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It’s Strange, But We Have Fewer Than 100 Doctors In Oyo Hospitals - Commissioner
Oyo State Commissioner for Health, Dr Muyiwa Gbadegesin, a former Senior Special Assistant on Information Technology and Special Projects to former Lagos State governor, Senator Bola Tinubu, in a media chat, spoke on his experience, the free medical mission, the “Abiyamo Project,” among others. Adebayo Waheed was there. Excerpts:
What has been your experi-ence so far in the Ministry of Health?
We have a comprehensive policy for the health sector, but what we presently have on ground in terms of personnel, infrastructure, processes and funding are inadequate. So, we have been working very hard to create the foundation that would enable us to deliver on those campaign promises made by the governor. Specifically, he promised free health care for children under the age of five, for the elderly and pregnant women. We focus on those areas. As you know, the government is really the last refuge for the average man on the street. When we look at the health sector, we don't believe the government can provide all the health needs of the people.
There is also the private sector; they have a role to play. There are also development partners who are very active in the state. I am talking of World Health Organisation (WHO) and United Nations Children Emergency Fund (UNICEF). They are actively supporting our immunization programmes and other schemes.
But, when it comes to the crunch, the average man on the street relies on public hospitals. So, our focus is how do we upgrade the infrastructure? How do we recruit more personnel and how do we ensure that those personnel are continuously trained so that they would remain up to date in terms of the necessary skill? Then, what kind of programmes do we need to put into place?
For example, one of the first things we did and this is one of the things I proposed when I was the Special Adviser on Projects, it is something we have been doing in Lagos and Ekiti states, the Free Health Mission.
It is not designed to be a solution to all the problems, but what we wanted to do with that is to reach out and touch the lives of our people as quickly as possible. You won't believe that when I went around the state, the question I asked the average citizen I interacted with was, when was the last time you saw a doctor? Some said 10 years ago, some said five, some said seven, some said eight, and so on. You won't believe it, in the state, we don't have up to 100 doctors in the employ of the government. So, we needed to do that Health Mission and what did we do? We had 120 health professionals, both from within the state government and outside. They were recruited for a period of time and we provided free drugs. We did free hernia surgeries, general out-patients services, including diabetes and blood pressure check, dental services, everything from scaling and polishing to extractions and fillings, as well as optometrics. We gave out free eye glasses, carried out eye checks and provided eye drugs. We were able to satisfy up to 200,000 people: elderly women and children, including the free hernia surgeries, that was a quick stop-gap measure.
At the same time, as we were going around, we used the opportunity to inspect all the health facilities. We have been able to do the assessment of what they need and what their requirements are and these are going to feature in our budgeting process subsequently. One of the key areas we are trying to focus on is maternal and child health. We have a very bad maternal mortality rate. It is woeful and we are introducing what we call the ‘Abiyamo Project’ or ‘Project Abiyamo’, which is somehow modeled after the Abiye Project in Ondo State to directly address the issue of women dying unnecessarily during child birth. We should not have people dying of things that make no sense in a developed society; that they could not get to the hospital on time or they got to the hospital, there was no blood or there was malpractice on the part of the doctor or the traditional birth attendant, who is not qualified at all is the one handling the child birth and then she dies from something that she should not. Those are the things we are trying to get at and we will be launching that programme in the next two or three weeks. There is a range of other programmes. So, this is a complex sector and we are dealing with people's lives, so it requires a painstaking approach and I'm trying to encapsulate these things in a short and sound bite, but, we do have a comprehensive document plan that we are following which is called the State Strategic Health Development Plan and we will also be launching it. The reason for that is that we want a proper structure and system. When we launch it, there will be committees involving all the stakeholders from the public and private sectors, including key people in government. The committee will be charged with the responsibility of guiding strictly the development of the health system.
After all the stages of the Free Health Mission, what next?
Well, the Free Health Mission, as I said earlier, is more of a stop-gap measure. Our plan is to have comprehensive trips round the year. We will touch every local government area. In the last phase, we visited every local government, spent a day in each place and we were able to see a minimum of 5,000 people, giving all those services that I mentioned earlier. We did that in all the 33 local government councils. We will do that again before the year runs out. In the latter part of the year, we will go round all the councils. Each time we are doing this, we keep all the data, the record of each patient, the diseases that are common in a particular area and that data later goes into our planning process.
So, when we say what next, it is the rebuilding of the health system. Once we are able to cover these areas and have adequate data on each location, we now carry out our response specifically. One area, Irepo Local Government, had a preponderance of gastric ulcer. We want to know why they have that kind of ulcer and how we can prevent it and how we can make adequate provision for the treatment of the patients.
There were some areas where the BP was high. I saw some people with 200/120 and were still walking around normally. So, in that particular area, because we already know there is a problem with BP, is it something that has to do with their diet? We will address that as well and take measures. For problems associated with infrastructure, drug supply, etc, we have already commenced the Private Partnership Programme (PPP) pharmacy system in the hospitals, whereby we have managers who provide regular and constant supply of drugs to the hospitals. They will never run out of drugs.
We are also providing our own essential drugs service where we give free drugs to anybody who needs them. That is ongoing as well. We are establishing the free ambulance service, which is both for emergencies and also for obstetrics cases. We have four live mission and 30 tricycles and there will be more and more of such facilities, so that every community will have some kind of emergency response and this ambulance service is also sitting on an IT Foundation, which is an emergency response. A toll-free number provided by a mobile telephone company, which we fed into a control room, so that if you witnessed an accident and call the number, we will mobilise the nearest ambulance to respond to the scene and take care of the victim(s). So, those are the next key steps that are involved.
Having identified the dearth of doctors in the service of the state government, there is no doubt there would be a plan to correct the situation. How many new doctors are you planning to recruit?
We advertised a couple of months ago and the plan is to recruit up to 1,000 medical professionals, not only doctors. We also need nurses, pharmacists, midwives, dentists, the full range of medical personnel. We are in the process of engaging additional personnel and not just engaging them, but also ensuring that we are able to keep them. You will recall that when this administration came in, our doctors were on strike, but the governor was able to bring them back to work by pumping up their pay. So, it is not just about the salary, it is also about the conditions of service. In the past, the doctors in the government’s employ were not enjoying in-service training. We are trying to re-introduce that.
If you have opportunities for training even while you are serving with us, you can improve your skills. So, as we are recruiting, we want to send as many medical personnel as possible to the rural areas. We are also fashioning a partnership with the University College Hospital (UCH), Ibadan, which is a federal institution present in the state and also a critical component of the state health care delivery system and a way we can also enjoy the services of their consultants in our own hospitals. There is an ongoing discussion with them.
What is this 'Project Abiyamo' all about and the modus operandi?
It is going to be a free service. As I noted earlier, our administration is running a free health programme and one of the groups of beneficiaries are pregnant women. It is a grassroots-based service which will involve the setting up of a ward development working committee, initially. We are starting with six local government councils. After six months, we will add another 10 local governments and in another six months, another 10 will be added until we cover the entire state. The reason for this is that for any ambitious project like this, there will be some teething problems. We want to start with a manageable number of local governments and later, we will scale up the coverage.