ANYBODY who has never gone
through a near-death experience
may not fully appreciate what it
means to go through the valley
of the shadow of death that has
become the daily routine in most
public hospitals in Nigeria.
It is a fact that Patients who
are not financially empowered
and left with the option of
patronising the publicly owned
general or local health centers
are meant to go through a neardeath
situation because of the
certainty of the uncertainty of
quality of treatments and drugs
that such a poor patient would
get.
The public health system
in Nigeria has systematically
collapsed under the heavy
weight of perennial and
persistent managerial
corruption, inefficiency and
ineffectiveness of officials of
government.
All that a researcher needs to
do to gauge the real situation
of affairs in the nation’s public
healthcare is to pay a visit to
any general hospital anywhere
in Nigeria and to take the pains
to visit the laboratory and ask
the relevant questions of the
functionality or workability of
the critical infrastructures in
and around the hospital. Such
critical factors like survival
rates, patient safety, specialized
staff and hospital reputation are
not available in much of these
public hospitals and these are
essential factors for determining
the standards of hospitals.
The first sign of doom that
would stare you on the face
the moment you enter a public
health facility anywhere in
Nigeria is the environmental
insanity and degradation.
You would be shocked to see
medical workers competing
for space with rodents and
cockroaches.
The medical and non-medical
staff do also run their petty
businesses by the side making
the public hospitals appear
like a multipurpose shopping
complex.
The next bad sign to notice is
that the moment power supply
system from the national grid is
switched off as is often the case
with the epileptic electricity
power supply system in the
country, you would notice
that most of these public
health facilities lack functional
generators to power the critical
health equipment. Virtually
all the public hospitals that
can afford run diesel powered
generating sets as sources
of their electricity power
thereby spreading pollutants
around the environment and
further exposing their patients
to the risks associated with
environmental pollution.
A story was once told of a
man who took his relative for
common surgery of appendicitis
but had to also go to the general
hospital with a generating set just
so the procedure would not be
interrupted by poor power supply.
The public healthcare system in
the country is going through some
of the worst forms of criminal
negligence and abandonment.
One reason for this is the
phenomenon of foreign medical
tourism by most government
officials and their family members.
Another related cause of the
total degeneration of quality
in the public healthcare is the
lack of professional supervision
and the next giant reason is the
porous mechanisms of public
procurements that create room for
corruption.
The Bureau for Public
Procurement is weighed down by
multifaceted factors of corruption
and bureaucratic inefficiencies.
I will return to discuss the
causative factors that have led
to the gradual and systematic
collapse of the public healthcare
but first let us examine emerging
scandals from the presidential
medical facility in Abuja.
The wife of President
Muhammadu Buhari, Mrs. Aisha
Buhari is in the news as expressing
her disappointment about the
poor state of facilities at the Aso
Rock Clinic.
The wife of the president
expressed her frustration at the
total non-availability of basic
amenities at the prime health
facility set up by the federal
government to take care of the
health and related well-being of
the members of the political class
within the presidency and also the
staff who work within the confines
of the presidency.
The presidential clinic is known
to be one of the most heavily
funded government’s owned
health facilities in the country
which gets humongous budgetary
releases yearly.
The question raised by the wife
of the president came within few
weeks of the reported castigation
of the Aso Rock Clinic by the
daughter of the president who
expressed strong views to depict
the clinic as being badly managed.
An interesting factor is that the
Aso Rock Clinic was set up just
like a “father Christmas” avenue
whereby free medical services are
offered to patients composed of
the privileged few who are already
earning so much money from the
central treasury of Nigeria.
The AsoRock’s Health center is
said to provide medical services to
the president, vice president, and
their families, members of staff of
the state House and other entitled
public servants.
But even as the Aso Rock Clinic
offers free medical services to these
aforementioned beneficiaries,
the question to ask is why are
there no checks and balances in
the management of such a prime
facility?
What are the steps put in place
to ensure transparency and
accountability?
What steps are being
implemented to ensure that drugs
and other essential equipment
meant for that clinic are not
diverted?
These sets of interrogatories
are critical because of the loose
practice amongst Nigerians
whereby there is the tendency by
many to abuse any opportunity of
benevolence because it is generally
believed that with humongous
crude oil money flowing into
government coffers, whatever
goodies anybody can grab from
government must be done with
reckless abandon.
In framing the above
questions, one is aware of the
unreasonableness of providing
free healthcare services to top
government officials particularly
when such persons do still enjoy
generous allowances.
Again, if the family members
of the state House can have
unfettered access to Aso Rock
Clinic, what kind of family
members do we mean given that
in Africa the extended family
system is deeply rooted in our
culture?
It is possible that occupants
of top political offices operating
within the Presidency will open
the floodgates of free medicare
to their kiths and kins in the
name of being family members.
African and Nigeria’s notion of
bigman sometimes means that
those who occupy privileged
positions behave like persons
who are above the law. Indeed,
even the militarily hand-picked
writers of the extant constitution
inserted a crude provision under
section 308(1) which gives blanket
immunity from prosecution for
about 78 executive office holders
such as the Prssident, his VP; the
governors and their deputies.
There is this climate of impunity
that this section creates making
it look like these persons can do
just anything including carting
away public assets eveb from
public clinics without being called
to account until such a person
vacates office. So the questions
of probity and integrity of the
process of managing AsoRock’s
clinic are largely yawning for
transparent responses.
Let’s also ask the managers,
what kind of data are maintained
in the Presidential clinic to record
the beneficiaries and their status?
What is the quality of regular
audits that are carried out in that
AsoRock’s clinic to block leakages
and theft of public fund which
both the EFCC and ICPC Acts
criminalizes?
Why does government
subsidize healthcare services for
some selected few who are in the
corridors-of-power whereas the
people who are the owners of the
sovereignty of Nigeria are allowed
to die from commonly treatable
ailments such as malaria fever?
Section 14 (2) (a) of the
Constitution states as follows:
“Sovereignty belongs to the
people of Nigeria from whom
government through this
constitution derives all its powers
and authority”.
This sacred provision therefore
means that any activity of
any government official that
compromises the health and
security of the people of Nigeria
must be seen as a threat to national
security and the offending
government officials must be
prosecuted and punished for this
crime against humanity.
In such serious countries like
China, Singapore and even
Vietnam, public officials who steal
fund meant for public healthcare
are executed in firing squads.
But in Nigeria which prides
itself as the largest black nation in
the world and claims to practice
constitutional democracy, the
most attractive job is politics
whereby successful public office
holders do not have to worry
about the effectiveness of the law
enforcement agencies even if they
decide to empty the entire health
budget of their states into their
private pockets.
It is only in Nigeria that the
millions of people are left to die
whereas the few government
officials are ferried abroad at
public expenses to be attended to
by foreign doctors.
Millions of rural and urban poor
in Nigeria are left to their cruel
fate and do often suffer sudden
deaths because of the insufficient
health care facilities and medical
workers at their services. Doctors
and medical workers in public
hospitals have lately made it a
routine to always embark on
strike over disagreements with
government on conditions of
service just as all of these persons
divert their human resources to
run their private clinics thereby
allowing poor patients to die
gruesome deaths.
These challenges of nonavailability
of functional public
healthcare are compounded by
the high rate of absolute poverty
afflicting over 100 million
Nigerians meaning that they
cannot afford to pay for private
health services which are few
and far between. In the last two
years the cost of pharmaceutical
products have shot through the
roofs due to high taxations by
the Nigerian Customs services
and the fees charged by the
National Agency for foods and
Drugs (NAFDAC). Because of
non affordability by millions
of ordinary Citizens of these
foreign pharmaceutical products,
they are exposed to the deadly
vagaries of patronising cheap
and substandard drugs and
quacks. These are consequences
of the depraved tendencies of the
elite to service their greed at the
disadvantage of the many who are
poor and not privileged.
Just one example will suffice to
show you how crude and wicked
political office holders are in
Nigeria and to show you that they
do not care about the welfare of
the people which in any event, is
the primary constitutional duty of
government.
This example that has come
in handy is the 2016 and 2017
annual budgets that go to the state
House Abuja whereby this nonperforming
Aso Rock Clinic is
located.
The amount budgeted for
the repairs of presidential villa
between 2014-2015 amounted to
N3.68Billion but between 2016
-2017, the amounts skyrocketed to
N12.43 Billion.
In all of the last two years, the
princely sum of N22.5 Billion is
By Emmanuel Onwubiko
Aso Rock’s clinic of infamy
budgeted for the state House
Headquarters.
Then look at the shocking
statistics from the United
Nations which shows that
5.1 million citizens are faced
with food shortage due to the
insurgency in the North East.
UNICEF also stated
that 2.5million children in
the country are severely
malnourished even as only
N50,000 is required to treat
each child but the public
officials spend hugely from the
public till to travel to foreign
jurisdictions to meet doctors
for their health services at
public costs.
Even president
Muhammadu Buhari whose
wife has raised the alarm
about the state House Clinic,
has spent many months in the
United Kingdom for medical
treatments costing Nigerians
tons of millions of dollars.
The presidency has still not
disclosed how much of public
fund was spent for president
Buhari’s several months of
foreign medical tourism.
Mrs. Buhari criticized the
managers of Aso Rock Clinic
for allegedly blowing away
N3.89 billion last year and
has yet to account for N331.7
million budgeted for it this
year.
The situation of Aso Rock
Clinic is a huge signal to show
that Nigeria’s public healthcare
is in an emergency situation.
If the prime healthcare center
in the Presidency lacks
even ordinary syringes to
administer on patients, how
much worst will the local
health centers in Arondizuogu
or Kaura Namoda be?
The Nigerian government
must therefore take decisive
actions to bring the public
health emergency to a minimal
level by tackling the hydraheaded
issues of medical
tourism and the different
levels of corruption that have
led to the collapse of the public
healthcare.
The shame of the entire
drama is that all the political
elite have sinned and
fallen short of the glory of
exonerating themselves from
these vices tearing down our
public healthcare.
Nigeria should classify
corruption in the public
health sector and Defence
as offences punishable by
the death penalty to serve as
effective deterrent and to stop
Nigerians from dying only
because they have no money
to patronize private hospitals.
The national health Insurance
scheme must be reformed to
efficiently provide services to
poor Nigerian and get millions
of Nigerians to enrol. Besides,
the corruption that surfaced
recently at the NHIS must
be frontally tackled and dual
principles of transparency and
accountability be restored.

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