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#health In Nigeria

“We Don’t Have Money”

“Patient is yet to purchase drugs due to financial constraint”.

“Patient is yet to have investigations done due to financial constraint”.

Anyone working in the Nigerian health system, or even studying, has probably heard many variations of

those statements and the one used as the title of this post said countless times by doctors and patients respectively. During my pre-clinical years, I used to think that everyone in the country could afford baseline laboratory tests at least. If they weren’t able to provide the money then it meant that they were probably unserious, that’s what I previously thought. Boy, was I wrong.

My clinical rotations opened my eyes to reality. We’re doing our rotations in two hospitals, both ours and a federal medical centre, so I’ve been in both public and private healthcare environments. I’ve come to realise that the most common diagnosis is not malaria, or typhoid, or even diabetes. Underlying all of these pathologies is a most crippling social diagnosis: financial disability.

In this country people die from diseases that are ordinarily not meant to cause one to come close to death because they do not have money to buy ‘cheap’ medicine or do a complete(or full) blood count. They are not lying, at least the genuine ine aren’t. They barely have enough to feed their family that day, let alone pay for a test. People have walked up to me to solicit for funds for their sick loved one. They have never said they they were in need of a million naira. Ten thousand naira would more than adequate for them. The truth of this shocked me to my core.

Truth is, even if these doctors and nurses want to do it out of goodwill, they can’t solve all the problems they encounter. Healthcare is quite expensive all over the world, the higher the standard the higher the cost, and sadly a lot of Nigerians cannot afford it, hence the needless deaths. The numbers speak for themselves. Nigeria has one the highest maternal, infant and under-five mortality rate. “Nigeria is one of the most dangerous places for a child to be born”, Bill Gates said this during his meeting with the president in Nigeria while advocating that more funds and attention be on healthcare and education. The Bill and Melinda Gates foundation, along with a PEPFAR (President’s Emergency Plan for AIDS Relief) couple of others, have been offering and are still offering foreign assistance for years to help the country with management of diseases of public health importance which include HIV, tuberculosis and polio. Foreign aid is the reason why antiretroviral (used to treat HIV) and anti-tuberculous drugs are now free in government facilities. A rich country like Nigeria is presently dependent on foreign aid for maintenance of a number of her important health schemes, I find that very odd.

Sometimes I think it’s so unfair that people of low socioeconomic class account for the majority of the sick. It’s all one vicious cycle though; poverty and illness. Either can predispose to the other. It is obvious that the citizens cannot help themselves by themselves, this is where I believe government help can step in, and should step in. The unnecessary deaths can be reduced if more attention is paid to healthcare on a national scale.

Every human, irrespective of socioeconomic class, is deserving of a standard of healthcare. Everyone should be able to have urgent baseline tests performed if the need arises. Unfortunately this does not obtain over here, but I believe it can. Our healthcare statistics will improve markedly if there is satisfactory health insurance. There is a clause however; the insurance pool cannot be well funded when taxes a large proportion of the population still does not pay taxes. The taxes are what fund the healthcare insurance in many developed nations. The wealth of funds are what is dipped into every time a tax-paying citizen is ill.

For Nigeria we would need a two-stage process. First, taxes should be paid by all (or at least 90%) of the working class. Taxes are now more imposed on the companies and blue-collar jobs, but those are not the only vocations that exist. From the roadside tomato seller to the young girl selling weaves online and the man who paints houses for a living, everyone needs to contribute a proportion of their earnings to this tax bank. I’m not an economist so I don’t know the details of the functionality of that, I do know however that the tax of a few cannot provide for the services of the whole country. It is only when this is done that a durable insurance scheme can be drawn up and put into action.

On a side note, I’m not one to be political, but in view of next year’s elections, I urge you to do your research before standing behind anyone. Check out their mandate, see if they have any plans regarding the often pushed-aside health status of this nation. Please do your research, if they have made positive contributions in their past positions of influence as leaders, chances are they are less likely to lead us in a negative path.

Thank you for reading.

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By Ada & Her Tune.

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One reply on ““We Don’t Have Money””

I agree with the framework of your discuss. But how can we increase income tax from the informal sector if we don’t have comprehensive national ID? No record of births (and deaths). No reliable income statistics. So, my take is: Let’s restructure Nigeria first, to give more powers and responsibilities to federating units. Let’s focus more on building our institutions of governance. Of course we also need to be patient for the results. Our problem is complex. So, we should be ready to work hard and steadily at solutions. We need men and women who can lead us in this task.

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