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

"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.