Dr. Steve Ovu is a medical officer at the A&M Health Science Centre, Texas, United States. When Adebayo Folorunsho-Francis met him at a recent health event held in the country, the enterprising doctor gave a candid assessment of the Nigerian health sector, with particular emphasis on some nagging issues hampering its growth. He also suggested ways of resolving the issues. Excerpts:
Tell us about yourself, especially your educational background
I attended Birrel Avenue High School, Yaba, and obtained a BSc. with Honours from Prairie View A&M University, Texas, United States. I also had both Doctor of Medicine (MD) and Master of Public Health (MPH) degrees from Texas A&M University in College Station, Texas.
Why did you decide to study medicine?
I decided to pursue medicine after a successful surgical intervention to remove my infected appendix at the Eko Hospital in Ikeja. The feeling of relief overwhelmed me that I wanted to do the same for others in some way.
At a recent event, you talked about the problem of wrong diagnosis and how it is claiming lives in Nigeria. Give us your experience on this.
Please permit me to relate only on what I have experienced– poor medical management.
Tell us about poor medical management in Nigeria then.
There are quite a few issues that come to mind such as lack of “bedside oxygen” at the emergency rooms or no oxygen at all; patients having to provide their own medical supplies such as gloves, syringes, saline, laboratory diagnostic kit etc; absence of in-hospital imaging machines (CT scanners, MRIs); unavailable stat labs for quick assessment of patient haemodynamic; absence of electronic documentation of patient data, and so on. These aresome of the disturbing findings in our local hospitals.
All these factors constitute poor management,which greatly affect efficiency of care; this often translates to poor quality of care and loss of life in severe cases. These are provider-services issues, not considering whether the patients can or cannot afford these services.
What is your take on fight against counterfeit medicine in the health sector?
I am not familiar with the statistics of this issue but I can see this being plausible, given the significant physician-patient ratio in a rapidly expanding population. The difficulties students face getting into medical school, graduating from medical school and progressing to become consultants are factors that could fuel the promotion of incompetent/quack care givers because they have to “make it”. Not considering those who impersonate doctors for the purpose of fraudulent activities.
As a medical practitioner, what is your assessment of the state of health care in Nigeria?
My perspective on this issue is a culmination of my experiences in volunteering at one of the federal hospitals in Lagos, visiting family members at our public hospitals, prison medical missions and subjective reports from patients treated in the country. An overview of our health care is analogous to visualising an oak tree with many branches.The stalk represents provider services, in dire need of “available resources” (financial and human resources) to drive the business of healthcare. From the perspective of population medicine, healthcare should be structured to meet the health demands of the people and help avert undesirable health outcomes.
We need fully-equipped hospitals (which have functional emergency room services, intensive care units, general/specialised wards, trauma divisions, etc) that can accommodate acute issues concerning airway management, cardiovascular-related insults, pregnancy-related emergencies, fractures from high rate of motor vehicle accidents, manage infectious and chronic diseases, and provide medical technology for efficiency. We are talking about hospitals that will not demand the patients to go buy the accessories they need for adequate care. Time is life oftentimes, especially in emergency crises; and we have to equip our hospitals to provide all necessary devices to render competent care at a reasonable cost. The people don’t need a charitable non-functional health centre but health institutions that can fix them up with billing fees at the end of the rendered service. This will open up concerns for health insurance, which is fundamental for operations.
What about the branches?
The branches are the issues that have to do with patient expectations/management, such as respect for persons. Patients want to be treated humanely and not bashed when seen at a healthcare institution. Next is affordability of care. This tops the priority list for most patients over quality of care. Location of institution, accommodation (that will take care of the question: “Will they have beds for us?”), the list is endless.
What is the way forward, if we are to have a vibrant health sector?
Firstly, I will say significantly increasing revenues allotted to the health ministry to equip, build and restructure health institutions. Secondly, training more care providers to improve quantity and quality in the health sector. Thirdly, there should be preventive care –going after the root causes of morbidity and mortality (bad roads, water/waste hygiene, nutrition choices, vaccination and maternal care).
There are several primary health centres in the state, yet most Nigerians don’t access them for treatment. Why is this so?
They were not cutout to meet the teeming population of Nigeria, and I am yet to see a health centre that is not already congested with patients. This makes it difficult for anyone to want to go and spend the entire day in such place.
Is strike action really a good way to press home the demands of health officials or are there other means to draw government’s attention?
Strike by health professionals is unethical. But in a country like ours, where little or nothing happens until extreme measures are taken, one can understand but need not condone the strike actions. We need to get the healthcare professionals (doctors, nurses, pharmacists,etc) on board legislative issues because these people know where it hurts and are in better positions to make informed decisions on care governance in the country than the types of people on the cabinet.