‘Nige­ria needs a Bank of Health’

Daily Trust - - HEALTH - From Us­man A. Bello, Benin

Prof. Michael Ibadin is the for­mer Chief Med­i­cal Di­rec­tor, Uni­ver­sity of Benin Teach­ing Hos­pi­tal (UBTH). In this in­ter­view, the Pro­fes­sor of Pe­di­atrics spoke on the need to struc­ture the coun­try’s health sys­tem to at­tract in­vestors, the need for Bank of Health like Bank of In­dus­try, and how to tackle med­i­cal tourism, among oth­ers. peo­ple es­pe­cially politi­cians with cer­tain ail­ments be­lieve that their con­fi­den­tial­ity would be bet­ter main­tained abroad. And be­cause of the de­sire for any­thing for­eign, a lot of peo­ple would rather go abroad for treat­ment even when we have all the fa­cil­i­ties to take care of their ail­ments here.

But we can re­duce the num­ber of per­sons trav­el­ling abroad for friv­o­lous med­i­cal at­ten­tion, by know­ing what can be treated here. To do this, we have to cre­ate a Cen­tral Clear­ing Body un­der the Min­istry of Health so that any­body go­ing abroad for treat­ment must have some forms of cer­ti­fi­ca­tion from the body no mat­ter the ur­gency. For in­stance, if any one ap­plied to go for treat­ment abroad, such per­sons should be screened to know whether such con­di­tions can be treated here and if it can be han­dled, the body would call such hos­pi­tal and send the pa­tient there.

And if the per­son in­sists, he or she has to bear the cost through tax.

There must be a par­a­digm shift in the way we look at health. Now, we look at health as so­cial ser­vice and that would not at­tract in­vestors be­cause no one wants to put fund in so­cial fund­ing where the re­turn is mar­ginal.

Gov­ern­ment should repli­cate what it did in agri­cul­ture that makes it at­trac­tive to in­vestors to health sec­tor. We can make it a pol­icy not to reg­is­ter one­man clin­ics or hospi­tals but a min­i­mum of four or five peo­ple

Brain drain is one of the rea­sons for short­age of man power in hospi­tals, how can the prob­lem be ad­dressed?

Brain drain is not par­tic­u­lar to doc­tors. As long as there is huge dif­fer­ence be­tween earn­ing in Nige­ria and abroad, peo­ple will move for greener pas­ture. What is re­ally re­spon­si­ble is the con­di­tion of ser­vice, if the con­di­tion of ser­vice here is com­pa­ra­ble to what ob­tains there, peo­ple would stay. There is huge dif­fer­ence in terms of work­ing en­vi­ron­ment, wel­fare pack­age, fa­cil­i­ties to work with and re­mu­ner­a­tion. If a doc­tor is earn­ing N500, 000, it is equiv­a­lent to £1,000 and £1,000 is earned by or­di­nary heath work­ers in Europe.

What tourism? en­cour­ages med­i­cal

One of the fac­tors that en­cour­age med­i­cal tourism is lack of fa­cil­i­ties for di­ag­no­sis com­pared to what we have abroad. There are some ail­ments that can­not be di­ag­nosed here, not be­cause the med­i­cal per­son­nel are not here but be­cause the equip­ment to do it is not here. So, they pre­fer to go there.

Also, the equip­ment there are more ro­bust and would likely give pre­cise re­sults than the ones here. Again, there are spe­cific treat­ments that may not be read­ily avail­able here.

Another rea­son is that whether the treat­ment is avail­able here, of dif­fer­ent specialties who pull re­sources to­gether to float a full hos­pi­tal, then, gov­ern­ment can now come in by way of giv­ing soft loans.

If we have to achieve bet­ter health­care de­liv­ery, the same way we have Bank of In­dus­try and Agri­cul­ture, we should also have a Bank for Health where those who es­tab­lish hos­pi­tal can go and ob­tain loans at four per­cent in­ter­est to equip the hos­pi­tal.

There is an al­le­ga­tion that pa­tients at UBTH are re­ferred to pri­vate lab­o­ra­to­ries for tests by doc­tors. What is your re­ac­tion to this?

We have a very ro­bust lab­o­ra­tory and ver­sa­tile equip­ment, but you can't rule out hu­man fac­tors be­cause the way we have pro­lif­er­a­tion of clin­ics, we also have pro­lif­er­a­tion of lab­o­ra­to­ries by the some peo­ple who are work­ing for gov­ern­ment.

If he is on duty at night and he knows that no­body is watch­ing him while his lab­o­ra­tory is nearby, he can tell the pa­tient that the test is not avail­able in the hos­pi­tal and di­rect pa­tients to his lab­o­ra­tory.

Abroad, an av­er­age white man is hon­est but the re­vise is the case here, it is not as if you don't have fraud­u­lent peo­ple there but they are in mi­nor­ity but here dis­hon­est peo­ple are the ma­jor­ity. So, when you give them the chal­lenge, they are likely to di­vert pa­tients away from the hos­pi­tal.

I can as­sure you that any test that can't be done in UBTH can­not also be done in any pri­vate clinic or lab­o­ra­tory, be­cause our equip­ment are quite ex­pen­sive which they can't af­ford.

Di­a­betic, hyper­ten­sion, stroke, eye prob­lems are on the rise in Nige­ria. What is re­spon­si­ble for this?

First, the way we live now is com­pletely dif­fer­ent from what it used to be. Those days we were closer to na­ture by eat­ing nat­u­ral food but now we eat junk and fast food with preser­va­tives.

So it is life style and feed­ing habit. In the past peo­ple would trek to the farm and back home but to­day no­body wants to do ex­er­cise.

A lot of pro­cessed foods are now avail­able and chem­i­cal sub­stances are used to ripen even agri­cul­tural prod­ucts like man­gos, ba­nana, or­anges and oth­ers fruits, Even palm oil, they add ad­dic­tive that makes it red. They are not nat­u­ral and not good for the body. If we want to ad­dress this we have to go back to na­ture and do away with seden­tary life style.

How would you de­scribe your ten­ure which ended some weeks ago?

My ten­ure was very event­ful be­cause we have com­mis­sioned many struc­tures like fire ser­vice sta­tion and built child emer­gency room, child heath ad­min­is­tra­tive build­ing, men­tal health ward and ad­min­is­tra­tive build­ing, fam­ily health build­ing, dig­i­tal emer­gency build­ing, and NHIS build­ing to men­tion a few. We built some of these struc­tures from rev­enue gen­er­ated from within the hos­pi­tal.

It is the re­ces­sion that crip­pled the fi­nances of the hos­pi­tal. Our cap­i­tal al­lo­ca­tion has not been very good, the high­est that we ever got was N355 mil­lion but ev­ery­thing was not re­leased that year. Bud­get per­for­mance in terms of cap­i­tal has ranged be­tween 40 and 60 per­cent, but we have been able to cope be­cause these struc­tures were tied to clin­i­cal area.

Prof. Michael Ibadin

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