical regulation whose dogged belief in the central role of self regulation of the medical profession in the improvement of service delivery rejuvenated the Medical and Dental Council of Nigeria.

Professor Eldryd Parry is graduate of Cambridge and Cardiff Universities, Officer of the British Empire, Founder of the Tropical Health and Education Trust (THET) and Fellow Emmanuel College, Cambridge University.

Professor Parry is an award-winning editor and scholar of extraordinary insight whose contribution to the development of academic and preventive medicine in West Africa and the Horn of Africa helped shape medical education. He is a leading expert on tropical medicine and diseases and a compassionate humanitarian whose life has been dedicated to strengthening healthcare services as well as improving the skills of healthcare workers in less developed countries.

Professor Adetokunbo O.Lucas is a graduate and Professor of the Havard School of Public Health.

Professor Lucas is an officer of the Federal Republic and Member of the Governing Board of the Global Fund for Fighting AIDS, Tuberculosis and Malaria. He has been a major force in scientific research whose deep life long interest in tropical diseases facilitated the advancement of the frontiers of knowledge in Leprosy, Onchocerciasis and other diseases.

He is an international leader in the fields of preventive medicine and Tropical diseases who effectively deployed his knowledge and passion to human development in these fields.

These three extraordinary senior colleagues were recognised with awards at the Second Partnership for Health Conference that held in London on the 6th of November. 

Wednesday, 15 December 2010

The conference - Nigeria: Partnership for Health

On the 6th November 2010, over 150 colleagues working in different capacities within the Nigerian health sector assembled at the beautiful facilities of the  Royal College of Obstetrics and Gynaecology  for the second of the Nigeria: Partnership for Health conferences. These conferences are a collaboration between Nigerian health professionals in the Diaspora, and health professionals and institutions in Nigeria, highlighting how we are engaging with the major health issues facing us both in preventive and curative medicine. The overarching aim is to garner enthusiasm and confidence in opportunities in the Nigerian health sector, nurturing new relationships and inspiring action. This year's conference was organised and hosted by the Public Health Foundation of Nigeria.

But why bother with this conference in the first place? Nigeria is at a crucial point in its corporate existence, enjoying its longest period of sustained democratic governance, yet the lives of millions of ordinary Nigerians has remained largely unchanged. Several sectors of the economy have undergone astronomical growth. Over 70 million Nigerians now own mobile telephones, the financial sector has seen continuous growth despite some revelations of entrenched corruption, and the oil and gas sector remains the cash cow for the government. Despite this, progress has been very slow in the Nigerian health sector, and Nigerians are impatient for change.

Why should this be the fate of a country with a skilled health workforce inside and outside the country? How can we get Nigerians and friends of Nigeria to re-engage sustainably in the development of its health sector? How can our partners, donors and research institutions interested in health in Nigeria contribute to the improvement of the vast population's health? How can we motivate the thousands of Nigerian health professionals in the Diaspora to re-engage and contribute to improving the health and health care of Nigerians? How can partnerships, research collaborations and links be initiated and sustained? These are some of the challenges we as Nigerians working in the health sector of countries in the West are confronted with. These are the issues focused on during the conference, following up on the highly successful inaugural conference in 2008.

The 2010 conference was aptly themed "Moving towards sustainable collaboration".

Specific objectives included:

I. Identifying and exploring opportunities for collaboration between Nigerians and friends of Nigeria in its health sector, and mobilising Nigerians in the Diaspora to avail themselves of these opportunities for collaboration.

II. Mobilising and engaging Nigerians in the Diaspora working in the health sectors to contribute to the Nigerian Government’s vision for health and health care

III. To feedback on progress since the last successful Partnership for Health conference in 2008.

Captive audience!
The conference was sold out and had a large turn out of motivated Nigerians from all over the UK, Europe and Nigeria. Nigerians working in different aspects of the health sector: doctors, nurses, pharmacists, medical students and policy makers. Quietly sat in the audience were senior colleagues like  Professor Adenike Grange (Former Minister of Health of our Federal Republic). People came with their ideas and experience ready to share, and to learn. The energy in the room was amazing, a real credit to the sheer determination of Nigerians not to let their country slip into the abyss. 

Dr Ego Nnadozie, representing the  Minister of Health
Attendees at the conference were welcomed by Dr Aliko Ahmed – President of the Nigerian Public Health Foundation who reported on progress since the previous conference. Then the representative of the Nigerian High Commissioner, welcomed delegates and apologised that the Nigerian High Commissioner, Dr Dalhatu Tafida was in Nigeria at the moment engaging in the political arena in the run-up to the elections. Dr Ego Nnadozie, who represented the Honourable Minister of Health informed delegates that the Minister was eager to engage with Nigerian health professionals in the Diaspora, and was in touch with different representative organisations on how to facilitate a process for doing so. The opening session ended with a fascinating presentation from Dr Liz Tayler, representing DFID in which she challenged delegates not to only focus on skills, but on the politics of health, and to hold both our governments and donors accountable for their promises using new tools such as Gapminder

The first session was titled "Protecting and Preserving the Health of the Population", and included Dr Muhammad Ali Pate – Executive Director, Nigeria Primary Health care Development Agency, Lord Nigel Crisp – Former Chief Executive, National Health Service who spoke about "Turning the World Upside Down - health worker development and migration". Dr Ugo Okoli – Project Adviser/National Programme Consultant to the Midwives Services Scheme of the National Primary Health Care Development Agency. She had left the UK in the past year, and spoke of her experience in settling back in Nigeria, and the demands and joys of her new role. Dr Agomuo, the Chief Medical Director Federal Neuropsychiatric Hospital Enugu Nigeria told delegates about a successful collaboration in an unlikely area: "The Amaudo Project". The session was ended by the ebullient Dr Ebun Sonaiya speaking to health maintenance organisations (HMO) as drivers of quality in the health sector. It is difficult to capture the proceedings of this session into one paragraph, but suffice to say that Dr Pate's presentation really brought some hope and confidence to the conference that finally the right people were being placed in critical positions in the management of our health sector. In his eloquence and competence, the audience could relate to the dreams they had for their country and began to look forward to a new dawn. 

Dr Muhammad Pate, Professor Adenike Grange and Dr Ugo Okoli 
The second session was titled "Moving Healthcare in Nigeria into the 21st Century". Another high calibre panel was available to address this from different points of view. We started with the return of Dr. Seyi Oyesola who had spoken at the 2008 Partnership for Health conference, and fed back on his experience as Chief Medical Director of the Delta State University Teaching Hospital Oghara, Delta State. Mr Gbenga Olatunji; the Market Development Manager for Johnson & Johnson West Africa spoke about how they were supporting various tertiary care facilities in Nigeria, as an example of how partnering with industry can deliver advanced surgical care in Nigeria. Dr Dilly Anumba, the President of the Medical Association of Nigerians across Great Britain (MANSAG) spoke about the benefits and challenges of health care missions, while Dr Folabi Ogunlesi – Chief Executive Vesta Healthcare Partners Management spoke about how he was working with the university college hospital of the University of Ibadan to institute quality management systems for the hospital. The session ended with a passionate presentation by Gloria Urhoma, giving the nursing and midwifery perspective for moving healthcare in Nigeria into the 21st century - using her personal story. 

Dr Dilly Anumba, President of MANSAG
The quality of the presentations throughout the conference was exceptional. The speakers appreciated their dual roles of informing, and inspiring. The disengagement of Nigerians from the health sector in Nigeria had caused too many deaths already, and it was felt that it could not be allowed to continue.

All the presentations at the conference Partnership for Health II are now online and you can view them all on our website:

Most of the pictures are now also on the website.

With these presentations online, and available to you and any other interested party, we will always be able to remind ourselves of the promises made by ourselves, our speakers and our government at these conferences.

Further reports on other sessions of the conference will follow shortly, including reports from the keynote speaker and the workshops. the change you seek!

Saturday, 11 December 2010

They don't get it - our Senators and our health

Anyone following Nigerian politics will have seen the uproar in the press when the the Governor of the Central Bank of Nigeria, Mr Lamido Sanusi made public, and stood his ground despite public hounding by our "distinguished" senators that the National Assembly consumed 25 per cent of Federal Government's total overhead budget.

You might ask...but what has that got to do with health? And we will explain. According to the website of our Ministry of Finance, available to all Nigerians with Internet access, the recurrent budget of the NASS (National Assembly) is about N138b, their capital budget is N16b. (Available via the Federal Ministry of Finance). Check it yourself. If we take these figures, they still receive more recurrent funds than either of Health, Housing, Power, Transport, Agriculture and Water Resources, Interior and Justice Ministries!

But still you might ask....but that's not enough...that is not health specific. Well it is! All over the country there have been strikes by doctors demanding what might appear to be large increases in their salaries. All the state Universities in South Eastern Nigeria have been closed for 5 months (yes - 5 months!), because their State governors say they cannot pay the new salary structure agreed by their counterparts working for Federal Universities. So you might ask - why are Nigerians that are lucky to have jobs in these desperate times, especially doctors holding society to hostage. 

We submit that the major reason is not that they cannot manage on what they earn, or indeed that they are unwilling to manage. But people are rebelling against the astronomical amounts of money we are paying our "distinguished" senators, for what in most other countries is considered largely altruistic public service. The most painful part, for anyone that still bothers to watch NTA network news is that on a good day, just a handful of these our distinguished senators bother to turn up. 

How can we possibly afford to pay Senators in Nigeria N15.18m in salaries and allowances monthly ($100,000.00), when we cannot pay our doctors, teachers, nurses, a fraction of that. That is the absurdity of our country. Their allowances include the most ridiculous items such as "hardship allowances", "newspaper allowances", "domestic staff allowances" and let us not forget "a wardrobe allowance".

But as this blog is titled - Our senators do not get it. They just do not! We have lived in a perverse society for so long. But due to the Internet, access to information, and Nigerians inspired by Julian Assange of Wikileaks, we will see changes in the landscape of Nigerian politics. 

Find below an exert from an interview granted by Professor Jubriul Aminu, one of our longest serving senators, and a former Minister of our Federal Republic about the anger felt by people due to the N15 million he "earns" monthly. Read and decide on what you can do. For one come January - Register to vote. Maybe we can take our country back....just maybe. But do not expect these guys to give up their N15 million lightly.

“Who are the Nigerians that are worried? It is you media people who are worried. I can take you to my village in Song, you will see that they are not worried. So, people should stop this nonsense of talking about allowances and how much the members are getting.

Friday, 10 December 2010

Wikileaks' latest leaks focus on Pfizer- Nigeria lawsuit

The Wikileaks cable leaks continue and today, makes allegations on Pfizer's attempts to influence a settlement on the clinical trials lawsuit filed against it by Nigeria Read all about it here

Hmmm... we had earlier blogged about the Pfizer lawsuit here, here

and here