The financial impact of health in Nigeria today: fate of the common man and way forward

in LeoFinance3 months ago
"Dr. Musa, let me tell you what ABC Hospital is doing currently. I just left there, and I'm told it's only one doctor that is on duty and claims to be attending to emergencies for God knows how long. How can only one doctor be on duty in a whole ABC hospital? I wanted to inform you as it is hot so you can intervene on them." Aunty Eunice said to me over the phone two Sundays ago. Thankfully, her mom is a retired nurse. She lamented how she had waited to see a doctor for over two hours and eventually had to opt for an over-the-counter (OTC) medication for her child. I allowed her to finish talking before I responded. By virtue of my work position, I have contact with all hospitals in Kwara State operating health insurance, and coincidentally, I am the enforcement officer, meaning I have to handle all complaints from hospitals or even enrolled patients.

I took my time to analyze what the situation currently is with ABC Hospital as regards medical personnel with Aunty Eunice, who happens to be my colleague at work but also like a big sister since our mothers are both retired nurses. ABC Hospital is among the top 5 leading private hospitals in Kwara State (the name ABC is used instead of the actual name so as to protect confidentiality) and used to have about 8 medical doctors on payroll. The medical director lamented that he had just five remaining and could not find doctors to employ. The COVID-19 pandemic created a gap in the continuity of medical schools, which has recently been worsened by the increasing exodus (JAPA, meaning to leave the country for greener pastures) of doctors and nurses. Another consultant and medical director met me on the road and lamented how she has been overworked because she does not have a doctor to employ in her private clinic. Usually, after she's done with her government work, she retires to the private clinic to work. You will wonder if she has any time to rest. After I explained the situation of limited doctors in ABC Hospital and Nigeria at large to Aunty Eunice, she was speechless and could only pray for Nigeria.

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Just a few days ago, it was on the news in Nigeria that Lagos State University Teaching Hospital shut down five wards as a result of inadequate medical personnel LUTH NEWS . The various government hospitals have witnessed a high turnout of patients, longer waiting periods, and few medical professionals. It is common to be booked to see a specialist months ahead or even to run an investigation. The tertiary facilities often complain that they spend too much money on the procurement of diesel to run the hospitals and have, among other factors, inflated costs at each service point for drugs. Government hospitals are supposed to be the saving grace for the common man. A friend of mine messaged me last night that she needed at least a N100,000 ($100) deposit before her mom would have an explorative laparotomy for a ruptured appendix. I was shocked as a medic to discover it was a federal medical center, and according to what she said, the doctors were busy and only one attended to them sparingly.

Speaking of the cost of drugs, reputable companies like GSK (GlaxoSmithKline) have opted out of business with Nigeria, resulting in an exorbitant hike in the price of their products, such as Augmentin. Augmentin used to cost N4,000 but skyrocketed to N22,500 only for me to see the price at N57,000 augmentin (price varies according to pharmacies), which makes me wonder what the fate of the common man is for common medical illnesses in the face of a harsh and unfavorable economy where the masses are more interested in feeding to survive than any other thing, oftentimes leading to overwork in an attempt to make more funds to make ends meet.

I told a medical laboratory scientist some time ago that it would be profitable to have one of one's children as a medic. Things like good roads, power, water, etc., can be difficult to get, but good health is something that should not be compromised. Having a child in the medical profession gives a fair hedge when it comes to access to healthcare. This notion is unfortunately irrelevant if your child also leaves for greener pastures. At this junction, I would ask my medical professional colleagues that have left the country: are they going to be really useful to their aging or elderly parents, relatives, or the sick back in their home country? I would not go deep into the reasons they've left, but a reminder that the few back homes would be depended upon to offer succor when the need arises. At the rate we are going in Nigeria, doctors also need to establish connections to see doctors.

The budgetary allocation of the health sector in Nigeria is not excused as a major cause of the problems highlighted. The recent budget proposal by the current administration for the 2024 year revealed that only 5% is to be channeled to the health sector SEE NEWS HERE . A friend and senior colleague, Dr. Dele Abdullahi, the NARD president, lamented that the quota was a step backwards but admonished that the allocated amount be used judiciously. While I worked with the state government up until August 2021, my take-home pay was N197,000 ($197) per month after a hectic work week. I remember losing 4 kg in 3 months while in obstetrics and gynecology. You will agree with me that I should have readily opted for the greener pastures, like my professional colleagues. Thankfully, I got a less hectic offer from the health insurance sector in Nigeria, which pays better yet has opened my eyes to a lot of decadence and levity in the health sector as a whole.

WHAT THEN IS THE FATE OF THE COMMON MAN?

Don't fall sick! I wish everyone could just be healthy, right? Would I say do not walk into the hospital for any reason, including for the purpose of delivery? Well, I wish it was that simple. A wealthy nation is dependent on the health of its people. You will agree with me that nations thrive better when they have a vibrant and healthy populace compared to having the population tilted towards the elderly, who may likely be sick or nursing terminal ailments.

Medicine is now focusing on the prevention of illnesses and the promotion of healthy lifestyles, as opposed to the curative and rehabilitative stages, mostly seen as a result of late presentations. It is more cost-effective to prevent sickness and promote healthy lifestyles. These range from, but are not limited to, having adequate rest, eating balanced diets, especially fruits and vegetables that are known to have antioxidant properties, regular exercise, drinking water regularly, limiting the intake of carbonated drinks, and reducing harmful habits such as cigarette smoking, alcohol consumption, substance abuse, etc. If an annual medical checkup won't be expensive, have your system checked at least annually. Take vaccines such as the hepatitis B vaccine, engage in safe sexual practices, and do not abuse drugs, as they may predispose you to drug resistance eventually.

Have a medical professional as your friend; you may benefit from free consultation or guidance in the right direction. I wish you a healthy life, and I would appreciate your comments and contributions. Thank you for reading.

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I know its a late reply but interesting article. I especially liked this part:

It is more cost-effective to prevent sickness and promote healthy lifestyles. These range from, but are not limited to, having adequate rest, eating balanced diets, especially fruits and vegetables that are known to have antioxidant properties, regular exercise, drinking water regularly, limiting the intake of carbonated drinks, and reducing harmful habits such as cigarette smoking, alcohol consumption, substance abuse, etc.

There is a saying "An ounce of prevention is worth a pound of cure" and I believe in that 100%. I see so many people come into the Pharmacy with a desire to have a tablet to fix them. The reality is that lifestyle changes would do them much better. As an example : "Ozempic" for weight loss. It is effective for weight loss and a good diabetes medication. However at a cost of N200,000 / month wouldn't it be better just to change diet and exercise?

As for your cost for medication. I'm thinking that you are paying "world" prices on a "local" scale. The price for Augmentin (called Clavulin in Canada) is similar to the Canadian and Filipino price. Global commodity = Global price. Except the local community can't afford it so that means only the rich get treatment. Sad.

As for limited resources in the hospital. I'm in a rich country and hospital and doctor visits are free. However, when things are free everyone wants to get the most they can. Hospital waits 6hrs and longer aren't particularly uncommon because there are only so many doctors who get overworked here too. Then again, their wages are pretty good with a general physician making N- 250,000,000 yearly with a specialist making up to 4x that amount (N500,000,000 for surgeon and N 1,400,000,000 for Opthalmologist).

I mention this only because while Nigeria is experiencing a "brain drain" of Doctors looking for better pay elsewhere and I understand your frustration with those are are abandoning their countrymen for many people -- Money Talks.

Just wanted to say I enjoyed the article. I'm trying to write my response to your article on agriculture but I'm still sifting through your posts trying to find it and got distracted by this one ;)

Oh... Thank you very much for your contribution. Yet today, I got a call from a doctor colleague informing me she's LEAVING. I screamed but, I rejoiced with her.
Sincerely, I'm wondering if I'm doing right by staying back.

But in my article, I'm trying my little best to fix that which can be fixed.

You can imagine my colleagues practicing in other countries needing a physician to consult their loved ones? I see a time that money would not get medical treatment but the queue to see the few that stay back.

That has another effect, the doctors are now setting up private facilities since the government facilities are always choked with patients.

The brain drain is massive and experienced professionals are on the decline.

Don't know if you heard of fake products making the news in Nigeria in the last 48 hours? Surely we have fake drugs too... Rocephin inclusive

I'm yet optimistic that great things will come out of Africa, Nigeria especially!

I can't speak for Nigeria as my knowledge there is very slim. Indeed if you wonder about the #earnspendgive community I've been using it to gather what knowledge I can so I'm not totally ignorant...but it is certainly not enough.

However, I do know about the Philippines. Do you know what the main Filipino export is?

Nurse

Now you may think that I"m joking but I'm not. Remittance back home from OFW (Overseas Filipino Workers) is the third largest source of income for the Filipino economy.

Imagine just for a moment if you sent one Doctor to Canada to work as an Opthalmologist. Imagine that he (or she) is indeed making 1.4 Billion Naira yearly. Imagine that they take what they need to live a quiet, comfortable life in Canada (200 Million Naira yearly). Then they send back 1.2 Billion Naira every year to train and support other doctors.

I know human nature and I really doubt that would ever happen..
... but just imagine the change it could make if it did?

Anyways, still working on my agriculture post...but I did refind your article :)

Thank you very much. What if.... But it is as we see it.... Such monies would take other paths rather than build more doctors.

Thank you

I know.
.... What if?

In Canada we lose Doctors to the USA and then lament the shortage. Our wages are good but theirs are better.

In some parts of Canada (like Sasatchewan) they make Doctors sign a service agreement to local communities when they start medical school. They pay significant fees to go to school but all of those fees are refunded one they perform a number of years working in the province. In fact the "work in province" is compulsory for acceptance for a number of years (4 I think but I don't live there). It's not a perfect solution but better than nothing.

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This is a terrible case I must say and the government is less concerned because they will often fly abroad to get quality treatment . The budget allocation for science research and medicine is really pitiable.

I hope someday soon we get priorities right in our nation. Thank you