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Government should include the private sector in all health care delivery - Dr. Ewaoche

Dr. Emmanuel Ewaoche

The Medical Director of Besop Hospital and Fertility Center, Dr. Emmanuel Ewaoche says that the government should include the private sector operations in all healthcare delivery in the country, he said this during a chat with newsmen in Abuja. Experts:

Q: May we know you officially?

A: I am Dr. Ewaoche Emmanuel, the Medical Director Bepos Hospital and Fertility Center Garki, Abuja.

Q: Do you think the private sector has any significant role to play in health care delivery in Nigeria?

A: We have a lot of roles to play in Nigeria's health sector. But the truth is that we are not given capable hands to handle so many things. Example, if you take the period of covid-19 in retrospect, so many private sector operators are eager to help and there were a lot of restrictions. Don’t touch this, don't touch that. But when things become overwhelming, they have to relax. They started giving the private sector a chance to start testing and start treating. We were not allowed to treat initially. We were not allowed to have all those tests initially but when the case became overwhelming they called on us.

So, in essence there are so many things the government put in place that made it impossible for the private sector to operate freely.

Like, if some endemic diseases occur, the private sector should not participate. Remember the Ebola period. Private sector operators were exempted from participating. When they saw that it had become very overwhelming, the private sector started treating.

If they give us, chance we can handle these things. Government alone cannot handle the population of this country without the private sector.

Q: There is rumor that even the people in government refuse to give their best and refer cases to their private practice (PP). How true is it?

A: That is not true. There is no doctor with our oath of Geneva convention that will refuse to render essential services while in government. It is only a little time that we spend on PP.

Take for instance, a consultant in a government hospital will go as early as 8:00am to supervise the younger ones and put them in so many strategic positions. Even if they have to leave it will be later in the day.

So many of them schedule their operative periods. They have their days that they operate.

And if by any circumstance that you are not there, somebody must stand in for you. So that statement is not true.

Q: People are accusing the government that the whole health sector is not performing. What is your take on that?

A: The health sector in Nigeria is underfunded. There are so many problems in the primary health sector, when we talk about healthcare it starts from the primary healthcare sector. If you go to the primary health sector today you will feel sorry for yourself. I am sorry for the people that are going there. Recently I had a case from the private health sector during the strike. The woman registered with a private sector operator. They were conducting delivery and did not know that the woman was obstructed. They referred her to Wuse Hospital. Wuse could not handle it because the doctors were not there. They had to bring the woman here. It was a thug of war. The woman laboured for almost 48hours.

So, if the funding at the primary health sector is enough, things won’t be going wrong often. The manpower is available. They can handle so many things.

When you come to the secondary health sector it is underfunded. If you go to most of these government hospitals today, the radiology machine is broken down. They cannot repair it. Go to the surgical unit, you will see the same thing.

When I was in government, some of those doctors in the private sector used to come with their equipment. Orthopedic surgeons come with their equipment to operate in government hospitals. Endoscopic surgeons, they come with their equipment to operate in government hospitals.

Some of the equipment in the radiological unit - CT scan, Xray machine - if you go to so many government hospitals today, they are not functioning.

It is not that the money is not there. The money is there but somehow it goes the other way round. Look at our tertiary institutions today, most of them are shadows of themselves. Look at the National Hospital today, there are so many cases they cannot handle. They will refer you to the university teaching hospitals, Ibadan, Lagos, Kano.

Bone marrow X-ray they cannot handle, the National Hospital which is supposed to be the epic of hospitals in Nigeria.

So, the tertiary hospitals are not exempted. They are really underfunded. I must confess to you. So, the health sector funding by the government is poor, very poor. Except there will be a turn-around.

Why is it that doctors are running out of this country? When you don’t have anything to work with, common diagnostic tools, you can’t see on your table. You want to do a scan you can’t see a standard scanning machine in the government hospital. You look for an X-ray machine, you can’t get a standard digital Xray machine in a government hospital. Most of these things you can obtain in the private facility, but they are exorbitant. If you want to do CT Scan, in some hospitals it is about Sixty thousand naira. If you want to do an MRI, it is Eighty thousand Naira or more.

These are things the government can achieve conveniently. And they don’t have a maintenance culture. If there is maintenance culture all those equipment that I have mentioned won't be out of service.

Q: What does the government do about health tourism?

A: Well, there are so many things they can do to enhance some of those hospitals to be up to date, in terms of facilities, in terms of manpower. If they can make the health sector attractive, people will start coming in. Why they go to hospitals outside the country is because the equipment is not there. We seek better treatment outside the country.

Nigerian Doctors are well recognized all over the world. They are recognized in the UK, Canada, Saudi Arabia. Our doctors are doing extremely well in so many of these places. They are doing well because they have something to work with. But in our environment, we are always improvising in one way or the other.

Q: What are needed to improve the health sector to meet international standards in Nigeria.

A: There is so much we need to do. Private sector has so much to offer. Some of these things are not there in the government sector. But when you are bringing in some of those things from outside the country, the import duty alone will discourage you.

So, if the federal government can look at it critically so that some of those things coming into the country for the private sector can have some waivers. It will go a long way to make us happy and do our best.

I can tell you today that most of the health services rendered in this country are mostly done by the private sector. About 70% of healthcare services in this country are rendered by the private sector.

And apart from that we reduce the unemployment in the labour market. Look at me, as small as I am, I have over 30 staff. So, the government should encourage us. They should reduce the import duties on some of those items. It will go a long way in helping us.

There are certain things we cannot import because of the fear that customs will seize it, or the import duty will be escalated. They will say demurrage and so many things. Those are not encouraging.

Q: Thank you for your time.

A: You are welcome.

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Abuja Bepos Hospital Besop Hospital Emmanuel Ewaoche

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