“I would like to be realistic to say a few words concerning health delivery system in Nigeria. It is very poor, sorry to say that. I am happy that the MD of Aso Clinic (Dr. Manir) is here. There are lots of constructions going on in that hospital, but there is no single syringe there, what does that mean? Who will use the buildings?”

The above statement made by the President’s wife, was as honest as it was reassuring. Honest, because it was rendered in the no-holds-barred style, typical of Mrs Buhari, and exemplified in her berating of a few people she claimed had hijacked her husband’s presidency and her “Animal Farm” analogy. Though we are still awaiting the eviction of the Hyenas and the Jackals from the kingdom, four months after. She, indeed, hit the bull’s eye with that comment. Reassuring, because it provided some succor to the rest of us that the decay in the healthcare delivery system is not limited to lesser mortals like us. Similar to the soap opera of the yesteryears, it shows that “the rich also cry”. It is helpful because one can also understand why our healthcare delivery system has continued to fail. The First Lady squarely put the blame where it belonged: leadership.

Perhaps, the most important point the First Lady made which may not have been intentional was to provide answers to those of us who had been wondering why her husband had spent a lot of time in the UK on medical vacation. We are not oblivious of Buhari’s campaign promise of ending medical tourism in Nigeria if he became President. Over 2 years after, he has not only failed to end it, he has joined the train. Therefore, Mrs. Buhari’s outburst was very useful in helping us understand why the President preferred London hospitals to the one in Aso Rock. You can say what you want, but the point remains that if Aso Clinic does not have a syringe, it would be an act of suicide for the President to submit himself to that hospital for the treatment of an ostensibly very serious ailment.

It is sad that in most of our discourse, little or no attention is paid to healthcare delivery. Most people focus on the economy, the polity, ethnicity and religion. These may be important but we tend to ignore the more important issue of health. As a result, we keep dealing with avoidable deaths of our people. Life expectancy in Nigeria remains abysmally low at around 54.5years placing us as number 177 out of the 183 nations ranked by the World Health Organization (WHO) as at 2016. Meanwhile, average life expectancy in the world, according to the United Nations is 71.5 years as at the end of 2015. However, beyond the damage that poor healthcare delivery has done directly on the populace, is the vexed issue of capital flight that has been engendered by the rich seeking help elsewhere.

Medical tourism has been estimated to cost the country over $1billion annually. This figure was provided by the Honourable Minister of State for Health, Dr. Osagie Ehanire at an event in Lagos recently. An investment of $1billion annually would eradicate the need to go elsewhere for medical attention. It is of concern that we spend a large chunk of our foreign exchange earnings on medical care abroad. Related to medical tourism is brain drain. Most of our best qualified healthcare professionals are found in foreign countriesto where they migrate, in search of better conditions of work. It has been reported that there are over 3,000 Nigerian medical doctors in the UK and over 5,000 in the US. This is in addition to thousands of others spread elsewhere around the world. Meanwhile, according to the WHO, out of the country’s requirement of about 237,000 medical doctors, we only have about 35,000, leaving a gap of over 200,000. This is a very serious problem that should not be left to address itself as we have so far done. I shall return to this in due course.

The challenges of the healthcare sector can be discussed under four broad headings. There may be a few others that I may not be able to discuss in this column, but the idea is to bring this matter firmly into public consciousness and have many more people begin to interrogate ourselves with a view to finding solutions to the problems. I will now take the challenges in turn.

 MEDICAL FUNDING

 Just like other sectors like education, health care is grossly underfunded. This did not start today. However, the paucity of funds has assumed more frightening dimensions in recent times. Looking at the federal budgetary allocations to health care, it would not be difficult to understand why there is no traction in this sector and why there may not be any improvements until we change our priorities. In Naira terms, except in 2017, we have continued to allocate less funds to healthcare year after year. In 2014, the allocation to healthcare was N264.5b which represented about 5.6% of the total budget of N4.7t. By the 2015 budget of N5.1t, we allocated a reduced amount of N259.75b to the sector, which was about 5.2% of the total budget. In 2016, healthcare attracted a further reduced amount of N250.06b from a budget size of N6.06t representing 3.73% of the budget. It was only in 2017 that the sector was lucky to attract a larger allocation of N308.4b out of a budget size of 7.44t representing 4.15% of the budget.

If these stories appear sad on the surface, then the application of the concept of ‘time value of money’ would make it worse. Applying an average conservative inflation rate of 15% per annum, over the period, would show that the N259.75b in 2015 represents only about N221b in 2014 prices. Similarly, the N250b of 2016 represents N175b in 2014 prices while the N308.46b of 2017 represents N185b in real 2014 prices. These don’t sound attractive, but they are not only real, they are true. If we apply the exchange ratevariable into the equation, it would be very clear that what we are dealing with is a massive compression of our healthcare budgets over the years. Exchange rates hovered around N160 per dollar in 2014, N199 in 2015 and early 2016 and N305 later in 2016 until now. So, if we convert the allocations into dollars, we would see that this sector should actually have collapsed by now. So, we must salute those who have managed to keep it alive till this time.

According to the WHO, Nigeria spends only $67 per person on health care per annum. Angola, on the other hand spends over $200, while South Africa spends seven times what Nigeria spends at about $470. The WHO recommends that no less than 15% of the annual budgets of countries should be dedicated to healthcare. A lot of countries are incompliance. In spite of all the hullabaloo of Obama Care and Trump “Careless”, America dedicates over 20% of its huge budget to health care delivery. Iran’s healthcare budget is 18% while China is close to 13% and Turkey, 11% of much larger budgets.

Meanwhile, we are here, struggling with 4 to 5 % of a kindergarten budget.

It is conceded that a larger budget does not necessarily guarantee a better quality healthcare delivery system. We know that budgets do not deliver results. Conversely poor budgets cannot deliver results irrespective intentions. Norway, Switzerland and the United States are the world’s three biggest healthcare spenders –spending $9,715 per person (9.6% of GDP), $9,276 per person (11.5% of GDP), and $9,146 per person (17.1% of GDP) respectively.

But other countries’ health systems are managing to achieve similar or better results for far less. Hong Kong spends $1,716 per person (6% of GDP), Israel $2,599 per person (7.2% of GDP) and Singapore $2,507 (4.6% of GDP). These countries, like Norway and Switzerland, have life expectancy of between 82 and 83 years. By comparison, life expectancy in the US is 79.

 MEDICAL STRUCTURE

 Going by constitutional provisions, healthcare delivery is divided amongst the three tiers of government viz, local government, state and federal governments.  Local governments are responsible for primary healthcare which includes the management of local dispensaries, environmental sanitation and protection and routine immunization.

The State governments look after the secondary healthcare system including the General Hospitals and Health Centres while the Federal Government is in charge of tertiary and referral institutions such as the National Hospital, the Specialist/Teaching Hospitals and the Federal Medical Centers.

We all know that the local dispensaries and community health centers have disappeared. Why won’t they disappear when they are not being funded? They are supposed to be looked after by LGAs. The LGAs themselves are non-existent in majority of the states because many state governors want to be in control of the finances of the LGAs and instead of holding elections for the LGAs, they foist their thugs and cronies as Transitional Council Chairmen, an arrangement which should not last more than 6 months. They renew their tenures after every 6 months in perpetuity. These transitional Chairmen do not have access to the LG allocation and owe their stay in office to the Governor. On receipt of the allocation, the governor gives them some stipend to help them run the LG and keep the rest. It would be a pipe dream to expect that part of the priorities of these Chairmen is healthcare. They know they cannot do it and instead of wasting their time, they face other things. Once salaries of LG staff are paid, (that is, where they are paid) every other thing becomes secondary. Any wonder why the primary healthcare system has completely collapsed.

In essence, the first level of healthcare provision and prevention of diseases cannot be implemented. So, what is the alternative? The first level, where possible, now moves to the second level, the state level for solution. Where that cannot happen, four other options are open. The options are that the people who should have been beneficiaries would resort to quacks and undocumented health workers, engage in self-medication, descend to the level of seeking alternative help from native doctors, spiritualists and herbalists or simply resign to fate and wait for death.

Statistics have it that out of the 30,000 Primary Health Centres nationwide only about 2,500 or a meagre 8.3% are functional. If this is not a bad report, I wonder what else is. The implication is that diseases that could have been arrested or prevented at lower levels are left to blossom into unimaginable national epidemic dimensions. Given this state of affairs, the Federal Government has had to intervene with the Nigerian Primary HealthCare Development Agency (NPHCDA) to take care of primary healthcare needs and immunization. I must acknowledge the positive impact this agency has made.

On the State level, we have seen that most general hospitals are ill equipped and ill funded and have dilapidated to terrible levels. The Federal government is now saddled with the responsibility of maintaining Federal Medical Centers in the States as well as the statutory responsibility of managing teaching hospitals and other tertiary centers like research institutes. But the Central government has had to intervene in both the primary and secondary levels where the owners have failed.

It is important to examine this structure to be sure it is working. My sense is that it is not.

 MEDICAL INFRASTRUCTURE

 Closely related to funding and structure is infrastructure. My personal contact with healthcare professionals both in Nigeria and abroad shows that one of the major reasons for the brain drain we mentioned earlier is the poor medical infrastructure and ineffective medical policy of the country. Some of our doctors would have stayed back if they were assured of support in terms of modern infrastructure for them to operate. In a country of over 180m people, one can count on one’s fingers, the number of sophisticated equipment like MRIs, CT scan equipment, dialysis centres,  and cardiology centres we have. Even if you are the best doctor available, you will record very limited success if you rely on antiquated equipment for diagnosis and treatment. So, when our brothers and sisters look at the infrastructural support available in the country, the urge to relocate becomes more imperative. Yet this is a country that hands over a billion dollars annually to other countries (its competitors) for medical bills. We must, therefore, agree on how to put the required infrastructure in place for our hospitals to compete. You must trust me on this, the money we are talking about here is very small. We must also discuss efficiency and cost effectiveness in terms of shared services and infrastructure. Is there any use duplicating equipment in a particular location where services could be shared and its savings passed on to the consumer?

 MEDICAL POLITICAL ECONOMY

 This is probably the most important aspect of this subject. How is healthcare delivery organized? Who is in charge? Does he understand the issues? Is he just a quota minister representing his state or he is a professional who would resign if decisions that impinge on his performance are taken? We remember the late Prof. Olikoye Ransome Kuti, who was Minister of Health in Babangida’s government. Kuti who was also Fela’s elder brother moved the nation’s healthcare delivery system to a crescendo through his focus on primary healthcare Programme. How did he do it? He was clear about where he was headed and astute as a professional. It was easy for everyone to follow him. It happened before, during a military administration, it can happen again, but the appointment has to be devoid of sentiments.

Access is also very important as the National Healthcare Insurance Scheme was set up in 1999, to address. Several years after, just about 5% of the population has enrolled in the scheme.

The whole idea of this section is to point our attention to the fact that the success of any policy is dependent on the philosophy behind it. Sloganeering and propaganda will not cut it.

I have heard a few people raise stiff opposition to the discussion of the basis of our continued mutual existence. I think such position is misguided. I believe that the only choice we have is to sit down and talk. Some people refer to the constitution as sacrosanct. I agree with them to the extent that there is no new constitution in the horizon. Anytime a new constitution emerges, the present one becomes obsolete.

As we discuss, we should avoid the temptation to focus only on the very important subjects of the economy and politics. Any discussion that does not focus on having a heathy populace is meaningless. Like the saying goes, a healthy nation is a wealthy nation.

Source: reubenabati.com

A brief peep into our future, as a nation, could be not so rosy but what is particularly scary is an impending and perhaps inescapable, drug epidemic. What is scarier is how we seemingly, and rather disturbingly, play the ostrich at how huge this problem is or the devastating effects it promises. It is so prevalent to have become the norm that one who doesn’t do drugs, in any of its many and ingenious forms, has to, once in a while, check if he’s the one actually on the normality path.

Addictive and obscene behaviours that were hitherto considered motor park louts and socially deviants’ second nature are now common and even glamourised in our universities; citadels of learning and centres of civilisation. There are drug powered orgies everywhere. To them, codeine is water and shisha is the new cool. The quest to get ‘high’ from illicit drugs has even gone insane that they give no fig about the healthiness of what they take in as long as it gives the desired result. Can you imagine human beings now sniff lizards’ dung? Some have become foragers whose job is to look for and fetch Spirogyra which they dry and sniff.

I was told of some female students at a popular religion-based private university who left school to have a ‘good time’ and, after the timeout at the club, followed home some guys who were held spellbound by what they saw. The ladies took the hard drugs provided, weren’t satisfied and sought to be taken to a covered gutter! Having seen their host disgusted by their queer request, they got perfumes, sprayed them all at once into thick towels, buried themselves and boom! These, really, are the mothers of the next generation.

These students are supposedly the leaders of tomorrow. What saddens the heart the more is that these disturbing trends have somehow inexplicably crept into the secondary schools. And this time, it’s not only the young students that are caught in this unfortunate web, the teachers who should be inspiring icons shamelessly compete with them. Well, that too is somewhat inspiring. Talk about salt, a natural preservative, itself being spoilt.

Like many other social vices, unemployment and poverty have been fingered to be major causes of this. I’m afraid this is no more than a rehashed defence to excuse responsibility. Unemployment isn’t uselessness. Not all poor people do drugs. It’s, in fact, a travesty of it. Talking penury, how much does a mixed bottle of codeine cost? Thousands. And some take 5 to 8 bottles daily, spending roughly 10 thousand naira. If that’s poverty, I’m afraid the real people below the benchmark would love to be in that category.

Esteem issues, largely borne out of the empty and bandwagon standards we set particularly on social media, also have a hand in this. Slim is cool and not-slim is trash. Resultedly, some female folks get entangled in the net of esteem deficiency which leads them to unhealthy practices. Apart from anorexia nervosa, a distressful medical condition, they are also at risk of hardened addiction by binging on hard drugs like cocaine. The quest for a flat tummy has really gone bonkers that many see the healthy path as too long and stressful and therefore opt for the short drug-powered adventure. It doesn’t end well.

The absence of independent-mindedness and the dependence on some external loci of control have always made us look for motivation or, sometimes, instructions in others who aren’t necessarily better than us. Aristotle was a mentor to many philosophers. Abraham Lincoln inspired many great leaders. His ideas are even still ideals in some quarters. Nelson Mandela was the hope and the model of steadfastness to many Pan-Africanists. The litany is long. Who are the models of this century? Our thieving politicians? It’s a no brainer that contemporary youngsters will rather choose the fugitive and drug head but affluent stars. Model shopping is nobody’s job by the way but it’s known that our favourite songs’ lyrics, music videos and the like are full of cuss words, objectification of women and glorification of hard drugs. It takes a five-star miracle for the younglings not to pick on these things.

This is no moral argument. It can’t be. This is not a generation that lives on or cares about morality. Besides, morals are largely cultural, relative and subjective. So, not that- it will be a futile exercise. This is neither an advocacy for complete eradication of drug abuse. You know what they say about wishes, beggars, and horses? It will be a tall order! The crux is we need to actuate pragmatic and enduring solutions before it becomes too late.

To expedite action, government, especially at the centre needs to step up its game on blocking illicit drugs’ major routes of entry into the country. This is a national emergency. All apparatuses of national security especially in the health sector should be activated to ensure those already trapped in the country are flushed out. The indifference due to the notion that the country is only a ‘conduit pipe’ for this drugs is wrong- it is now a priced destination.

Furthermore, for any progress to be made really, there should be a continuous and aggressive nationwide campaign against and sensitisation on the potential destruction of drugs. This will serve two purposes concurrently. The first is to break the intergenerational transfer of this dreadful menace and the second is to win over and rehabilitate those who are already involved. Focused counselling is highly needed in our schools, especially at the secondary level. Alumni associations and Parents and Teachers Associations should look in this direction.

This is treating it as a medical emergency. Rehabilitation centres should flourish to accommodate people who seek help. In addition to actually doing its work of teaching morals and proper living, religious bodies or institutions could help in this regard. These are the kinds of projects they should champion. That, of course, will be complementary to the efforts of NGOs and the government. Government, in particular, should make investment in its human resources a priority. Of what use are capital infrastructures if the people to use them are mentally damaged?

Lawal Temitayo, a psychologist and writer, tweets @Lawatem

Source: The Cable

Gov. Rotimi Akeredolu of Ondo State on Friday in Akure flagged off the distribution of 2.9 million long lasting  insecticide treated mosquito nets to residents of the state.

Akeredolu, who was represented by Dr Jibayo Oyewole, the Special Adviser on Health Matters to the governor, noted that malaria still remained a major public health problem in Nigeria despite  preventable measures.

He said that malaria constituted a major economic burden in the country because about N148 billion  was lost annually in the form of treatment cost and prevention.

According to him, statistics have shown that more than 60 per cent of hospital attendance was due to malaria and three out of every 10 admission beds were due to malaria.

The governor said that the critical elements needed to achieve positive change in fight against malaria was the change in behavioural and social norms with regards to sleeping inside treated mosquito nets.

“The ownership and use of the nets has remained the most cost effective and easily deployed methods for malaria prevention.

“Significant reduction in malaria related deaths and disability over the years have been attributed to the massive promotion of the ownership and use of the nets,” he said.

The governor said the distribution of the nets was to ensure universal coverage of the populace in the state.

Similarly, the governor’s wife, Mrs Betty Ayanwu-Akeredolu, said malaria infection still posed a great threat to health and socio-economic wellbeing of many Nigerians.

Ayanwu-Akeredolu stressed the need for concerted efforts to fight malaria.

The governor’s wife, who was honoured as net ambassador in the state by the Catholic Relief Service ( CRS ), encouraged the people to use the nets correctly so that there would be effectiveness of the campaign.

She said nobody should sell the nets because some organisations and government paid for them.

“These nets do not come free, but a lot of funds have gone into it; therefore let us use the nets for what they are meant for and not for fishing but sleeping inside them after hanging for 24 hours.

“I have committed myself for Ondo State that is free of malaria and if we all make concerted efforts, we will create the Ondo State we deserve and history will not forget us,” she said.

Mrs Rebecca Bassey, the representative of Catholic Relief Services, said that over 16.5 million nets were being distributed in six states in Nigeria,  Ondo State being one of them.

Bassey noted that the state had demonstrated itself to be a dependable and reliable partner, considering its show of love for giving safe and conducive environment for the campaign.

She added that the exercise would no doubt contribute immensely to collective efforts towards eliminating malaria from the state and Nigeria in general.

“National Malaria Elimination Programme (NMEP) of the Federal Ministry of Health and CRS with funding from Global Fund are distributing over 16.5million nets in six states in Nigeria including Ondo State,” she said.

According to her, CRS has been implementing programme in Nigeria for over 17 years.

Source: TheNation

I don’t know how many people saw the headline in the Vanguard about 3 million bottles of Codeine consumed daily in the north.

So right off the bat, I had issues with believing the story and I basically shelved it aside. That was until I discovered the scene as shown in the picture I took at the Ikeja Mall (popularly called ShopRite). The ground where I parked was littered with used codeine bottles with straws used from the previous night. On further enquiry, I was told it was a normal occurrence at night at the same location.

What I saw, got me concerned enough to ask questions. I called friends who worked in the industry to try to understand the problem and the issues surrounding. While I am not an expert on this issue and I don’t claim to know much, I do feel like an interested party mainly because I am a parent and I have a responsibility to protect my children as well as other young people. So my aim is to present my findings in order to enrich the conversation among those who like me know little about this subject but are looking to find a solution.

On the surface, it appears that pharmacies are the main beneficiaries of this epidemic. Not with the rising turnover from sales of Codeine related drugs. I understand that the price of Codeine drugs have gone up due to increased demand. There is obviously a commercial explanation for this drug epidemic. But if you thought that this problem can be solved at the level of the pharmacy, then it shows how little you know of the challenges involved. The pharmacies (though key stakeholders) are at the far end of the value chain to make any significant impact. For there to be any impact, we must start from the very top of the supply chain and attack this problem from every end of the value chain.

First, it is important to note that virtually all the cough suppressants and expectorants containing Codeine are manufactured in Nigeria. However, the Codeine which is a vital element in the production is imported as raw materials by these drug companies. While Codeine is considered as one of the “Safest Opioid analgesics”, it is, however, a regulated drug. It is regulated at the international level and at the local level. At the international level, it is regulated by the International Narcotics Control Board (INCB) an independent and quasi-judicial monitoring body for the implementation of the United Nations international drug control conventions on narcotics and controlled substance (1961), The United Nations Convention on Psychotropic Substances (1971), The United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988). This board among other things in collaboration with government agencies determines the levels of controlled drugs which can be imported in a country at any given point in time. For there to be an increase in volume, there has to be scientific and statistical proof that more controlled substance is needed. In Nigeria, the Narcotics and Controlled Substances (NCS) Directorate of NAFDAC is charged with the responsibility of ensuring that Nigeria fulfils its obligations under the relevant international conventions which Nigeria is a signatory to. They do this by granting import authorizations for the importation of narcotics (in raw material or finished goods) for medical and scientific use. In addition to that, they also have the responsibility of monitoring and inspecting importers, marketers and end users facilities to ensure proper handling, storage and utilization of controlled drugs and substances to prevent diversion and illegitimate use. In other words, they have the responsibility to approve the importation of Codeine as raw materials and also monitor its distribution and use in Nigeria.

What has become clear is that the volume of Codeine imported into this country has increased exponentially in recent years. What we do not know and need to find out is if these increases are from legal importation or from smuggling activities. As far back as 2012, NAFDAC stated that it had reduced the volume of codeine importation from 3,400 kilograms to 1,200kg (a 65% drop). Is this still the case? Can we get the importation data of Codeine imported into Nigeria from 2011 to date? This will help us plot a trend analysis to see if the figures have been truly increasing or decreasing and to seek justifications either way. Can we have the figure of how many importers have been licensed by NAFDAC to import these controlled substances from 2011 to 2017? Have they increased or decreased? Assuming there was an increase in importation, what scientific data did we submit to the INCB to justify such as increase? In what way is NAFDAC monitoring the distribution and use of Codeine related drugs? Has it noticed a pattern among certain distributors indicating a diversion for commercial purposes? #AskQuestions

In my opinion, these and more are the questions we need to ask because therein lies the problem and also the solution to this epidemic that is tugging at the hearts of our young people. To understand the enormity of this problem, you need to talk to young people, schools and even event planners. One event planner told us that for ethical reasons, she had to turn down some jobs to plan party events for young people because their parents approved Codeine to be part of the cocktail. If this is true, then it means that the problem is bigger than we thought. It also means that if you have a teenager or even a young child, you need to be careful the parties that you approve for them to go because the drinks they take may be spiked to give them a high. The scariest part of this drug epidemic is about how this issue is becoming mainstream and normal. A pharmacist told me that previously when they come to buy Codeine, they would typically feign illness and ask for one bottle. She says but now, they just walk in confidently and say ‘I want to buy Codeine’ and they can repeat that round like 2 – 3 times a day buying two bottles per time. She says, even if she refuses to sell to them for ethical and regulatory reasons, they only need to go to the pharmacy next door to get the product.

This matter concerns everyone whether you are a parent, a pharmacist or a government official. What makes this Codeine epidemic more dangerous is the relative ease of obtaining the drug and the danger inherent in mainstreaming the subject as just another recreational past time. If you are a human being, you should be concerned. I will end with a story of what I experienced at one pharmacy. I went in to purchase a drug, and there was this woman that came in and asked one of the sales girls to get her a particular drug. The next thing I observed was that the in-house pharmacist came out and beckoned on the woman to come. He followed up by asking her a few questions, ‘Do you have a doctor’s prescription? What do you want to use this drug for? Are you aware of the side-effects of this drug?’ At some point, the lady got uncomfortable with the questioning and stormed out of the pharmacy. Even though I didn’t know the exact drug she came to buy, it was obvious to me that she was abusing a prescription drug and that the Pharmacist knew as well. If only there are many pharmacists like this guy who would put profit aside and care genuinely for people who are hurting themselves and their families, maybe we might have the chance to stop this epidemic before it overwhelms us.

Source: yinkaogunnubi.com

The Aso Villa clinic, officially known as State House Medical Centre, received only N1,195,257,022.13 out of the budgeted N3,365,000,000 since 2015.

Jalal Arabi, permanent secretary of the state house, said this in a statement issued on Sunday.

Arabi said this could be verified from the ministries of finance and budget and national planning.

“The attention of the presidency has been drawn to recent media reports suggesting that the State House Medical Centre had received N11.01billion as appropriation for the period 2015-2017,” read the statement signed by Attah Esa, deputy director of information, at the state house.

“According to the permanent secretary, State House, Jalal A. Arabi, contrary to the above claims, out of the total capital appropriation of N2.9 billion and recurrent appropriation of N465 million for the period under reference, only the sum of N969 million (representing 32.97%) for capital and N225 million (representing 48.41%) for recurrent was actually released.

“It may interest the public to know that there was zero capital allocation for the medical centre in 2017, while out of the N331 million being the recurrent appropriation for 2017, the actual amount released up to September was N91 million (representing only 27.54%).

The statement said despite the shortfalls between budgetary provisions and actual releases, the medical centre provided free services to the “over 10,000 registered patients” annually.

“In addition, the centre has continued to execute on-going projects,” the statement read.

“Apart from the presidency, other beneficiaries of the free services include political appointees, the military, para-military, other security agencies, members of the national assembly, and the general public,” it read.

“Considering the unrestricted patronage base and free services of the State House Medical Centre, coupled with the funding hiccups and periodic receipts, it may not be far-fetched to notice gaps between demand and supply of medical equipment and consumables at certain stages of the budget circle.”

The medical centre has been in the news since Zahra, one of the daughters of President Muhammadu Buhari, took to social media to complain about the state of thefacility.

One week after her public criticism, the president’s wife called for a probe of the allocations to the clinic.

In August, TheCable did a report on the embarrassing situation at the hospital.

The house of representatives has set up a committee to probe the clinic.

The Nigerian government has said that it is yet to confirm if the ailment spreading across some states is monkeypox.

The Minister of Health, Isaac Adewole, who briefed journalists after a meeting of the Federal Executive Council, FEC, said the Centre for Disease Control has taken samples for laboratory analysis locally and in Senegal.

“We will know within 48 hours if what we are dealing with is monkeypox,” he said.

The minister, however, urged Nigerians not to panic. He said if it turns out to be monkeypox, there are two types of the disease; Central African and West African.

Mr. Adewole said the West African one is not deadly.

He also said 33 suspected cases have been recorded across seven states; with no deaths recorded.

PREMIUM TIMES reported how suspected cases have been recorded in Bayelsa, Rivers, Ekiti, Akwa Ibom, Lagos, Ogun and Cross River states.

Mr. Adewole also announced that FEC has approved the composition of a committee that will review laws that allow medical doctors to carry out private practice while they work with government; an indication the government plans to stop the practice.

Culled from premiumtimesng.com

The Nigeria Centre for Disease Control (NCDC) says 31 suspected cases of monkeypox have so far been reported in seven states across the country.

Chikwe Ihekweazu, the national coordinator/chief executive officer of NCDC, made this known on Monday in Abuja.

According to Ihekweazu, following the notification of a suspected monkeypox outbreak on September 22 in Bayelsa, other suspected cases have been reported from six more states.

He listed the affected states as Bayelsa, Rivers, Ekiti, Akwa Ibom, Lagos, Ogun and Cross Rivers.

Ihekweazu said that samples had been collected from each suspected case for laboratory confirmation.

“Results are still being awaited. So far, there have been no deaths recorded,’’ he said.

“It is unlikely that many of the suspected cases are actually monkeypox, but all are being investigated.

“All the suspected cases are currently receiving appropriate medical care, and the patients are all improving clinically in their various states.”

Ihekweazu said that the ministry of health, through the Nigeria Centre for Disease Control (NCDC), was supporting the affected states to ensure the outbreak is brought under control and to limit further spread.

“NCDC has activated an Emergency Operation Centre (EOC) to coordinate the outbreak investigation and response across the affected states.

“The EOC is currently supporting State Ministries of Health in their response to the outbreak through active case finding, epidemiological investigation and contact tracing.

“Measures have been put in place to ensure effective sample collection and testing for laboratory confirmation.

“Risk communication activities have been heightened to advise the public on preventive measures. All 36 States and the FCT have been notified for preparedness,’’ the NCDC national coordinator said.

Source: www.thecable.ng

The Wife of President Muhammadu Buhari, Aisha, on Monday decried the poor state of healthcare delivery in Nigeria and what it portends for Nigerians.

Recalling the recent trips made by the President to London for medical attention, Mrs Buhari wondered what would happen to Nigerians who could not afford to travel abroad for treatment and are forced to turn to poorly equipped hospitals.

“If somebody like Mr President can spend several months outside Nigeria, then you wonder what will happen to a common man on the street in Nigeria,” she said at the opening of a two-day Stakeholders meeting on RMNCAH+N –Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition in Abuja.

The meeting was organised by her pet project, Future Assured which has all state governors’ wives, development partners, primary healthcare coordinators and other state holders in attendance.

Mrs Buhari illustrated her concern with her experience after a recent visit to the State House Medical Centre. She had gone there for treatment, after rejecting advise to travel abroad for better care.

She said, “Few weeks ago I was sick as well, they advised me to take the first flight out to London (but) I refused to go. I said I must be treated in Nigeria because there is a budget for an assigned clinic to take care of us.”

Unfortunately, she discovered that despite the huge budgetary allocation to the centre, it wasn’t properly equipped.

Mrs Buhari, therefore, called for the probe of the budget for the medical centre.

“If the budget is N100 million, we need to know how the budget is spent. Along the line I insisted they call Aso Clinic to find out if the X-ray machine is working, they said it is not working. They didn’t know I am the one that was supposed to be in that hospital at that very time,” she said.

“I had to go to a hospital that was established by foreigners in and out 100 percent. What does that mean?”

She also faulted ongoing construction at the medical centre, suggesting it was misplaced priority.

This much she told the Chief Medical Director of the State House Medical Centre, Dr Hussain Munir, who was also at the event.

“I’m sure Dr Munir will not like me saying this but I have to say it out,” she said.

“As the Chief Medical Director, there are a lot of constructions going on in this hospital but there is no single syringe there what does that mean? Who will use the building? We have to be good in reasoning. You are building new buildings and there is no equipment, no consumables in the hospital and the construction is still going on.”

To turn the situation around and improve healthcare delivery in the country, she called for urgent action.

“I think is high time for us to do the right thing. If something like this can happen to me no need for me to ask the governors wives what is happening in their states. This is Abuja and this is the highest seat of government, and this is the Presidential Villa,” she said.

For her, the problem is not one of poor policy, but one of ineffective policy implementation and the mindset of those responsible for providing health facilities.

“One of the speakers (at the event) has already said we have very good policies in Nigeria, in fact, we have the best policies in Africa. Yes of course we have but the implementation has been the problem,” she said.

“So, we need to change our minds set and do the right thing.”

Source: channelstv.com

Every 1 out 6 couples are usually affected by Infertility issues. When the cause is from the female partner, it is referred to as female infertility, and when caused by the inadequacies of the male partner, it is referred to as Male Infertility.

According to statistics, Male Infertility occurs in approximately 30 percent of all infertility cases.

These are the four main causes of Infertility in males:

1. A pituitary or hypothalamic disorder - (1-2%)
2. Disorder of the Gonad-(30-40%)
3. Sperm transport disorder-(10-20%)
4. Unknown causes -(40-50%)

If we note, a lot of the reasons are still attributed to unknown causes or unknown diagnosis. But male infertility occurs because of sperm that are abnormal, or sperm that do not function as they should maybe due to their inadequacy in numbers or problems with ejaculation. Sperm should be considered abnormal if they have short life span or low mobility.

Abnormalities of the sperm are caused by some or one of the following reasons:

1. Inflamed testicles.
2. Swollen veins in the scrotum
3. Abnormally developed testicles.

Ejaculation problems include the following:

1. Premature ejaculation
2. Retrograde ejaculation: This occurs when semen is forced back into the bladder.
3. Erection dysfunctions
4. Complications from surgery or therapy.

Other random causes of Male infertility include:

1. History of Sexually Transmitted Diseases.
2. UTI: Urinary Tract Infections
3. Use of certain wrong types of medications.

Diagnosis of Male Infertility

Through the help of lab tests and examinations, the causes of male infertility can be determined. The test would include checking out the following:
1. Semen analysis to check out the number and quality of the sperm being produced.
2. Blood test to check for infections or hormone problems then lastly,
3. A physical examination of the penis, scrotum and prostate.

Doctors would look out for the following in the tests:

1. Total amount of semen: A volume of 2 milliliters is considered normal during intercourse and ejaculation. A lower amount may be an indication of blocked ducts, a prostate gland issue or an issue with the seminal vesicles.

2. Sperm Count: A sperm count of 20 million to 300 million per milliliter is considered the normal range for sperm counts. Anything below 10 million is considered as “low sperm count”.

3. Morphology: This refers to the shape and size of the sperm being produced. This is put into consideration because they affect the ability of the sperms to reach and fertilize an egg. If 30% of sperm produced is shaped “normal”, then that is a good pass mark.

4. Motility: This has to do with their speed, movement and number of active cells. In calculating movement of sperm, the range is from 0-4. A score above 3 is considered good. Active cells are rated in percentages. Above 50% is considered good.

Treatment of Male Infertility

Sperm Production can be treated by taking clinically proven supplements. Anything that can increase the number of healthy sperm increases your chances of conception. There is a Natural Supplements with No side effects, it will detoxify your system, boost your sperm count and increase your motility. It’s a 3-in-1 SOLUTION PACK.

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The Federal Government has denied the report that the outbreak of Monkey Pox in some parts of the country resulted from the alleged free medical care by the government in the affected areas.

The Minister of Information and Culture, Alhaji Lai Mohammed, in a statement on Sunday, said Nigerians should disregard the report which, apparently, is being spread by some unscrupulous persons to fit into a sinister agenda.

Lai Mohammed said,”The Federal Government has not conducted any free medical service or care in either Bayelsa or Rivers state, as alleged in the fake report being circulated. So that could not have been the cause of the outbreak of Monkey Pox in both states.

“Monkey Pox is a virus found only in monkeys and it is rare in human beings. It belongs to the same family as Chicken Pox and Smallpox.

”It is suspected that someone may have contacted it by eating monkey meat, thus triggering the current outbreak.”

Monkeypox epidemic was first recorded in Bayelsa with three other suspected cases in Rivers State and one other confirmed case in Akwa Ibom.

Source: channelstv.com

The Minister of Health, Prof. Isaac Adewole, has extended the suspension of the Executive Secretary of the National Health Insurance Scheme, Prof Usman Yusuf, indefinitely.

The minister had in July suspended Yusuf for three months and set up a committee to investigate the NHIS boss who was accused of fraud in a series of petitions. Vice-President Yemi Osinbajo who was the acting President at the time had asked the minister to investigate Yusuf.

The committee set up by Adewole comprised senior officials of the ministry, the Department of State Services and the Independent Corrupt Practices and Other Related Offences Commission.

Yusuf’s suspension coincided with an ongoing probe at the House wherein the NHIS boss had accused Health Management Organisations of frustrating the NHIS and perpetrating fraud worse than the oil subsidy.

The House, therefore, saw the suspension as an attempt to intimidate Yusuf and stifle its probe.

The committee set up by the minister, however, found that fraud to the tune of N919m allegedly took place under Yusuf who had spent less than a year in office. The report was then sent to the President on September 4.

In a memo with reference number HMH/ABJ/032/Vol.XII/29 which was dated October 5, 2017, the minister informed Yusuf that his suspension which began in July, would continue until the President acted on the report.

Adewole said since the report had indicted Yusuf, there was no need for him to return to office.

The memo read in part, “Please refer to my earlier letter ref C405/T/132 dated July 6, 2017 suspending you from office for three months to allow for an uninterrupted administrative investigative committee to look into the various allegations against you including that of monumental fraud, gross abuse of office and nepotic acts inimical to the objectives of the NHIS under your leadership.

“The committee has since submitted its report which I have forwarded to his Excellency, Mr. President, for further action.

 “While awaiting Mr. President’s directives and considering that the committee found you culpable in many areas of your performance as the executive secretary of the scheme, I am further extending your suspension from the office pending the decision of Mr. President on the report.”

According to the panel’s report the N919m was dubiously given as payment to consultants for staff training under the suspended NHIS boss.

The committee said as the head of the agency, Yusuf was personally responsible for all administrative, procurement and financial lapses.

According to the report, “His (Yusuf’s) deceitful attitude coupled with ‘name dropping’ of Mr. President as having sent him to sanitise the NHIS but he caused more harm than good to the scheme.”

The committee, therefore, recommended that the Economic and Financial Crimes Commission probe the agency for diversion of funds and contravention of the Procurement Act of 2007.

The report states that Yusuf contravened the Procurement Act of 2007 through nepotism and other irregular award of contracts and should be sanctioned in line with the provision of the Act.

Explaining how the alleged staff training scam took place, the committee said in some instances, the number of trainees was far more than the entire number of employees at the agency while in some other instances, some employees were registered for the same training in two different states at the same time.

Most of the consultants were said to have charged about N250, 000 per participant.

The report states in part, “The total number of staff at the NHIS is 1, 360. The total number of staff trained by the scheme based on analysis of payment vouchers on training was 1, 992 while the figure submitted by the NHIS was 2, 023 within three months (October-December 2016).

 “The difference between the number of staff trained and the number of staff on the nominal roll was as a result of manipulation of names. It was discovered that some staff did not attend (training) but payments were made for both course fee and staff allowances.”

The panel alleged that some consultants were directed to remit part of their fees into a specified private account as kickbacks.

Source: punchng.com

Fellow Nigerians, I finally returned to Port Harcourt after over two years of absence. It is strange how time flies and how it changes everything. Port Harcourt had always been one of my favourite cities in our dear beloved country. Once upon a time, Port Harcourt was known and referred to as the garden city because of its blossoming flowers. The good people of Rivers State are particularly warm and affectionate and I really enjoyed their generous hospitality which is so lavish and sincere. I will never forget the wedding of one of the daughters of the great Chief and former Minister, Alabo Graham-Douglas. Port Harcourt, and Rivers State in general, was so peaceful that I flew in our European photographer, Dragan Mikki, to cover the epochal event for us. Security was not even an issue as we boarded a speedboat to go to Abonema, the ancestral home of the Graham-Douglases. There was no fear of our Oyibo photo-journalist being kidnapped. We also flew Dragan from Port Harcourt to Abuja to shoot pictures of our dear First Lady, Mrs Stella Obasanjo, now of blessed memory. Wow, I feel so nostalgic about those good old days.

I made so many wonderful friends in Port Harcourt. Ovation International magazine has had one of its biggest fan base in that fun-loving city till this day. I remember and treasure the evening I was hosted by the big boys of the garden city and I was treated like a visiting President. I saw enjoyment at its best. I was given the title of O-talk-na-do of Port Harcourt and the whole place reverberated powerfully as a result of the Ovation invasion. I was received at the Government House by the Deputy Governor Sir Gabriel Tamunobiebere George Toby, on behalf of the Governor, Dr Peter Odili, who was out of the country when I visited.

I would later meet and become inseparable friends with the then Speaker of the Rivers State House of Assembly and later Governor, Rt. Hon. Chibuike Rotimi Amaechi. I visited whenever I was chanced or invited by Amaechi. Our relationship blossomed when he left his Peoples Democratic Party and joined All Progressives Congress. We worked actively and passionately for the success of Major General Muhammadu Buhari, now President and Commander-in-Chief. While Amaechi’s stupendous efforts won at the Federal levels, he could not replicate the same on his home tuff. His Governorship candidates and other aspiring legislative ones failed as they were roundly and soundly defeated by the opposition party. I doubt if my friend agrees till this day that his candidates were truly humbled but that is a matter for the courts as events unfolded.

I don’t know, and may never know, what happened in Rivers and how Amaechi the physician could not heal himself after fixing Abuja admirably. That is another story for another day. All I know is that Rivers has not been the same. I read a lot of blistering attacks on the new Governor, Nyesom Wike, who used to be one of the closest friends of Amaechi before things fell apart between them and the center could no longer hold. Since life is about perception, I did not look forward to going to Rivers anytime soon.

All that changed when I least expected. A phone conversation with the great man many of us refer to as “the godfather” in journalism circles, Mallam Ismaila Isa Funtua, changed all that. He had called while I was in Ghana to personally invite me to the 2017 Nigerian Guild of Editors Summit in Port Harcourt. He informed me he was also talking to Nduka Obaigbena, Chairman of Thisday newspapers, as well as Kabiru Yusuf, Chairman of Daily Trust newspapers. I was indeed honoured by the invitation and I agreed to return to Abuja and fly from there with these distinguished personalities to Port Harcourt.

The journey to Port Harcourt was smooth as the four of us flew from Nnamdi Azikiwe International Airport, Abuja on a small chartered plane and landed under an hour. Everything was in place for our arrival including, cars and security provided by the Governor. We drove straight to our hotel, checked in, freshened up and rested a bit before going to join the Governor for dinner. I had not seen Governor Wike since he moved into that Government Lodge where I used to visit my dear friend, Hon. Rotimi Amaechi. As we walked in, the Governor rose to salute “the godfather”, Alhaji Funtua: “my father welcome…” he said. He turned to Nduka Obaigbena, “my boss, how are you?” To Kabiru, “how are you Sir?” And to me, “my brother, I can’t believe you came. I told Alhaji you won’t come…” I smiled and we hugged briefly. I immediately understood why he felt that way but I love peace and would always work for peace.

Wike appeared extremely happy to see us. I saw firsthand why he is regarded as a consummate politician, regardless of what side of the political divide you belong. He understands the game of reaching out to friends and foes. He did not hold any grudge against me for being one of those who fought tooth and nail to sack their Federal Government from power. As we walked to the garden where he hosted us, he held me at a stage and recollected how I dealt him some heavy blows in my column one day when he was still Minister. He said his whole body was vibrating with emotion as he read my article. As he spoke, I remembered a Yoruba adage, “the man who used the toilet can forget but the one who cleaned the mess would always remember.” We both laughed over it.

We spent several hours with the Governor who regaled us with exciting tales from  behind-the-corridors of power. Believe me, the man knows so much about Nigeria and sure knows how to navigate the murky waters of power as dished up by the political class. He’s a powerful networker who has no bounds or restrictions. His biggest assets are his disarming smiles, raucous laughter and general affability. It is impossible to sit with Wike and not laugh. He had many of his friends and political associates around. It was obvious that he enjoys a grip on the major political actors in the State, including a former Governor, a former Deputy Speaker of the House of Representatives, a former Party Chairman in the State and several others who sat with us.  They were all there to testify to Wike’s ability to unite them. Also with us were senior journalists, Eric Osagie, Managing Director of The Sun and Louis Odion, former Commissioner for Information in Edo State.

We took a walk round the beautifully refurbished State House, including the spanking new Presidential Lodge for visiting Presidents. Everything was tastefully done. The Governor looked confident and very much at home. He walked us back to our cars and we said goodnight. We drove back to our hotel at about 1am. It was quite an experience. As I prepared to dive into bed, what kept ringing in my head was that I hoped our leaders could unite for the sake of their people and disagree to agree but it seems a tall order and mere wishful thinking. There is nothing wrong in fighting about principles but there is no need to do so on the basis of personalities. What we often have in Nigeria are personality clashes which do us no good as it detracts from good governance through the unhealthy and unnecessary distractions that it causes.

The occasion of the Editors Conference was superbly put together. We arrived in good time and took our seats. We met Chief Olusegun Osoba, former Governor of Ogun State and certainly one of Nigeria’s greatest journalists of all time. I was delighted to see him because he was still recuperating from a recent surgery, but still made the sacrifice nonetheless. There were so many greats of our industry on parade and I was proud to be a member of the fourth estate of the realm. The speeches were awesome. Our Chief host, Governor Wike spoke from his heart during his welcome address. He berated those he saw as busybodies maligning the State of Rivers. He asked rhetorically, why everyone is coming to host one event or the other in Port Harcourt if there was total breakdown of law and order as being peddled by certain sections of the media. The discussions on the media itself were revealing, especially the one on the media as business. This is because it will always be a pertinent topic if our media houses are to stay focussed and relevant in the development of our great country. I enjoyed the contributions of media icons, Azubuike Ishiekwene and Kabiru Yusuf. I came in briefly as one of the commentators. I spoke on how to stay relevant in the media business.  I had no regrets attending the landmark event and I’m grateful to Mallam Ismaila Isa Funtua for the kind invitation extended to me and the entire arrangements made for the trip.

How the Yahaya Bellos Are Fighting Cerebral Palsy

In most African societies, children born with cerebral palsy are often victims of social stigmatization. Superstition holds it that these children are either descendants of the gods or children who have been offered by their parents for rituals or other nefarious spiritual purposes. For most of these children, it is easier for a camel to pass through the eye of a needle than to be admitted into any school just like other children. In many homes and neighbourhoods, they are separated from other children, treated with contempt and ridicule and eventually pushed to the fringes of society as outcasts. Indeed, it is a most gruelling and traumatic experience for these children, their parents and other loved ones, many of whom are now forced into a journey of hopelessness, having tried all means possible to find help, to no avail. Not for the Yahaya Bellos.

The story of Kogi State Governor, Yahaya Bello and his wife, Amina Oyiza Bello, a lawyer, is a remarkable tale of hope and resilience in the crusade to de-stigmatise cerebral palsy, educate people and bring hope and love to the children who are the most affected. The hand of fate dealt the Bellos an unkind blow in 2007 when what began as celebration with the birth of their son Hayatullah Onoruoyiza Bello was soon cut short upon discovery that their new bundle of joy was stricken with cerebral palsy. It was a pain too hard to bear. Defying the odds, they hit the ground running. From one hospital to another, from country to country and continent to continent, they travelled with Hayatullah in search of a resolution.

In the midst of this crisis, Hayat Foundation, a special intervention foundation that focuses on issues dealing with persons living with Cerebral Palsy and other Disabilities was born. The objective of the foundation is to bring succour, support and improvement to the lives of persons, children, parents and siblings alike, living with cerebral palsy and other disabilities. By this singular gesture, the Bellos have not only confronted their challenge headlong but also stretched out their arms to the less privileged in our society who may not be as lucky as their son. “Because I experienced and felt loved while I was growing up as a child, I became convinced that I have same responsibility to my son and therefore would not abandon him by hiding him in an obscure corner of the house where people will not see him”, Mrs Bello affirms.

Putting words to action, the Bellos will launch the Hayat Foundation on Friday October 13, 2017 in Abuja. Through this foundation, they hope to set up a Pan-African institute for children with special needs in the mould of the Kennedy Krieger Institute in Baltimore, Maryland, United States. Already, several well-meaning Nigerians have united behind this noble non-political, non-profit initiative. They include Toyin Saraki, Folorunso Alakija, Abah Folawiyo, Florence Ita-Giwa, Ben Murray-Bruce, Ademola Adeleke, Abike Dabiri, Mo Abudu, Sade Okoya, Laja Adedoyin, Daisy Danjuma, Osasu Igbinedion, Aisha Falode and Adesuwa Onyenokwe. Others are still calling in to support this humble and highly courageous lady who has refused to be cowed or intimidated into hiding her son from the public just because he is physically challenged.

I seriously salute her for this worthy project.. She needs our prayers and support.