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“Madam, how long has this child been sick?”
“Almost ten days now, Doc.”
“What have you been doing for the child since then?”
“I gave her some drugs.”
“What are the names of the drugs ma?”
“Emmm, I don’t know sir but the chemist man mixed it for me.”
“Ok, madam; what else did you do?”
“Oh, after the drugs didn’t work, I gave her some herbal drugs and my neighbor took us to their church for prayers and anointing; but later we bought more drugs from……”
The above is a simulation of the typical story heard in most consulting rooms around the country. It isn’t an exaggeration but the cold bare facts and can, in fact, be worse.
Primary health care (PHC), as defined in the Alma Ata declaration of 1978, refers to essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation, and at a cost that the community and country can afford to maintain at every stage of their development in their spirit of self reliance and self determination.
There are still many hurdles to the realization of the components of PHC in the country. Like in most developing countries, poverty and ignorance ranks high as the reasons why the dreams of PHC are yet to be realized. Yet, it is common knowledge that in the health care system, the doctor is the head of the team and ought to be the first port of call. That is the ideal, but the actual thing done is miles away from the ideal. The truth is that, in the country, the physician is the last person the sick person calls on after exploiting other options. This further hinders the possibility of the doctor helping. Most patients come to the hospital at a point when he or she must have been abused with all sorts of drugs bought from patent medicine dealers, herbalist or faith healers. They go to the hospital after they have exhausted ‘other options’ and in a debilitated state when they are almost too far gone to be saved.
This perhaps is the perhaps the greatest problem facing the health care system in Nigeria. It is hydra headed and dangerous. At the root of it all is ignorance. It is ignorance that makes the unsuspecting market woman trust the druggist (who, by the way, is erroneously baptized “chemist” which is a name they hardly can afford to answer). The same ignorance makes her patronize the pseudo laboratory technician who is ever eager to diagnose hepatitis or staphylococcus. The same ignorance makes her cap it all with concoctions from the herbalist and casting and binding from the spiritual healers.
Suffice it to say that this ignorance is not limited to the market woman but extends to educated professionals in diverse fields of endeavors. One is apt to dismiss the trend as a product of poverty but the truth is that the services of the pseudo health care providers don’t come cheap either. At best they gradually, but persistently, nibble at the purse of individuals that patronize them.
People are more likely to trust their mechanics for repairs on their cars than they are of their body to the doctor. They would rather try other options before taking a shot at what the doctor has to offer. Hence, the health care system gets a debilitated patient at a time the expected miracle cannot help either the patient or the health institution.
The health care system may have its share of problems that but authenticity isn’t one them and it still presents itself as the best chance of care and cure exemplified by its counterparts in the developed countries.
That people die in hospitals doesn’t mean the hospitals killed them. The high mortality associated with hospitals is perhaps a factor of the state of the patients at arrival. The fact remains that some patients come in at a very critical state when even state-of-the-art hospitals in the developed countries could not save them. Worse still, they come in after assaults from the pseudo-doctors that discharge them without the decency of a referral.
Our problem is that of ignorance. Health care system is not only curative but preventive. It is high time people understand that preventive medicine, rather than curative medicine, is their only hope of staying healthy. There are no short cuts to health. The short cuts may seem cheap but in the long run they are very expensive and cannot be equated to the implication, which is imminent death.
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I come alive when I write and the feeling that those few lines may impact positively on a soul unknown to me or even elicit a smile makes it a worthwhile endeavour.
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