Nigeria’s 2023 Elections (SW): Why can’t NMA have a bilateral relationship with INEC…?

On the 25th of February 2023 the much-anticipated general – presidential, senatorial and house of representatives – elections took place across the nation.

Before, during and even after the elections a lot of unprecedented events unfolded, causing a massive ripple effect on citizens, systems, as well as the healthcare sector, nationally. In the light of this, one of the healthcare providers (HCP) in the southwest (SW) region of Nigeria – Dr. Agbaje A. A. – shared his opinion with the Medical Mirror (MM) team on the various overwhelming happenings in the country.

MM: Before elections, there was an abrupt change of policy on Naira design and circulation. How did this policy affect the healthcare sector and to what extent. Especially on the part of service providers and service consumers?

We have to understand that there is a direct relationship between the health sector and the economy. Both sectors are critical to the survival of citizens in every developing nation. The idea of Naira change policy wasn’t bad, but the problem was with its implementation.

HCPs are first citizens before they’re doctors or in any other profession. So, we also need access to money to get to work; either by purchasing fuel or via public transport systems. We need our welfare taken care of, and all these won’t come easy if our money in the bank isn’t accessible.

During the period of Naira change policy, there was heavy scarcity of cash. Healthcare providers were affected economically, as well as the general populace who couldn’t afford or access money to pay for services rendered. You then see people having lack of interest in coming to the hospital to seek healthcare or they resort to using other means to sort themselves out when sick.

Also, the patient burden in facilities during this period wasn’t as much as it used to be. As the consumers (patients) couldn’t afford the basic healthcare packages. And this was NOT because they do not have money, but it was due to lack of access to their hard-earned money.

MM: Thinking on the build up towards the presidential election, would you say that HCPs especially Doctors were rightly involved in the campaign or electoral process?

HCPs involvement in campaign and electoral processes, for me, is divided into two. Personally, I think the HCP’s political awareness and relevance is still at the infancy stage, I mean look at our colleagues in the Law firms? These people were able to organize a debate or meet up for aspirants to attend, address them (the lawyers) and the general public, which they did! On the flip side, NMA or any HCP other organisation was not able to do such! Simply because we no longer command the right respect and get the required responses. I don’t know why this is so, maybe it has to do with our leadership. But something critical needs to happen to restore our status.

On the general campaign by HCPs, I think it’s okay to support any candidates openly. But respect is critical, and we should not allow politics get in the way of providing services to our consumers (patients). For example, because I believe in Peter Obi doesn’t mean I should turn my back on a sick patient who is a chronic supporter of APC.

Also, I think we – as HCPs – need to be more involved, not just at campaign levels but the whole process. Why can’t NMA have a bilateral relationship with INEC for instance? We know our elections aren’t always free and fair without one or two instances of collision, voter intimidation or fight, where people get injured at polling units (PUs) or someone could collapse while on the queue to vote. It won’t be out of place to have 1 or 2 Medical officer(s) attached to PUs and be on standby to provide medical services in case of emergencies. This is an innovative idea that can work if INEC and NMA synergise on a bilateral relationship.

MM: Great idea! Thank you for sharing. Albeit, between the presidential election itself and the announcement result, how was this period for HCPs? Was the whole tension of the election rigours felt within the walls of hospitals/health facilities?

This period for many HCPS was a bit tensed. I, for example, could not leave my area because of the news of violence around where I stay. The hospital had to send an ambulance to pick me up. Other colleagues of mine staying on the island couldn’t leave either. Now, we are at work but still worried about what might happen. What if political thugs start their usual riots, how do we get home? and so much more.

MM: Gearing towards the gubernatorial elections (postponed till March 18th), what effects do you think the outcome would have on the health sector?

For the gubernatorial election, I think we should look at it on a broader term. The current Lagos state budget allocated to health as at last year is about 8.87%, the current or incoming government need to do better.

If there is a new government, will they prioritize healthcare and health sector?? How is the relationship between the NMA bodies and the government?? I’m not interested in individuals, what has the leadership being able to do to change the trajectory of healthcare and health assessments for Lagosians??

We still don’t have an effective HMO system that will enable the poor to have easy access to healthcare and minor surgical cases. What will be done about this?? Who takes care of individuals who are involved in accidents and need emergency care when we (HCPs) can’t get across to their families on time?? How many “functional” primary health centers are in the hard-to reach areas and far end of Lagos? Do we have a universal heath scheme for ALL citizens that we can be proud of?? These and many more, are questions that need to be asked and answered respectfully.

MM: Any recommendations for the new government concerning the state and national health systems?

My recommendations are pretty simple. They are:

• 1) Increase the annual health budget and ensure its adequate implementation.
• 2) Make remunerations and salaries of heath care workers more appealing so many would be discouraged from “japa-ing”.
• 3) Let there be an accessible universal healthcare system for all. We need a single electronic card or record that Lagosian should have, such that, when a person walks into any government hospital the persons data is on it. Also, health data from all hospitals should be linked together. So that, when a patient is transferred from Lagos State University Teaching Hospital (LASUTH, Ikeja) to Lagos University Teaching Hospital (LUTH, Idi-araba), officials or HCPs in LUTH won’t have to be making requests manually for patient’s medical reports from LASUTH and vis versa. We can unify all health records from health facilities into a single database. This is 2023, let us all work towards more technological advancement in the health sector.
• 4) More preparedness and facilities are needed to handle emergencies. Therefore, we need more ambulances – that can respond to call when required – stationed across notable check points. For instance, the last train-bus accident in Lagos exposed the real lapses in response time to emergency and how victims were left outside the hospital due to “lack of bed space” – a common rhetoric in the government owned tertiary level health facilities.

In 2023, despite the array of knowledgeable people in our medical association(s) and government positions, we should not still be having some of these problems. It’s rather shameful. 

MM: Finally, what are your advice to HCPs and the general public in this period of elections and transitions.

Some of the tips I have for HCPs and the general public in this election period include: 1) Don’t walk or keep late night. 2) Always go out with your ID Card. 3) Avoid Protest or Vandalism of any kind. 4) Avoid arguing in public spaces about your choice of candidates or political views. 5) Be safety conscious; if you hear anything, do not wait to confirm what’s coming, SAFETY FIRST! 6) Obey all security rules and listen to all law enforcement agencies. 7) Dress the way you want to be addressed. 8) Let friends, relatives or those who care about you know your whereabouts each time you need to leave home or share your location with trusted friends/family. 9) Vote right, vote wisely. And finally, I wish Lagos and the entire nation the BEST.

About Respondent:
Dr. Agbaje A. A. is a young medical professional who is dedicated to the advancement of patient care and strives to make a positive impact in the lives of his patients. He is committed to staying up-to-date with the latest medical research and technology in order to provide the best possible care. Beyond medicine, he is keenly interested and strongly passionate about politics, journalism, sports and active social media advocacy for public enlightenment and community development.