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'Why President May Not Sign National Health Bill' - News - Nursesarena Forum

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'Why President May Not Sign National Health Bill' by Idowu Olabode : November 20, 2014, 01:55:16 AM
Interview By Wole Oyebade

While stakeholders in the health sector currently await President Goodluck Jonathan to assent the National Health Bill into law, Professor of Public Health & Community Medicine, College of Medicine, University of Ibadan,Michael Asuzu, doubts the bill would see the light of the day. He shares his thoughts with reporters, among other issues bothering on Ebola Virus Disease(EVD), Medical Officers for Health and the need for Community Health Midwives in local communities. WOLE OYEBADE was there.

DESPITE several promised of the National Health Bill, it is yet to besigned into law by the president. Are you surprised?

The health bill has many Achilles heels and we must understand that. There are many things wrong with the bill, though still has many magnificent things. Yes, there are funds for the Primary Health Centres (PHCs) tomake them run properly. But there are two Achilles heels holding it, so that people don't just blame the president unnecessarily. Other health workers say they don't want money to go into primary health care because doctors will be in charge.

In Nigeria of today, pharmacists want to be in charge of the money going into primary health.But pharmaceutical industry is not in health. Just less than a quarter of pharmacists are in the hospital, others are in the pharmaceutical industry - that is where the body of pharmacists is.

 So, why should the pharmacists that are only one-quarter or less say that unless they are in charge, there would be no health? And all the other people are fighting. So, that is a big one and it is not small in this your country.

The other one is Sections 51 and 52 of the health Bill that says I can take your womb or oval and take it abroad once the minister of health permits me. These are issues that the western world whose religion is money and imperialism have put in our National Health Bill and some people who are morally concern and national conscious are saying 'No! We cannot have a foreign tool inside our NHB. Purge Sections 51 and 52, then we will know that it is our bill.' And these two issues are no jokes.

Again, you have got to educate people. Nursing is all you can do for a person in relation with his health, happiness and well-being,which the person should be able to do for himself if he has the knowledge of the things to do. That is what nursing is and it involves everything that makes you healthy and happy and fulfilled person.

Medicine on the other hand is similarly defined, as that you should do for any person in relation to his health, happiness and well-being that even if he has knowledge or skills he should not dare to do for himself. Because there are matters of life and death and it would be ethically wrong for him to do to himself or to his next of kin, up to the second degree of kinship.

 And between those two professions lies all of health and happiness. Any other person who works in the healthcare is doing just a bit of these. If they deal with those issues in the bill, I'm sure Jonathan, in his sleep, can sign it into law.

Where is the place of Medical Officers of Health in this divide between doctor/nurse and other health professionals?

Medical Officers of Health and the statutory community nurse midwives (which this country has never had) are the front-runners of primary health care.

 The community nurse midwives produce primary healthcare and the medical officer of health superintends over that and protects him or her from all the other marauders who say they are doing public health. Because apart from the community health midwives and the medical officers of health, nobody else has a comprehensive understanding of health and public health issues.

A medical officer of health has statutory powers because he is the only doctor who is a legal person as well. So, he is Surgeon General of a State or national government.

In the old parliamentary democracy that we had, up till 1966, the equivalent of a Surgeon General in the presidential democracy is call the Inspector General of the Medical and Health Services and the Chief Medical Adviser to the government. He is the only person, apart from the Medical and Dental Council, who can walk into any health facility anytime he likes to find out what they are doing and make sure they know what they are doing.

The post of Surgeon-general was recently a subject of controversy In this country people have been fighting for and against having Surgeon General at the national level or whether you have a Medical Officer of Health. That is what you have in your country. Global practice is everywhere, but this is the only place where they don't want to know what they are.

The medical officers of health understand what they should do, but they need facilities to do it and a regular update that it is done. They also need a Surgeon General or Chief Medical Adviser to the government or Inspector of Medical and Health Services who can go there and find out whether they are doing what they ought to do. When you have all of that then you wouldn't have anything like epidemics venturing here.

I trained in medicine at Ibadan, but after practicing medicine one and a half year through my youth corps, I decided I'm not going to be a medical doctor. I'm going to be a health professional, who is the Medical Officer of Health, outside of which any other person is a technician of some sort. Incidentally, I have to end up in the university because that is where you are going to have the capacity to influence these things. But these are the foot soldiers (Medical Officers of Health and Community Health Midwives), which we don't have, ever in our history. If you don't have them, you are not ready for primary health care.I'm not talking of public health nurse or clinical or domiciliary midwife or nurse that forage into the community, but Community Nurse Midwives who know the people; know where they sleep and those that are sick and do community rounds the way we do 9 rounds in the hospitals on a weekly basis, to see the people and ensure that they are living at the maximum point of their health.

 Without these community nurse midwives, you cannot achieve health for all.

How would you define primary health care?

It is a healthocracy; health of the people, by the people, for the people, with the people working together with informed educated who are ready to empower them to get power and do what they need to do. So, if the people are not educated on their powers and how to use it, then it is useless.

We should thank God that Ebola came to Nigeria. Lagos is the only federating unit in Nigerian federation. A federating unit should be able to run by itself. If Abuja, denies you money and you survive for eight years, then you are a federating unit. Others are suffragant-basis States. They go to Abuja - cap in hand - and if they don't give them money, they will die that day. So, they are open to corruption forever. So that is why I said we should thank God that Ebola came to Lagos, and into the hands of a government that is capable of existing as a country.

If you think Lagos is very small, then go and look for a country called Malta, Liechtenstein, Hong Kong before China took over, they all survived and had better economy than all the economies around them. Lagos State is a federating unit of this country and should be capable of showing the way to others States on how to run things.Lagos State is the only one that has the history of Medical Officers for Health. Doctors should be able to finish their carriers as Medical Officers of Health, not people who are not respected or paid salaries, or at the end running to ministries of health to do some stupid things and collecting a lot of money.


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