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After the damage of Boko Haram: Battling with the battered health sector in Borno state using the partnership model for emergencies

Published

1 year ago

November 17, 2023

Special features

After the damage of Boko Haram: Battling with the battered health sector in Borno state using the partnership model for emergencies

By: Bodunrin Kayode

Reporting the health sector within the web of humanitarian crisis in Northern Nigeria is my hobby. Health is one of the beats I have chosen to ensure that I contribute to further the cause of humanity before I say good bye to this world and to enhance excellence my calling journalism. Reporting health up here means one must have enough empathy for the people who are at the mercy of the terrorized health sector in Borno state and North Eastern Nigeria. This sector is so important to humanity that each time the insurgents want to plunder primary health centres, they cart away the drugs and skilled workers before bringing down the structure by fire. That is an indicator that even the wrong doers in the bush know the value of health in our shared humanity.

Prying into the Borno Health Partners Forum

I do not attend the Borno health partnership forum to report on everything that is happening but to contribute my quota to the best of my ability to belp rebuild the sector which has been battered by lingering years of insurgency. By this I mean about 14 years of insurgency where almost every infrastructure was destroyed by the insurgent Boko Haram in their trail.
And that I have been doing to the best of my ability especially the guidance of the meeting as a catalyst in the “risk communications pillar.” The subsector where massive enlightenment is given to the people whenever emergencies like sickening cholera out breaks chokes the medical practitioners or the recent diphtheria which has killed over 67 people in its trail. Sadly the ” risk communication” is one of the most badly managed pillar because the bank rolling world partners refuse to allow the Borno State Government to lead as it should. Deciding which path to walk at any given time and even choosing where to go with the permission of the health Commissioner who is equally guided by the Governor of the state Professor Babagana Zulum. Representatives of the two world health bodies have rather decided to turn themselves into a cabal or a caucus who meet separately and impose their decisions on the rest of the partners regardless of the interest of the Commissioner who is represented by the incident manager (IM) at any given time. That itself has created a shaky foundation for that pillar and the mounting of lingering lacuna which strips them bare whenever their own managers are in need of action or solutions in certain ways.

Out of interest, I have seen many non medicals like myself in the house and they all do their best to help out in one way or the other to make things work out. The only pillar which has not existed in the last seven years is that of “security” which will go a long way to act as a liaison between the military, police and the health sector. But I have a belief that with the evolution of the sector over the coming years, we would soon have a sitting security personnel who would be an instant reference point whenever challenges of that nature falls on the table of the IM.

One also realizes that it’s time to begin to analyze on a yearly basis some of the developments in the sector so that the world gets to know those that are behind the heavy toil for the sector to be moved from where it was when boko haram struck capturing 22 council areas in the entire state to the envisaged level of excellence we are trying to take it to. And there are many non medical professionals with like minds whose contributions to crushing emergency challenges over the years have been invaluable to astounding emergencies like cholera which has harassed health managers and kept them on their toes. Looking back into the sector, I remember that there was one year of the cholera scourge that everyone who was a doctor in the ministry had to abandon their files, put on their coats and gloves and were lined up at the muna garage axis ensuring that they helped slow down the mortality rate which was screaming to high heavens. That is an indication that the medical workers both serving and retired have also managed to stay above board at the primary health care level.

Pending challenges to be crushed in Borno state

There are many pending challenges before the health partners working as a team to make things better for Borno state. One of the challenges before them is the inability sometimes to understand the fact that change is the only permanent phenomenon in life and we must all prepare to embrace it. A lot of partners still do not understand why change from the old order of doing things to the new is important. Some so called financial partners want to completely adjust the ideal narrative by wrongly taking the drivers seat in almost every pillar including risk communication and sometimes, the good old surveillance. Two sensitive pillars which are supposed to go together. 90 percent of the time I have sat in that meeting, Abdu Mbaya or Modu Kyari who is the deputy head of the communications pillar in the primary health board are hardly carried along. One little brat or the other in the United Nations international children’s fund (UNICEF) and world health organization (WHO) will stand up to speak for the entire Borno State which they know nothing about. And most times when they speak, they do not impress the IM or the meeting because they talk only about what they understand in their own foreign designed system. They hardly display knowledge on how to solve problems in the 27 Council areas of the state. One particular one, name withheld in the WHO who used to be a tea boy for a previous disgraced communication expert is the most confused of them all because of his obvious limitations of what to do for the good of the state. He parades himself with some air of importance that does not align with his rascally and rude persona badly polluted with the trial and error syndrome associated with road side mechanics.

I don’t blame them completely. Its simply because the state has been unable to sit on the drivers seat all these years in some of these pillars before the advent of Dr Lawi Meshelia. Some of us who should know are equally to blame too because we saw these dysfunctional nitwits play with the intelligence of the state and we did not raise alarms to the Commissioner or the Governor of the State, Professor Babagana Zulum knowing in his disposition towards mediocrity regardless of who is involved. It is change in the old order that will bring about what will benefit the state when it comes to enlightening people on how to get the best out of the web of complex information needed to make the operations at the primary health care get better for instance.

The management of emergencies at the primary care level have seen many administrators on and off the forum of partners and each one, foreign or Nigerian did his or her best to better the system. But that does not mean that they do not have their limitations. One is talking about constraints ranging from management style to low capacity based on background training and sometimes downright timidity in stamping their feet to getting certain things right based on contemporary practices. And that is the reason why some partners used to jump into the drivers seat without permission from the State which is supposed to be the driver for everything as it concerns the building of the health sector and crushing emergencies like the on and off Polio, monkey pox, COVID-19 or Diphtheria as it is announced by the state epidemiologists from time to time.

The numerous interventions of emergency manager Beatrice Muraguri

Most of the partners have done their best. It’s not just bad news all the way because most critics of journalists believe they only do bad news without seeing the good sides of anything. I wish to report to you that we have seen quite a good number of good managers in the system. I can never forget the frantic efforts of Dr Collins Ovilli who jumped into the trenches with other doctors like Mohammed Guluze then emergency manager to ensure that the cholera mortality figures do not scream more than it was then. To us poisoned by insurgency in our backyard 50 dead is noise but 100 is really a screaming figure.
At present, Dr Beatrice Muraguri is one of the good souls of the WHO and has been making her presence felt in all the three states badly influenced by the lingering insurgency. Sometimes I have sat in that meeting hall in Damboa road, watching and listening to all her contributions and they are always for the common good of humanity. Sometimes she used to ponder and literally pressing the state to hurry up and sit tight on the drivers seat to crush these emergency headaches. To her as a clinical epidemiologist nothing is impossible if minds and hearts are brought together. Diphtheria for instance has reached 67 deaths as at the time of writing this report, do we want to wait until it gets to 100 before we deal with the challenges bedeviling the management of the disease? In as much as people are not perfect, Dr Beatrice is one woman who means well for Borno state. I have watched her from my binocular and I have seen her as an extremely transparent professional who has water tight empathy for the people of the entire BAY states. She is a distinguished African woman who understands how to serve humanity using the template of the state or council areas accordingly. She is not one of those whose bosses had questionable records before being asked to leave the WHO because of dubious activities aided by a commissioner name withheld sacked suddenly from the government. We have seen a theatre Commander here who shut down the activities of three non Governmental activities NGO’S when they ran foul of the laws of the land, “so none of them will tell us they are better than the people they met on ground” said General Adeniyi the then TC.

Co management of the sector with WHO

In spite of all these challenges for instance, since the advent of Dr Lawi Meshelia, a lot of things have changed for the better. Some of them were procedures which had to change even though with difficulty. Lawi drives the system like a task master and some of the partners used to the old system do not likne him for doing the right thing. But Lawi a foreign trained public health specialist like Beatrice is getting tremendous results. Even though I could read from his body language sometimes that he is not happy with the trickles of results he has been having in areas like the risk communication and surveillance pillars which have terribly shaky foundations going by what we see from the cholera and now diphtheria torments of the people. Since Lawi arrived as the incident manager, he has succeeded in gradually changing the old ways of doing a lot of things. Obviously this foreign trained public health specialist understands that emergencies in a system where most of the infrastructure has been destroyed by insurgency you virtually have to be regimented to get results. That means he must step on some toes if he must get results. Emergency is not the “na so we de do am” kind of phenomenon in which obvious mistakes are tolerated as the norm. It must be a near perfect phenomenon and that is what the distinguished university of Maiduguri (unimaid) trained Dr Lawi is tying to achieve. Before his advent, the ministry officials allowed pillar heads to just do what they wanted without proper capacity to back the system. Then came Shafiq Muhammad a Pakistani who for the first time between 2017 and 2018 tried to fix a suitable template in which the emergency system could work without forming themselves into a parallel ministry of health that would be dabbling into non emergencies. That system has stood the test of time till this day because it was a transparent system. But like a disease it relapsed into the old system with the exit of Dr Shafiq because the very foundation was not properly fixed in such a way that pillar heads who are ministry officials will own the system and drive the steering and change gears at their convenience. It was literally in disarray because nobody had dug the right hole for the pillars to be firmly rooted. Safiq learnt very fast from Martinez Jorge and drove the system from 2017 to 2018.By the time Jorge left Safiq was running at a speed faster than he met on the ground but there was a lot to be defined properly. When safiq left, we have had several other managers including Dr Kida who had to act as IM even at retirement. His style was actually different because he tolerated most of the excesses of the partners. Always smiling and not wanting to step on toes. With the advent of Dr Lawi, pillar heads and deputies meet regularly with him to state what they have achieved and he freely directs if he thinks they are driving down the wrong way. This kind of proactive professional on the drivers seat has come at a time when he is most needed. He is trusted by his permanent secretary Mohammad Guluze and Commissioner Professor Baba Mallam Gana a consultant Oncologist. Lawi has an almost regimented managerial style which most of them had not gotten used to. But one believes that as time goes on, they will surely get used to his style and we would wake up one day to discover that all the emergencies are gone with the dry wind of the sahel savanna.

Ex Raying the background of the current IM Lawi Meshelia

Dr Lawi Meshelia is one of those medical practitioners who benefitted from the extension of service years by five years by Governor Babagana Zulum which is why he is still in service. He was equally the arrow head in charge of the primary health care agency when Borno won the best primary health care agency prize money of $1.2m attached to a competition created to bring primary health care under one roof in Nigeria.
He holds a Masters Degree in Public Health (MPH) from Royal Tropical Institute, KIT in Amsterdam, Netherlands. And of course an MBBS from the University of Maiduguri. His exposure and broad mindedness to tolerate people stems from the fact that he did his secondary school at the Federal Government College Odogbolu in Ogun State and has traveled to almost all the states of the Federation. Dr Mshelia has attended courses with certificates in different aspects of public health in countries in Europe, East Africa, West Africa and South-Central Africa. He also attended numerous public health courses across Nigeria to stream line his focus. He has actually brought a semblance of stability and order since he took charge as IM.

Battling the second challenge which is the red tapes in the Ministerial system

I had to mention Lawi’s background so partners understand why he is so suited for the job and if care is not taken you may call him a slave driver because you must do things the right way he wants you to do it. If at the end of the day the results is tremendous, he hardly takes the glory but transfers it like a dutiful civil servant to his superiors in the ministry where he had worked all his days as a medical doctor. Ever ready for emergencies and working towards solving any red take that will stand in his way as long as it is not finance which he does not have power over. By the way, it is this finance that used to make some ngos misbehave and tend to want to take the steering wheel from state health managers.

Handling the first visit of the commissioner and his desires to win the next prize for the best primary health in Nigeria

When the Commissioner of Health paid his first visit to the emergency operation centre EOC recently, it was excitement galore all the way. He obviously never anticipated that so many partners will be lined up one by one introducing themselves and taking it upon themselves to uplift the health sector of Borno State which has been badly battered by insurgency. He came across as a very lively and friendly medical practitioner shaking hands with partners and thanking them for a job well done.
Professor Baba Gana commended the partners for being very supportive in their contributions to moving the sector from where they found it to where it should be. He assured that the molecular laboratory in Umaru Shehu Hospital will soon become a reference lab for the future of the sector especially in dealing with emerging emergencies. That to him will relax the delay in going to competent labs outside the state to get results of suspected cases as at when due. On vaccinations the British trained oncologist said that left to him, the country should begin to develop its own local capacity to produce vaccination which will go a long way in trampling upon stubborn emergencies like Diphtheria, Cholera and measles so that they do not linger longer than expected. How soon that will happen? Only time will tell.

After the damage of Boko Haram: Battling with the battered health sector in Borno state using the partnership model for emergencies

Related Topics:After the damage of Boko Haram Battling with the battered health sector

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Feature

My vision is to engage Nigerian youths in sports to promote national pride on the global stage and grassroots developments without political infiltrations, says Senator Obinna Ogba

Published

4 weeks ago

November 25, 2024

Ochuwa Ibrahim

My vision is to engage Nigerian youths in sports to promote national pride on the global stage and grassroots developments without political infiltrations, says Senator Obinna Ogba

On moving Nigerian sports forward in Nigeria highlight a task that is long overdue. For any renewal move to be achieved, drastic steps and deliberate actions need to be upheld. A former senator representing Ebonyi Central Senatorial District in the 8th and 9th Assemblies, Senator Obinna Joseph Ogba, who is also a sports administrator, hails from Amanvu-
Nkalagu Community in Ishielu Local Government Area of Ebonyi State. Senator Obinna bares his mind on ways Nigerian sports can take its place in the community of sports nations.

Excerpt:

We heard of your move from PDP to APC. What informed your decision and belief in this government?

A political party is like a vehicle that can convey you to a destination, and when you get there, it becomes about Nigeria. I never liked APC as a party before, but Senator Oluremi Tinubu talked me through it while we were at the Senate together. She was then the chairman of my committee. It was then I began to yield to APC agendas.
The party I belonged to also disenfranchised me from the Ebonyi State governorship ticket. Myself and others, like my mentor in Ebonyi State, Sen. Anyim Pius Anyim, decided to support APC before the election. It’s therefore wrong for people to assume I just joined APC after the 2023 election. So far, so good. We have been doing well and making efforts to contribute our own quotas, hoping that one day our names can come out at the national level.

Can you mention some of your scorecards during your terms in the 8th and 9th Assemblies?

I don’t like blowing my own trumpet but prefer people to talk about my achievements. However, let me mention them. No senator from Ebonyi State has done what I did since the state’s creation in 1996. I built a stadium while I was the Chairman of the Senate Committee on Youths and Sports for eight years. I assisted in facilitating over 480 Ebonyians into the federal civil service, and all of them are growing in the system. It gives me joy to see those Ebonyians. We attracted developments like road constructions and bridges. I included my community projects in the Nigerian budget, which was unprecedented in the history of Ebonyi State. That is why, on the floor of the Senate, I thank those who introduced constituency projects because, without such initiatives, people like us might not get anything as community gains from the federal government. A cassava processing plant is also part of what my representation brought to my community to date. My first senatorial bill was on the University of Sports, the first in West Africa, which has today been signed into law. Again, to show you that President Tinubu is doing well in recognizing the importance of youths, he has approved the university, which would soon be commissioned, and a vice-chancellor will be appointed. The National Sports Commission has been an illegal entity, and if the President didn’t like it, it could be scrapped. But I had to push a bill for the National Sports Commission, which former President Buhari assented to. That was my bill. Presently, Mr. President has also started implementing the law. Very soon, he will appoint a Director General to run the day-to-day operations of the Commission. When you look at the Commission for Physically Challenged Bill too, I was a partner to it. The National Lottery Bill was also my bill, though former President Buhari refused to assent to it, but the National Assembly vetoed it. That is one of the two bills in Nigeria that has been vetoed. The NDDC Bill during Obasanjo’s era was refused, and this National Lottery Bill was also refused by Buhari, and both were vetoed by the Assembly. I have a lot to tell. The South-East Development Commission (SEDC) Bill was also initiated by me. Now that President Tinubu has consented, myself, Senator Stella Odua, and Anyanwu were the first to sponsor the bill. Buhari assented to the North-East Development Commission (NEDC) but refused the SEDC Bill then. Thank God the present Deputy Speaker has now represented and sponsored the bill, which was assented to by Mr. President. The South-East would forever be grateful for that.

If Mr. President offers you the position of Director General of the Sports Commission today, what would you do differently?

Well, since I know everything about the bill, I have been in sports management all my life. I was a Commissioner for Youths and Sports in Ebonyi State, Senior Assistant to the former Ebonyi State Governor on Youths and Sports, First-Vice President of the Nigerian Football Association (NFA), a retired referee, coach, and former member of the Confederation of African Football (CAF). My credentials in sports speak for me to develop Nigerian youths and sports, to uplift Mr. President’s government in the areas of youths and the Renewed Hope Agendas because you need a system that can relate the agendas to the grassroots. One sure way is through sports. I mean wholesome sports. Be mindful that football is not the only sport we can push to the forefront; there are many other arms of sports too. The era of Nigerians going for international sports competitions without bringing home medals would be a thing of the past. We would ensure sports activities are developed without political infiltrations. I will use my experience to convince Mr. President of the need to develop sports to make his Renewed Hope Agendas proud.

I will develop athletes’ training policies to get them adequately prepared for any competition whatsoever. Releasing money within two to three weeks before a competition would not yield any results; such funds would be a waste. The Olympics is a four-year interval event, and we would no longer wait for athletes to roam the streets without adequate care.

I am aware Mr. President has released ₦12 billion to the Sports Commission, and such funds can be used to care for these talented athletes and not just be spent on a fire-brigade approach for winning Olympic medals with only weeks of preparation—it would never happen. Such funds need to be put to use between now and the next Olympics, while releasing a few billion naira around the tournament period would suffice to achieve commendable results.

My governor just established a football club and appointed me as the chairman of the club. As I am here, I think and talk sports. If given the opportunity, I will do well. In fact, in talking about sports in Nigeria, there is no way my name would not be mentioned. I have a lot to offer. Even most sports ministers usually consult us when they are appointed. You know, after your advice, when money comes, they won’t call you again or even follow the advice offered, and that’s why they always fail.

When people without a track record in sports are appointed, someone like the man from Plateau State who had no knowledge about sports and didn’t belong to the sports community, he was unable to do anything. When you don’t belong to the sports community, you find it difficult to do well and may become frustrated.

In sports, we can also partner with private organizations to raise funds to support sports, making accountable use of the resources garnered to support Mr. President’s Renewed Hope Agendas. I believe in the power of sports as a uniting force for the country.

If given the privilege, I can also establish a National Sports Fund for sustainable funding because most sports funds come from the government alone, and it shouldn’t be so. I will also facilitate sports commission workforce welfare, including coaches and staff. These are the administrators, and adequate training is expected to be given to them for efficiency.

My vision is to engage Nigerian youths to promote national pride on the global stage. I am confident that with the right approach, Nigerian sports can be taken to international levels sustainably.

What do you admire most, and what are your suggestions to Mr. President for almost two years of his administration?

It was his effort to give national honors to athletes who could not win the CAF tournaments but became second with silver medals. No President has ever done that. The President and General Secretary of the NFA were also given national honors. In 1980, when Nigeria first won gold, they were not given national honors. Up to 10 times now, it’s happening for the first time.

Though people say things are very hard and go demonstrating, as an Igbo man, we don’t believe in that. We support President Tinubu’s government. By the time he finishes his second term in office, everything will be normalized.

Why do you think South-Eastern States supported Mr. President?

Our people don’t lie; we focus on what we believe in. Imo and Ebonyi States are APC states. We also believe that by 2027, APC will capture more. Mr. President has been doing well. See the Southeast Development Commission (SEDC) he assented to and approved. Mr. President’s wife visiting our state and we are there to warmly welcome her. We don’t hide our support for him.

How do you think Nigeria can perform well in international competition?

Simply by early preparation. Participants must be fully engaged and exposed to international friendlies to sharpen their talents. We should also learn how to play boardroom politics—that is, not allowing all these Francophone country referees to officiate in our matches against other Francophone nations due to biased officiating. Neutral officials, perhaps from Northern Africa, would be better suited for such games.

If I am appointed Director General, I will make sure Mr. President hosts an African tournament, which would also sell the nation to the world. After Obasanjo, it’s only former President Yar’Adua that hosted an African game. We have something upstairs to offer and make his 2027 election easier for him to win.

What do you think affected our sporting facilities in Nigeria?

Lack of maintenance. We lack a maintenance culture. All our facilities become old. I don’t see any reason why the National Stadium in Lagos should not be working. How much do we think the stadium would cost to maintain that we cannot afford? That stadium, in question, can also yield revenue to cover maintenance costs.

Nigeria has only one FIFA-approved stadium, which is in Akwa Ibom State because the state keeps maintaining it. The National Stadium in Abuja can be maintained too. If appointed, I can reach out to Julius Berger to maintain the stadium to secure a contract from us.

There is also another way we can manage it through private partnerships. Even UBA, as a bank, can be contracted to maintain the stadium for 20 years and earn revenue from it. Dangote, too, can handle it. Look at Murtala Muhammed Airport (MM2) in Lagos—it’s been under private management and functions profitably to this day.

Again, the National Lottery needs to go into sports. In fact, the National Lottery is not paying enough to the federal government as it ought to. We have to ensure they pay all that is due to them.

In addition, our national leagues should be opened for support from government and private organizations. They should not rely only on clubs to survive.

In all, there is no government that has done what Mr. President has done in Nigeria. Security issues have gone down. The proposed tax reforms, too, are a fantastic economic policy to take Nigeria to the next level.
In moving Nigerian sports forward in Nigeria highlight a task that is long overdue. For any renewal move to be achieved, drastic steps and deliberate actions need to be upheld. A former senator representing Ebonyi Central Senatorial District in the 8th and 9th Assemblies, Senator Obinna Joseph Ogba, who is also a sports administrator, hails from Amanvu-
Nkalagu Community in Ishielu Local Government Area of Ebonyi State. Senator Obinna bares his mind on ways Nigerian sports can take its place in the community of sports nations.