OrderPaperToday – In this interview, Mr. Chike Okafor, member representing Ehime Mbano/Ihitte Uboma/Obowo federal constituency of Imo State in the House of Representatives, and immediate past chairperson of the House Committee on Health Services speaks extensively on a range of issues affecting the Health sector, including poor funding, executive’s proposed recruitment of foreign medical personnel and emergency response preparedness.
The Health minister, Dr Osagie Ehanire, recently stated a request for N234.6m to hire foreign doctors and nurses. What is your opinion on this?
Well, I do not have the details behind that assertion but I must say health is one area we do not need to play politics with. You do not need to bring sentiments into it.
It is because there is a problem there, that is why even when the facilities are there, because we do not have the confidence in our health system, you see people running to other countries to get medical attention.
It where you are confident that you will get medical attention.
So, let’s not bring politics into it and if the minister said so. Let us give him all the support.
Do you think that is our only problem? Is it the equipment we are lacking or the personnel?
I think both are challenges.
The hospitals that we run to here in Nigeria that adjudged the best are foreign hospitals.
Why is it that everybody is rushing to the Turkish Hospital? You can see that it is not really about the environment but also the personnel.
I will say issues of health have to do with emotions and sentiments. We need to look at some of these issues holistically and allow the medical practitioners to make their decisions.
In the 8th assembly when I was the chairman on Health Care Services, we were not really the best because I was not a medical doctor, my deputy chairman wasn’t either; the chairman on Health Institutions, Mrs. Betty Apiafi was not a medical doctor and her deputy was also not a medical doctor.
Out of the 28 members in my committee, only one lawmaker was a medical doctor but today, they are blessed because the chairman is a medical doctor, the deputy is a medical doctor and the chairman, Health Institutions is a medical doctor.
So what does it tell you? That we now have practitioners in place interfacing with all the medical agencies professionally, unlike in our time when we meet and they speak all their ‘jargons’ we didn’t not understand. I had to engage the services of one medical consultant to help me out but today, I watch the chairmen of both committees engage them constructively and positively.
I want to use this opportunity to commend Femi Gbajabiamila, the speaker, for deeming it necessary to have medical practitioners heading these committees. We really do not have issues of communication between the committee and the various agencies and if that would help us in this country, so be it.
How would you rate the proposed 2020 appropriation for the health sector?
I am very much disappointed. I have looked at it in terms of percentage, are we going up or coming down?
In the 8th assembly, we did a lot of advocacy for increased budget for the health sector. We engaged the leadership, we set up an advocacy committee which was led by the wife of the then Senate president, Mrs. Toyin Saraki, who was the deputy co-chair. We led a delegation to the former Speaker and Senate President and that is what led to the improved budget for health.
If there was one thing we achieved, I would like to give credit to Dr. Tejuosho and Senator Omaunwa, who were chairmen, Senate Committees on Health and Primary Healthcare respectively. We formed an alliance and put all the pressure on the leadership for improved funding for the health sector and that is why we were able to get that excess of N35 billion under normal position for health. This also gave the health sector an additional six to seven percentage.
Today, I understand that we have less than 4%. Are we moving forward or going backward?
We can play politics with any other thing, you can play politics with road construction but let us not play politics with health.
Abuja declaration of 2003, which Nigeria was signatory to, insisted that 20% of national budgets should go to health. Other countries of Africa like Gambia and Kenyan are already doing it but here we are in Nigeria struggling to get 2-3 percent. I understand we have other challenges like the security all over the country, I also realise that we need to fund our railway, buildour airports, do all the roads and all that but let’s not play politics with our health sector because they say a healthy nation is a wealthy nation.
If you put all the infrastructure in place and the health of the nation is not catered for, where will you get all the human beings to enjoy these infrastructure?
So, I’m not impressed. We need to do something before it gets late. I would like to enjoin our Senate president, Ahmed Lawal and Speaker, Femi Gbajabiamila, to go back and rejig that budget so that they can give the Nigerian masses what they truly desire as it relates to health because like I said earlier, a healthy nation is a wealthy nation.
Speaking about healthy nations, why isn’t there a committee that would focus generally on epidemics instead of a Committee on HIV and Tuberculosis and Malaria as we have?
The previous health committee has now been broken into standing committees of Health Care Services, which by the grace of God I was the chairman, Health Institutions and Committee on AIDS, Tuberculosis and Malaria, that should be the one you are referring to.
It can also be epidemics but they actually deal with all the health related emergencies and epidemic challenges.
Has any of the committees come up with emergency measures, either currently or previously, to prevent reoccurrence of epidemics such as Ebola?
I am sure you can recall that in the 8th Assembly, we had this Ebola surge, we also had quite a number of epidemics that arose basically in the North East, for example, meningitis at the time.
What we did as a committee, or as a responsible assembly at the time, was to interface with the Ministry of Health, particularly the National Primary Health Care Agency, to be sure that they were abreast with the challenges as they arose.
Most recently, I can’t think of any epidemic we had, at least not in the light of the 9th Assembly. Our job as lawmakers is to strengthen our oversight within the domain of the ministries and agencies to ensure that they carry out their functions optimally and that is how far we can go. We are not directly involved in the implementation.
From your oversight experience, do you think agencies saddled with the responsibility of handling these epidemics have the capacity in terms of preparedness?
Ebola was not expected but it was well handled. If you followed the trend of Ebola when it started in the north-eastern part of Africa, it caused more damage and I think it is about time we gave credit to the country and the government when they perform well, just as well as when there are lapses we give them knocks.
I think that the whole world applauded Nigeria in the way and manner the Ebola surge was handled, it did not get out of hand. I think that the Ministry of Health then was under Prof. Isaac and we really got kudos. I could recall one of the outings we did in Geneva, it was a health outing, it was a typical outing where Nigeria was applauded by the whole world and also for the challenges of meningitis in the north-eastern part of Nigeria.
Without the effective management of these epidemics when there occurred, we probably would have recorded more deaths than what we had. I think the Federal Ministry of Health has really done well in managing those situations. Recall that the Centre for Disease Control was created some years ago and via an Act of parliament of the 8th Assembly. That centre became a legal entity as it were. The Act of parliament also had the Centre for Disease Control strengthened to be able to also engage in pre and proactive measures.
I would say that Nigeria has done well over 70% in curbing these epidemics in the past and I am sure that the agencies of the Ministry of Health are also well equipped to curb any emergency. As the chairman of the 8th Assembly’s Committee Healthcare Services and all the agencies, the Centre for Disease Control was directly under our jurisdiction and I can say that they performed well over 70% by my own assessment.
In another related issue, during one of the public hearings organised by your committee, Dr. Philip Shuaibu, the executive secretary of Nigeria Primary Healthcare Agency, accused lawmakers of having the highest number of abandoned projects in Nigeria under the health scheme.
How true is this?
It is a very critical and topical issue and when it became big and we understood it, we decided that we would not allow any member to domicile the construction of a new health center unit because the Federal Ministry of Health, over the years, has succeeded in setting up at least one healthcare centre.
So, what we had to do was to say, instead of having members eager to start new construction, let us engage in revitalising the old ones and that was as a result of the complaint made by the executive director of NPHCS.
Most of us are not doctors so what the politician wants to do is to own a project in his constituency and health is one major area that is burning in everybody; whether you are a lawmaker or politician, you want to see that you are intervening in the area of health or to provide some services.
For instance, we just came back from Uyo, Akwa Ibom State, where we went on oversight. What we saw is buildings are there but no nurses or doctors. A situation where you have an emergency, you go to the hospital and then they tell you, call the matron or doctor, that negates the entire vision of revitalisation.
So, we agreed with Dr. Shuaibu at a time that as lawmakers who make the laws, do not bring your zonal intervention projects for construction, point out the ones you want to revitalise; be it drugs or equipment, to the NPHCS.
The gains and importance of primary healthcare cannot be over emphasised because today, secondary healtcare centres like the general hospitals and federal medical facilities have been overstretched.
Ordinarily, ailments and other health challenges are supposed to be handled at all NPHCS. I do not see any reason why a pregnant mother cannot go to the NPHCS and deliver, I do not see why prenatal cases cannot be handled there as well.
Today, go to our teaching hospitals and federal medical centres and you will see pregnant mothers coming there for antenatal,which makes these facilities over stretched.
Infact, only referral cases are supposed to be handled at teaching hospitals or federal medical centres but today, that is not the case. A woman is one month or two months pregnant and she is going to register herself with teaching hospital, I do not think we can continue like this because we are not doing ourselves any good. We must continue to shout that our primary healthcare should be revitalised and made functional.