Monday, August 12, 2013

NIGERIAN NATIONAL MERIT AWARD
Award Winners' Lecture
WHO CARES ABOUT NIGERIA'S HEALTH; REALLY; WHO CARES?!
Oyewale Tomori, DVM, FAS, NNOM
July 6, 2005
Port Harcourt, Rivers State.
WHO CARES ABOUT NIGERIA'S HEALTH; REAUY, WHO CARES?
Oyewale Tomori
Redeemer's University, Redemption City Km. 46 Lagos- lbadan Expressway
Mowe, Ogun State.

The honour given to deliver the Merit Award Winners' lecture is as unique as it in distinctive. I want to express sincere gratitude and appreciation to the Chairman and members of the Governing Board of the Nigerian National Merit Award (NNMA), for providing me with this incomparable and inimitable opportunity. I thought I should use the opportunity to look at the health of our nation. I plan not to limit myself to the area of my calling, but to extend the discussion to the totality of health, as defined by the World Health Organization (WHO). I will therefore be treading in the slippery grounds, where I have no formal training, but where personal experience has been my teacher. I will discuss the health of Nigeria, my precious country, from my heart and from my soul. A precious thing does not always give you joy and happiness, just as not all tears spring from the depths of sorrow. There are tears of joy, as there are tears of sorrow: There are tears welling from delight and pleasure, as there are tea F-S springing from grief and pain. Sadness and misery have been the fountainhead of tears, so also pride and bliss mixed with ecstasy have been wellsprings for tears. Nigeria my precious country has been all these to me, and I am still happy to call her precious. I am still blessed to regard her as a jewel, my home and the country that gave and still gives me my citizenship. I see a new country: where NEPA is the New Electric Power Authority. I behold a nation where I am free to say what is on my mind as a free citizen. I rejoice as a citizen of a new and beloved country where there is respect for human dignity and justice. A priceless country, where fair play is like free air, where there is no corruption, where the benefits of education is within the reach of the
majority of the population that was my dream for Nigeria………….. Some forty three years ago. Let me start from the beginning, not the beginning of Nigeria, but from when I first became conscious of my Nigerian-ness. It was the night the Union Jack was lowered forever, and the green white green flag fluttered in the gentle breeze of Lagos Race Course. That night was the night of September 30 1960. All I remembered was a special lunch and a brown plastic cup given to us to celebrate our 1st October 1960 independence. The cup was stolen, lost or broken, as was the case with our independence. For our leaders stole it from us, and we let them. In our struggle to retain our independence, the military came and the cup of independence was broken, no, smashed under the rough and rugged boots of the military. Our independence was blown to tatters by the armed forces, and some of us with it.
Our flag shall be our symbol that truth and justice reign Help us to build a nation where no man is oppressed and so with peace and plenty Nigeria may be blessed.
That was the anthem I knew, it is still the one I can sing from memory. An anthem that was full of words of inspiration, words of grand dreams, lofty aspirations, ambitious targets, noble objectives, admirable desires and expectations. The words of the anthem inspired me and gave feelings to my hopes for a beautiful life in a magnificent country among lovely people. These indeed were my feelings forty three years ago as I sat for and wrote the English paper1of the West African School Certificate examinations, at the Government College Ughelli, my alma mater. The topic of the essay was Nigeria forty years from now”. I wrote and I wrote, till my cramped fingers ached in excitement for the future of my dear country. I wrote furiously. I dreamt dreams and put the dreams on paper, Yes, I saw a country where although tribe and tongue differed, but in brotherhood we stood. I saw a vision of a country where as Nigerians, we were all proud to serve our dear motherland. I saw tarred roads crisis-crossing the entire land of Nigeria. Potable water was running in every house, houses where electricity never blinked for one second. Every child had access to free primary and secondary education. Our universities were offering courses relevant for the development of our country. Technical schools and polytechnics dotted every nook and corner of Nigeria; training people who turned Nigeria into a technological paradise, people who made Nigeria a beauty to behold. Oh, it was a delight to be sick in the Nigeria of my dream. We had hospitals where good health care was delivered with humanitarian touch. There were no armed robbers as those who would have chosen the profession of armed robbery were in good schools or polytechnics. Nigeria in 2002 was to be the utopia. I wrote with the passion of a young man in love with his country and very proud of his motherland. I was a teenager, who wanted to live and die for his country. I had plans for myself too, I would go into science, may be medicine, may be engineering, I would discover cures for diseases or build bridges across the river Ethiopia in Sapele, (for that was the only big river I knew then), and work to link all the riverside towns of Nigeria's delta and mangrove swamps. I prayed to God to help us build a nation where no man is oppressed. A country blessed with peace and plenty was part of my prayer for Nigeria, that November day in 1962. Distinguished ladies and gentlemen, that was 43 years ago. What happened to my prayers? What happened to my well laid out dreams? The dream that has turned to the present day nightmare, the horrendous noonday horror that is my beloved country. A country that celebrates mediocrity and puts the mundane on a pedestal of acclamation.
Not two years after I wrote that essay, we woke up to the mayhem in the Western Region of old. This early morning disaster in the infancy of our independence was soon followed by the horrors of coups and counter-coups. We went on to the civil war, the festering wounds of yesteryears, scarring our remembrance. Then came the military administrations, the less said of which, the better; because they watered the seed of discontent and nurtured the sapling that has now grown into the giant tree of fraud and sleaze. Today, our entire land has become the irrigated garden, where the off shoots of the tree of vice daily enjoy tender and loving care. I will try and look at the way forward so that my country will discover whither it is going, so that it will not wither like a tree separated from her roots. I will offer suggestions for the way forward, so that our country will not be a "failed" state. The shield of our national coat of arms is the heart of our nation. This heart seats precariously, and supported by three legs of two obviously unbalanced horses, each standing on one leg. Below the shield, we have the four working principles of our nationhood. We started with the principles, UNITY & FAITH. When we failed to achieve the two, we added two more: PROGRESS and PEACE. We forgot that without following the first two working principles, we cannot use the new ones. The little faith we had in ourselves and our country has been chipped away by years of collective unruly and disorderly behavior. We are furiously progressing backwards, as we leap from the 21st century to the Stone Age. I know for example that my secondary school practical zoology experience is far richer than that possessed by the crop of zoology graduates we churn out of our universities today. Every unimaginable disaster has happened to us: from floods to army weapons depot explosion, and horrifying civil disturbances. Nearly all our national disasters are self perpetuated, nearly all, have their roots in our national failure to plan well, or failure to implement the good plans we made. Allow me, distinguished ladies and gentlemen, to take you through some aspects of our health, education, economy and our social life. Indeed, the WHO has defined health as not just the mere absence of disease, but “the attainment of a state of emotional, mental, physical and social well being”. Let us see how we have hurt ourselves, and done significant damage to our hopes, desires and aspirations as a people and a nation.
October 1, 1960 was a Saturday! We got our independence on a Saturday and it is as if since then we have not returned to work; as if we are having an unending week end, a 45 year long week end. It is as if we took a holiday from development, a long vacation from progress. In our unending independence celebration, the people watched, and sometimes participated in the looting of our treasury and our natural resources. In our endless celebration of independence, we got ourselves back into colonial bondage exchanging one slave master for another slave diver. The new slave driver carted away our inheritance to develop the land of our original slave master. As the foreigners developed their country with our resources, we underdeveloped our own homeland through our profligacy.
Distinguished chairman, 1989 was the year of my last visit to Port Harcourt, some 16 year ago. I had come across from Ekpoma, in Edo state, where Lassa fever had devastated a family. The extended family lost the family, the mother and two sons, who were physicians, among the nine people who succumbed to the 1989 Lassa fever outbreak. The epidemic was remembered as the disaster of Ihumudumu, the area of Ekpoma where the index case reside with his family (figure 1)
Featured articles on 1989 Lassa fever outbreaks in Nigeria.
The 1989 journey to Port Harcourt was on the trail of one of the Ihumudumu family members who had been whisked out of the town to a safe haven, here in Port Harcourt. She was the last adult in the devastated Ihumudumu family that had not yet been stricken by the dreaded Lassa fever. She was taken secretly at night out of Ekpoma, to a safe distance far away from the clutches of witches of the town. The story circulating in the town was of the oldest witch in Ihumudumu taking vengeance on the stricken family, for an altercation between her and the head of the Lassa fever ravaged family. We eventually traced the case, but laboratory tests carried out IN THIS COUNTRY; (note the emphasis), revealed that she did not contract the disease. In 1989, we were able to carry out laboratory tests for the diagnosis of Lassa fever and such other hemorrhagic fevers; but the carcass of our laboratory system now form part of the mortuary of our national healthcare delivery system. We were to come back later in the year to the famous Enugu National Clinic of Professor Nwokolo, one of the distinguished recipients of the Nigerian National Order of Merit. Two doctors referred to his hospital from Owerri later died of Lassa fever. The story of Lass a fever which began in 1969 at the Church of the Brethren Mission Hospital in Lassa town was to spill over into Evangel Hospital in Jos, where nurses and doctors succumbed to the plague. Failing to fully appreciate the fatal consequences of Lass a fever in 1969, the disaster of Evan gel Hospital was to repeat itself often and so often again, in Nigeria. The disease quietly sneaked into the Charles Borromeo Catholic Hospital in Onitsha in 1974. For many of fatal cases, the infection was transmitted to them, within the hospitals and they paid the highest price of poor medical practice. When the attending physicians, nurses and other health workers also contracted Lassa fever disease, the hospitals closed down, further compounding the deplorable health care delivery service in the affected areas. This scenario was to repeat itself in every hospital where Lassa fever patients were on admission. Lassa fever disease nearly aborted the 1977 FESTAC festivities, as rumours of the outbreak of the disease sent fears down the spines of prospective participants Lassa fever was to appear in different parts of Nigeria, often with disastrous consequences: from Ekpoma to Aba, from Owerri to Aboh Mbaise, from Lafia to Jos, the disease rendered our healthcare delivery service impotent and made us realize that our disease control activities were totally ineffective. Annually, during the dry season period from December to April, Lassa fever disease outbreaks have become regular features of the life of the people of Ekpoma and surroundings. The never ending outbreaks of Lass a fever disease, and such others as yellow fever, measles, meningitis and poliomyelitis are stories that have shown our country as one that hardly learns from its errors, a nation constantly and forever living to repeat and commit the same errors with ever worsening devastation. The story of Lass a fever and such other fevers, has led me to ask question: WHO CARES ABOUT Nigeria’s HEALTH; REALLY, WHO CARES?! Fig 2: the face of an award winner.
On 11 December 2002, the picture above was taken (fig 2) it was a day of the actualization of a dream nurtured for almost 25 years, from the day I first knew about the Nigeria National Merit Award. It was a day of joy mingled with happiness, and a day of fulfillment. But take a look again at the face in that picture; it certainly does not
portray joy. I saw that picture soon after it was taken, but it was months later that I really had a good look at the picture and saw what it portrayed. I went back to the depths of my mind to find out what was going through my mind as the orator read the citation for the award. In an unpublished write up, titled: Diary of an award winner, I tried to match the picture with the thoughts of my mind. What was going through my mind as the strings of achievements were read out? What was I thinking of as I was preparing to receive. The nation's highest award for academic and intellectual attainment? Why was there so much sorrow reflected on my face on a day when the President of my country declared that winners of the Nigerian National Order of Merit constitute a group classed as "Nigeria's greatest assets.
"Let me quote from a portion of the unpublished Diary.”
The highlight of the day was standing up and listening to the citation for the award. In the short time it took to read the citation, my life flashed before my eyes.
* I remembered growing up in my village, and
* I remembered the death of my brother, my mother's last child, who bled to death from the cudgel of a traditional circumciser.
* I remembered the quiet and silent crying of numerous of my father's wives as they regularly paid visits to our backyard, to bury their infants. Infants that succumbed to the ravages of commonly fatal, but preventable diarrhea and respiratory infections of children.
* I remembered the so many children who grew up into adults paralyzed in one or two legs by poliomyelitis.
* Oh yes, I remembered another sibling, who did not survive his last attack of asthma, which took him away at the tender age of thirteen. We used to call him Haw..Hee, Haw. .Hee, describing the laborious breathing of an energetic boy, incapacitated by inhaled pollen grains or dust particles.
* I remembered the days of my secondary school at Ughelli, as well as the heady undergraduate days in Samaru.
* I remembered that for the diligent student, the maximum number of years for completing the Visit African School Certificate and the Higher School Certificate courses were 5 and 2 years respectively.
* I remembered that the two words “examination leakage" was unheard of in our time.
* I remembered that in those days, you entered the University in September and graduated in June of the third or fifth year, depending on the course of study. There was no cultism; there was no “sorting”.
My mind took a fast forward drive to the 1980s and 1990s, as
* I remembered 1985-1992 YF outbreaks, which devastated our country, and I can still see the agony in the face of the old man of Oju, Benue State who offered to sell all his cattle, to buy the drug to cure her only daughter of the yellow fever disease. The yellow plague, over a period of 7 -8 years, killed many more children in Nigeria, than was ever recorded by all the countries of the world in 50 years.* I remembered the 1993 poisoning of more than 100 children who received adulterated paracetamol syrup in several hospitals in Benue and Oyo States.
* I remembered the heart rendering wailings of the woman of Wase in Plateau State, who lost her only child to just a spoonful of the poisonous paracetamol syrup. The same batch of the sweet and adulterated paracetamol syrup was to kill more than one hundred children in Pankshin, Shendam and Langtang all in Plateau State, and in lbadan in Oyo State.
* I remembered that the one of the constituents of that syrup was a batch of diethylene glycol, purchased in Onitsha market and fraudulently and perhaps deliberately labeled as ethylene glycol.
* I still remembered that a year after this national disaster, batches of the fake ethylene glycol could still be purchased at the same market, presumably being used to prepare paracetamol, Or more Nigerian children to consume and then die.
* I remembered that those were the days of ineffective and impotent NAFDAC.
Yes, in that interval it took to read the citation,
* I also remembered the 1996 meningitis outbreak in Kano, when eleven children died like guinea pigs from complications of the unlicensed, and unregistered experimental trial drug, Trovafloxacin (Trovan), manufactured by a pharmaceutical company.
* I remembered the reluctance of our government to logically pursue the prosecution of the perpetrators, the murderers of our innocent children. The then Minister of Health declared that: "Nigeria will demand reparations from Pfizer if the company is found guilty." He set up a panel made up of his top officials, to, of all things; find out if his Ministry actually gave Pfizer permission to carry out the drug trial. Of course, you may be pleased to note that up till today, we still have not concluded the 1996 investigation. I remembered the looming devastation of AIDS in a country that cares less and ever less about her health and her well being. I remembered the health statistics of my country, where (Figure 3)
* Life expectancy is currently as low as 45 years
* 48 of 1000 children born in this 21st century, will die before the age of one month and
* Within the first five months of their life, 25 more will be added to the harvest of infant corpses
* of the sumptuous harvest of infant deaths continues unabated as another 37 of the 1000 children born this day will die before they ever celebrate their first birthday
* through neglect and uncaring attitude at least 198 out of 1000 children are sent to their graves before they reach the age of 5 years. In really bad years, this number can climb to 227 per 1000.
Figure 3: From WHO World Health Report, 2005.
It must have been the deplorable state of our national health statistics and our national self inflicted pain, betrayal, and neglect, which led to the sorrow expressed on my face on the day my nation, was honouring me with an award that was for significant contribution to medicine and for the development of Nigeria. On that day of joy and pride, I could only ask myself these questions:
. Can you receive honour for what you have not completed?
. Can you win an uncompleted race?
. Can you find health in so much infirmity?
. Can you do so much and make so little impact?
. Can so big an input yield so little an outcome?
Now you know why there was little joy on my face on December 11 2002. When I ask who cares for the health of Nigeria, I am not limiting myself to the mere absence of disease, but extending it further to the definition of the World Health Organization (WHO). The WHO says “health is much more than the mere absence of disease, and includes the attainment of a state of emotional, mental, physical and social well being.” I look at the traffic chaos on the streets of our major cities, and the agony we subject ourselves to as we carry out our daily duties. We are battered by the pollution of unnecessary noise from blaring vehicle horns and excessively loud music from oversize loudspeakers. We create a desert in the ocean, as we suffer unimaginable agony of unending line-up for scarce petrol in a country that ranks eleventh among the world's oil producers. We clothe ourselves in the darkness created by a failed electric supply authority, and deprive ourselves of needed rest as the noise of generators keep us awake, and the fumes choke the very life out of us. We degrade our environment, with the waste of our ostentatious living. We unleash physical degradation on our landscape, turning the natural beauty of our land into hideous monstrosities. We decorate our terrain with unsightly filthy heaps of our decadent life style. And when we say we are having fun, we start the week end with a 10 a.m. family wedding in Wuse Catholic Church, a 12 noon flight for a naming ceremony at Lekki, Victoria Island. We end the day at a villa near lkogosi Warm Springs, to rejoice with the man celebrant celebrating the second burial of his mother who died when he was nine months old. Any wonder our country won the 'TWHAP' award, The World's Happiest People!
Back to my question: Who cares about Nigeria's heath? I submit that none of us really cares about our health, we only pretend we do. Neither the government, nor the person really cares about Nigeria's health. Professor Adetokunbo Lucas in the Guardian newspaper article titled WHO 2000 Report and Nigeria stated
Figure 4: Professor Lucas on the State of Nigeria's Health System.
"The Nigerian health system is silk, very silk and in need of intensive care. It is BLIND, lacking vision of its goal and strategies, it is DEAF, Jailing to respond to the cries of the sick and dying, it is IMPOTENT, seemingly incapable of doing things that neighbouring states have mastered" (Figure 4). Our national health system has become the greatest obstacle to achieving health for all Nigerians From year to year; the WHO report and the UNICEF's Progress of the Nations consistently show our determination to remain at the top of the ladder of disease and disorder. We are a nation rejoicing in our squalor, celebrating our sickness, exulting in our self inflicted pain. We are a nation that is pleased and satisfied with our deplorable health situation, frothing with unbridled joy in the sewage of our infirmity. Back to the WHO 2000 Report, which ranked countries on performance of health systems, places Nigeria in position 187 out of 191 countries. We were ahead of 4 countries: Sierra Leone, Myanmar, Central African Republic, and
Democratic Republic of the Congo, which are in a continuous state of fratricidal conflict. Nigeria was ranked far behind her neighbours such as Benin (97), Ghana (135), and Togo (152). A very recent Guardian newspaper editorial of May 30 2005, titled: Renewing the healthcare delivery system, opens with this sentence: "The Federal healthcare delivery system is a washout". We are neither able to prevent nor control, even the diseases for which a reliable vaccine is available.
Let me illustrate with one example, yellow fever disease.
Figure 5: Yellow Fever Epidemic, Nigeria 1986-1993,
Some twenty years ago, yellow fever disease invaded Nigeria (Figure 5), it started in Oju LGA, in Benue State. By the time the investigation team got there, the village was decimated with over 1000 dead, many of them children under the age of 15 years. Medical attention was inaccessible, and where accessible, it was not affordable. Who could tell how many actually died? "It is not easy to say the exact number if the dead," said the village dispenser. But the picture can be obtained from a situation where an average of five people died daily. Oju was the beginning, not the end of the yellow fever epidemic which decimated families across the country. Our country was thrown into unprecedented disarray for five to six years by the yellow plague. For five years, the disease went round the country claiming thousands of life. Yellow fever became a regular feature on the pages of our newspapers, radio and television (Figure 6).
Figure 6: Yellow Fever Everywhere...Nigerian Newspapers
Where next? Who next? These were the questions on everybody's lips. That was a terrible time for our country. Fear and confusion was written on all faces, as tears were shed for lost loved ones. It was as if the Nigerian was a trespasser in his own country, if he escaped the military harassment, and the accidental discharge from the police gun, yellow fever was waiting to shoot him dead. All ages, were affected, and long before AIDS orphans became a feature of African development, there had been yellow fever orphans.
Figure 7: Yellow Fever Resurgence in Africa 1987-1992. Nigeria accounted for more than 90% of global cases and deaths.
So much was the devastation caused by yellow fever in Nigeria that our country accounted for over 90% of global cases of yellow fever. Indeed, the WHO concluded that these figures were the largest number of yellow fever cases and deaths ever reported by any country since 1948 when the WHO started receiving reports (Figure 7). Yet a potent YF vaccine had been in existence since the 1930s. Indeed the earliest research carried out on yellow fever was carried out in laboratories built in 1925, at the present site of the National Institute for Medical Research (NIMR), in Yaba. The vaccine was used to bring yellow fever under control in countries of West Africa, where mass YF immunization was in practice. Right here in Yaba, Nigeria produced YF vaccines for the control of the disease. Today, the once thriving and productive YF vaccine laboratory, has defied all attempts to resuscitate it, and become instead, a cadaver and a monument to our greed for lucre and a reminder of our national indifference to matters concerning our health and development. But what happened to us in 1986? The story is summarized below (Figure
8).
Figure8: Yellow Fever in Nigeria: 1984-1994 on how not to control the disease.
The white back ground represents the epidemic; the darker bars represent the million of doses of YF vaccine imported to Nigeria to control the epidemic.
Figure 9: Yellow Fever transmission, Nigeria, 1986-1993.
It is obvious that although Nigeria was flooded with millions of doses of yellow fever, the disease ran riot all over Nigeria for five or six years (Figure 9). Many reasons and many groups and people were responsible. Our inability to control yellow fever was a classical example of the conspiracy and the collusion of different arms of the society. Everyone participated in the national past time of looting and pillaging, of fiddling with the national treasury, while yellow fever killed the young and the old from Sokoto to Lagos and from Bama to Bakassi. During those yellow fever dark days, the government, the civil servants, some educated elites, (like you and me), as well as the society, worked hand in hand to make this country a global example of shame and derision. Coldhearted apathy submerged in corruption swam in the swimming pool of greed and avarice with deliberate incompetence, supplanting the truth in calculated fraud for self gain. On top of all these, public ignorance reeled and lurched in self pity. But all that is history. Today, YF has been reported in Liberia, Burkina Faso, Guinea and Senegal. This is a repeat of the 1984 scenario, which preceded the Nigeria yellow fever epidemics of 1986-1992. Mark my word, within the next 3 to 5 years, it will be a miracle, if Nigeria does not become be the venue for the festival of the yellow plague, the fever of suffering and death.
HIV/AIDSAND NIGERIA
This brings me to the issue of HIV/AIDS in Africa and in particular, Nigeria, and our dear country. The TIME magazine once described Africa as a Continent in Peril (from HN/AIDS) (Figure 10). Let us look at the sad and distressing statistics: Since the AIDS epidemic began in the '70s, close to nineteen million Africans are estimated to have died, of which, about 4 million are children. An additional 12 million orphans are in
Africa as a result of AIDS. The HN adult infection rate is between 20-25% in Botswana, Swaziland, Zimbabwe Zambia, South Africa and Namibia.
Figure 10: AIDS and Africa
There are over 2 million AIDS orphans in the seven countries listed above of the total global estimate of 15 million orphans; Nigeria currently has 1.8 million or 12%. Life expectancy in Botswana dropped from 75 years' in 1987 to barely 45 years in 1997 and in Zimbabwe from 72 years to 50 years over the same period. Of the 39 million people living with AIDS, 25.4 million are in Sub Saharan Africa, and approximately 2.7 million, representing about 11% are Nigerians. The estimated 3 million Nigerian women infected with HIV/AIDS represent 12% of all infected women in Africa. And painfully, most of these women have no access to medical relief The HIV epidemic in Nigeria has progressed steadily from a prevalence of 1.8% in 1991, 3.8% in 1993, and 4.8% in 1995,
to 5.8% in 2001 Nigeria has crossed the 5.0% threshold for action and the next stage of the epidemic is bound for exponential growth (Table 1).
NIGERIA HIV AIDS PROFILE 2003
. Adults 11549 yrs) with HIV/AIDS: 3,300,000.
. Adult HIV prevalence (%): 5.4
. Women (1549 yrs) with HIV/AIDS: 1,900,000
. Children with HIV/AIDS: 290, OOO
. AIDS orphans (ages D-17): 1,800,000
. AIDS deaths: 310,000
. No data available for new HIV Infections in 2004.
Table 1: Nigeria HIV/AIDS profile, 2003
Recently, the US National Intelligence Council (USNIC) came out with a report titled: "The Next Wave of HIV/AIDS". The Herald International Tribune of Saturday-Sunday October 5-6 2002 considered the matter serious enough to merit an editorial. I want to intimate you with the contents of the report and editorial, so that we can behold the future humanitarian tragedy we are neglecting today. The report provided disquieting and alarming estimates of the next big wave of AIDS infection. The report says that the rates of infection will grow dramatically in five big countries: Russia, China, India, NIGERIA and Ethiopia, which between them account for 40% of the world's population. The report estimates that the number of infected people in these countries will triple over the next eight years reaching approximately 50 million to 75 million in 2010. Using figures from UNAIDS, the report showed that South Africa failed to implement an aggressive HIV control Programme, and thus infections soared from < 1 % in 1990 to nearly 25% of the sexually active populations in 2000. Compare this with the situation in Thailand, which began from the same starting point of <1 infection="" p="">rate as South Africa, in 1990, and has pegged the rate to around 4%, through the implementation of an aggressive and sound HIV control Programme. That same US report tells us that "Nigeria and Ethiopia could be devastated, losing a big slice of government and business professionals and suffering a loss in economic and foreign investment. The ability of the two countries to play regional leadership roles could be seriously weakened. The effect of the next wave of HIV could harm economic, social, political and military structures, the report concluded. The next HIV/AIDS wave will tear asunder the fabrics of our society, affecting spending priorities, increasing health care costs. We have discountenanced the 2002 USNIC report on HIV/AIDS, in similar fashion, as we have done with the 2005 USNIC report which predicated that in 16years, Nigeria may be a failed state. It is hard to believe a report that paints Nigeria as a nation where noting works, nobody is in control and there is anarchy and confusion everywhere. I see this report and the one on HIV/AIDS in a different light. I remember my people saying that… “A lame man who has previous information about a disaster will start crawling away before the disaster catches up on him.” to be forewarned is to before armed. It is much better to be lame than to die an agonizing death.
Distinguished ladies and gentlemen, I was in Zimbabwe for the ten years between 1994 and 2004 and
• I saw a once vibrant nation reduced to a languid nation of mourners, where the only successful businesses are those of the funeral homes and grave diggers. They dig graves at the rate of two per hour per day, Saturdays and Sunday inclusive. Zimbabwe is a country where life insurance has given way to death insurance, as you pay to ensure a decent burial.
• I saw industries close down because HIV/AIDS took nearly all of the top management personnel between the age of 25 and 55 years.
• I saw the disintegration of families with their orphans surviving on the streets to become the future generation of tramps, vagrants, vagabonds, drug addicts, and societal menace.
• I saw, in the ten years I spent in Zimbabwe, beauty queens reduced to monstrosities, ravaged and mutilated by the silent killer lurking in the crevice of sexual pleasure.
• I saw a football player turned to an old man at the age of 25 years, taking 30 minutes to walk a distance of 30 feet.
• I saw devastation played out on a daily basis, with close to 80% of hospital beds occupied by those suffering from AIDS and mortuaries filling up faster than available space.
• I saw more than ENOUGH, and I do not want to see that in my country.
But what are we doing to prevent the next great HIV wave in Nigeria? What are we doing to save our nation, our country our future our society from the coming peril?
What are we doing? As usual we are in the words of a departed politician "siddon looking" as our we prepare for the death of our future. We are leaving the HIV/AIDS issue to our experts only. We cannot afford to do that for the sake of our country. For HIV/AIDS have many facets and many aspects. HIV/AIDS is about science, it is about medicine, it is about sociology, it is about economics, it is about communication, it is about the family and the society, it is about education, it is about family values, it is about self respect, self restraint and human dignity. HIV/AIDS is too big a problem for the Ministry of Health; it is too damning devastation for the Presidency alone. It is too terrifying a threat to leave in the hands of charlatans; it is too petrifying a risk to leave in the hands of bureaucrats, it is too scary a menace to leave in the hands of the military. It is too economically devastating to leave in the hands of businessmen; it is a disaster that will surely wither our nation unless we know whither we are going. It is a problem that has a role for each and every one of us. It is about our families, our children and the future generation. HIV/AIDS is about the survival of our nation. It requires the participation of all of us from the President to the pauper, from the trader to the traditional ruler, from the virologist to the vulcanize.
As I look back on the history of HIV/AIDS control in Nigeria, I see a country that has buried her head in the sands of denial and disdain for the disease, exposing her rear end for the charlatan, the swindler, the con artist and the pretender to use as a playing field. The ignorant and the charlatan are in the forefront of HIV/AIDS control in Nigeria. Today Nigeria is seating complacently on a time bomb of AIDS disaster. Again, dear colleagues, I am asking: What are we dong? Whither are we going?
Nigeria's Economy- A tale of untapped potential
I am on the mailing list of the Economic Commission for Africa (ECA) in Addis Ababa, Ethiopia, and annually I get a copy of the Economic Report on Africa. Although I do not understand some of the terms they use, I often find the document an eye opener on the interrelationship between the economy, our health and our development. The 2002 edition featured Nigeria under the title Untapped Potential. The report says that "on all accounts Nigeria is a desperately poor country. In a ranking of the world's country by income level, Nigeria fell near the bottom, with per capital income around half the average for sub Saharan Africa. This performance is more disappointing, given Nigeria's abundant human and natural resources. According to the UNDP Nigeria is among the world's poorest countries, and that our poverty has been on the rise since the past decade with more than more than 60% of Nigerians presently living on less than one US dollar a day. Misplacing priority in budgetary allocation, education and health spending has declined sharply since the mid-1990s. The 2001 budget provided minimal funding for key items that would benefit the poorest groups, such as universal basic education, while providing considerable resources for the construction of an Olympic-size stadium in Abuja. Although substantial funding was provided for the national immunization Programme, difficulties with implementation of the Programme have placed Nigeria among the last three countries in Africa reporting polio cases. In 2004, Nigeria accounted for 782 (approximately 84%) of Africa's total of 934 reported polio cases. As of 23rd
June 2005, Nigeria has reported 193 or 92% of Africa's total number of polio cases.
True to its name, the giant has taken the colossal share of the disaster. Do you know that countries like Angola and Democratic Republic of the Congo, countries in a perpetual state of war for the last 30-40 years are now free of polio? Do you know that Sierra Leone and Liberia, on which Nigeria through ECOMOG spent billions of naira, are now free of polio? Sometimes, I wonder how much we actually know about our country.
Education
Let me now shift my focus on our education, and talk about some side issues that derailed education in Nigeria. For those who remember, in 1973, Yakubu Gowon was then our Head of State, and in power. It was in that year that the university teachers went on strike for better pay. It was rumoured that on the advice of some of the university teachers seeking favour or serving the government of the day, the government told the teachers to pack their bag and baggage from university quarters. The government won the battle, and tertiary education in Nigeria lost the war from which it is yet to recover. Aware of the danger of being made homeless by the swipe of a decree, many university teachers decided to take loans to build their own houses. As interested on mortgage loans soared and university salaries remained stagnant or dwindled, income barely matched the repayments and the Saudi exodus began. For those who could not make the Saudi express, something had to be done to make ends meet. Remember it was the era of the oil boom, the period of the Executive forwarding Agencies without as much as a typewriter, not to mention an office. It was the time when according to our government, “the only problem we had was not lack of money, but how to spend it” and didn’t they spend our money! For those who had sold their soul to mammon among the university staff, it was easier to join them than face the hardship of poor salary and lack of funding for research.
According to the ECA publication titled: Economic Report on Africa 2002, Nigeria’s poor human resources base is considered to be its biggest handicap in attracting capital, improving productivity and reducing poverty. The combined primary, secondary and enrolment ratio is 45%, and adult literacy rate is 63%. More disturbing, the quality and relevance of education for national development have declined with declining government spending on education from 15% of federal budget in 1994 to 7% in 2001. Presently, Nigeria ranks among five countries that have the greatest number of school dropouts in Africa, alongside Democratic Republic of Congo.
Recently, the ILO reported that 75%-80% of Nigerians currently working outside the country are home grown, receiving part or all of their education in Nigeria at a huge cost to the country. The report concluded that no nation can successfully carry out its development Programme if it deliberately or inadvertently fails to retain her trained manpower and does not provide the environment for them to contribute positively to national development.
THE WAY FORWARD
It is not enough to enumerate our woes, it is not even sufficient to offer suggestions. What is important is what we do to make positive changes. If Nigeria must change, the change must come first from the individual. It must come from the Nigerian sitting in this Ebitimi Banigo Auditorium; it must come from the Nigerian out there on the streets, the one resting in his house or relaxing in the beer parlour. It must begin with the individual and ordinary Nigerian. Corruption has thrived like a tree by the riverside in Nigeria, because the average Nigerian is praying for a chance to be in authority, so he can devour the national cake. The average Nigerian has no condemnation for the thieving, light-fingered person in authority because he is not so sure that if he gets into power, he will not steal the nation dry. In one way or the other, by remaining silent when we should have talked, by condoning the illegal acts of those who are our friends or relations, by participating in the looting of what was put in our care, we have contributed to bringing this country to its present state, and made our nation the feeding ground for locusts, caterpillars and cankerworms. We have each contributed to writing the modern history of Nigeria, as modified from the book of Joel chapter l, verse 4 (Figure 11)...
Figure 11: Modern History of Nigeria. Adapted from Joel 1:4
The question is which of the devouring insect or worm am I?
The question is which one are you...a palmerworm, a locust, a cankerworm or a caterpillar? It is the average Nigerian, who must be willing to change. He must be willing to reinvent himself, and creatively think out a way to make Nigeria a country he and all of can be proud of it goes back to individual family laying the foundations of honesty, probity, integrity honour and consideration for others in every child. The 'Jet" speed with which our President's anti-corruption bill was passed by the Legislative arm of government, and the "legion" of corrupt people that have been punished under the anti-corruption law, coupled with our leaders' immunity from prosecution, but not from raiding our treasury, all add to our lack of seriousness on tackling the issue of corruption. One is happy at the current anti-corruption crusade launched by the government, but saddened at the same time that it is limited in scope and threatened by the impeachment sword, ever hanging on anyone willing to tackle corruption in Nigeria. The future of Nigeria is too important to leave in the hands of our leaders. Sometimes, it is like telling a goat to keep watch over a round of pounded yam wrapped in leaves. We, the people, must together actively rebuild our nation, and set it on the path of righteousness. We must populate this country with citizens who will break away from the thought bondage of the past, and help reinvent our nation in a new process of creative thinking.
Secondly, we should be asking our leaders the right questions relating to the problems of our society, based on our intimacy and identification with societal needs and aspirations. What can we do about AIDS? Why is Nigeria, which once produced yellow fever vaccine, now importing the vaccine from a country like Senegal? Can we tap the solar energy to supplement NEPA? According to Eugene Ionesco, "It is not the answer that enlightens, but the question.”
The society at large must demand, as of right, a better and improved standard of living from the government and leaders in every sphere of our life, from our community leaders, our traditional rulers, and our academicians. The public must work with these groups of people to ensure that education is made public property and available in the public domain. The society must demand from these groups that our children receive appropriate education. The society must demand from the government, and support the building of more libraries, zoological gardens, natural history and science museums. The society must ensure that our children spend more time in zoos and natural history museums than they spend in disco and cinema halls. The society must work hand in hand with the government and industry in setting science-based developmental targets. Our industries should sponsor educational programmes rather than sponsor programmes that tend to perpetuate the undesirable traits flamboyantly and recklessly displayed daily in our life. We must neither separate society from education nor education from the society.
CONCLUSION
Distinguished Ladies and gentlemen, it is not that we have no bright ideas, nor is it that we do not have solutions to the problems that confront us. I think we are a nation that can just not be bothered with development. We seem to be a nation that would rather act than think, a physically strong, but mentally lazy nation. We seem to consider many things more important than enhancing the status our life and improving our health. In spite of these harsh words, I must not and cannot give up on my country, because when Nigerians are outside our borders, we excel; we outclass and we surpass others. We do extremely well. We must search for and look for the light at the end of the tunnel, and make progress in the direction of the light, no matter how long the tunnel may be. Who knows, just ahead may be the corner and the turning point to our desired goals and aspirations. I see the light at the end of the tunnel in the wisdom of our country, in the likes of the men and women who have been honoured with the National Merit Award. I see the light at the end of the tunnel in the indomitable spirit of our country men and women. I see the light in the likes of distinguished men and women who are here today. More than that, I hear the voice of the young, singing the song of the olden days
I hear the song of Nigeria
In the morning, I hear it,
Above, the blaring horns
I hear the song of Nigeria
In the afternoon, I hear it
Louder than the screaming sirens
I hear the song of Nigeria
In the night, I hear it
Stronger than the midnight explosion.
I hear the voice of Nigeria of old (Figure 12).
The silent voice of sanity
The quiet voice of probity
The mumbled voice of honesty
I hear the voice of Nigeria of old
The calm voice of decency
The still voice of honour
The hushed voice of reason
I hear the voice of Nigeria of old
The silent voice of sanity
The quiet voice of probity
The clear voice of honesty
The calm voice of decency
The gentle voice of honour
The hushed voice of reason
Figure 12: The Voice of Nigeria.
The tranquil voice of integrity
The serene voice of virtue
The soothing voice of godliness
I hear it, oh I hear it.
The voice of my old Nigeria.
If Nigeria must survive and develop, if we must be transformed into an egalitarian society, then we must be guided by the voice of sanity, probity, honesty, decency, honour, reason, integrity, virtue, and above all, the voice of God.
Thank you, distinguished ladies and gentlemen for your patience and attention.
REFERENCES:
1. Lucas A.O. (2001) WHO 2000 Report and Nigeria. The Guardian newspaper.
2. United States National Intelligence Council (2002) "The Next Wave of HIV/AIDS"
3. International Tribune Editorial on HIV /AIDS, Saturday-Sunday October 5-6 2002
4. Economic Commission on Africa (2002) Economic: Report on Africa.
5. Lonesco E. (1988). Quoted by Delacote G., In Putting Science in the Hands of the Public. Science 280 (5372): 2055,
Oyewale TOMORI,
DVM., PhD., FRC Path (UK), FCVSN, FAS, NNOM
June28, 2005.
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