Between Hope and Heartbreak: The Reality of Nigeria’s Health Sector...

The healthcare system in Nigeria is far from perfect, and while I can't say it's all bad, there are rooms for improvement and when I say rooms, I am emphasizing seriously on the plural 'rooms' because it's shambles down here for real; it's painful and disheartening talking about it especially as someone who is in the system.

I have been a medical doctor for five months now and what I've seen these past months as one is not what I expected; it's whole different from what I saw in movies, not that I was expecting the medical sector of Nigeria to be as fantastic as those of developed countries like United States of America, Canada, Australia and others. But then, when you've seen patients die because there wasn't oxygen cylinders, electricity, or available doctors, you will get to understand that indeed it's something to worry about.

That's when I don't even talk about hundreds of patients who has died because we don't have a single defibrillator... I don't even think Nigeria as a whole could boast of a hundred defibrillators.

So what happens when people go into cardiac arrest? We rely solely on CPR without defibrillators? And the painful thing isn't that we aren't taught these things in school nor that we don't know how to do it, but, it's just that the structures aren't there, Do you know how painful it is when you have to see someone die for something you could have easily prevented! Oh man! We have a long way to go in this country.

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Another painful thing is discovering that money wasn't the problem , nah! They aren't because the money or funds for these things are there. The election period exposed my eyes to know that the money is here and available, but the top seat occupants don't just feel it's necessary, by top seats I don't just mean the president, I mean all of them down to the supervisor level.

One of the most annoying experience I had was working in close relation with a government executive on an outreach. I was disappointed for real. The outreach was funded by the community's doctors in diaspora with the intention of giving free treatment and medications to everyone. As a fresh graduate , I was eagerly suggesting essential drugs to purchase but the executive was more interested with how much of funds he could pocket making him slash many drugs from the list and the outreach became a clinic session where patients were just told to buy drugs because someone somewhere ate the money meant for the free drugs.... Nah! Nah!! It's painful for real.

With these samples above I gave you, you don't need a soothsayer to know that the healthcare system of my country, Nigeria is in no way near good at all despite the fact that we are among the countries that produce best brains in this profession of medicine.
Roll with me and see some of the problems we face in our health sector ;

• Limited Infrastructure:

It's not uncommon to see many primary health centres in Nigeria and these primary health centres were meant to be serving as first point of contact for rural patients since most of the big hospitals are in the urban regions, however, these primary health centres aren't staffed; there are some single doctors there making it just a building rather than a hospital it was meant to be.
This increases the death rate of patients in the rural area because before they could be brought to the urban hospitals, some of them are already in their critical stage.

• Poor Equipment:

In some hospitals with standard structures, the problem becomes equipment. I worked in a primary health centres immediately after my graduation and a woman who was six-month -pregnant came in for her first antenatal visit due to complications.

It's even bad enough she was coming at that time because she already has complications with the pregnancy which prompted her coming but then, what was worst than her coming late was the hospital not having all the routine drugs available to give this woman, not even tetanus toxoid vaccine, not even calcium carbonate nor folic acid and tomorrow we will be asking why are there increasing children with deformities.

Many hospitals don't even have a single defibrillator, many don't have ultrasound and some basic equipments and just refers their patients to get them done elsewhere delaying diagnosis and prompt treatment.

• Brain Drain:

The healthcare system of Nigeria has been suffering from brain drain from time immemorial but, these recent brain drains for over four years now is becoming alarming.
You wake up to see that your consultant already left the country overnight.
When I was doing my clinical rotation in cardiothoracic surgery, a unit that has just three consultants, two left for Saudi Arabia within a week. But whose fault is it?

When doctors aren't paid as due with lots of doctors struggling to survive with the rising inflation, you leave them no option other than looking for greener pastures wherever it's available. Because no matter how you want to make it look like doctors shouldn't be after money but saving lives,I want to ask, have you ever seen a doctor who presented his certificate in a shopping mall and was gifted the cheapest goods there? Or you think they don't have families too?

This brain drain has led to excess workloads on the available doctors leading to burnout and suboptimal care, but they own private hospitals where their patients receive top care treatments whenever they come.

HOW CAN WE MAKE THESE THINGS BETTER?

To be honest with you, it's painful because it's not that Nigerian leaders are filled with people devoid of ideas, but just that, it's filled with people never willing to implement any but that doesn't mean we will stop talking you know...

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• Telemedicine:

With this telemedicine, I don't mean between the patients and the doctors, I rather am suggesting it between doctors that stay in the urban areas and the rural areas. This is because publicising this in a country like Nigeria where health knowledge of the citizens is poor will only cause more harm and also, there's nothing as important as the doctor's touch also. But this will help doctors share ideas faster and save patients.

• Steady Power Supply:

The hospital has many equipments starting from the radiology room down to the wards that needs electricity to function well.
I can remember a typhoid perforation surgery we did in my final year where we had to use our phones as touch lights for our consultant with sweats dripping inside the abdomen of the patient, imagine if that wasn't a dirty wound already, we would have been causing more harm than good.

Ensuring that there is steady power supply or better still making use of alternatives like renewable energy resources (Solar energy for instance) will help keep these areas functional.

• Raising it In The Country's Scale Of Preference:

To solve these problems, our leaders needs to see it as something important.
Running hospitals take a whole lot of money and the current allocation of less than 5% of her GDP to health sector solves little or no problem.
This will be used for equipping and paying the medical staffs in various hospitals.

• Mobile Medical Teams:

Having a mobile medical team which will intermittently visit most of these rural areas to run outreaches and clinics would go a long way especially in dealing with the common diseases and referring the severe ones on time.

• Health Insurance:

Our health insurance, NHIS, should be made affordable and cover many people. This helps people come to the the hospital whenever they feel a new symptom without worrying of paying everytime they visit the hospital increasing timely visit.

• Addressing Brain Drain:

The government of Nigeria needs to have a one-on-one discussion with her doctors and ask them exactly what is making them leave the country en masse and solving these challenges because unless the root cause of this brain drain problem is addressed, it will keep getting worse and maybe by the time we've built mansions and equipped these mansions to run as hospitals, there will be no strong hands left to manage them.

TO THE PATIENTS

Nothing beats early presentation! Once you feel that something is wrong, it's always important to go to the hospital to be attended to.
This way, even if you go to the poorly staffed primary health centres, you will still have ample time to get yourself to the urban hospitals before it becomes a critical case.
Also, the relevance of living a healthy lifestyle cannot be overemphasized... Balanced diets, exercise, reducing stress and many others.

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In summary, Nigeria's healthcare system is trying, yes but, there are many rooms for improvement. These solutions not only address immediate needs but also lay the foundation for long-term sustainability.

Here's the link to the question hereI am inviting my colleagues to share their response in this topic @chuksmeezy and @graat

Thanks for reading and have a nice day 👍

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