We’re Trying To Make Ebonyi A Healthy State -Umezuruike

Dr Daniel Umezuruike, Ebonyi State Commissioner for Health, spoke with NNAMDI AKPA in Abakaliki on the government’s plans to deliver qualitative health services to the people. An interview excerpts:

• WHAT are the plans of the government regarding qualitative healthcare delivery to the people?

First, we are undergoing a baseline survey of what is in the health sector. We want to know what we have on ground and where we will need intervention to fill in the gap.So far, our men are in the field doing this baseline survey and what we are getting so far is very revealing and in no distant time, we will come up with the report and make some recommendations.Secondly, we want to have a good healthcare system in Ebonyi, because that is very important, and this involves organisation of people, institutions and resources to deliver the health care to the people. We want a good healthcare that should be self-sustaining and will not depend on ad hoc measure. What we have on ground is ad hoc and when we have emergency, people start running around. But if you have a good system, you will achieve the goal and it will be self-sustaining.

• The last administration gave financial grant to some private hospitals to boost healthcare delivery in the rural areas. Will this government sustain this policy? 

I will not say yes or no, but we will continue to encourage rural healthcare package. So, if there is need for that, we will support them, but for now, we want to upgrade all the facilities in our General Hospitals and health facilities in the state and make them functional.
We want to do this in stages as our resources can carry, because if you carry everything along, the tendency is that you will not get it right.

• Does the state have enough resources and manpower to sustain all the General Hospitals?

Manpower is a very major challenge facing the ministry, which presently has 546 staff. But when it comes to professionals, that is where we have problems.We have very few medical doctors, few nurses, few midwives, pharmacist and other professionals, who are the people that can deliver the service.The other staff are too many, so after this baseline survey, we will be able to say these are the people that are actually supposed to be doing the service.
It will not help you when you come to the general hospital to see one doctor, one pharmacist and five clerks.

• What will the five clerks be doing, because they will not achieve anything without the professionals?

We will retrench or sack, but we want a situation where they will be a place they can be more useful and helpful. We need the skill manpower in particular; people trained in those areas, and presently the number is not very encouraging in our primary and secondary health institutions.

• What is the ministry doing to solve this manpower shortage?

We are trying to make some necessary adjustment by finding those that are supposed to be sent to another places and transfer them. If we can get the right professionals to man those instructions, that will be good for us, and if we found that we can’t staff the 13 general hospitals, we can start with six that will have full complement of staff.We have 431 primary healthcare centres in the state and some of them have few staff. If we can’t staff them, we can start with five healthcare centres in each council and make them render service 24/7 with enough facilities to function well.

• What measures do you have to strengthen primary healthcare system in the state?

This is one of the areas the state government has more interest in, and that is why the governor appointed three Special Assistant on Primary Healthcare Development.
Primary healthcare is the foundation of the health sector, while the blocks and concrete walls will be the secondary healthcare and the roof is the tertiary healthcare.You have to make sure your foundation is very strong, and that is what we are doing, by strengthening the primary health care in Ebonyi. Ebonyi State, prior to this administration, was one of the few that had not pass this law on primary healthcare, presently. There is a Bill now been discussed for it to be pass into law, so that Ebonyi State Primary Healthcare Development Agency and the Local Government Primary Healthcare Development Authorities will function as a body, because you can’t do any interventions in the primary healthcare without synergy.Presently, primary healthcare is under the local government and all the staff are being manned by the local government and before you can do interventions in those areas, you have to go through the local government.
But when this bill is passed into law, it will be functioning as a body under one roof.

• What is the target of the law?

Our target is to have one standard healthcare in each of the 431 medical wards.
We are looking at what can we offer effectively, starting with five primary healthcare in each council that can give services 24/7, coupled with welfare and facilities and full complement of staff, including midwives and nurses.
It will be better for us and we will still continue to upgrade as times goes on until we reach our desire goals of one standard primary healthcare centre in each health wards in the state.
With that, we will achieve the universal coverage we are talking about.

• Looking at the economy situation of the state, how do you hope to achieve this?

There is this saying that ideas rule the world, so if you have good ideas, you can spend little and achieve the desire goal. Most of this primary healthcare centres have standard buildings, like MDGs projects. What you need to do is to organise them well, putting the right manpower there, providing dedicated energy source (solar or generator), then put up to four nurses cum midwives.With the facilities in place, they can provide the services in 24 hours. This is what we want to achieve and the governor is also very supportive and wants to invest in health. We know there are challenges, but I believe the government can do it.

• What is your reaction to the feeling that government does not sustain its programmes?

Good planning is important. We don’t just dabble into any project; we check what we can do and how we can sustain it. Ordinarily, we would have said let us keep those 13 general hospitals when we know we don’t have funds. That is why we are developing it gradually, starting from six general hospitals and five primary healthcare centres in each council. This is a good plan to take only what we can achieve on and sustain it. So, there is no doubt whether government can sustain any of our projects, because we plan before we go into any project.

• Recently, your ministry did a programme where insecticidal treated mosquito nets were distributed to households in the state..?

(Cuts in) Ebonyi State, in partnership with USAID, distributed 1.7million long-lasting insecticidal treated nets. If you consider that there are about three million people in Ebonyi at present, you will agree that the number has gone a long way in providing bed nets to all the households. The campaign was impressive and many people got the bed net. The aim is to eliminate malaria by preventing the contact, which is mosquito. Malaria is still the major public health problem in Nigeria and the Tropics, affecting about five million people across the globe annually, especially women and children. It was successful and our governor was decorated as USAID ambassador.
Just recently, there was cholera outbreak in the state, resulting in loss of lives.

• What measures is your ministry putting in place to tackle it? 

Cholera outbreak started in February and this government came in May and the cabinet was formed on July. When I came on board, I wrote a memo to the governor notifying him of this disease, so he quickly mobilised the ministry and gave us matching order to control it and its spread in one week.We swung into action and within the time-frame, we were able to control the outbreak by taking intensive management of the people already infected and also instituting preventive measures by providing hospitals with materials and other anti-biotic.For the prevention, we did public awareness, using the media to educate people on how to prevent, because it is preventable and curable. We taught people how to prevent it, what to do if they contact it and we set up taskforce to ensure that they abided by what we taught them. We also taught them personal hygiene, like washing hands after using the toilet, before eating, when they come back from work, keeping their environment clean and stopping open defecation.For the control, we are now doing long-term preventive measures. We are working in collaboration with other ministries, like Water Resources, to provide portable water to all the citizens of the state, because water and drinks must be contaminated before you talk of cholera. The other thing is the toilet facility, which has been with the Ministry of Environment. All households must have proper toilet facility, and they are enforcing it, because when people defecate openly, flies can peach on it and contaminate our foods and drinks and people get cholera through these. We are doing all these and others to make the Ebonyi a healthy state.