Nigeria’s Health Sector Maladministration and the way out(1)

 

(By Goke Omolade)

In such a merit-focused environ, there is hardly any compulsive legislation making hospital headships the exclusive privilege of only holders of medical certificates. In fact, from a personal working experience of over 14 odd years in an hospital setting; making medical doctors heads of hospital is a great disservice to the nation at large and the patient in quest of effective service delivery as almost all have been virtual administrative disasters! After all one can only give what one has and as if living to an ageless cliché: He who does not know and refuses to know will never know while he who knows he knows not and quests to know will know aplenty. Put simply, it has been a case of ancient ignorance being garbed in kaleidoscopic masquerade colours!

BEFORE anything, let the resilient echo and conscience-pricking tenets of the Hippocratic Oath (as written in modern form in 1964 by Louis Lasagna, Academic Dean of the School of Medicine; Tufts University, Ma),  guiding the practice of Medicine, the central core of any hospital setting, speak up: I swear to fulfill, to the best of my ability and judgment, this covenant; I will respect the hard-won scientific gains of those physicians in whose steps I walk, gladly share such knowledge as is mine with those who are to follow. I will apply for the benefit of the sick, all measures (that) are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

   I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug. I will not be ashamed to say ‘I know not’ nor will I fail to call in my colleagues when the skills of another are needed for the patient’s recovery. I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty.

  Above all, I must not play at God. I will remember that I do not treat a fever-chart, a cancerous growth but a sick human being whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick. I will prevent disease whenever I can, for prevention is preferable to cure. I will remember that I remain a member of society, with special obligations to all my fellow human beings, their sound of mind and body as well as the infirm. If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help!

   On the other hand, let us retrospect the personage of Nigeria’s first Medical Doctor (Samuel Layinka Ayodeji Manuwa; 1903-‘76) who, for all practical purposes, was a thoroughbred doctor per excellence. Having been certificated as a medical doctor in 1934, he was said to have devoted his entire essence to his chosen career and by dint of hard work, in 1951, he was appointed the director and later made the Inspector General of Medical Services/Chief Medical Adviser to the Federal Government. One singular, outstanding feat about this pioneering medical hand was that apart from being the first Nigerian to graduate as a Fellow of the Royal College of Surgeons; he was also said to have invented an excision knife to treat tropical ulcers; while tropical medicine was reputed to be his forte. Similarly, he was recorded to have worked so tirelessly for the establishment of Nigeria’s first Teaching/University College Hospital (UCH) in Ibadan.

   With the hindsight of the above-illustrated basics about early medical practice in this part of the world, there is certainly no way hospital administration, in its current form, can be made different or divorced from expected global standards because its origins/foundational outlays had affinity and contact with exalted virtues and values such as service excellence, merit-oriented placements of manpower and resource allocation. Examining the headships of hospitals in decent societies, the predominant and driving forces are the skills, competence, broadmindedness and far-sightedness of those so saddled with such onerous responsibilities.

   In such a merit-focused environ, there is hardly any compulsive legislation making hospital headships the exclusive privilege of only holders of medical certificates. In fact, from a personal working experience of over 14 odd years in an hospital setting; making medical doctors heads of hospital is a great disservice to the nation at large and the patient in quest of effective service delivery as almost all have been virtual administrative disasters! After all one can only give what one has and as if living to an ageless cliché: He who does not know and refuses to know will never know while he who knows he knows not and quests to know will know aplenty. Put simply, it has been a case of ancient ignorance being garbed in kaleidoscopic masquerade colours!

   It may amount to sheer hypocrisy and empty fault-finding to single out one segment of stake holders to a societal problem and lay all resultant blames and ensuing crises on it when in fact almost all others are no less guilty of similar charges. In a real sense of identifying the innocent from the culpable; it is the average citizen that is usually at the receiving end of a typical scenario underlain by selfishness, vested interest, ego-tripping, lack of noble/clear-cut goals and, by implication, visionary leaders. Often, such a tug-of-war is class; status, gender, profession-driven and very readily the combatants spare no resource or punch in this ill-purposed, needless exercise (in futility). At worse, it is like a pyrrhic victory which enervates both the belligerent victors and never-say-tire victims. Take the Nigerian health sector, especially its current style and mode of administration, as an instance.

To be continued.

Omolade lives in Akure. gokeomolade@hotmail.com

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