Nigeria

• Nigeria’s national census of 2006, counted population of 7.5 million in Onitsha and its surrounding communities.
• Nigeria’s population now stands at 200 million.
• Healthcare expenditures in Nigeria are 3.7% of GDP, compared with the United States’ 11.7%

The latest census of facilities providing primary, secondary and tertiary medical care by the Federal Ministry of Health of Nigeria reveals the following:

The graphics produced by the Nigeria Health Ministry’s reveal the lack of hospitals to serve the 200 million Nigerian population. They also highlight the few hospitals serving the Southeastern Nigerian State of Anambra, one of the most populous Nigerian states. The hospital will be built in the rural area known as Ogburu Local Government Area (LGA). The Okoti-Odekpe community whose local Chief and residents donated the property for the hospital, is located within Ogburu LGA. These graphics were downloaded on October 25, 2019 from https://health.gov.ng and https://hfr.health.gov.ng.

The challenges that arise when attempting to provide Western style quality health care and treatment for mentally ill patients in the economically deprived areas of a developing country such as Nigeria have been studied since the early 1960’s.  Now, however, Fr. John’s idea of establishing Western style hospital care for the poor, has begun to grow roots among medical professionals with an entrepreneurial bent.  This page provides two examples of African physicians who have explored solutions to the problem in their own way.

TED Talk – Without Adequate Medical Facilities

Seyl Oyesola, M.D.

Seyl Oyesola, M.D., was born in Nigeria but spent much of his childhood growing up in Cleveland, Ohio.  In 2005, Dr. Oyesola collaborated with Alexander Bushell, to develop high quality – but compact – hospital equipment.  He used their invention during his many mission trips to perform heart surgery in Nigeria.  But without adequate infrastructure support, he and his medical team encountered many challenges in his efforts to care for his patients – challenges he overcame with ingenuity and perseverance.  Here in his TED Talk, are the messages we found most interesting, and supportive of our project.  Dr. Oyesola is not part of our organization but we applaud what he and others are doing collaterally to help the poor of Nigeria.

TED Talk – World Class Health Care – Alternative Solution

Ernest Madu, M.D

Ernest Madu, M.D., is a 58 year old cardiologist and Entrepreneur.  His specialty is nuclear cardiology.  He has successfully focused his energies on providing affordable public healthcare in low-resource nations.  His TED Talk explains the urgent need to find alternative solutions to providing healthcare for the poor of Africa, specifically, Nigeria.  While Dr. Madu is not directly involved with our organization.  The thoughts he expresses in his TED Talk presented here, give further support for our project – we need to build a Western style hospital for the poor in southeastern Nigeria.

Are there any hospitals within the rural communities (Okoti-Odekpe) where we plan to build the Catholic League Medical and Mental Health Hospital?

There are no hospitals in or nearby Okoti-Odekpe.

Are there hospitals in the nearby City of Onitsha, which lies about 10 km away from Okoti-Odekpe? 

Having examined some statistics from the Federal Health Ministry of Nigeria (above), we can also turn to other open source information:

Specifically looking at Onitsha, the major commercial city near the rural area where we propose to build the Catholic League Medical and Mental Hospital, the casual observer finds a GOOGLE list of websites posted by some existing private hospitals within the City of Onitsha.  The GOOGLE service provides a list other “hospitals” or clinics that do not have website presence. The GOOGLE search used in October, 2019 was “Onitsha hospitals.”

IMPORTANT We refer to these only as a point of reference.

Of the websites examined, one hospital states it provides two hospital wards with 25 beds each for patient care.  Descriptions of medical services vary in number and kind, depending on the medical facility. 

Are there healthcare problems in Nigeria that might be better addressed by physicians and nurses working with modern equipment in a new hospital, practicing internationally accepted medical practices?

The answer to this question depends on many complex, historical circumstances unique to Nigeria.  The Catholic League Medical and Mental Health Hospital, with a mission of helping the rural poor with modern, Western style medical and mental health care, would become the only such hospital where medical practitioners struggling to address issues facing the poor, such as, (for example: the ever present danger of malaria, viral hemorrhagic fevers, an outbreak which affected so many Nigerians in 2018, continuing issues with inadequate HIV testing, ebola, lack of vaccination of children for measles and penta viruses. Official Nigerian government studies find that over 1/3 of Nigerian children, mostly in rural areas, continue to go without these important vaccinations. A hospital can also be the source of critical care which trauma victims which today continue to die in rural and poor areas simply for lack of access to a hospital in their community. Trauma injuries arise from gunshot, criminal violence, inter-tribal disputes (e.g., Fulani vs Igbo or Yoruba), vehicular wrecks, or even everyday household accidents.  Add to this, conditions which affect humans worldwide – internal medicine diseases. A well-equipped and staffed hospital is critically needed to serve the community of Okoti-Odekpe and all rural poor in the large catchment area around Onitsha and Anambra State.

Medical literature published by Nigerian and foreign medical and academic researchers regularly report continuing problems with healthcare throughout Nigeria. One example is a recent study of the high incidence of Surgical Site Infection (SSI) in a Nigerian Teaching Hospital, with assertions that SSI complications exist elsewhere in other Nigerian surgical theaters. 

“Surgical Site Infection SSI is a serious complication that limits the benefits of surgical interventions. It is a serious problem globally and particularly in Africa and other developing countries where inadequate resources and skilled personnel among others are contributing to the acquisition and spread of this infection. This study determined the prevalence of SSI and antibiotics susceptibility pattern of surgical site pathogens at a University teaching hospital in Abuja, Nigeria. Medical records of 729 and 825 patients operated and discharged in the year 2013 and 2014 respectively were examined for documentation of SSI based on Centre for Disease Control (CDC) criteria. In the year 2013 and 2014, the prevalence of SSI was found to be 15.6% and 13.58% respectively. In the two years, Staphylococcus aureus was the most prevalent pathogen causing SSI. This was followed by E. coli in 2013 and Klebsiella spp in 2014.” 

Abstract of Article,  Prevalence of Surgical Site Infection in a Nigerian University Teaching Hospital, Journal of Pharmaceutical and Allied Sciences 14(1) 2017: pp.v2430-2438

In 2009, Nigeria’s Health Ministry admitted healthcare problems in its National Strategic Health Development Plan Framework (2009-2015):

“Health is Wealth’ goes the popular saying and therefore in every country, the health sector is critical to social and economic development with ample evidence linking productivity to quality of health care. In Nigeria, the vision of becoming one of the leading 20 economies of the world by the year 2020 is closely tied to the development of its human capital through the health sector. However, the health indicators in Nigeria have remained below country targets and internationally set benchmarks including the MDGs, which have recorded very slow progress over the years. Currently, the health sector is characterized by lack of effective stewardship role of government, fragmented health service delivery, inadequate and inefficient financing, weak health infrastructure, mal-distribution of health work force and poor coordination amongst key players.”

In 2018, Nigeria’s Health Ministry, with assistance of UKAID, USAID and UNICEF, in a multi-year scientific study, the National Nutrition and Health Survey found continuing healthcare problems: Following internationally accepted scientific onsite investigations within all 36 Nigerian states only 64% of children (0 to 59 months) were found to be healthy; the remainder, one child in three, had medical or malnutrition conditions.  In the Southeast [the situs of the planned Catholic League Medical and Mental Health Hospital] half of children (12 to 23 months) had failed to get penta or measles vaccines.  Vitamin A deficiency and inadequate antenatal care (ANC) were found. HIV testing during ANC in the North continued to hover below 30%. While in the Southeast 24% pregnant women had not received HIV tests.  A footnote explained that Nigerian HIV testing during ANC is an “opt-in” decision; in the United States, the test is performed without more unless the ANC patient “opts-out.”

How much does the Nigerian Federal Government spend for health care of its population within the homeland?  And what about the availability and quality of medical care throughout all areas of the most populous nation of Africa?

A recent CIA Factbook reported the following:  Nigeria provides 3.7 per cent of GDP (Gross Domestic Product) for healthcare overall.  Compare:  United States spends 17.10 of GDP; UK 9.10; Cuba 11.10, etc. United Nations, World Health Organization, and international medical agencies regularly warn of healthcare deficiencies affecting health, economic, and mental condition in Nigeria.

Some Foreign Embassies provide their observations of local conditions regarding healthcare in Nigeria on their web pages.  The Irish Embassy has the following “Health” warning:

“In most parts of Nigeria, medical facilities are very basic and even in major population centres the level of available medical care is quite limited, and payment must usually be made up-front. Accordingly, medical evacuation to Europe or South Africa is frequently required for anything more than a minor accident or illness.”

The American Embassy provides the following comments for those who visit the US Department of State web pages:

Organization and Capability

The best health care in Nigeria is available in private and nonprofit medical facilities. However, even these facilities typically fail to meet U.S. standards. The quality of government medical facilities is unacceptable by U.S. standards; however, the government is committed to resuscitating its health care through systematic funding and revitalization.

Medical Personnel

The quality of health care providers ranges from poor to fair. Most physicians and nurses do not meet U.S. standards of training. Recent graduates lack experience with modern equipment and sophisticated procedures.

Medical Material

Nigeria imports the majority of its pharmaceutical and medical supply needs, primarily from European sources. Medical shortages have hindered medical practice, research, and training.

Blood Supply

The blood supply is not safe. Blood-banking services are unacceptable by U.S. standards.

Social Factors

Little opposition exists to Western medical practices; however, many people in the country continue to consult traditional healers because of the absence of adequate Western medicine. In Muslim-controlled areas, there is some resistance to women being treated by male physicians.

Three regions, three main ethnic groups

Geographically and culturally, Nigeria is divided into three distinct regions by the Niger River and a tributary: Majority ethnic (tribal) populations are generally recognized to reside in these regions. In the North, Hausa; the West, Yoruba; and Southeast, Igbo. Articles found by referring to the sub-menu items of ABOUT NIGERIA, above, provide a brief selection of various areas and conditions in Nigeria.

Observations about the History, Geography, Politics

Parts of the below text are found in an article by Amanda Briney at: What You Should Know About Nigeria

Nigeria is the most populous African country. In 2018 it reported a population of over 203 million. Nigeria is located in West Africa along the Atlantic Ocean’s Gulf of Guinea. Its land borders are with Benin, Cameroon, and Chad to the east and Niger to the north. There are over 200 distinctly different tribes but Nigeria’s main ethnic/tribal groups are:

• Hausa,
• Igbo, and
• Yoruba.

Fast Facts

• Official Name: Federal Republic of Nigeria
• Capital: Abuja
• Population: 203,452,505 (2018)
• Official Language: English
• Currency: Naira
• Form of Government: Federal presidential republic
• Climate: Equatorial in south, tropical in center, arid in north
• Total Area: 356,669 square miles (923,768 square kilometers)

History of Nigeria

Nigeria has a long history that dates back as far as 9000 B.C.E. as shown in archaeological records. Around the 17th and 18th century, European traders began establishing ports for the slave trade to the Americas. In the 19th century, this changed to the trading of goods like palm oil and timber. Beginning in 1886, the Royal Niger Company and then the British Government claimed a sphere of influence over the tribes within the area and in 1914 it became the Colony and Protectorate of Nigeria. Throughout the mid-1900s and especially after World War II, the people of Nigeria began pushing for independence. In October 1960, an independent federation of three regions with a parliamentary government of Nigerians assumed control of the government of Nigeria.

In 1963 Nigeria proclaimed itself a constitutional federal republic. Throughout the 1960s, Nigeria’s government was unstable. Around 1963 a civil war ensued during which the Southeast region, populated mainly by Igbo, suffered greatly from bombings and starvation during their abortive attempt to form an independent nation called Biafra. The war against the Yoruba-Hausa federal forces resulted in millions of deaths. One film about the night-time airlift of food and medical supplies to Biafra reveals the effect the civil war had on hundreds of thousands of Igbo tribe families.

Oil and gas industrial operations provide 95% of Nigeria’s foreign exchange earnings. Other industries include coal, tin, columbite-tantalite (“coltan”), rubber products, wood, hides and skins, textiles, cement and other construction materials, food products, footwear, chemicals, fertilizer, printing, ceramics, and steel. Nigeria’s agricultural products are cocoa, peanuts, cotton, palm oil, corn, rice, sorghum, millet, cassava, yams, rubber, cattle, sheep, goats, pigs, timber, and fish.