On our radio show, a cancer survivor who had only discovered he had prostate cancer accidentally said: “how can you have a body for so many years and not service it?”That’s right,even cars get checked regularly.
Providing healthcare is intricate; it requires well trained, well remunerated doctors, good infrastructure and governance and well informed patients.
Medical training in Nigeria is rigorous. We learnt the theory exceptionally well, and were truly ‘grilled’ by our seniors. The infrastructure is a slightly different matter. We learnt to be creative and innovative though; from cutting up tubing to use as torniquets and putting latex gloves to good use for procedures and trying to repair bent cannula.
We worked in the most impossible setting. Sheer volume,aggressive patients and not that much pastoral care. I must add a caveat though,there are some incredibly dedicated and caring teachers that helped some of us.
Nigerian doctors are usually quite successful outside our shores; but of what use is that to the country? We need good healthcare teams for our ever expanding population. We have some of the worst health outcomes across board globally.
Doctors who stayed behind to develop the system are to be applauded; but their report so far has been less that impressive. Amenities are still below par and the system is not much further forward. Using mobile phone lighting to operate CANNOT be right. I have, however, learnt that the private sector is usually the trailblazer when looking at sector development.
Before I examine the private sector, let’s look at the public/patient’s view to accessing healthcare. I was having dinner with a friend and going on about healthcare as usual and she said, “Healthcare ke? We haven’t talked about education, jobs, power. We use family and friends who are doctors to manage without paying”.
This corresponds to what I have heard from doctors who have to insist on patients paying first before they will have any conversation because they have been cheated out of their fees under the guise of asking for ‘advice”.
Surgical procedures attract top naira as the patients feel like ‘something’ has been done resulting in some unnecessary intervention.Medicine is mostly based on history,investigations and medical management and that is as valuable as being ‘cut’.
Do patients value healthcare?
The private Healthcare sector is run by silos of doctors running their own mini empires (much like most people). Power has to be 24/7,staff have to be paid and professional development has to be continuous and these have to be paid for. What room does that leave for safety and quality of Healthcare? Specialists are having to provide primary care in an effort to increase their income when they could be focussed on honing their specialist skills by increasing their critical mass (the number of specialist cases they see) which makes patient outcomes better.
There are stories upon stories of serious incidents where patients have been mismanaged. I’m sure you all know at least one. Where is the space to follow the appropriate pathway, learn from mistakes and increase accountability?
There are many people who access healthcare outside the country even for minor ailments. They do not trust the system, making medical tourism a very profitable venture for many other countries .Many of the doctors you are going to see abroad are either Nigerian trained or were trained by a Nigerian. Many are not as qualified but because they are abroad. They seem more authentic somehow.
It is important to celebrate doctors and healthcare teams that are making it work in such a difficult setting.
I invite you to mention good clinics and healthcare teams that you have a personal experience of and they may just get a feature.