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Fashola Is A Tyrant----Lagos NMA Chairman

ARTICLE | NOVEMBER 14, 2014 - 9:02AM | BY LARA ADEJORO



Expressing his displeasure over the non-payment of salaries for doctors employed by the Lagos State government and the poor state of the health sector, poor working conditions, the Lagos State Chairman of the Nigerian Medical Association, Dr. Tope Ojo in this interview with LARA ADEJORO says any nation waging war against the health of his people by targeting the custodian of health is only  destined to ruin.

What is your take on the non-payment of salaries for doctors employed by the Lagos State government?

Tell Fashola that he is a tyrant. Anybody that attended a Nigeria University 25 years ago, who is a graduate of the first generation and the second generation of a Nigeria university that has gone through a university at a cost that is equal to no cost and he's now saying that a Nigerian child should pay N300,000 in a state university, that person is breeding a milieu for potential Boko Haram, prostitute, criminals, armed robbers. The milieu will be built because the common woman who fries plaintain, runs a small boutique or that guy who vulcanises your tire or those that earn meagre salary cannot afford the pay and those children will come back to be what? I attended a university when the entire education for me to study medicine was not up to N20,000 for six years because I was only paying tuition, I was paying N45 for accommodation per section, I was taking N90 or N120 per month between 1986, 1987 to 1993 and it still doesn't matter because we all belong to the same generation and Fashola belongs to that because he is just in his 50s. So, the same level of tyranny is what will inform him to have hated the Lagos State employed doctors. Why he hates them is simple, his predecessor and his political god-father, Tinubu pretending to be an advocate of a democracy in 1999 was able to ride on the euphoria of that moment to deal a decisive blow on Lagos State employed movement when that culminated into the sack of Ayodele Akele, then they thought he was rude but because of the high level of intellectualism among doctors, they continued with the battle. The only people that formed a formidable opposition which led to protest of the Lagos State doctors between 2007 till date is why the Lagos State Government is bent on annihiliating the medical profession. And you know, health is wealth, any nation that is waging war against the health of his people by targeting the custodian of health is only  destined to ruin. Since the last 3 years, the Lagos State Government has refused to employ any doctor on full-time basis, whereas all other employee has been done. Our Comrade in Edo State, Governor Adams Oshiomhole was casualising the workers too, he casualised almost all the work force of Edo State but because he could see the massive tsunami of protest and uprise of the Edo people, he unequivocally reversed that. In fact, he had to sacrifice his permanent secretaries that failed to comply. So, in Edo State, casualisation has been completed wiped out but Lagos State is the only state in the country that has continued to employ doctors on casualisation because the doctors have been the only ones confronting the state government since 2007. We just came back from a strike and the strike was not to ask for increment of salary, we were saying that all Nigerians should have access to health, that if your family member dies from Ebola, he should have life insurance, hazard allowance, these are basic things we were talking about. We were saying the post-graduate programme should be all encompassing for Nigeria to produce more specialists and are these things wrong? They flattened it and said doctors are asking for money and at the end of this, the Federal Government and the Nigerian Medical Association (NMA) had a truce. The truce was such that, there will not be any victimisation and negotiation will be on going but Lagos State said, it's a policy of no work, no pay. When for 8 months, the Academic Staff Union of

Universities (ASUU) went on strike, the Lagos State chapter was paid, when the judiciary workers were on strike, they were paid. The polytechnic staff went on strike and they were paid and they were saying no work, no pay for doctors. Since the strike has been called off, we have written over 50 letters and the Governor never replied.

But the Lagos State House of Assembly already said they were going to intervene on that?

There are a lot of good people in the House of Assembly but the Lagos State Government is like the proverbial dog that will get lost, that will never listen to the flute of the hunter and that is what Fashola represents.

So, what has been happening?

They've not paid doctors since July maybe except for the few that are sycophants but as far as I'm concerned, they've been owing doctors since July, August, September. In fact, it took a threat for them not to withhold October salary and I'm aware that a few people are not even paid in October. So, we've done a lot of advocacy initially, thinking that we could work together but we have found out that the state government is unrepentantly bent on destroying the health of Lagosians because once you are annihilated from your doctors, I wonder what you want to do. A lot of facilities they are building are devoid of personnel because they don't have any recourse for the medical association on the basis of planning and an encompassing participation to say this is what is required. You can't just say there is a General Hospital in Ijede, it must be a situation that, if anybody has bone injury, you tell him or her to go to Gbagada, then you have others but they are doing it based on their own shallow understanding. The Lagos State Government has systematically over the years replaced intellectualism with mediocrity.

Now that over 50 letters have been written to the state government with no reply, what is the next step?

Those that made possible change in the words of Frantz Fanon is violent change inevitable, that is the reality of it. If the Lagos State government has made things to fall apart, then surely the centre will definitely not hold. Advocacy of 5 months down the line and doctors are being singled out based on a policy that rests on chicken legs, definitely can no longer guarantee peace in the health sector.  We have written several letters of friendship, trying to exist together on the basis of genuity but that has been completely rebuffed by the state government.

What will you say about the strike embarked upon by the Joint Health Sector Union (JOHESU)?

You see, in a country where you have common sense been replaced by some tendencies that is based on petty material gain, in a country where legislation has been reduced to money bag legislation rather than democracy and common sense, then you have this. What they are telling you now is that even the cleaner can become a consultant. Who is a consultant? A consultant is a doctor who has gone for another six years of excruciating academic sojourn through the post-graduate colleges and then becomes a consultant, that is a specialist in the various fields. When going to the hospital, will you say you are going to see your consultant nurse. These are the issues because what the Nigeria government  is doing is illegalising the system into eternal destruction.

Don't you think there are adverse effects on the fact that the health workers are on strike. Won't the doctors be over-burdened in the discharge of their duties?

It doesn't make any difference. Whether there is strike or not. The health sector is now dangerous. There is going to be increased mortality based on anarchy. Now, we are trying to deal with impersonation from allied health workers who parade themselves as gynaecologists when they are midwives, parade themselves as orthopaedic surgeons when they are plaster room technician, and now you are giving them the room, it is death, death and death. That is the meaning. The Nigeria government has over-stamped death certificate in Nigeria based on this. For Nigerians, it is a sad story that the Nigeria ruling class is eternally corrupt morally, socially, monetarily. You talk about what happen in America but does this kind of policy hold forth?

What is the hope for the patients and Nigerians generally?

There is no hope. They should be on the street, fighting against the death sentence that has been passed on them by the Nigeria government.

Why Fasola is punishing Lagos Doctors

VINDICTIVE,OPPRESSIVE & ANTI-DOCTOR LASG! Sahara Reporter- http://m.youtube.com/watch?v=CLlengRo2MM ...MEDGUILD

WHO DID IT BETTER; LAGOS AND TEXAS: RESPONDING TO A CASE OF EBOLA

 

On 20th July 2014 Nigeria was thrown into commotion, Lagos state particularly as the country recorded its first victim of Ebola diagnosed in a private hospital in Lagos. The index case was a Liberian, the late Patrick sawyer who evaded authorities in his country to seek care in Nigeria; haven suspected that he had been exposed to the deadly virus. His arrival caused a lot of panic with resultant loss of lives and several people contracting the illness. Though Patrick Sawyer died five days after being diagnosed with the disease, Nigeria was able to do a splendid job of containing the spread of the illness. Through contact tracing and active surveillance we have been able to rid the country free of Ebola.

But in a similar twist of fate another Liberian Thomas Duncan, has been diagnosed with the Ebola virus in Texas United States of America, making the second Liberian to have taken the disease through the air route to a country in which the disease is not natural. The index case arrived the United States from Liberia on 20th September 2014 haven had contact with an Ebola victim while in Liberia. He marked the first case of EVD to be diagnosed in the US and since then up to eighty people have been put on a watch list.

There seems to be so many similarities in the two events, but through a critical look we can analyze the two events and compare the ways both have been managed. But before we go into critical analysis we should have at the back of our minds that the United States has a functional health system with adequate funding and a motivated work force against the backdrop of a robust economy. The situation in Nigeria is completely the reverse, a poor health system; indeed some would say no system exists, but the health workforce is far from motivated against a backdrop of poor socio economic conditions.

Mr Patrick Sawyer travelled to Nigeria from Liberia arriving at Muritala Muhammed International Airport on the 20th of July. The purpose of his visit was to attend a conference in Calabar although hand site report revealed that he sneaked into the country haven suspected that he had contracted the deadly virus. He came down with the sickness at the Airport and he was transferred to first consultant hospital Lagos.

At that time there was practically no protocol existing in the country on handling of suspected Ebola cases, indeed there was little expectation by Nigeria and even the western world that the deadly virus could be transmitted to a country that did not share contiguous border with Sierra Leone, Liberia and Guinea; the three countries in which the virus had already assumed an epidemic proportion.

However, through the heroic effort of members of staffs of First consultant hospital lead by the late Dr Stella Adadevoh whom so many now consider a national hero,  saved the day. It would have been unthinkable the overwhelming effect the disease would have had on our health system if those people had not taken pain to do their job diligently. Through their heroic efforts and an appropriate response by authorities of the Lagos State government it was possible to effectively carry out efficient contract tracing and active surveillance which made it easier for the country to contain the disease.

The case in Texas seems a little different. Even though the patient arrived from Liberia at a time when the attitude of the whole world was trigger ready to fish out any suspicious case of Ebola especially with the slightest inkling of contact with an infected person or region, the patient presented at a hospital in Dallas (Texas health Presbyterian) with symptoms of fever and even after giving information that he just returned from Liberia he was asked to go home with antibiotics prescribed. He returned to the hospital two days later haven spent time with close family and friends while exhibiting symptoms of EVD and it was until the second visit that he was then put on a watch list and eventually diagnosed of EVD.

Thomas Duncan who is presently in a bad shape had contacts with dozens of people and therefore puts up to eighty people into the surveillance zone for EVD. This list includes five school children who have put much fear in the minds of many parents whose children attend the same school with these pupils.

There is no doubt that the United State health system is ready to cope with the challenge of curtailing the disease but that does not obviate the error that has now put many people in harm’s way. One would have thought that with already perceived danger of a global spread the health system in the United State would have been so much ready that such a case should not have been missed.

I must however clarify that such errors are not beyond any health system for as long as humans interact in any system there are bound to be errors. The point that is being made however is that Nigerian doctors need to be appreciated. They have been working in a no system environment, poorly motivated in a harsh socio-economic environment, yet he puts up his best to deliver service best that he could.

Though so many regard the Late Adadevoh a hero of the country; I quite agree with that clamour, but the late doctor was actually just doing her job. She did it in a manner in which she has learnt, not minding the fact that the society had next to nothing to offer in return. So many Nigerian doctors are daily giving their all and a couple of times their lives to saving patients lives. They do it without expecting so much from the society yet the Nigerian doctor seems to be the most bashed by the public more than any other society that I have learnt about.

Even before EVD, Nigerian doctors face the daily threats of HIV, Hepatitis and many other communicable diseases. They also face harassment by the patient who they care for. They do this and only receive a wage too paltry to take care of a quarter of their needs. With or without Ebola the risk of communicable disease is rife amongst health workers, yet the doctor receives a paltry sum of five thousand Naira as hazard allowance.

We need to think deeply and give to the Nigeria doctors what they truly deserve. The doctors deserve to work in a virile and well funded health system with the capacity to improve upon the practice of medicine and consequent improved service delivery. The Nigerian doctor deserves encouragement and support, not frequent strikes as a need to demand for basic means of sustenance. It’s time to change the social ethos, lets support our doctors for all the work they do. Health is wealth, and remember an unhappy doctor is a dangerous doctor.

THE NIGERIAN HEALTH SECTOR; JUST BEFORE THE WATERLOO

Its been over two weeks now since the Nigerian Medical Association pulled her members away from work through out the country making a lot of the common Nigerians groan under the agony of seeing their loved ones suffer from illnesses without getting proper care and some even loosing precious lives in the process.

Much as many may feel that the worst has come, it is instructive that we take a critical look of the present predicament and understand that the worst is yet to come. Judging by the facts of the issues that has led to the present action of the NMA, it is clear to me that if urgent and decisive steps are not taken then the Nigerian Health sector is just about to meet its waterloo.

No doubt NMA and her doctors have received the worst bashing from the general public; which has been fueled by the support of the Union of the Joint health workers under the aegis of an amorphous body called JOHESU. This situation is so because people lack dept into the issues that has caused the present action of the doctors and of course the fact that they cannot phantom why the doctors would appear so callous as to abandon their patients.

If we must avoid impending doom it is imperative that we take a critical impartial analysis of the present issues, so that we can take decisive steps to avoid the worst coming to being. Rather than just always criticize the doctors for withdrawing services, it is better to first understand the issues dispassionately; next we can then query the decision of the doctors to have taken withdrawal of service as the option to pursue their agitation.

For all those who have good knowledge of the goings-on in the  health sector of Nigeria, it would be clear that whatever crisis we are witnessing now is a result of conflict that has long bedeviled the sector and has been brewing for over two decades ago.

Without prejudice to any of the disputing sides, i make bold to say that health service requires the collaborative efforts of various professionals and other allied workers whose only goal is to come to a positive outcome of patient care. Every part of this whole has its integral role that it plays and one part may not claim superiority over the others.

However, in any scenario where we have different people coming together to achieve a single goal, there must be direction and this direction must be provided by leadership. The problem in the Nigerian health sector is that leadership has been misconstrued as superiority and as noted earlier, this problem has been on for decades. I also make bold to say that both sides are guilty of this misnomer.

Much as we try to have a clear understanding of the distinction between leadership and superiority, we must however also have a clear mind as to who to Captain the ship. It is commonsensical that only one captain is needed to direct this Ship, and anything other than that leads to chaos; which is exactly what we must avoid.

It is also commonsensical that the best person to captain the ship is the most knowledgeable person about the entire process and without doubt that positions falls to the doctor. That the doctor is the one with the most knowledge of the patient is what the other health professionals find discordant to their ears and this has been the bane of the long standing conflict.  But no one gets annoyed or argue when the lawyer says that he is the only learned person. Why should this concept be a problem within the health sector.

The common man may however find it petty that such issues should be taken so seriously by the doctors and more so resulting in such serious action as withdrawal of services. I must however paint the full implication of the issues as it affects the medical profession and ultimately how it affects the care of the patients too.

What the other health workers are asking for is not just a name, but to use and be accorded what is due to the term consultant. Other than that they also believe that it is their right to also head the health team. (Using the term health team gives a clearer implication of this request.)

Let us all be clear that the term consultant may refer simply to an advisory role between a professional and its client. Within the hospital setting however this is not so. The term consultant refers to a specific role which describes a relationship between a patient and a physician who has completed his specialization in a particular part of medicine. It is a position of responsibility as well as authority.

The implication is that if a doctor does not become a specialist, irrespective of many years of practice or getting to the highest position in service, it still does not confer on him the title consultant. What do we then make of a Nurse or pharmacist who wants to attain the same status. It has been believed that because these other health workers now pursue postgraduate degrees up to attaining a PhD it is therefore expected that it is okay for them to receive such status. But pursuing an academic career is completely different from specialization. Even a medical doctor who decided to attain a PhD does not get the title consultant.

The implication of having other health workers attain the status and role of consultant is that it provides more than one captain to direct the ship. For instance the consultant pharmacist may believe that he is a specialist in the field of drugs and therefore may decide on what drug a patient may or may not be given. Every one else including nurses and laboratory scientist may decide on themselves what they want or do not want for the patient. There exist no other word for this other than chaos!!

How would a patient get well with conflicting orders? Indeed who would be ready to get on board a ship with more than one captain. Well I wouldn’t, even if the ride is for free. Let it be clear that the scenarios painted above are not just suppositions, they are realities that already exist even before the conferment of this title. The doctors have however been able to save the situations in the past by referring the other team members to their specific roles and responsibilities. Now that the title has been conferred on other health workers it has been impossible to get proper direction for patients’ care in places where this happened and patients have been at the receiving end of it all.

With respect to the issue of headship, a clear distinction must be made between the head of administration of a hospital and the Chief Operating Officer. The position of the head of administration of the hospital has been occupied by people other than medical doctors. The NMA has no issue with anyone with the requisite skills to occupy that position. But when it comes to the chief operation officer of the hospital; by whatever name it is called, Medical Director, CMD, CEO of CFO, that position we maintain should be headed by a Medical doctor.

This is a position of high responsibility and one in which the officer has to make judgment call that is not based on just administrative matters but that is based on the clinical responsibility of the hospital. We must have at the back of us our minds that the goal of the hospital is patient centered. It is ONLY (note emphasis) the doctor that has the COMPLETE knowledge of the patient and can take most responsibility regarding patient care. It is therefore a desideratum that the doctor only can occupy this position in other to deliver on the expected goal of the hospital and health systems.

One cannot but be puzzled and amazed at the rate at which other health workers have jostled for the top post. These are people who are indeed very protective of their position and roles. Would the pharmacist allow the pharmacy department to he headed by a pharmacy technician? Would the laboratory scientist prefer to take instruction form the technicians? We know the answer to these questions. I also know as a matter of fact that there is a law in this country that bars non radiographers from using radiological equipments even the technician within that department is not allowed.

It is dismal that while these group of health officials are highly  engaged in professional territorial protection, they are also agitating for the job, authority and responsibility of the doctor. This and the chaos that may arise from it is what the doctors are protecting for engaging in the current industrial action.

Haven understood the basis of the industrial disharmony one must still ponder why the option of withdrawal of services has been taken by the doctors; especially when the grave consequences are well known.

In any reasonable society doctors are not to be allowed to go on strike under whatever condition. The onus however is not left to the doctors alone but also to the government and the general public. We must remember that the doctors are also a part of the society and become subjected to the same factors affecting everyone. The physician oath indeed recognizes this fact and provides that a physician should be well treated by the society as long as he plays the role of dedicating his time to patients care.

While one cannot take away the option of the doctors to agitating for their well being amongst other things, it is a terrible thing for doctors to withdraw services especially in a large scale. I believe that other methods must be available for the NMA to pursue its demands. We know that dialogue do fail but even when pushed to the wall the option of strike is very grave.

The organized labor NLC, TUC, etc and civil society groups should rather come to the aid of the doctors and serve as pressure groups to pursue the clear demands and aspirations of the doctors. But what would you have NMA do when those who we believe are supposed to be the intercessors are the ones who actually worked against the NMA.

As a matter of fact, while JOHESU had gone on strike a couple of times over this issue in the last one year, NMA has averted the same course by postponing an industrial action at least four times last year alone. NMA had continued to embrace the part of dialogue to pursue its demands. The game changer was the point when the Nigerian Labour Congress teamed up with the other health workers and threatened the federal government to sign the agreement with JOHESU even without prior fair hearing from NMA.

With the Federal government haven signed an agreement with JOHESU which is the complete reverse of the understanding with the doctors, NMA is left with no other choice than to take her destiny into her own hands. This is the reason for the current action of NMA and I sincerely await a dispassionate suggestion as to what other methods NMA could have adopted. The ultimatum given to the Federal government was a public document which was put on the pages of the news paper, Nigerians; including the civil society group did not deem it wise to intercede during that time frame and we all allowed the NMA to proceed on the withdrawal of services.

We all have a blame in this. The NLC, TUC and civil society groups have failed the country. We do not just claim to be a sane society without living up to such responsibilities. Up till today members of the civil society groups have not deem it fit to come into this present imbroglio.

As noted earlier, worse times are coming. How do we expect to achieve the team spirit with so much passion and acrimony. This is only a forbearer to unending disharmony. There is no team that can deliver without harmony, and there is no way the health sector can deliver on its goals without a team spirit. We must not wait to get to the end of the line. We must all act fast and decisively to forestall this grave consequence.

In other to move forward, the government must first find a way for the NMA to suspend its industrial action. One way is to ask that the whole team return to status quo ante. It is clear that only in settled waters do things mirror themselves, undistorted. Only in settled waters can we find a lasting solution to the problem at hand. No half measures.

The NMA as the rightful leader of the health sector must understand what leadership truly confers. It is a responsibility not only to the doctors but to everyone within the health sector. This is a role NMA has not truly delivered over the years. Only when the NMA assume this rightful responsibility can the other members of the team be ready to follow her leadership.

NMA and other health workers must come to a round table with a no winner no vanquish spirit. Together they can plot a future for the health system of this country. A future that cater for the needs and responsibilities of every member of the team, a future that is patient centered, geared towards improving quality in health care and elevation of the various professionals and allied groups within the health workforce.

This is the only dream that is truly positive. The only vision that can be pursued and lead to a positive future. Lets all swallow our pride and act wisely. Posterity be our judge.



  

ANOTHER DISASTER, ANOTHER MISSED OPPORTUNITY

In a previous post i titled ‘One missed opportunity attracts another.’ It was the issue of the carnage in Yobe that happened close to Nigeria's centenary celebration and President Jonathan addressed the Nation at the centenary celebration without using the opportunity to properly address the terrorism issue and give Nigerians the reassurance of good leadership that could bring the dastardly acts into an end. That was a missed opportunity, and it has attracted yet another one.

Monday 14th of April now tagged “black Monday” in Abuja was another stain in our Nationhood. Another disaster struck. The dastardly act happened fast, it happened early and as quick as it happened it spread the wave of sorrows, tears and blood. Emergency response no doubt, but lives already lost in dozens. Within 24 hours latter over a hundred girls were kidnapped from a secondary school in Yola. ‘It never rains, it pours‘.

While Nigerians recounted these harrowing experiences the President continued his political crisscrossing of Nigeria from Kano to Oyo. In Kano it was political campaign, with pomp and pageantry.  Whereas in Abuja Nigerians and non Nigerians alike scampered to assist the wounded in every way they could. some went as far as donating blood. Even non Nigerians did so.

It seemed the President lived in a world of his own. What message does this send to the perpetrators. A father who attends a party while his house suffers the anguish of hoodlums is not likely to be able to fend away the hoodlums for good. Yes president Jonathan is the Father of the Nation, and as a father he has a lot of responsibilities to wake up to.

Even the sleeping confab was jarred from its slumbers as voices resonates of threats to halt the confab in view of the insecurity which had continued to devastate our nation with a reckless abandon. One cannot but ask the question, when would we be able to jolt the President. What is the president’s acceptable casualty figure or rather  when do we get to the tilting point.

in another clime, some pundits would ague that one tilting point of President Obama's campaign last year was the humane response to hurricane Sandy. In spite of the nearness to election, President Obama visited the storm ravaged areas and showed enormous empathy. Even as he continued his campaign the presidential media people continued to show the president's continued concern and monitoring of the events.

This humane act; some would say was politics, earned president Obama a lot of points. At least it made the New York City Mayor Michael Bloomberg endorse the president after the storm hit. Big lesson here. Its not election year in Nigeria, yet the president anxiously continued his political crisscrossing. In Kano the welcome was less than cordial, at least not with the response of the broom wagging fellows who ensures they swept off the feet of the visitor they never welcomed. Lesson learned is that even when we play politics, it should be with humane outlook. That way the people tend to believe you more.

Why can we not get the same kind of Obama response from our politicians or rather when would we get such a response. Its just one missed opportunity and then another. Again the president missed yet another opportunity to straighten things. The violence and dying pattern has now become part of us. Politrics is a non desideratum at this time. Nigerians are dying and we cannot continue to stand aloof. Or how many more needs to die!?

PHOTO SPEAKS: 24 HOURS AFTER "BLACK MONDAY"

CLOSED UATH SPINE UNIT STIRS CONTROVERSY

From daily trust news paper. Published on Tuesday, 22 April 2014 17:58

Written by Judd-Leonard Okafor

Barnabas Ioever, 27, is left helpless after the management of University of Abuja Teaching Hospital, Gwagwalada stopped his scheduled spine surgery and discharged him.

The hospital management has denied discharging him, insisting instead that it referred him for better care, though there is no record of a referral.

Ioever was discharged April 3 after unspecified “discussion” between UATH management and Dr Ahidjo Kawu, consultant orthopaedic and spine surgeon who was managing Ioever, Daily Trust has learnt.

Possible closure of spine programme at UATH had been in the offing but it came to a head when the hospital management instructed “me to discharge a patient who needed surgery urgently,” Dr Kawu tells Daily Trust.

Ioever was admitted in hospital with an injury to his spinal column late February after his company vehicle crashed on a run to deliver soft drinks in Kano.

The second bone in his lower back was fractured, according to an MRI scan he underwent in March.

Its covering as well as nerves at the base of the spinal cord were compressed, including those that normally send and receive messages between the lower limbs and pelvic organs—bladder, rectum and internal genital organs.

UATH chief medical director, Dr Peter Alabi, insisted Ioever “must have been referred.”

“If he was not referred anywhere, we will ask whoever [the] consultant was managing him and find out exactly what must have happened,” he said told Daily Trust in response to questions.

He explained standard practice. “If you know that you cannot effectively manage a patient till the end, don’t delay him or her. It is not abnormal to ask a patient to go to another hospital.”

Ioever wasn’t referred to any other hospital. Since his discharge early April, Ioever “is still at home and seriously in pain,” says his brother and carer Robert Ioever.

“He cannot eat well, because if he should eat, he must defecate, and the process of passing out stool is very, very difficult. He cannot sit up, much less stand up.”

He passes urine through a catheter line inserted into his urethra, just before his surgery was cancelled. Now his family is considering legal action to compel UATH to provide care.

According to Robert, the discharge came first as fault with machinery, then he was told “the CMD has cancelled our operation because they don’t have a doctor that can handle such cases”, and then being told of a standing order that surgeons only carry out spine surgeries “once in two weeks.”

He remembers being confused and his brother tossed from doctors to management until their discharge a week later.

Ioever has become the latest victim of strangled relations at UATH that affected its six-year-old spine surgery programme, which didn’t take off for the first two years after it was created.

Another patient Toyin Ayinla was last to undergo spine surgery before the closure.

His surgery on April 1 was interrupted with threat of stoppage in the wake of decision to implement the closure, sources say.

Ayinla injured his spine in October 2010 after attempting to push a campaign vehicle out of mud using his back.

He underwent management at University of Ilorin Teaching Hospital for over a year but his movement problems remained.

“Even to bathe myself became difficult. But now everything is okay. I bathe myself, I walk, I do everything now,” he told Daily Trust Tuesday morning on his way to a physiotherapy appointment at Unilorin teaching hospital.

The spine unit has garnered media headlines since it went operational four years ago, and sources indicate publicity surrounding it may be reason for its closure and its coming under attack.

“People close to the chief medical director convinced him that the head of the spine unit is trying to position himself to be the new chief medical director,” said Dr Kawu.

UATH was short of instruments required for spine surgeries, forcing a collaboration between the unit and the firm Spine and Scoliosis.

In one collaboration, equipment for cervical surgery, estimated at $236,000—some N50 million—and donated by US-based DePuy Spine Inc to Dr Kawu to operate on indigent patients in Nigeria after he completed a fellowship at the Scoliosis Research Society at the New York Hospital for Joint Diseases were held back by a customs agent in Lagos for nearly a year.

They include 78 implants and 419 instruments donated after a counterpart fee of $500 was paid, Kawu told Customs in a protest letter in July demanding the equipment be released.

On release, the equipment were distributed among six orthopaedic hospitals, including UATH.

Dr Alabi claimed no knowledge of previous use of spine surgery equipment, which was reported widely.

“We didn’t have any link with anybody to bring us any equipment that was seized by Customs. A particular consultant in this hospital was in a deal and I don’t know how he ended up with it,” the chief medical director said.

“It [the seized equipment] does not belong to the hospital. It belongs to whoever had a link with those people. It is not an instrument for the hospital. We were never in the picture. We didn’t have any interface with Customs for any equipment that was imported on our behalf.”

Asked whether referred in particular to Dr Kawu, the hospital’s spine orthopaedic and spine surgeon, he said, “If you want to suggest that, I don’t know.”

The equipment have been used for free surgeries since then. Other payment by patients cover equipment UATH lacks and services such as anaesthesia and theatre use but never the procedures.

They helped knock down cost of a surgery to decompress and stabilise injured spinal bone (as in Ayinla’s case) to around N500,000, compared to N1 to N2.5 million in other hospitals, Dr Kawu estimates.

Ayinla said he paid less than N400,000 to cover equipment for his procedure. Robert has paid more some N470,000 to buy rods and screws for his brother’s surgery, in addition to nearly N100,000 for anaesthesia, orthopaedic implants and theatre at UATH, which the hospital is yet to refund since Barnabas was discharged.

UATH management has since insisted Spine and Scoliosis, which sells implants to patients and supplies instruments, stop its supply, insisting they will acquire their own set.

“What they couldn’t achieve in six years, now they want to in one week. All the patients that required [spine] surgery are being turned back and left to their faith,” said Dr Kawu.

“The bottomline in this saga is ego and greed,” he said.

One source told Daily Trust that among reasons for closing the programme was concern that UATH could lose out on funding if its surgeons continue to use private equipment supplies to cut the cost of surgery on patients.

But Dr Alabi insisted UATH was “not putting any hold on spine surgery.”

“Whatever we doing now, we will continue to do and we can only improve. But we cannot put the lives of patients in danger in [that] what we cannot do and then we go and do it. That is not good practice. We are a teaching hospital and we go for the best.”

Surgery to correct spine deformity in Ummi Salma, 9, currently hospitalized at UATH, is to hold at Nizamiye, which donated its facilities free for seven days.

And Barnabas is still home with his spine injury, waiting and hoping.

Epiphany: Please Take A Look At This Picture

10th April, 2014

Kindly allow me to explain this simple picture.

It looks almost like an ordinary picture nowadays. It perhaps does not strike much in our desensitized minds. Take another look. What do you see?

My brother (late) was once asked by the New York Times to describe his experience as the only consultant treating HIV in a nine-county area of the Mississippi Delta region of America. This was in the early days of the virus when there were few specialists. There was something peculiar he said. Quoting from the New York Times of July 3^rd, 2001; Epidemic Takes Toll on Black Women:

“Dr. Brimah hears from his patients that H.I.V. is often the least of their worries. ”There are issues,” he said, ”of looking after children, trying to get insurance, the lack of a father in the home, alcohol, drugs. They have so much going on.”

I could not understand and relate to how this could be in America; that was until Katrina when the poverty of the Mississippi Delta region was exposed to the world.

Take a look at the picture. What do you see?

The picture shows two boys. Did you notice them? Now look closer at them. One, the one on the left has no shoes. He has no shoes. That little boy is barefoot in the ash of the burned buildings.

I am not sure of the boy on the right, perhaps he is likewise.

Now look at their clothes. They are haggard. In that picture, I see abject poverty. These are not beggars. These are children of Nigeria.

They are walking in the burned debris; looking for something. Perhaps it was their home. Perhaps it was their parents’ house. Perhaps their parents were killed and now they are scouring the burned ashes to see anything they can salvage. Perhaps they are looking for charred objects for memory of their parents lost.

Or perhaps it is not their home, but they are looking all the same for something of value in the debris.

Think about the lives of those boys; think about their hopes. Think about the opportunities they had, the gifts of Nigeria they never partook of or ever hoped to enjoy; and now they have gone from little to none. The homes I have seen in all the burned images, huts, mud buildings with thatched roofs. This has zinc roofs. These houses, are they in Nigeria? I never knew of this poverty. Of the millions in rural areas we have so abandoned.

Look at those boys and imagine what next from here. What did they have before the fire and the death? What will they have after? What did the government do for their area? What did the state government do for that region with the nation’s wealth? What will the government do for them now that all has been lost, perhaps even their parents?

What do we do for them? How do we strive, fight for them to have a better life? Or do we just drive our cars, text on our phones and believe their rights are not our fight, despite God blessing us with knowledge, power, youth, technology and spare time to spend watching Man U and Arsenal European games of men kicking leather balls?

Are we preoccupied with getting cars, perhaps private jets by looting the nation, leaving these boys to such a life?

What did those boys do to merit this treatment with guns and anger from our activities and our generation?

This picture is from Vanguard; I believe from one of the recent episodes of ‘unknown gunmen’ massacres, Zamfara 250 perhaps. The ones in which the culprits never get caught, thanks to our security department being depleted –by the politicians in power—of all resources and not having the modern equipment necessary to counter the crime –the politicians in power arm and create.

This is what our nation is. As though the lack was not enough, the chronic corruption has now caused intractable terror. The politicians have made the youth, the herdsmen, the farmers, wild and now they are killing the poor who gained nothing from Nigeria and partook naught in the plundering of Nigeria. The poor who simply minded their business, who unlike some of us even, did not criticize the government. What is their crime, other than being Nigerians?

In that picture, I see the truth. I see the pain. I see darkness.  I see the crime and the sin. And most painful of all to me, I see my lack of empathy, my cowardice and my ungratefulness and my failure.

We Youth have the power to correct this. We have the numbers to overturn this shame that our nation has become. We have the capacity to easily revolt and stop this madness and fight the wicked.

It is time for our independence from the plundering, wicked Cabal. The over recycled vestiges of colonialism that have remained, dead roots, with no leaves, twigs or fruit to offer, desperately stuck in the corridors of power.

They do not leave, not because they do not want to, but because they are too ashamed to; and in their inner souls they wish to right their wrongs, but they fail to come to terms with the truth that they lack the ability to. They have a sickness, a dangerous sickness.

Form your revolution at your location. Own your revolution. Collaborate. Join the revolution: http://NigerianMassesRevolution.com  We must declare our independence this year. It has been one-year-too-many. A handful of Cabal must no longer hold the millions of us down.

It is the God demanded duty of every nation to provide for its weakest; else God punishes such nations that abandon their most vulnerable with the terror and curse we now experience.

Our great men and women of the past, Mrs. Fumilayo Kuti, Enahoro, were told that it would not work. They were young like us. They were challenged with worse than us. There was no global human rights then, no media, yet they stood up to the colonial masters and demanded freedom, the freedom we got.

Now it is our turn to stand up to the Cabal and demand our second freedom; freedom from their treachery, freedom from their tyranny. All of them must leave the mantle of leadership of this nation.

They have done enough harm. It is time for a new attempt to re-found and re-forge this great land and redirect the course of this great nation and the great nations that make its many parts. Let us declare our second independence this October 1^st.

Nigeria Must Be Free! Nigeria Will Be Free!

#NigerianMassesRevolution  #Our2ndIndependence

Dr. Peregrino Brimah
http://ENDS.ng [Every Nigerian Do Something]
Email: drbrimah@ends.ng Twitter: @EveryNigerian

MUCH ADO ABOUT GDP REBASING

Over the years, successive governments in Nigeria have always bamboozled us with great terminologies such as GDP, per capita and other macroeconomic indices which they have always used as a good scorecard for their stewardship in spite of the terrible spate of misgovernance.

Not minding the obvious abject poverty and hunger, lack of power to do as little as lighting a bulb, the spin doctors of the government still find these economic jargons a justification for their time in office.

The recent pronouncement by the world bank of Nigeria’s economic fortune as judged by the rebased GDP figure has been met with a lot of excitement especially amongst the government quarters; and of course the fact that Nigeria is now the biggest economy in Africa, and number 26th in the world ranking. I have entered into various discussions of the relevance of the recent pronouncement and most people seems to be at best cynical while a few still feels sympathetic to the government.

The cynicism is not unexpected, given the frustration that is rife in our society these days. Is it not enough that the government fail to provide electricity for domestic and business use, also fail to make gasoline available for purchase, yet it becomes inappropriate or sometimes illegal for someone to buy the commodity into Geri cans. It Is as if the government is trying to force us into darkness.  Well that is the subject of another discussion for another day. Now we would try to X-ray what the GDP rebasing is all about and its relevance to our daily life.

According to Investopedia ( financial encyclopedia) GDP is defined as the monetary value of all the finished goods and services produced within a country's borders in a specific time period.  It includes all of private and public consumption, government outlays, investments and exports less imports that occur within a defined territory.

GDP  =   C  + G + I + NX

where:

"C" is equal to all private consumption, or consumer spending, in a nation's economy
"G" is the sum of government spending
"I" is the sum of all the country's businesses spending on capital
"NX" is the nation's total net exports, calculated as total exports minus total imports. (NX = Exports - Imports)

The simple explanation of the above Arithmetic jargon is that GDP sums up all the money exchanging hands in Nigeria due to payment of goods and services. It is expected that as the GDP grows the economy grows and so is the standard of living because another calculation from the GDP is what is called the per capital GDP which is the GDP divided by the population of the country. This however is based on the assumption that the wealth of the country is evenly distributed, but we all know the situation with wealth distribution in Nigeria.

GDP was first developed by Simon Kuznets for a US Congress report in 1934. Kuznets however warned against its use as a measure of welfare.

While the GDP tends to give an impression of growth, it doesn’t clearly tell the whole story. Just looking at the GDP alone tells a part, but other indices are also part of the financial report. The per capital income for instance is a fair idea of the resources available to the citizens because it divides the GDP by the total population of the country. Therefore even though Nigeria has overtaken South Africa in nominal GDP, with a population of 150 million and south Africa with population of 51million one can imagine that the per capital GDP of south Africa is about three times that of Nigeria.

Besides all these the component of the GDP shows that summing up the GPD can definitely not be a good representative of what is happening to the economy. A closer look may reveal a number of things. For instance from the above calculation “G” which represents government spending is a very contentious issue in this country. Year in year out government continue to pass huge budgets without a complementary improvement be it in infrastructure of otherwise.  Adding that figure to GDP is definitely going to be a confounder.

A sector by sector look at the GDP also shows a lot going on or not going on with the economy. For instance,  the manufacturing sector of the economy contributed 6.81 percent to the new GDP data equivalent to N5.47 trillion ($34.8 billion) out of the total 2013 GDP rebased estimate of N80.22 trillion ($510 billion).

In spite of the various strivings by government to boost the manufacturing sector it stills underperforms compared to other countries. World Bank data shows contribution of manufacturing sector to the GDP in Austria is 19 percent, while that of Thailand remains 34 percent. For South Africa, it is 12 percent, while it is 13 percent for Iran.

Crude petroleum and natural gas which comes under the mining and quarrying sector contributed 14.4 percent or N11.55 trillion ($73.56 billion) to the total 2013 rebased GDP. Considering the fact that this sector contributes about 75% of our present earning, it therefore shows untapped potentials due to failure to develop the sector which has largely existed as rent seeking.

In 1962, Kuznets stated “Distinctions must be kept in mind between quantity and quality of growth, between costs and returns, and between the short and long run. Goals for more growth should specify more growth of what and for what“.

It is therefore instructive for the government to wary on the full implication of GDP when indeed the standard of leaving of the general populace cannot be said to have improved.

The same world bank that has given the rebased figure for Nigerian GDP, just last week published a report which showed that Nigeria is one of the poorest countries in the world. While this may seem like double speak,. what it reflects is the reality of what is going on in the country. In spite of the huge spending, the lives of the common Nigerian (now so many) has not being improved. Indeed people seems to be getting poorer.

The reasons for these cannot be far fetched. A country that finds it difficult to pay decent living wage for its civil servants, fails to provide an effective transportation system, fails to provide power to her people, yet goes ahead to increase the price of petrol. We all know where the money goes.

I believe that governance is a social responsibility and the works of the government cannot be measured by how much figures is brandished but how the lives of the people are affected. Other figures that may be of interest are: poverty line in the country, food availability, rate of inflation, infant and maternal mortality. The number of people with access to health care. Number of people with access to electricity or access to portable water. Number of houses per Nigerian, youth unemployment figure. These are figures closer to the people which reflect the true picture of what is going on in the country.

The government needs to embrace these figures and work by it. Nigerians cannot be moved anymore by the cosmetic figures that has little bearing to the lives of the people and usually comes just before some global institutions are trying to lure us into one financial policy or another. The government can no longer pull a wool over our eyes. The reality of the economy must continue to stare at us and evoke necessary response that is capable of delivering us from this quandary. Nigerians are truly in pain.