Innocent Achanya Ujah is the national president of Nigerian Medical Association. Ujah, a renowned professor and consultant obstetrician/gynecologist, spoke on the sideline of the just-concluded physician’s week in Uyo, Akwa Ibom State. The event had the theme, “Nigeria in the COVID-19 Era; Health Systems Strengthening for National Security and Prosperity.’’ In this interview with BRISIBE HARRIMAN, he stresses the need for healthcare investment and financing, doctors’ safety, the lingering health challenges, especially the continuing Covid-19 pandemic, among others. Excerpts:
How do you feel having the presence of the former President, Goodluck Jonathan, who signed the National Health Insurance Bill, in this year’s physicians’ week?
I must say that we have started on a very good note. For every good reason we must thank God on many grounds, that we were able to bring the former President of Nigeria, who has been everything. He is a man of destiny. He was a former deputy governor, governor and vice-president. So, to bring him to Uyo is a great achievement. Secondly, we are celebrating the physician’s week. We are celebrating ourselves and also reflecting on the health system in Nigeria and see how we can improve on our health system. We are happy the incumbent president has put a committee together on health sector reform, with the vice president being the chairman. The president of the Nigerian Medical Association is a member of that committee. We would do our best to ensure that Nigerians enjoy better healthcare delivery. On a very serious and happy note too, we have a Nigerian elected as a president of World Medical Association, during my time, is a great achievement because leadership comes with a lot of cost, gains and pains. Mine, largely is gains. So, by every standard and with the caliber of the people here, the deputy governor representing the governor, everybody has contributed to the success of the activities. The activities of today are going on simultaneously all over the country. So, we celebrate this week and we reflect on the activities of the health system of Nigeria and of course the welfare of Nigerian doctors.
The former president in his presentation suggested the role of sub-nationals in embarking on the National Health Insurance Scheme at the state level. What is your take on this?
That has started in many states. But what we are saying is that health insurance scheme should be made compulsory for all adult Nigerians, but we need funding because funding is very important, and not just to pay salaries and refurbishing the system, health is very expensive.
We also believe that if the federal government of Nigeria can establish a health bank, just like the bank of agriculture, bank of industry, then, we will get a lot of funds. And the private sector would be better for it because they would get loans on single digit interest rate and develop the health system like Apollo in India and that would strengthen the health system in Nigeria. And we believe that government alone cannot provide for health and there must be other avenues to provide for health and one of these, is the establishment of health bank. Because nobody would want to go and borrow money at 30 percent interest rate. There is no way he can pay back. You send him to penury. And that is not what we want. So, we are advocating seriously for health infrastructural bank for this country.
“As soon as Covid was announced, we put in place mechanism. We told government what it should do and they would not listen, otherwise we would not have had the many cases we had. In the first four weeks of Covid, if Nigeria had shut her borders, we wouldn’t have had this because it was an imported disease
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You would agree with that the Covid-19 pandemic really exposed the poor state of the health system in Nigeria. How do you react to this and what is the position of NMA?
NMA, right from the beginning of the pandemic, has been very proactive, through advocacy and constructive engagements, dialogue and conversations. As soon as Covid was announced, we put in place mechanism. We told government what it should do and they would not listen, otherwise we would not have had the many cases we had. In the first four weeks of Covid if Nigeria had shut her borders, we wouldn’t have had this because it was an imported disease and all we needed to do was close the airlines , airports and land borders and stayed for at least four weeks, we would not have suffered this much. But even at that, we thank God because Nigerian doctors and other health workers were up to the task. They demonstrated resilience, commitment and that was why even in the face of inadequacies, we were working. Sadly, we lost over 20 to 30 doctors to Covid and you know once a life is lost, it is not replaceable. The worst thing is that their death insurances have not been paid. And we think that they should be paid. We believe that their death benefits and insurances should be paid.
And one way of encouraging the health workers is to motivate them. Some of these basic things can be fulfilled. It is our firm belief that with the right support from the governments, our efforts to provide excellent health services to Nigerians will continue to improve.
The issue of strike by doctors has become endemic. What do you think is the way out of this incessant industrial actions?
Everything in Nigeria that is bad is endemic. Poverty is endemic. Inflation is endemic. But we are not saying that doctors should go on strike. Doctors go on strike only as a last resort. All we need to talk about is that let us be proactive in responding to the needs of doctors. Can you imagine some states owing up to 21 months of salary arrears? Do you expect the doctors in those states to put in their best? And most of these arrears are in the South East. That’s the truth of the matter. We have statistics for this.
How do we stem the tide of brain drain in the health sector?
Within the health sector reform, we have strategic option to discuss brain drain because we must provide a conducive environment. Let’s not say A is receiving this. If you are in Europe and America, even doctors are not paid the same. If you are an entomologist, you are paid differently. If you are a gynecologist which is a high risk, you are paid differently. If you are an anesthetist, you are paid differently.
We have a situation where circumstances and risks are very high and people are leaving because of harsh work environment and that’s the truth. Insecurity is also a factor. Insecurity is a big factor. You know people can’t sleep with their two eyes closed, but we urge the government to respond appropriately and increase the momentum to reduce insecurity in the country. The issue of brain drain among medical doctors must be urgently addressed by governments; otherwise the consequences of turning a blind eye to this will be catastrophic.
