‘Health is wealth’, goes the popular maxim, nope, not in Nigeria, ‘Wealth is Health’. I do not know of other countries, don’t want to know, don’t care to know, not my problem, but by the World Health Organisation’s (WHO) recommended standards of doctor-to-patient ratio of 1:600, we have an abysmal ratio of 1:3500 due to the abject shortage of medical personnel. I mean, without the support of the health-related Non-Governmental Organisations (NGOs), basically the rich countries taking pity on us for having ‘no government organised’, where would we be?
Within this dearth of medical personnel, where ideally every health sector professional – doctors, pharmacists, dental surgeons, nurses, medical laboratory scientists, etc., should be like hot cake, we have them leaving the country in droves. So in this shortage of medical personnel, we have a surplus! After expending huge resources in training them, we can hardly pay them their true worth. Where do they justifiably go? The private sector or drawn by the international money vector – 50,000 Nigerian Doctors are in the US alone according to one of the US officials interviewed during the recent trip by the President to the United States…Oh! Hello dollars, here we come! Back home, when they are in the private sector, can we afford them? Majorly, no – so no wealth, no health. What about when abroad, are they of any use to the Nigerian health sector? Nope. Well…until they come back and they discover the knowledge, skills and experience gained are well and truly way above and beyond what medical infrastructure is available for them on ground here assuming they are not equally frustrated by those back home. What then happens? Go back abroad or be in the private sector. Of use to whom? Wealthy healthy ones invariably.
On the path to developing our economy, in the midst of scarce resources, the necessity to move our industrial and agricultural sector forward by all means, how much value for money does/can one get from the health sector? Granted we need people to be healthy, if they can afford it. Ok, now we are healthy, what next? Would this mystically revolutionise our thinking, make us visionaries, improve our work ethic, engender creativity, inventiveness and generate innovative ideas in us, implement our policies and plans better? Maybe? Or more likely we are healthy morons – physically healthy, economically and productively moronic. Granted it is the duty of medical professionals to keep patients alive but they can’t make them live.
Take the Boko Haram, MEND guys, kidnappers, criminals, etc., for example, all engaged in a multitude of nefarious activities. While their psychological state of mind is patriotically and productively questionable, what is not in question is their physical well-being. Try picturing the amount of energy it requires to be carrying guns, running with it, riding bikes, power boats, canoes outsmarting patrol boats… You really would have to be in pretty good shape physically to engage in such arduous activities. And it does not end there. Let’s apply the same physically challenging activities to the street hawkers, daily chasing cars, wheel barrowing all kinds of goods for miles on end, balancing 25-50kg loads on their heads, you’d have to be unbelievably healthy to engage in such menial but physically draining activities. Put the nomadic cow herdsmen in the frame and you wonder if one can possess any ounce of laziness to take on the daily long strenuous and perilous walks over all kinds of terrain in order to make a living? While medical people may think they are not holistically healthy according to the WHO definition of health, physically, most of these guys would outrun most of us, come rain or sunshine, while carrying heavy loads.
Medical personnel or no medical personnel, these people would still be there, toiling away endlessly and of minimal productive value to the Nigerian economy at large, individually valuable may be, but certainly not nationally. To take these millions of teeming masses of underemployed or misemployed energy, channel and launch it on an agricultural or industrial setting, the economic growth would simply be exponentially mind blowing. In the need to prioritise industrial growth and reduce massive unemployment, do we expend more immediate resources on the health sector or divert a lot of it to the agro-industrial sector, assuming there is a plan in place for effective implementation?
For now, the recommendation of WHO for 15% of the national budget on health is not economically feasible. Is the return on investment the most healthy of the Nigerian populace up to 15% and able to justify that huge chunk of the budget on health considering our current economic challenges? To borrow from the maxim of an economically-minded health professional, a consultant lecturer no less, “the value of a medical professional is based on the productive value of the life saved.”
What is the worth of a life? As a rich man with an ailment or disease, it is guaranteed that I am prepared to pay any amount to any medical personnel available to save my life. As one of the hawkers trawling our streets with misemployed energy but engaged in an accident – at the point of death, I would be begging not to pay. Hippocratically, for most of the time, I would be saved, but unable to pay. While life is precious to the medical personnel, the national economy demands its productive value. Hippocrates may have saved the life, but economically, national non-productivity has won the day. So, who now pays the medical personnel? When push comes to shove and the health sector goes on strike, it would be hypocritical economic necessity that would dictate the turn of events and not the Hippocratic oath. The conundrum, economically, is, when not on strike, what is the productive value of the lives toiling away to the nation? This minimal difference, if any, between the economic value of our citizens when the health sector is fully functional and when it is on strike is why such strikes can be allowed to go on for weeks with what can sometimes be deemed a callous response by the authorities. Unfortunately, at the end of the day, economy rules not health.
The day the economy appears so good enough to be able to conveniently afford the international compensation rates of our health professionals, attractive enough for them to stay and not jump the nation’s ship, then we can spend all we like on the health sector able to focus more on preventive than curative health. Until that El-Dorado time comes when health will truly be wealth, wealth is health for now…just hope on the wings of a dove that you can afford it…or be on the death queue of the public health sector. Ask those unfortunate enough to be acutely sick or for any reason are in the accident and emergency ward during any health sector strike…you really do not want to be there, trust me.
No country on this planet does not value its health sector, the problem is, are we productive enough to pay their value’s worth?
- Dele Owolowo, Author ‘Nigeria’s Odyssey…’, is an Educationist, Trainer and Rural Entrepreneur with widely travelled background. [email protected]
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