Dr. Francis Adedayo Faduyile is the National President, Nigeria Medical Association (NMA). He is a public figure with passion for the best international standard of Medical practice and an advocate of good governance. In this media chat with Steve Ovirih, the NMA President expressed his concern about the challenges of the health sector and the plight of Medical Doctors in Nigeria issues
Excerpts:
TP.net – How has it been so far managing the affairs of NMA at the national level?
Dr. Dayo Faduyile : Well, I will say it is more of a mixed feeling. The first one is that I have been able to have exposure on varieties of issues that are beyond the normal doctor/patient relationship; I have been able to be exposed to administration and to see how we can take care of human and material resources as much as possible; I have also been opportune to meet with people in high places , people of substance and people in power in my bid to influence government’s policy on the health sector, in my bid to ensure policy change and improve the chances of Nigerian doctors to improve the health of the nation. However, there is the other side of the coin , which is the challenging part. Well, you have a lot of people who may not see your vision ; you have a whole lot of people who do not care to know your direction or the perspective of your policy thrust and do not care. Some of them, while agreeing that you may have a good agenda or policy thrust will just naturally throw a spanner in the works because your agenda and drive is strange to them. One of the major things we were able to do differently is the ability to change the NMA tactics and narrative from being a reactionary professional body or a combative association to being more of a discusional , more of an advocacy association so that we can have things changed. Of course it has not been easy but I can say that it has been a worthwhile experience and things have gone pretty well in the last 20 months of our handling the affairs of NMA.
TP.net – I was almost about asking of the challenges you have encountered. But you have looped into it. Will that be all about the challenges?
Dr. Dayo Faduyile : Well, you see there are so many challenges that if I start enumerating them we will not be able to exhaust them . But I can tell you, like the Economists would say that, the human wants are unlimited and the means of satisfying them are very scarce. So, there are so many things we plan to do but we do not have enough funding . For example, in our interactions with government agencies , ministries and Departments , there are some specific activities we planned to undertake but we couldn’t because we do not have the funds to execute them. One classical example was our agenda to Meet the state Governors , which we did. We met with them on how to ensure their interest is rekindled as regards the issue of the Primary Health Care Centre which forms the basis and bedrock of the health system of any country. Unfortunately , we have not been able to push that to a logical conclusion but we have been able to meet with them and drive home this very important point. Again, we have other challenges like our mode of interaction which has clearly changed. Our mode of engagement and interaction as a professional body is a total departure from being a combative approach to more of discusional and interactive sessions . I can tell you not many people acknowledge this but by and large we have been able to make the necessary progress even at a faster rate than when we were combative in our approach to making government to listen to us . So , we find out that it is better to pursue our agenda and goals without being needlessly combative . However, it is a lot of challenge to be able to convince people and for them to be convinced, and this is part of what we have undertaken.TP.net- Do you see an end to brain drain in the medical profession?
Dr. Dayo Faduyile: Well, as for brain drain , I will rather say there is no country that can stop her nationals from traveling to go and ply their trade anywhere in the world . The only thing is that what is the quantum ? What is the number of people who are leaving ? So, when we are talking about brain drain , we are talking about a large number and there are so many things that are involved as causes of such development. We have the “push and pull” factors. For the ‘ push ‘ factor we have a lot of things pushing our nationals out of this country which include integrity, good way of life, road, electricity and other things that make life worth living. But importantly , in terms of health, we don’t have enough medical personnel because the govt at both federal and state levels are not employing adequate staff strength and we have very few medical personnel in place and again these very few hands are overwhelmed and frustrated , some of them are not paid appropriately and as when due. Some of them are owed to the tune of between six months salary arrears and one year and again what are the incentives that are available for medical professionals? Some of them don’t have the incentives and the equipment needed for them to be able to perform Optimally are not there. So , these are the things that are pushing medical professionals out of this country. What are the “pulling” factors? They are like the opposite of the “pushing” factors. In those countries they are going , they enjoy economic stability, electricity supply that is standard and no doubt very reliable , security is fairly okay and again they respect and know the worth of these medical professionals whenever they get them into their services they know our medical professionals excel with little or no supervision. They pay them well, they give them loan , they give them all the wherewithal that will make them settle very quickly in their new country. So, until the government comes out forcefully to declare a state of emergency in the health sector and make a categorical change on how to encourage medical professionals in the field, I am afraid we are yet to see an end to brain drain . In fact , the rate it is going now is getting worse . If you see any young doctor or any young health professional, eighty percent of them are already looking beyond the shores of this country to go and ply their trade . Government needs to put things in place and change from the approach that obtains now which doesn’t seem to be working.
TP.net – You mentioned insecurity as one of the reason medics are fleeing the country. What is your take generally on insecurity in Nigeria because few weeks back, an NMA member, Prof Jerome Boluwaji Elusiyan, CMAC OAUTHC, Ile Ife was killed by unknown gunmen along Iruekpen/Ekpoma road. Do you think the nation is doing enough about security?
Dr. Dayo Faduyile: You see , it is when everybody feels secure that we can all sleep with both eyes closed. Government has largely failed in terms of security because we hear of a lot of assassinations , a lot killings , a lot of needless and avoidable deaths of people in this country and the culprits are not always brought to book, in fact they are not even found. A major deterrent for anybody who wants to work against the norms and the law is the ability of the long arm of the law to catch them and within the ambits of the law and powers of government deal decisively with them. If they know they will be caught , the chances of them breaking the law will be reduced to the barest minimum but in Nigeria , it looks as if everything goes . So we need government to be more proactive in ensuring lives of citizens are secure and protected . It is only when the security apparatus of the country is rejigged and efforts are made to bring in these killers to face justice that people will feel secure in this country. Government should make obvious concerted effort to stop forthwith wanton killing of citizens either doctors or any other member of the civil populace. But for doctors especially because of our duty where we work 24 hours a day. When there is a medical emergency you have to go and call the doctors who eventually have to move in the middle of the night ; doctors will have to transfer back and forth in order to treat patients , especially the specialists , they are more prone to being attacked and again there is this erroneous belief that Doctors are rich and this is really unfortunate! If you see anyone and they say he is a doctor, it is imediately assumed that he is very, very rich. Unfortunately, that is not a true reflection of things. So, these are the thinking that make the miscreants to look towards the direction of medical professionals . But I must say this that until government ( both federal and state) decide to take security issue headlong, it may be very difficult to create in the mind of the people the impression that we are safe in this country. So security issue is very germane and it is one of the reasons so many people are leaving the shores of this country. Prof Jerome Elusiyan was killed and that is just sad and unfortunate. If it was me or any other medical expert that had gone for that external supervision beat , you know it is possible it could be me . That is equally how the miscreants, robbers and bandits could have struck too. A lot of things need to be put in check in this country. The highways are not safe and when the highways people ply everyday are not safe , it portends danger , huge dose of danger for all of us. So government needs to proffer urgent solution to the security challenges of this country.
TP.net – Budget for health in the 2020 Appropriation Bill , do you think it’s enough to cater for the health sector?
Dr. Dayo Faduyile: Budget for health? Certainly it is not! The Nigerian government ( federal and state) are not interested in health. They say where your interest is , your heart is. The government of Nigeria , meeting with other African Heads of State in 2011 in Abuja agreed that for effective and fairly efficient health system , every member states should be able to budget at least 15 % of their annual budget for health and I can tell you , Nigerian government since 2011 till date , that is about 19 years now, has never gone beyond five percent except for one year. Every other year has seen the FG budget paltry and meager 5% for the entire health sector. This 2020 budget is even less than 5%, so , I can’t see what the government is doing to show that it is interested so much in the health sector. Look, we have told them severally , I mean NMA, that we need to declare a state of emergency in the health sector. The primary healthcare , the bedrock of the health of any nation is almost in comatose here. The government has shied away from enhancing a viable and virile primary health care system in the country. But when they want to declare emergency in Agriculture, they have Bank of Agric; when they want to declare emergency in the nation’s industry, they have Bank of Industry, okay. We told them, declare emergency in the health sector and give us Bank of Health so that we can have these private practitioners go and obtain single digits loan , pay over sometime and they will be able to establish. Most of these countries we are going for medical tourism, the medical tourists are going to their well equipped , standard and professional private hospitals. But the government here has no plans to fortify health and to strengthen the health sector. We have told them that we need to consolidate the National Health Insurance Scheme (NHIS). The government is simply showing lip service to the scheme. What stops our states now that they are putting up their own state health insurance schemes, but their focus is on the political side of such scheme . we really need to sit down and sincerely ask ourselves: are we ready to take care of our health ? You know we always say “health is wealth”. So you can see why Nigeria is not wealthy? Of course, we have failed to take care of our health! If you go to America , their major focal point of election campaign is the health issue. If you go to UK, their election campaign thrust is National Health Scheme (NHS). That is what we are saying! Nigerian Health has no place, has no role in government policy thrust and that is our agitation as NMA, as Nigerians who are conscious of the need for the wellbeing of our father land. The health of the nation is Paramount , unfortunately , we have no government that shows interest in how to ensure a robust health sector. Go and look at our primary Health care centers , they are in shambles . Government is not interested and the people are simply docile about it. We all need to wake up to these realities so that we can put government to task on the need to show more commitment to the health of the nation.
TP.net – Doc, can we say The Ministers of Health have not made their impact as medical professionals felt in influencing government policy thrust on health matters?
Dr. Dayo Faduyile: You have stated something that is very correct; the ministers of health are medical professionals. However , there is this popular saying that a tree does not make a forest. Even if they are doctors, it may be difficult for them to make the required changes if their principals do not buy their idea, opinion or perspective. They may have pushed and they may not get desired support for their apparent push to materialise and yield result favourable enough for the health sector. The fact however remains some of their superior in government may not be interested in their ideas but we all have to keep pushing in that direction . I think we need people who can walk with the whole health team , the whole cabinet and make those changes. That is why we really need regular interaction between the key policy makers in the health sector and Federal Government. To have a good health system, we need financing , funding , we need to interact with people in the environment because if the environment is dirty , you will not get good health ; we need to talk about water ; if the water is bad there won’t be good health ; agriculture, feeding , malnutrition, all these things are mutually interrelated . So , we need a health professional who can interrelate will all these different segments in order to have a viable and working health sector .
TP.net- When Ebola virus almost became endemic in Nigeria, it took the effort of Late Dr. Adadevoh to nip it in the bud. What has NMA done to keep her memory alive?
Dr. Dayo Faduyile : Dr Adadevoh of blessed memory was an angel in the medical profession specially detailed to Nigeria by Providence to help halt the spread of Ebola virus in the country at that time because when Diplomat Sawyer came to Nigeria the Doctors in government health facilities were on strike. So , you can imagine if there was no strike, the number of contacts the victim would have met in a public health facility would have been on the high side and that is how the virus spreads. We don’t have to mention the fact that the country is not prepared for such medical emergency; we have highlighted our challenges earlier in the course of this media chat. So, the NMA has had series of lectures in her honor . The NMA has recognised her at the annual national delegates meeting and every year we celebrate her and her high sense of professional commitment to the wellbeing of Nigeria. She actually physically restrained Mr. Sawyer and if not for her , Nigeria would not have come out of the Ebola crisis easily. She paid the supreme price in order to protect Nigerians from the Ebola scourge . Nigeria Medical Association is always proud of her and we will continue to celebrate her.
TP. net- Away from health matters Dr. Faduyile. How will you assess government input and impact in your senatorial district, the Ondo south senatorial district?
Dr. Dayo Faduyile: See, if we are talking about my senatorial district : Ondo south senatorial district, I think largely we have been unlucky. We have had successive government that have not shown adequate concern about the plight of our people in the southern senatorial district of Ondo state. We have been left to our fate as many of our roads are bad. We have not enjoyed any improvement in our health sector in the south and the main industries in our area are in comatose: OOPC is not there, Oluwa Glass has gone into Oblivion , NIROWI is not there and there is no concerted effort by successive govts to ensure these industries are revived . Our economy has been down now in the southern senatorial district for eight years running because for eight years now we had not had electricity , yet local economy runs on electricity ; most of our artisans whose trade require electricity have been forced out of business and can no longer function effectively. The normal requisite of electricity from the national grid had been cut off so it’s like in Ondo South we are cut off from civilisation and it is telling on our local economy. It is painful because it looks like government has completely forgotten us in the district. Even in Agriculture, we are supposed to be moving towards mechanised agriculture but reverse is the case. There is nothing on ground! So, we are earnestly praying that God should touch concerned agent of government to remember us in the southern senatorial district as regards the eight years old “light out” in the district.
TP.net – I have seen your bill board indicating your desire to run in the forthcoming Ondo Guber race . Are you actually running for governorship?
Dr. Dayo Faduyile : Steve, you journalists amuse me. You said you have seen my bill board , yet you want to know if I am running? It presupposed that it was a well thought out decision before the bill boards came out. If what you want is a polar response, then yes I am running for the governorship race in Ondo state. I think our people desire change ; we want a change for the better in Ondo state, we want a better deal , a better social contract with the good people of the sunshine state and we need to get the kind of change we want.
TP.net – It’s a pleasure engaging you this long Dr. Faduyile. I wish you success in your endeavors in the new year.
Dr Dayo Faduyile : Thank you too Steve. The pleasure is mine. Wish you and your media team the best too in the new year.
