By Eze Chukwuemeka Eze,
“…..The fact remains that if that was achieved, then, any Nigerian going to India for medical attention was going there for a jamboree as Rivers State was to be in a position to provide similar services obtainable in India.
At that time, Rivers State became the only State in Africa to establish a worthwhile Auto Disable Syringe factory that produced 160 million syringes annually. Based on the Rivers State health revolution, the Federal Government banned the use of all conventional syringes in the country with effect from 1st October 2012 and had signed a bulk purchase agreement with the Rivers State Government….”
PREAMBLE
Highlight of His Feats in Health When He Held Sway as Rivers Governor as Captured in Chapter Six of the Historical Book Titled – “Amaechi: His Feats, Inspirational and Revolutionary Leadership Style” His vision and revolution of Health Sector was to make Rivers State destination point for all health cases affecting any Nigerian with hope of making any Nigerian going to India for medical attention was going there for a jamboree as Rivers State was to be in a position to provide similar services obtainable in India but what happened, Nyesom Wike came and destroyed all these dreams and vision
Chapter Six
THE REVOLUTION AND UNIQUE FEATS OF AMAECHI IN THE HEALTH SECTOR OF RIVERS STATE
“The philosophy of this administration remains the need to create easy access to healthcare through preventive healthcare delivery policy, disease control, boosting access to primary healthcare facilities to reduce pressure on the secondary healthcare centres (General Hospitals), and reduction of foreign medical trips by establishing world-class health facilities in the state.
“Our healthcare programs these seven years promoted child and maternal mortality. We committed personnel and resources to a better healthcare delivery for our people. Thus, we are proud of such milestones as 436 additional doctors, and 400 additional nurses employed; 160 modern primary healthcare centres built, Kesley Harrison specialist hospital built; The Maxilo-Facial specialist medical facility at Garrison Junction; Self-Destruct Syringe factory; 1000-bed hospital ongoing; The war against malaria especially the bio-larvicidal factory that is ongoing; the total war against epidemics such HIV/AIDS, Polio and Ebola; and tackling Glaucoma and Cataract.
“Worthy of note is the Ebola scourge response effort; and how Rivers State emerged with a minimum casualty rate. Recently, the Rivers State Government was honoured for standing Ebola to the face. The fight tasked our best in men and resources. We quickly harnessed global comradeship built out of a universal fear that unless mankind overcame Ebola, the earth would be turned into a morgue. We rallied our people to alertness and healthy habits. The media was summoned to a race against time, and to the glory of God, with the hard work of our professionals and the support of Rivers people, the federal government of Nigeria and international development agencies, we were able to defeat Ebola. This is a testimonial to what is possible when the people and Government work together.
(ii) Amaechi: Tackling Rivers’ health challenges
According to Daisaku Ikeda, “A great revolution in just one single individual will help achieve a change in the destiny of a society and, further, will enable a change in the destiny of humankind”. To Lewis F. Korns, “The history of the human race always has been, and most likely always will be, that of evolution and revolution”. These great minds, in making their great statements, seemed to touch some aspects of the philosophy of Rt. Hon. Chibuike Rotimi Amaechi, as It becomes imperative to critically x-ray the health challenges and how the Amaechi administration went about addressing some of the challenges, and allow the reader to see if this perception is in order or not.
In this regard, efforts will be made to discuss the achievements and flaws (if any) of his administration in the area of Health during his tenure as the Governor of Rivers State. This will also review the serious steps taken by his administration to tackle the sorry state and comatose health sector in the State before October 2007.
The administration is on record as having set up the Primary Healthcare Management Board and sent the Executive Bill on Sustainable Development Amendment Bill No. 1 of 2008 to the Rivers State Assembly which was later passed and signed into law by the Governor.
According to Virgil, “The greatest wealth is health” and in the realisation of this, the Rivers State Government under the leadership of Rt. Hon Chibuike Amaechi, adopted a system of healthcare which thrust was anchored on Primary Health Care with the following specific objectives: Provision of quality and standard health facilities; Provision of efficient, effective, and affordable health services; Availability of well-qualified and motivated staff at all health facilities; Provision of health services to vulnerable groups at government cost; Preparation of the Bill for the establishment of Primary Health Care Board already implemented.
The following steps were adopted to achieve that vision –
Re-orientation workshop for heads of health establishments (Ministry, Hospitals, Health Units in LGA), held from 4th – 8th August 2008 as a first step;
Re-training of all categories of staff in the health sector of the state;
Recruitment of equipped staff to address the severe manpower shortage in the Health Sector;
Construction of Karibi-Whyte Mega Hospital at the cost of $98 million;
Maintenance contracts were instituted for different (medical) equipment in the Hospitals;
The government embarked on massive medical infrastructure development all over the LGAs;
Governor Amaechi took this up personally and met with doctors in the state and set up a Committee on Health Policy;
The state government started State Health Insurance Programme
According to Jack Goldstone, “Revolution is an effort to transform the political institutions and the justification for political authority in any society, accompanied by formal or informal mass mobilization and non-institutionalized actions that undermine authorities”. Without fear of contradiction, I make bold to state that if there was anyone in Nigeria who demonstrated that definition of revolution, it was Rt. Hon. Rotimi Chibuike Amaechi. To support that opinion, I shall further highlight his achievements in the health sector.
In Rivers State under Governor Amaechi’s watch, a tremendous revolution in health service delivery took place. The State Government offered free health services to all her citizenry in all government-owned hospitals or health centres. To achieve this, his administration constructed over 160 Health Centres in all the LGAs. These facilities were available free of charge to both indigenes and non-indigenes residing in the state, according to Dr. Sampson Parker, the then Health Commissioner.
According to Ralph Waldo Emerson, “Every revolution was first a thought in one man’s mind” putting this into action and throwing more light to(n) the revolution in the health sector in Rivers State, Rt. Hon. Chibuike Amaechi, the brain behind the revolution, had much to say. He had stated thus: “We have wonderful primary health care facilities. I was told by my Commissioner for Health, and it was confirmed at a meeting held with all the doctors in the state, that you cannot have sound secondary health care without a basic foundation which is basic primary health. That is where we are mainly focused. We have a plan to build 160 primary health centres. We have completed 100 and they are functioning. The 100 that have been completed have Doctors’ Quarters and Nurses’ Quarters, and they should live there. Why I said they should live there is that I have visited those hospitals but, most of the time I have gone there, doctors were not found there after 4 pm.
“The excuse they give is that how many patients do we receive in a day? Maybe 10 to 20 and so what are we sitting down for? That is the excuse. But you are paid to stay there. You are hired to be there. You are not paid to be in Port Harcourt. You are told you will live in the rural areas. There are generators attached to every hospital. Of course, there are management problems but we are addressing that. We will pay the health centre for every patient they see. We will pay the bill. So if you talk about primary health centres, we currently have a very robust primary healthcare system. We intend to complete the 160; if possible, expand beyond it. At the secondary healthcare level, we are refurbishing some hospitals. The old Niger Hospital is renamed Prof. Kelsey Harrison Hospital and is completed, furnished, equipped and will soon be commissioned for public use. We are furnishing the dental hospital too. But we intend to renovate 24 of the secondary healthcare centres so that if anybody needs to be referred from the primary healthcare centre at least, there is one secondary healthcare institution in every local government you can go.
(iii) Working with consultants
“We are encouraging negotiation with people to complete the construction of one of our major hospital projects. It is supposed to be a medical tourism. Initially, the vision (was)is to be 1,000 beds but it shows you that we were new when we had that vision because we did not ask basic questions. That is why it is good to have consultants. When we brought consultants, the basic questions they asked showed that we didn’t do our work well. The first question they asked was, do you have feasibility? No sir. How do you know you need 1,000 beds? Who are the patients? What are their financial capabilities to pay for the service? How do you sustain it? So their recommendation is, out of 1,000 beds, we go for 500 beds. Modern technology does not even allow a patient to stay more than one week in the hospital so if you plan for 1,000 beds and the patients stay for one week; you notice a lot of the beds will be empty. So we have reduced it to 500 beds instead of the 1,000.
“In fact, the early recommendation was, if you like the name 1,000 bed hospital, then establish a medical school at the Rivers State University of Science and Technology because the university is actually close to the school. Then, build 500 beds for them where they can use that as teaching hospital. If not, if I were you, the one they are building here can also act as teaching hospital to the university because it is very close to the hospital. So, we are dealing with primary healthcare, secondary healthcare and then tertiary. If we do have the money by God’s grace, we would complete the rest of primary and secondary healthcare projects and we hope that we would be able to raise a huge bond.”
That was the voice and mindset of the man behind the conceptualization of the revolution in health service and delivery in Rivers State. That dream was a revolution that was not only to make other states in the federation green with envy but also make Rivers State a medical reference point in Nigeria and the West African region. He also hoped to have made Rivers State a Mecca of sort to anyone seeking quality medical help from any part of the world.
To justify the revolution in the healthcare sector, Dr. Sampson Parker, then Commissioner for Health, stated, “We are about surfacing. All along, we were trying to create a solid foundation for the medical sector. That is what we are doing and that is why you hear us talking about primary healthcare and the structures we put in place for Primary Healthcare and all that. By the time we finish and go to the secondary and tertiary and make the enabling laws that will bring about the sustainability of this, then, we can call it success”.
The two major areas this administration concentrated on, according to Dr. Parker, were Health and Education. “To me, I always say this, the highest achievement of this government is nothing but re-establishment of the educational system. It is not about health, it is not about anything. My own is that, if we have achieved education, we have achieved healthcare. My challenges in the health sector are because of the illiterate population that hardly understands what you are saying. But, if we achieve education in the way the Governor is going about it, pushing it, establishing it, making enabling laws to protect it for sustainability, I think the people that will come after us will benefit from it”. The crux of the matter – fix education, fix everything.
On specific achievements of the Amaechi administration in the health sector, he stated; “I said that in all the things we are doing, the major thing is about the primary healthcare system. That includes the infrastructural development and the programme that makes up primary healthcare. That is the system and the utilization of such programmes. We have a robust HIV system and we are now the pioneer warriors against malaria. That is part of the primary care system. We have gone from what the country and Africa have been doing in the control of malaria. We have the malaria control programme. We are taking the bull by the horns and saying that we want to eliminate malaria. That is part of the primary healthcare system. We are not only eliminating malaria, we are building a factory for it, so that there will be sustainability of this war. It will also provide employment. The health sector today is one of the foremost employers of labour in Rivers State. These are the things we have on ground.
“We have gone so much into the medical industry. Right now, we are about developing an area in part of the Greater Port Harcourt City where we call the Medical Industrial Region. There, we have the syringe factory, the malaria diagnostic and test tube factory, etc. So we hope to be servicing the medical industry here.
With his reappointment into the State Executive Council in the second tenure of Gov. Amaechi, Parker said his focus was to improve on service delivery in the health Sector. He disclosed that about 100 medical Doctors had been employed to staff and manage most of the Health Centres in the rural areas. He said the Rivers State Government had currently embarked upon the exercise to eradicate malaria vectors from the State. The Health Centre at the Rivers State University of Science and Technology was soon to be opened to the public. The state was lauded the previous year for its daily commissioning of a health centre over 60 days in 60 communities in its 60-60-60 initiative. The Dental Hospital located in the Garrison area of Port Harcourt was opened.
He stated that the malaria elimination project was not only targeted at malaria but other mosquito-borne infections like dengue fever, yellow fever and filariasis. The Universal Free Medical Care programme whereby the state government was to pick the medical bills of all residents in the state was on, though beneficiaries were required to register.
Dr Parker disclosed that the existing General Hospitals were to be collapsed into Six Zonal Hospitals to cater for referrals coming from the Primary Health centres, not just to reduce the workload of the Braithwaite Memorial Specialist Hospital (BMSH) (now Rivers State University Teaching Hospital), but to reposition it to be more focused as a tertiary hospital.
Today for most Nigerians, India stands as the medical haven. To end that situation, Governor Amaechi, in his health revolution, decided to bring India to Rivers State. According to Amaechi, “My administration has begun talks with Indian authorities on how to establish a new medical school in the state. The collaboration is aimed at providing manpower for the school. Once we are sure that Indians can supply us with the teachers, then, we will be ready to establish it. This is because it is not good to establish a medical school without qualified teachers”.
Amaechi said the state’s branch of the Nigeria Medical Association (NMA) was also to contribute in providing teaching staff.
The fact remains that if that was achieved, then, any Nigerian going to India for medical attention was going there for a jamboree as Rivers State was to be in a position to provide similar services obtainable in India.
At that time, Rivers State became the only State in Africa to establish a worthwhile Auto Disable Syringe factory that produced 160 million syringes annually. Based on the Rivers State health revolution, the Federal Government banned the use of all conventional syringes in the country with effect from 1st October, 2012 and had signed a bulk purchase agreement with the Rivers State Government.
Amaechi being whom he is, always going for the best, concluded arrangement to expand this factory at a cost of 210 million Euros to be funded with equity participation between the State Government and the Export Credit Agency (ECA) of Germany and Austria. According to Dr. Sampson Parker, the ECA was bringing in 85 per cent of the funds for machinery and equipment, while the Rivers State Government (was to) put in 15 per cent for machinery and equipment including the civil works up to the completion of the project.
Building project for the plant was expected to be completed by August 2013 while procurement and installation were to be completed within 24 months of the commencement of expansion project. When the expansion of this project that was to put Nigeria as a producing nation rather than a consumer nation was completed, the plant was to be producing one billion syringes annually, one million litres of IV Solutions (drips), drip giving sets as well as one billion hypodermic needles for injections, annually.
Conclusion
Finally, if the efforts of Rt. Hon. Chibuike Rotimi Amaechi on health delivery in Rivers State were not revolutionary then I need to be educated accordingly. And if constructing 60 Health Centres and donating them to 60 communities within 60 days was not revolutionary and world-shattering, then, something was wrong with me!
Eze Chukwuemeka Eze is a Port Harcourt-based Media Consultant & can be reached at: ezemediaconcept2020@gmail.com or 08022049770.
