Dr. Olusegun Fakoya

Dr. Olusegun Fakoya

I read with interest the statement credited to the Lagos State Governor, Babatunde Fashola, whilst launching the Eredo Primary Healthcare Centre Constituency II in Epe division recently. Whilst the efforts of the State government in improving the delivery of healthcare in the state remains commendable, certain comments and spurious impression being created by those in authority need to be challenged.

The governor was quoted at this ceremony to have said: “Very soon, no doctor will attend to you at the General Hospital, except you have a referral from a primary healthcare centre. What you seek in the UK is now here with you. You do not need to travel long distances anymore.” While the first part of this statement remains contentious and shall be dealt with later, the latter part remains manifestly untrue and irksome. To say the least, it was deceitfully grandiose and completely opposite to the reality on the ground. Every Nigerian knows that our healthcare facilities, or systems for that matter, are so chaotically unorganised and completely unproductive. Most health facilities are horribly abandoned with patients and staff left to crude innovations on how to make the best use of such facilities. In a country where over 40% of its healthcare delivery is left in highly unorganised private hands, one wonders how such can equate to the very advanced and efficient system obtainable in most western countries including the United Kingdom.

Our healthcare system essential rests on a quartet of primary healthcare, secondary care, tertiary care and of course, the ubiquitous private healthcare. The core of this system is basically preventative, hence the primary healthcare system where preventative measures can be taken to forestall diseases. It was at the height of this romance with preventive healthcare that the late Professor Olikoye Ransome-Kuti as health minister started the mass training of Community Health Officers (CHOs) who were trained to handle basic ad preventable illnesses. These officers later acquired the pseudonym of Olikoye doctors and have contributed their quota to the progress or mess that is associated with our healthcare system.

Our healthcare system across the many states that constitutes present day Nigeria differs little, resting on the basic principle enumerated above. What has changed is probably the alarming levels of underfunding and massive corruption associated with the system. Our shambolic system sounds very operational, practicable and soundly efficient in theory. The reality, however, is a story of horror, inefficiency, tripling deaths from preventable illnesses and unmitigated disasters. Try as we may, we have simply failed to get it right.

The concept of Comprehensive Health Centres is not new. The notion of 24-hour staffing and operation as being implemented by Lagos State government is commendable. Nevertheless, I dare submit that this innovation (if it may be so called) cannot simply elevate a crumbling system to world standard. The system requires rather radical and innovative approaches to make it work efficiently. Whilst it may be said that Nigeria, being a dysfunctional federation with disparage political goals amply entrusted to malicious and incompetent leaders, the expectations of a functional federal solution to the present menace called healthcare system may be a mirage, yet it is still possible for states to individually and collective carry out emergency operations to abort the rapid decay of the parlous health system and eradicate its untoward effects on the citizenry.  It is only then “you do not need to travel long distances anymore” to seek for better healthcare.

 

 

 

What is wrong with our healthcare system?

For a system where funding is abysmally low and government interest is barely existent, and where existent purely for political gains, functionality would be a mere dream. Nigerian governments, over the years, have voted barely single digits of our budgets to health contrary to international recommendations and the requirements of the World Health Organisation (WHO). Our achievement of the Millennium Goals in this regard is highly doubtful. Our Health Centres, which remain the nucleus of our healthcare system are nothing more than empty buildings where all sorts of anti-good health practices are encouraged. They are ill-equipped, if there was ever any equipment there at all. In reality, no government has ever taken them into reckoning in the scheme of things except perhaps the regime of Babatunde Fashola as we are just being informed. They are usually manned by nurses, who over the years, with the absence of continuous professional trainings and developmental courses, become so rusty that at a point, should ideally be stopped from using the prefix “Nurse”. It is that bad, believe me, and I have the experience of over 15 years practice in this shambolic system to say this categorically.

A Comprehensive Health Centre is a step above your ordinary health centre and makes the provision of primary health care a full package. Ideally, such a centre should have the full complement of health professionals including doctors, nurses, and pharmacists and so on. In fact, a Comprehensive Health Centre should be able to undertake some surgical procedures and also have some level of expert staffing. The idea is that the burden on general hospitals (which represent the second-tier of delivery) would be lessened. We should not forget that the focus of a health centre is basically preventive, no matter its degree of expertise or professional staffing. Preventive illnesses should be vigorously tackled at this level and the results should be obvious for all to see. Comprehensive Health Centres cannot and should not be made to replace the functions of General Practitioners (GPs) which forms the thrust of the referral system in the United Kingdom, a system that Governor Fashola robustly referred to. It is not a crime to aim for a world standard provision of healthcare, but this should be based on a structural sound and viable foundation. There can be no shortcut about it.

The story of the General Hospitals and the Teaching Hospitals are in public domains and there is no point wasting space here talking about their legendary abandonment, underfunding, dearth of continuous professional development for staff, shortage of 21st century equipment and so on. In fact, it appears as if talking about any improvement at these levels (and even at the primary healthcare level) is forlorn for as long as we continue to battle with epileptic power supply, lack of clean and sufficient water supply, etc. The main thrust of this write-up, especially in relation to the statements credited to Governor Fashola, is simply that opening of Comprehensive Health Centres alone cannot be the panacea to the years of neglect of our health systems. Comprehensive Health Centres, where truly functional, would ease the burden on General Hospitals but this should not be enforced. These centres are scarce and insufficient. For an ideal model, which is my conviction Governor Fashola truly desires, attention should be urgently given to the powerful fourth force, the private providers.

Apart from perfunctory attention by government centred on registration of private health facilities and the occasional special attention brought about by influx of fake practitioners and charlatans, Nigerian governments  have over the years left a powerful force in the overall success of its healthcare delivery largely uncontrolled, unsupervised and unregulated. Our private healthcare system has become a veritable and deep jungle where every Dick and Harry, whether qualified or unqualified can operate. There are masses of private clinics and hospitals littering our landscape, most barely able to fit the description of a health dispensary not to talk of hospitals or clinics.

Government registration of those who even deemed it for to apply for registration is filled with massive corruption. I am repeating this boldly as I have been there before. There are demands for bribes before private facilities are registered and each inspection exercise is a mere exercise in futility as the original registration had been completed the moment money had changed hands. This is usually before the inspecting team left their base. It is best left to imagination the product of such a corrupt-ridden system.

The resultant effect is that unwary citizens are left at the mercies of unscrupulous practitioners who are only intent at making money and not in the least absorbed with service provision. The few genuine practitioners amongst this lot have their job made more difficult as they have to compete with charlatans in the midst of a largely illiterate populace who cannot actively separate the whiff from the shaft. The other spectrum is the influx of newly qualified and largely inexperienced medical graduates into the private health sector. This development is perhaps explained by the alarming lack of appropriate jobs for this cadre of the medical workforce. Alarming in the sense that medicine as a profession, for those who chose to stick with it, is a lifelong commitment of studying and development. Experience based on exposure, guidance, career development and so on, are the hallmarks of a good medical practitioner. However, what is obtainable in Nigeria is the influx of frustrated and often times, ambitious medical graduates into the money mill of private practice. Thus, the country is awashed with loads of mushroom private clinics and hospitals where the doctors have over the years been reduced to healers of only malaria fever and typhoid diseases. Challenge them with something radically different only at the greatest risk to your life and wellbeing.

Private healthcare delivery system in Nigeria is extremely dangerous with only a few exceptions. Those exceptions can only be accessed by the novo rich sadly. Majority of the citizens are saddled with the hugely available and widespread mediocrity. The picture is often of a 3-bedroom flat serving as the base from which professional deterioration and malpractices are manifested. There are various associations for private healthcare providers in Nigeria but none has focussed on improving the quality of facilities and that of practitioners. A situation where I graduated from medical school, completed my internship and national service and only to become a medical director is dangerous and unacceptable. A situation where my next step is to rent a flat, buy a made-in-India foot propelled suction machine, rickety steriliser and sphygmomanometer should not be a license for me to disseminate rubbish to the populace. I become so entrenched with survival and coupled with my alarming degree of inexperience, become so rotting that in a few years’ time, I had simply forgotten the pathogenesis of malaria fever or even the remotest causes and indications of ischaemic heart diseases. How many Nigerian doctors in private practice can successfully carry out basic cardiopulmonary resuscitation, not to talk of advanced resuscitation using a defibrillator? I need to make this clear, how many Nigerian doctors (including those in tertiary practice) can confidently manage a myocardial infarction popularly known as heart attack? Indeed, do we have the resources and manpower to effectively manage cardiovascular diseases in Nigeria? This is the sad state of our healthcare system. And this is the system on which Governor Fashola and others are predicating an efficient and functional healthcare delivery system. There is, indeed, cause for alarm.

It would be foolhardy to lay the whole blame for the rot in the system at the doorstep of Nigerian doctors. In a system where the government has been lackadaisical about the management of health resources and provision of healthcare, no doctor should be blamed. The simple fact is that the onus rests on the Nigerian state to harness its resources and manage same efficiently. The truth is that Nigerian doctors are part and parcel of the health resources available to the Nigerian state. Better managed, Nigerian doctors have demonstrated in other climes and places that they can be efficient, resourceful and productive. It is sad that it takes others to demonstrate the value of our own. The government has a constitutional and moral role in reforming the chaotic and disgraceful private healthcare system in the country. For crying out loud, this is not just a system that caters for few. It represents, once again, about 40% of healthcare provision. Examples abound worldwide as to how this level of healthcare can be reformed. Not only this, the government should focus stringently in reforming post-graduate policy for practicing doctors in Nigeria. For example, there should be certain level of professional accomplishment and attainment before sole ownership of private practices can be allowed. The whole concept of General Practice vis-a-vis private ownership calls for reformation. There is thus an urgent need for government involvement in private practice. The situation that presently obtains in the United Kingdom may be a model to copy, reform and develop. It needs stating here that the suggested reformation and complete overhauling of our healthcare system would be more pragmatically tackled at the federal level but can equally be initiated at state levels where the federal government, with its legendary non-performance, is found wanton. There is simply no excuse for lack of action.

Back to Governor Fashola. Whilst your effort at reforming and establishing Comprehensive Health Centres (CHC) is commendable, the truth is that such an effort is only scratching the surface in the urgent need for the provision of adequate healthcare system in Lagos State. Lagos, by its enviable position in the federation, amply magnifies the intractable problems with our healthcare system and this the government is aware of. Using health centres as the referral basis for specialist attention or treatment at General Hospitals is not workable and fraught with dangers. Even in the United Kingdom, accidents and emergency units (A&Es) make specialist referrals. In fact, some hospital units provide GPs at A&E units to attend to more routine cases and make appropriate referrals. The targeted aim of providing 57 CHC is indeed a milestone but can only succeed with attention to other salient issues highlighted earlier. Still the figure is grossly insufficient bto meet the needs of our teeming population in Lagos to make them the sole sources of referrals to general hospitals for specialist attention. Also, the referral system cannot be hinged only on these CHC while neglecting the private providers, who are often the GPs in our system .Experience in other places has shown that an effective referral system actively hinges on GPs and hence the need for government involvement in their operation and practices.  

The GP referral system forms the bedrock of any successful healthcare system. GPs are found in CPC, General Hospitals and even Teaching Hospitals. They are also more abundant amongst private providers, hence the need to take a second look at this category of providers. There is an urgent need to prune the number of such providers. A pruning process that would encourage amalgamation to institute quality and harness resources. There is a need for a more organized government involvement at this level of healthcare provision such that it would constitute almost a sort of bulk provision of desired healthcare with government regularisation aimed at ensuring quality and efficiency. This is probably the only way to encourage genuine and qualified providers and weed out charlatans. This is also the way to structure the process such that practitioners would be enforced to develop themselves and be made more useful to the society. There are indeed exciting potentials in the possibilities of the reformation possible with the additional benefits of job creation and job satisfaction. I do hope that someone somewhere relevant is listening.

 

Thank you.                

Dr Olusegun Fakoya

 

Good Morning fellow countrymen. Permit my reminiscences about a land I left behind so long ago. Permit my tears and frustration about a country I love and cherish so much. It is early morning but do permit the expression of my frustration about my fatherland. A land where hope has been dashed and where progress has been put asunder. Permit me to air my frustration about a land that pushed me so far away. I am lamenting about no other than my country, Nigeria.

True, there is no place like home. No matter how sweet the journey may be and no matter how successful the itinerary may turn out to be, the lure of home surpasses it all. I have travelled to the East and I have been fortunate to live in the West, yet the attraction of home surpasses the strength of the magnet. Home, sweet home.

I have always been adventurous all my life. Even with little in my pocket, I found the attraction of visiting unknown places irresistible. I had my bags packed, ready to move at the drop of the pin. I lay at nights dreaming, dreaming of faraway places. My dreams were filled with adventures. I dreamt of foreign lands and cultures. The wish to journey far and wide became almost like a liquor, an intoxicant that holds me spell bound. I became a slave to an uncontrollable desire. My obsession started such a long time ago that even now, I find it difficult to put a timeline. I remember in those days wishing to just be on the move with each prolonged vacation at the secondary school. I remember the day I packed my bag, having convinced my parents to allow me to travel to Warri to spend a couple of days with my father’s friend. It was in those days when there was nothing like cell phone. It was the era of “telephone is not meant for the poor”. I had written a letter weeks before my departure to my father’s friend. But true to the nature of things then, the letter only arrived after I had departed Warri. So, I arrived to the utter consternation of the family who had no inkling of my plan!

I was born and bred in Lagos. My entire childhood and adolescent was spent in the old city. My itchy legs however refused to be confined to the many limitations of Lagos. My tertiary education also provided an avenue to move out, hence I chose Ife. I traversed Ibadan to get to Ife and here my first education about my ethnic background started. It was stupefying being in a city where over 90% of residents had tribal marks! This became a pattern for my close to a decade stay in the old Oyo State. The ancient city was also a leeway to explore the inner parts of Yoruba land and witness first-hand the ancient richness of my progenitors. Ile-Ife offered me a direct glimpse of the historical tales I had learnt with early education. I skipped over fences and penetrated fallen walls to witness the ancient practices of core Yorubas in Ile-Ile. I saw beads of their different glory at Ife Museum. I also purchased many. I fell seriously in love with beads. I also saw many crafts that bore testimony to the ability of this ancient tribe.

I covered the then old Oyo State extensively. I vividly remember my first visit to Ilesha, a place that I would share as home with Ile-Ife for about 4 to 5 years. Here was this majestic beauty with stupendously rich sons and daughters. Here was a fantastic city with houses of unsurpassable beauty and attraction that words cannot completely describe. Ebenezer Obey completely encapsulated the resilience and industry of the Ijesha people with his evergreen words – “ka kole ka ra moto, Ijesha lo ni iyen”. A city that produced the likes of Ajanaku (“ti imi igbo kiji kiji”), S B Bakare, Lawrence Omole, etc. A city almost without blemish except one. I would never forget the indelible experience Ijesha afforded me. I grew up in Lagos where prisons are not common place. Of course, I am aware of the existence of the famous (or infamous) Kirikiri Maximum Prison, but then you have to take the pains to travel to where this is located in Lagos, unless you live around there or have other businesses to conduct around the place. At Ilesha, the story was different. This throw-back of modern existence was lying by the road side; a broad reminder of the legendary stubbornness of the Ijesha people. An unbelievable tale has it that the then king of Ilesha chose this institution over the provision of railway services for his people as he believed that this remained the only mechanism that can curtail the ferocity of his people’s stubbornness. No disrespect to the ancient and lovely Ijesha people though! Nle Awe! Iyan Orire, Oka Orire!!

I remember with nostalgia my years at Ilesha. Imo area was my home and my territory. I explored the town ferociously. Bolounduro, Okesha, General, Wesley Guild hospital and so on were play grounds. I made friends and partook of the warm Ijesha hospitality. I still retain vivid memories of those days. My abode was Ajanaku Quarters behind Highway Hotel in Imo. College of Education, Ilesha was a fertile ground to ake friends and meet new friends. I keep wondering what has become of these friends…   Life rolls on!

I visited Ede, Oshogbo (where we paid homage to Susan Wenger (Adunni Oloosha). The Osun River was fantastic and Ede was truly beautiful. I used these areas to explore other land marks and traversed the boundaries to reach places like Akure and even Ado Ekiti. I cannot just gloss over the import of Ado Ekiti to me and millions of Yoruba people, courtesy of the late Colonel Adekunle Fajuyi. A brilliant Yoruba Officer who took courage and gallantry to another height in the murderous history of the Nigerian nation. I paid tribute to the memory of Colonel Adekunle Fajuyi, just as his remembrance spurred that of another fine Yoruba Officer whose role in the Nigerian Civil War has not been factually enumerated. I also remember Colonel Victor Banjo and pay homage to his beautiful memory. May light perpetual shine on them all.

The “Omo Oloja” remain a cultural attraction to the rich heritage of the Ado-Ekiti people. These are the children of the reigning Ewi of Ado-Ekiti. In all honesty, the “Oja” (female kids) are truly beautiful indeed. I also explored the Yorubas even in the diaspora within Nigeria itself. I visited Ilorin and passed through Kogi. I passed by the famous confluence at Lokoja. Yoruba land is indeed wide and beautiful. It is esoteric in conception and discerningly puzzlingly. It is a land brimming with knowledge, especially of the esoteric kind, yet it is a land mired in deep rift and confusion. It is a land that has great potentials, yet one fettered in dishonesty and betrayal. Yoruba land is the wide world and it is the village. It is open and at the same time secret. It is the cosmogony and yet the smallest hamlet imagined. It remains a mystery for even the most ardent scholar.

My restless legs took me beyond the confines of Yoruba glory. I have over the years travelled East, West and North of Nigeria. I have crossed the River Niger to visit my friends and brothers from the Eastern part of our wonderful country. I have witnessed first the entrepreneur and financial acumen of my Ibo brothers. Their commercial sagacity is a virtue that should be stupendously harnessed by any wise nation. I have, sadly, also witnessed the horrendous damages caused by erosion in the East of Nigeria. I saw the impact of shrinking land mass and its consequent effect on a dynamic people. I tasted of Ibo warmth and hospitality and to date, cherish my association with my Igbo brothers and sisters.

I have also crossed the divide to visit Northern Nigeria. The “North” like our puerile politicians would call it. My unique reminiscence of the North begins with the different smell, look and feel of this rather challenging part of our federation. The North indeed smells different and looks and feels different. We set sail from Lagos in the night to get to Kano early in the morning. I had dozed off in the vehicle but woke up somewhere around Lokoja when I began to smell something different. Welcome to Northern Nigeria! I traversed the vast landscape of northern Nigeria by road from Kano to Sokoto. Assa-la malei-kun!! I saw the Alamajiris, a festering social sore that bestrides the length and breadth of Northern Nigeria. The abandoned street children, a potential army of social destabilisation and disharmony!

I saw the impact of encroaching desertification, vast expanse of land with scanty houses and population, yet the mighty North remains the most populous in our federation, thanks to hypocritical British colonialists. I saw round huts with “Ba Siga”. I saw women with painted feet and hands, albeit Islamic tradition. I ate “Tuwo” in different flavours till I got tired. I visited Argungun and went to Zamfara. I was there when Gideon Orkar (*of blessed memory) launched his coup d’etat. I learnt a lot about the culture of this ancient people. I was forced to learn passable Hausa as “Turenchi” would not get me anywhere. How proud the Hausas are about their culture. But the heat, brother! I saw sunshine at 5.00 a.m. and by mid-day, the heat was scorching. I would never forget the day I was convinced that the sunshine in the North must have been nothing but fire from heaven. My only regret is that I never visited Jos. Perhaps, it would have been cooler!!

I started this piece as a recollection of my worldly travels but ended up with pages of my experience in Nigeria alone. My other sojourns would have to wait for other times and moments. Suffice it to say that I am a proud Yoruba man, born and bred in a country called Nigeria. I am a proud Nigerian who have by virtue of birth, upbringing and life experiences removed the shackles of ethnic affiliation to come to an understanding of the unity of all. I am a proud Nigerian who sees the benefits in the corporate existence of this great nation. I am a firm believer in the abundant benefits of our great nation as one entity. I am a Nigerian troubled by the deficiencies so far glaringly manifested by my desire and wish. Nigeria today remains a cataclysm, an abject failure and joy killer. It remains a ghost of its potentials after several years of continuous pillaging by all and sundry. It is a country in the midst of a corruption tsunami. The phenomenal impact and socio-economic damages induced by the monsoon of corruption and bad leadership on our beloved country bring tears to my eyes.

I grew up in a Nigeria that witnessed a civil war. My childhood recollections of the civil war is a story reserved for another day. Over the years, I have witnessed turbulence and catastrophe in the land. I had hoped for a country that would epitomize peace and respect for its citizens. I had hoped that over the years, Nigeria would get its acts right. I had waited to see development and progress. The futility of my hopes aggravated my wandering legs. I defied “Andrew” and joined the bandwagon of exodus. Here I am in a foreign land. Still, I longed for the land of my birth. I longed for MY COUNTRY. I have endured tribulations in my journeys. I have witnessed first-hand racial discrimination and discrimination of all sorts. I have endured as home is no longer home. Our country has become a ravaged land, taken over by a swarm of locusts in the garment of indecisive, murderous and visionless leadership.

The day is coming to an end and the sun is receding pretty fast. Night is falling and the future looks bleak for Nigeria. In the midst of agitation spreading like wildfire in the Arab world and sporadically in other places, Nigerians remain placid and bemused. We continue to tolerate irresponsible leadership and continue to eulogise an opposition that has nothing spectacular to offer. I remained baffle by a country that can be so docile in the face of unprecedented abject poverty and unhindered suppression and political injustice. A docility that has gotten to the pint of stupidity.

Who will save Nigeria?

 

Olusegun Fakoya (Dr)

These are indeed precarious times for Reuben Abati. And like any sinking man, desperate to hold on to a fast dwindling job, Dr Abati has resorted to desperate measures. The flurry of articles from him in recent times speaks volumes about his desperation. For a man who hid under the “umblellah” (sorry, umbrella) of social activism for many years, the opportunity to partake in the sweetness of power has been a mesmerizing experience which he is in no hurry to willingly relinquish. Dr Abati desperation is such that he has even resorted to abusing and insulting Nigerians. His latest article titled “The Jonathan they don’t know” is just another wasteful enterprise aimed at refurbishing a bad product. It is rather too late in the day to attempt to turn an imbecile into a genius. 

Reuben, in his desperate article created a strategic divide based on perceived loyalty or otherwise. A very unfortunate division was created based on activism or passivism. His battle line consists of the “They” and the loyalists. Loyalists, by his definition, being those benefitting from the potpourri. Those in the privileged league of the manipulators and beneficiaries of our commonwealth. Those who persistently deny the nation of deserved economic and material development. The thieves who roam the corridor of power and keeps the lock to same in their bulging pockets. These, to Reuben Abati, are the good Nigerians, those who have left Goodluck Jonathan in peace. The “They” according to Abati “refers to all the cynics, the pestle-wielding critics, the unrelenting, self-appointed activists, the idle and idling, twittering, collective children of anger, the distracted crowd of Facebook addicts, the BBM-pinging soap opera gossips of Nigeria, who seem to be in competition among themselves to pull down President Goodluck Jonathan” Obviously, to this exalted company belongs the likes of Sonala Olumhense, Pius Adesanmi, Okey Ndibe and a host of others. I must confess that my humble self also has company in this prestigious group. Reuben, however, belongs to that other group of “good Nigerians” those who sleep and wake up with scandals, those who keep corruption as comfortable bed fellows. We heard of the rumbles of the Abuja plots of land, even when Abati was pretending to be a social critic. This rumble had hardly abated when the opportunity to explore his true identity came by the way of the presidential appointment. 

To Reuben, the group of “They” are a “bunch of unintelligent people repeating stupid clichés and too many intelligent persons wasting their talents lending relevance to thoughtless conclusions”. So, our exalted group of “They” consists of either plainly stupid people or naively intelligent people.  It is worth restating that Reuben Abati once belonged to this maligned group. Reuben’s insult to the intelligentsia and those Nigerians who have sacrificed so much to ensure that the Nigerian state assumes its true position in the comity of nations is unpardonable. It is bad enough for a hypocrite to denounce his initial constituency, it is criminal to turn around and lambast same for failing to see the sense in your sudden turncoat and imminent disintegration. It is so easy to castigate the same group of “They” who fought to ensure that the Jonathan Presidency becomes a reality. Has Reuben pondered on the causes of the massive evaporation of the uninhibited flow of affection and national support for candidate Jonathan?  What turned the almost hysterical Jonathan-mania into rabid Jonathan-phobia? Conscience, they say,  is an open wound…. Only truth can heal it.

Reuben’s effort to blow the trumpet of achievement for Goodluck Jonathan sounded very hollow, even on the pages on which they were written. For a previously “shoeless” President (Reuben can never stop us from making reference to this appropriate description) who promised heaven and earth on his campaign trips, the boast of 4,400 MW of electricity in a nation that is still in perpetual darkness went beyond the bounds of pardonable mischief. Reuben’s lukewarm reference to presidential concerns on corruption is nothing but laughable – “That is why he has directed the relevant agencies to get corrupt persons to answer for their misdeeds” Reuben, when the current charade on corruption is over, we hope that genuine convictions would indeed be possible. Farouk Lawan is still a free man, walking and enjoying free sunshine with millions of bribe money yet to be accounted for. Otedola’s cheeks are growing rosier every day while the nation’s Attorney-General is probably the richest Nigerian today courtesy of a lax regime that encourages graft. Furthermore, Reuben’s attempt to speak about his master’s inordinate love for the women folk smirks of nothing but jest.

 

True, Jonathan has loads of females in his government compared to his predecessors. However, the concern of majority of Nigerians is with the innate penchant of this man to surround himself with the most corrupt and despicable Nigerians ever created, whether males or females. 

Without wasting so many words like Reuben is fond of doing, the truth about Goodluck Jonathan stares at one in the face. It is not for nothing that he is viewed as clueless. This is a simple English expression within the grasp of even the barely literate. Jonathan has so far demonstrated his lack of understanding of the basic mechanism of governance, the constitutional and moral obligation of a government to the people and the fine etiquettes of Presidential approach. He is an opportunist who jumped at the ship of state without adequate preparation. His government is belligerent; an example is the latest crude and rude articles from Reuben Abati and the unpalatable appointment of Doyin Okupe as a frenzied attack dog. Jonathan is manifestly corrupt and he has no qualms in attempting to brush this under the carpet. It is beyond comprehension, that the President of over 150 million people, people who continue to excel in various spheres of human endeavour, would publicly declare on national television that he does not give a damn about declaring his assets. Reuben Abati is yet to address this sore point in his numerous essays.

Abati has my sympathy in his attempt to refurbish the morally tainted and structurally deformed presidency of Goodluck Jonathan. True, Jonathan is “nationalistic” in orientation in terms of federal appointments (to use the Nigerian phrase, he is a good disciple of national character), nevertheless, former criminals of the creeks are now handling sensitive national security apparatus. The old Ijaw Generals of the ill-famed creek wars are now multi-billionaires, smiling comfortably to the banks every month, courtesy of a truly national President. The likes of General Tompolo et al. Who cares whether Jonathan eats cassava or whole meal bread or even boiled plantain for that matter? The key thing is that in an austere environ when millions are out of jobs, when crime is blooming like the old Onitsha market and when terrorism is sweeping the land like a raging inferno, our belligerent President spends billions annually on food. This is an undisputable fact that Reuben failed to address. Abati has gone miles in his unfortunate academic odyssey of rationalising a bad product. He has thrown terms around, starting with Corporate Social Responsibility, a la the infamous Otuoke Church building, to the new “Saul Complex” in his latest tirade. Whether corporate responsibility or Saul Complex, a decaying product would always stink, no matter the intensity of the advertisement.

The Jonathan we know? The Jonathan we know is a President who promised so much and yet intent on delivering so little. The Jonathan we know is an opportunist. An over-ambitious man toying with the fate of millions. The Jonathan we know is a man who assumes a position of authority fully beyond his capability and comprehension. The Jonathan we know is a President who is so enwrapped in the loin clothes of his wife such that the country is actually confused as to who is in power.  He thus brought nothing but baggage into the act of governance. The Jonathan we know is a president who glorifies corruption and embraces its evil warmth – “if corruption does not kill Nigeria, Nigeria will kill corruption” The Jonathan we know is a non-performing President, a colossal failure. This is the verdict of the people, Reuben.

No Nigerian has any quarrel with any part of the country producing the leadership. What we care about is performance. We care less whether the President is an Itsekiri or Ibibio. We have no qualms with the Ijaws (whether the 4th most populous or 10th most populous) producing the President. All we desire is a leader intent on ridding our body polity of its various nuances. A leader committed to emancipating the fast dwindling lots of poor Nigerians. A leader committed to faithfully fighting the strangulating hold of corruption and the endless evils that have truncated our march to greater glory. We need a leader that can go beyond the pretences of party politics and truly be a leader indeed. Our complaints against the lacklustre performance of Jonathan have nothing to do with his ethnic origin, Reuben and mavericks like him do not need to confuse issues. We simply do not want the man because he is not performing. Period.

Yes, great minds like Abraham Lincoln, Mahtama Ghandi, Martin Luther King and Kwame Nkrumah made the world easier. Yet whatever they achieved was with plainness of approach, honesty and integrity. They were not achieved with the purchase of hundreds of porch cars for a frivolous and egomaniac meeting of wives of discredited heads of governments. They were not achieved on the lavish expenditure of state fortune on state banquets or meals. They were not attained with dourness and stupidity. They came out of a vibrant methodology and pragmatic visions. Jonathan lacks these qualities. Comparing the man Jonathan to these great minds is illusory and vain.

Reuben’s attempt is that of a sinking man desperately trying to catch a lifeline of straw.


This is a hilarious moment for Nigeria. Of course, I am not mad. I am only reflecting on the period in time and circumstances we have found ourselves as a people. Not too long ago, Shagari was indecisive, Buhari/Idiagbon too serious and impenetrable, Obasanjo was too amorous and unforgivable. Now we have it. A serious comedian as president. Jonathan no go kill man for this obodo Nigeria! Mba.

I just dey play with my tumbra of gin tonic. The weather cold pass wetin son of man fit just manage with ordinary heater. My Igala friend suddenly informed us of the ongoing demonstrations by students of the University of Lagos. Oh, sorry! Moshood Abiola University in good old Lagos. My broda, I no fit laugh. I just tire for dis country o jare!!

Reports say the students no want de brand new name bestowed upon dem by His Majesty, Emperor Goodluck Ebele Jonathan. Jonathan has only exercised his right as conferred on him by the uncharted constitution of the empire called Nigeria. Me no even no why these students dey protest instead of celebrating their new baptismal name. Instead of allowing akpteshi and burukutu to flow, dem dey hala. Dis one no clear me, I beg.

Other reports indicate that students of nearby Lagos State University dey celebrate. Dem celebration no get anything to do with the fact of the re-christening of Unilag but for the equality inherent in such a merciful act by the new maximum ruler of the land. For too long, Unilag students dey hala and shakara those of poor Lasu. Now equation don dey equal. No more bush meats, no more Unilag swagger, no more pepperless. Gbogbo awon guys na de same now, se you know?

While my sympathy is naturally with the unfortunate students of Unilag, who after 50 years, have suddenly being dashed a new father, may I be allowed for once to ponder on the manner of the leader at the helm of affairs in our dear country. Jonathan’s metamorphosis has been unique. From a spineless Vice President to a lacklustre Acting President and then a “shoeless” presidential candidate and now an imperious President who makes decisions with scant respect for the feelings of fellow citizens and without due consideration for established laws. With his amicably deceptive mien, Jonathan has treaded where even military rulers have dreaded to walk. Examples abound, my dear friend. Let us consider those of recent memory. Pump price of fuel was hiked in the manner in which Unilag was re-christened. By military fiat (sorry, civilian fiat!). Soldiers were deployed to the streets of Lagos, were they not? Someone just reminded me that this is supposed to be a civilian dispensation!

The story of Goodluck Ebere Jonathan is akin to the strategic transformation of the Bumblebee. It is the story of how power intoxicates. May Shakespeare rests well in his eternal sleep. Goodluck was the Humblebee with the scary coat seeking pollens here and there as both the Governor of Bayelsa state and lame duck Vice President under the tragic Servant Leader. The Humblebee repudiated the humility of Servant Leadership. He became opportunistically fascinated with political power at the demise of the Master Servant. His transformation started and the Bumblebee was born. Political lobbying and jockeying, including manipulations and subterfuge created the less than desirable Bumblebee. This was a hairy creature whose underbelly was still ugly but appearance rather deceptive. He became the Acting President. In furtherance of his unhidden political opportunism, Jonathan went to Nigerians with a cock and bull story of a shoeless boy from the Niger Delta. Foolishness took over the land; the Bumblebee can be a dangerous animal. Votes were massively rigged. He was even assisted in this process by the political power house in Western Nigeria. Never mind that they would be one of those to later criticize him.

The Bumblebee got to power. His initial act was to surround himself with his syncophants, including his brethren from the Niger Delta. Uncle Reuben was even included in the despicable package. His acts became untidy and uncoordinated. Bombs exploded on Independence Day in Abuja and the Bumblebee went on air without even waiting for security reports. He needed to defend his brethren who just came out of the creeks. The Bumblebee got so immersed in the juices of power, those juices are sweeter than his accustomed honey drink. He reeled from one controversy to another, from indecision to indecision. Mrs Bumblebee also provided adequate support as she used her “umblellah” to swagger from one territory to another. The Fumblebee was surreptitiously borne, alas!

Mr Fumblebee became emboldened. He dabbled into insane territory and took psychotic decisions, all in the “interest of Nigerians”. Pump prices of fuel were hiked even though later investigations showed monumental fraud. Soldiers were abused by being drafted to quench civilian uprising. Mr Fumblebee went on air, threatening to eradicate the dreaded Boko Haram sect in 3 months. This was after he had numerously consoled Nigerians on the terrifying deaths induced by same organization. Mr Fumblebee, in characteristic manner, even asked Nigerians to learn to live with the Boko Haram induced deaths at one stage! Now, this latest joker on a supposedly Democracy Day celebration!!

Back to my bottle of Gin plus tonic. Me, I know for de students wey dey protest. Why den dey hala no dey clear to me. Wetin, Mr Fumblebee do wey dey cause commotion? For practicing his belief in the concept of One Nigeria? De way things dey go for obodo Nigeria, Jonathan go kuku name de university wey dey for im papa backyard after Nnamdi Azikiwe or Shehu Aliyu Shagari. Afterall, no be One Nigeria we call am? Me, I go just siddon jeje. I no partake for dis roforofo of a protest. Even as Jonathan and pidipin (PDP) dey make terrible efforts to sectionalize the evergreen legacy of MKO. Na God dey punish Nigeria with shoeless mumu presido. Comot for me, o jare!

De man no dey tire. He just dey jump from one controversy to another. Even Baba Suwe no fit make person laugh pass Bro Jona. Na Unilag today, God knows wetin he go be tomorrow. Abeg, make I watch my mouth as very soon Brother Reuben go remind us of the corporate social responsibility of Mr Fumblebee. Jonathan don Cuckoo no be small. Uncle Reuben take follow am. As Bro Jona dey cry take style collect bribe, na same style im dey take dey punish Nigerians for dem stupid error in allowing the travesty of his selection to stay. Confusion dey reign supreme for de land and Boko Haram dey enjoy killing on an unrestricted basis. Dis country tire me no be small. Dis one pass bad luck. Na wetin we wan call MAU (Moshood Abiola University) students? Moshoodites or Abiolarites? Someone suggested Maulag – an era of Mau Mau in Nigeria? Na den go choose, no be my concern. All I know be say, dis latest joke from Bro Jona na one kind peculiar mess. Penkelemesi indeed!

I beg pass me another tumbra!!

Warning:  Article is admixed with Nigeria’s pidgin English. Apologies to readers that may feel offended as this is probably the language the Emperor and his darling wife may best understand.

 

Olusegun Fakoya

It is no credit to the regime of Babatunde Raji Fashola that the self-induced healthcare crisis still lingers and in fact, about to assume wider dimension. I am convinced that when Fashola and his cohort embarked on the ill-advised decision to summarily sack the almost entire medical workforce in Lagos State, little did they give any consideration to the possible snowball effects of such an irrational decision. If words are not to be minced, the unfortunate action of Fashola and his coterie of mis-advisers is social irresponsibility and democratic betrayal.

Since the self-induced crisis started, the arrogance and laissez-faire attitude of the state government has not in any way helped in resolving the raging inferno. The entire administrative apparatus of the state, along with the leadership of the party in power, has so far displayed an attitude that bothers on haute indifference. Indifference, that is, to the plight of the suffering masses of the state. Of late, there has been a flurry of actions and decisions of the state government that raises serious concerns on the quality of leadership in our fatherland. For a party that touts itself as a credible alternative to the murderous and corrupt one in power, recent actions of Raji Fashola, a scion of the Action Congress of Nigeria (ACN), put hope asunder for Nigerians who have grown weary of political mis-leadership and perpetual deceit. The stewardship of Raji Fashola in Lagos State beckons on history and posterity for a second review.

Whilst the aim of this write-up is not to delve too extensively into the genesis of the present crisis (that much is in public domain), nevertheless, it is pertinent to state that for a crisis that started as far back as 2009, it is a gargantuan failure of leadership that it still lingers, 3 years after. This is no compliment to the leadership abilities of Mr Raji Fashola. Indeed, some pertinent questions beg for urgent answers.

The first of these is simply this – should there have been a crisis in the first instance? The summary of the problem is the demand for what is termed CONMESS (Consolidated Medical Salary Scale) by medical practitioners employed by the state government. This demand dated back to 2009 and led to a prolonged strike of almost 3 months in 2010. An agreement was reached between the state government and the then striking doctors on the implementation of CONMESS. It is pertinent to state that there is a guideline and reference point in this CONMESS agitation – the CONMESS initiated by the Federal Government. Reports indicate that other states in the federation have started implementing this salary structure. Lagos State itself, despite the arrogance and braggadocio attitude of those at the helm of affairs, has not denied reaching an agreement with the medical doctors following that initial strike. In fact, Raji Fashola and his turbulent health commissioner have denied nothing, including the criminal attitude of turning the doctors pay into a complete mess following the suspension of the 2010 strike. Knowing full well the burden of their guilt in the whole fiasco, the state government has chosen to focus on a frivolous concept of disrespect on the part of the doctors to their employers. This has formed the thrust of its argument in support of the irresponsible and myopic decision to dismiss an entire workforce. A workforce built on several years of service in many instances. By deduction, it has become apparent that Fashola never intended to pay the striking doctors in the first instance. The doctors were merely conned to abandon the initial strike, a situation which has created a terrible mess for the state. CON – MESS indeed!

The second question thus becomes quite important. Did Raji Fashola single-handedly come to this less than altruistic decision? It is not far-fetched to surmise that the answer is simply no. It is ironic that at least two medical doctors are top ranking members of the Lagos State government as presently constituted. Ore Falomo and Jide Idris are two classic examples of professionals who are committed traitors to their calling. The utterances of these two men have been purely inflammatory and combative. There is no doubt that these two traitors have been busy mis-advising Fashola on steps to take in order to teach their striking colleagues a bitter lesson. There have also been insinuations in some quarters that the idea of sacking the doctors was first muted by the National leader of the ACN some years back. I may be missing something, but to my knowledge, Bola Tinubu has not said or taken any active action to date to dispel this insinuation. Somehow, the entire leadership of ACN feels so ensconced in the comfort of their delusional knowledge of the eternal grip of their party on the political fortune of the state. It is such that the party leadership can continue to wine and dine in unrestricted luxury whilst the citizens of the state are lamenting in anguish and dying from preventable illnesses.

The on-going saga speaks volume of the importance accorded healthcare delivery in the state by the Fashola regime. For a state to perpetually reel from one industrial action to another amongst a vital sector of its healthcare force makes a mockery of the outstanding “achievements” of this state government which praise singers would never cease to drum into our ears. Lagos State has never has it so bad, ironically from a democratically elected regime. The continued indifference and arrogance which characterises the reactions of functionaries of this regime to the lingering strike and purported dismissal of the medical doctors is unpalatable and unforgiveable. The governor is not exempt from this arrogance. Lagosians endorsed a democratic dispensation to enjoy the dividends of good governance, healthcare delivery inclusive. They did not vote for Fashola so that he could have a platform for carrying out his undisguised grudge against the medical profession.

The third point seems ominous and rather disheartening. The acrimonious state of inter-professional relationship in this country is further highlighted by the current situation. It is inconceivable that Raji Fashola, a trained lawyer, would harbour so much disgust and disrespect for  another profession, this time around, the medical profession. His lackadaisical approach and responses to the doctors’ dilemma is very unfortunate and speaks volume. The situation is however compounded when one considers the input of the likes of Ore Falomo and Jide Idris. Is this just merely inter-professional envy and disdain or even a case of intra-professional disharmony and disunity? Could it be that in the long run, the medical profession in Nigeria, and Lagos State in particular, actually has itself to blame? Is the medical profession its own worst enemy?

It is difficult for a government that spends huge sums on publicity and on questionable projects to convince the citizens of its inability to cater for its medical workforce. Examples abound of the wastefulness of this government; recent ones in memory include the huge sums expended on celebrating the birthday of its benefactor. Questions also arise on the embarrassing remunerations being paid members of its rubber-stamp state legislature. One can also not forget in a hurry many questionable practices of this government that actively siphons money into private hands, most especially its almighty benefactor. The case still lingers on the questionable Lekki-Epe expressway that in the first instance exposed the barbarity of the Fashola regime when it unleashed violence on peaceful protesters. In addition, tongues are still set on the issue of Alpha Beta Consults. It is really baffling, that in a state that collects federal revenue, payment of an agreed salary scale to its medical workforce has become such an embarrassing major issue. Coming from a government that proclaims to derive its mandate from the people, there can be no greater irony.

The all-powerful Lagos State government has used its last joker. In using this joker, wisdom took flight and reasoning was in abeyance. The consequences of the foolish decision were not properly evaluated. On would have thought that such a state government would have made adequate provisions for credible and effective alternatives. What we have is a sorry state of confusion and embarrassing inefficiency. One in which NYSC doctors were suddenly elevated to the role of saviours. The reality on ground is that the supposedly superior Raji Fashola and his coterie of mis-advisers have no magic wand. They only created a problem whose multiplier effects appear endless. My personal disappointment can only be imagined. I never knew so much foolishness has been ingrained into the acts of governance in this state.

This leads one to a brief purview of the Action Congress of Nigeria as a political party. While this party is ready to throw all it has into the re-instatement of Justice Salami, same party has been dilly-dallying on the issue of the sacked Lagos State doctors. For a party that claims to offer credible alternative in our body polity, its underbelly has been exposed to be not too attractive. This singular act of its supposedly shinning governor in Lagos State gives it no credit. Indeed, the hypocrisy entrenched in the foundation of the party cannot be measured by any other yardstick. If a PDP government were to have been in this mess, God knows that Lai Mohammed would have cried himself hoarse. Suddenly, everyone that matters in the party has suddenly developed sore throat.

The point remains that even a military junta with any sense of social responsibility would hesitate before summarily dismissing a very significant aspect of the entire health workforce of a state. This action by Raji Fashola calls for nothing but outright condemnation. Words should not be mingled on this. The continued arrogance and intransigence of the state government smirks of nothing but that of a state functioning in the absence of logic and wisdom. Chaos would only result when reasoning takes flight on a vital issue. In the absence of reasoning, mediocrity and confusion reigns supreme. Anarchy becomes the order of the day and ego assumes boastful control. Indeed, this is the situation in Lagos State today. The government has boxed itself into a cul de sac such that face would be lost if the doctors are recalled immediately. Unfortunately, I really cannot see just any other option for Raji Fashola if the crisis must be resolved. This is a bitter pill he has to swallow. A lesson to be learnt in the act of governance.

Fashola has thrown a futuristic punch at posterity. The sad fact is that the so-called achievements of his regime would always be blighted by his lack of statesmanship when crucial issues call for this precise ability. In the best of times, Lagos State cannot boast of a comprehensive healthcare delivery worthy of emulation. For such a shaggy and parlous healthcare delivery system to be persistently eroded by administrative indifference and incompetence, the end result is nothing but unmitigated disaster. The unfortunate recipients are only the poor masses of the state.

I do not write to placate anyone but to point out the truth as it is. The sorry state of affairs has gone far too long beyond comprehensive understanding. The Hippocratic oath taken by medical doctors is yet to be defined as an oath of eternal poverty. Lagos State government should stop fooling itself in its sentimental romance with this oath as its basis for social irresponsibility and unparalleled rascality. Lagosians are suffering and unwarranted deaths being recorded. Raji Fashola cannot continue to remain indifferent in the face of this glaring disaster. The onus is on him, not any other person, to immediately reverse this unorthodox and draconian decision. In the long run, the buck rests on his table. A word is enough for the wise.

Olusegun Fakoya