 It's still plus politics and today we're looking at the health sector in the country as we gear up for the elections come 2023 and as we decide who we pick to lead us these are some of the issues that we also need to consider or have at the back of our minds and in the studio with me is Dr. Korobot and online we have Dr. Alera but both of them medical experts and we've been talking about some of the major issues bedeviling the sector. Dr. Alera before you went off you were talking about the fact that there are not even enough trainers for those who might be you know ready to be doctors and I'm even wondering with all the strike actions that we've seen with universities and all the guys who have to do house man ships and then become resident doctors this there's just a lot to deal with in that sector and many of us might not necessarily understand the realities we're very quick to knock doctors and knock hospitals for poor performances but then now we have an opportunity to dig deeper into some of the teasing problems if not some of the things that have really really crippled the health sector but I always like to not just look at problems but solutions. We're seeing a lot of people asking for our votes some of them have even said that they would you know turn water to wine if given the opportunity. What should the average Nigerian voter be considering if they ever have to be in a parlay with these politicians what should be the questions that they be asking especially knowing that anybody could end up in a hospital and this could be their fate. That is actually the crucial question that we need to be answering and something that for me is very important. You see I tell people now in the last three months I've had to tell people don't do anything silly or unsafe or anything because even if you get into trouble and you need a hospital or a doctor I don't know where to send you and you know it actually stops people my friends in their tracks when I tell them that don't call me like there's nothing I can do for you. I've watched a friend die I've watched I've watched the life seep out of her pain that her eyes go blank and I was standing there and the doctors and there was and there was nothing we could do. Now this is the reality that everybody needs to think about while they are polishing up their PDC to go and take a boot. So you said something you said oh they're all promising us and telling what time to why. The truth of the matter is that in an emergency situation you are going to end up spending a hundred times more money than you would have spent if you had planned and prepared for such a contingency and that is what the majority of Nigerians are finding out that it's happening. They are now going to places where they get to a hospital and they tell you to put down three million Naira. Can you find three million Naira on a hop? Who do you call? So we have to now wake up and really face the conflict. This is not about ethnicity. This is not about whose turn it is. This is not about this party, that party, north, south, east or west. This is not about the color green, red, blue, black or polka dot. This is who, what can, what do I need to put in place to ensure that we're going to get good leadership that is going to look at square in the face and be able to change the situation that we are facing. And that is the situation. I don't want anybody telling me about telling what time to why. I don't want anybody telling me and that's what they've been saying. Dr. Korobo, bear me out. When M.G.C.N. came and said that, oh, we'll tell the universities to take on twice the number of students who want to do medicine. Who's going to teach them? In which classroom? These are harsh realities we have to face. We are going to end up paying 10 times more for health than we were paying a year or two ago. Yeah. Talking about paying payments, talking about, I'm so sorry to talk over you, talking about paying payments for health. The President recently signed the National Health Authority bill into law and I'm going to get both your thoughts on it. And the President said that this was done to achieve universal coverage. How much cover does this National Health Authority bill and, you know, some of the, I mean, we've had NHIS, we've had so many schemes. I don't really know how successful those schemes have been. Dr. Alera, would you care to answer before I come back to Dr. Korobo? I would, I would, look, let me be very frank and honest with you. I am Dr. Alera Roberts. So there I can wear green dress. Tomorrow I can wear blue dress. And the next day I can wear a red dress. I'm still Dr. Alera Roberts. What I can do, I can do. What I cannot do, I cannot do. And that's my opinion on the NHIS. Oh, wow. Okay, that's incredible. It is the same wine in a different wine scheme because we're using the same systems, we're using the same people with the same mentality, with the same attitude, with the same lack of governance. What difference do we have? So you're saying that it's, it's, you know, it's not necessarily going to change anything. It's nothing new. Has it changed anything? This has been almost a few months later. Has it changed? Dr. Korobo, first of all, I, I share. I still have to go to the hospital and cannot access care. Just find the fact that they have NHIS. And that's only 3% of the population of the country. Well, first of all, I share Dr. Alera's passion. And honestly, I am with her 150%. You know, when she speaks, you can hear the passion in her voice. You see, there are some key realities here that we must take time to understand. When we say you have one doctor to 35,000 people, 45,000 people, let me make that simple. It means that in Lagos, for example, here, you would have access to doctors in Leckie, in VI, maybe Nikeja. But in other areas of Lagos, you will not see a single doctor there. And some people have to travel far just to come see a doctor. This is the reality and we need to understand the statistics. You know, if you live in Leckie and you live in VI, what are they talking now? There are hospitals here, hospitals there, but go further down, passenger. You're going to find places where you drive for 15, 20, 30 minutes. There's no hospital. There's no doctor. So this is the reality on ground, the ratios. The aspect of not graduating any medical student, we recently graduated 2010. Yeah, that's they ought to have graduated in 2010, 2015, 2016 sets. This is 2022. The most of the people that just graduated, I'm talking about University of Portugal, for example now, ought to have graduated in 2020. So two years later. So you need to understand what she said. Parents are celebrating that, ah, my daughter or my son just graduated. And Dr. Leroy is telling you they didn't, I don't understand. I'm explaining to you that the people that we just graduated have been in medical school for eight years. Eight years. We're lecturers. I'm telling you a fact. And what is the reason for? Well, the reason is, like she said, systemic failure, the ASUS strike, a lot of factors not in place. You want to make sure that these doctors you train have the necessary skills, have acquired the necessary skills. So so that's the first fact. Now she said there that 50 medical students wrote exams, UK board exams and they passed. It is a fact. It is not stories where I lecture almost all the students have passed their club one. So they are leaving. That's the point I'm telling you from 50s, 60s, they are already planning to go. So these realities are very, very serious and we need to, we need to be able to face them for the aspect of the National Health Act and the Universal Coverage. Look, the NHS pays 750 Naira for a person. 750 Naira. NHS pays 1,500 Naira for you to see a specialist. These are our realistic values now. I mean, the NHS is a drug that if you go across the counter, you can buy for say 4,500. The NHS would offer it at 1,800. So what happens? Patients are registered. The few patients that are registered under the NHS go to the hospital that are not giving any care because the figures that NHS will pay is not commensurate with reality. And so like Dr Allero said, we are dealing with a systemic failure. This is not about politics. It's not about, you know, like she said, ethnicity tribalism. We are talking about facts here. Which of the presidential candidates have a grasp of the reality in the health sector? Well, I was having a conversation with the representative of the Spokesperson of the Buhari government and he said, well, I mean, the vice president was sick and he was treated in the Nigerian hospital. That's his start. Well, the vice president was sick, was treated in a Nigerian hospital that is beyond the reach of the average person. He was treated at the duchess, part of the Reddington group. How many people can afford the care? Can we now have the bill of the vice president? How much did he spend for his surgery? Or his care? You know, so that's the reality. How many people can afford to walk into the duchess and pay? The other aspect you mentioned about gunshot injury and all that, you have to understand that health care itself has, you know, gradings, primary, secondary and tertiary. Now, any serious government at the local state or federal ought to understand that the government hospitals can do it alone. So you need private sector and you should be able to categorize them and make it public. So we should be able to know that if you need interventional care, you have a heart attack and you must. These are a list of hospitals you can go first of all. Because if a hospital does not have the equipment, the personnel to handle the gunshot injury, they have no business handling it. So our health sector requires a rebranding different from every other sector of the country. We need people with clear minds, clear vision, experience to step in and help the health sector. Remember, I told you that the COVID made it clear. How many people drove their big cars during the lockdown? How many nightclubs were open? How many restaurants were open? How many schools were open? If we do not have good health, where will we be? What is our maternal mortality indices? Let me break these indices down to you in simple English. Out of every 1,000 women, five died. And you and I know that these indices are not correct. We know that more people died, but they are not reported. So a woman carries a baby up to nine months. Time to deliver, she dies in the process. So we have a lot of facts that we must calm down and understand. You see when women give birth and they go to church and they give thanksgiving, it is serious. They have just escaped death. And these are all, obviously, according to you and Dr. Alera, but these are all signs of a failed system. But let's talk about the World Health Organization's ranking of Nigeria. We are the fourth worst healthcare system in the world. I am very ashamed of that. But that is not flat. That is quite flat. You are quite poor in the worst. And I want to ask this question to you and Dr. Roberts. Getting a good president or a good leader or a good governor or a good chairman, does that automatically solve the problems that we are having in the health sector? Does that mean that, oh, well, we now have a good leader, so everything is going to be fine and dandy? Or where do we start? Dr. Roberts? Well, well, obviously not. And thank you so much for, because you could hear me, I'm a person who lost a friend and hurt and pain. Like I said, there is no member of the healthcare team that can be changed in under five years. Four, five years. And you are very correct. I have students in final year medicine who have been in medical school for 10 years. They have not repeated a single class. Two of them have not even failed a single exam or in cross assessment. It has been strikes that have delayed them. Those students have passed lab one and four of them have passed lab two. They're not even waiting for induction. They're gone. There's no way you're going to build a new healthcare system in under 10 years at the minimum. Because you now have to go back and realize that look, even from secondary school education, you need to be sure that the students who are going into the health sciences and I'm talking about the nursing, physiotherapy, pharmacy, biomedical engineering, medical lab science have the requisite primary secondary school education to get into those courses. And we are building from there. Wow. So how is it that we have to actually sit down out the country and decide that this is important for us and we're going to do it in such a way that whether it is a module or not, who is in power, the process continues. Okay. All right, Dr. Robert. Finally, Dr. Korobo, I also just want to quickly squeeze in the issue of wages for doctors. There have been many calls, several calls for government to look into it. And I mean, the issue of wages for a lot of people, including ASU, this has been a running battle with governments and not just the Pahari administration. I always like to emphasize successive government. So talking about that and good leadership, because we can have a good leader, but is that enough for us to deal with the system? She says we might not even get in 10 years, but where do we start? Well, I think first and foremost, when it comes to the wages ASU and doctors, we are both ASU members ourselves, as well as doctors, I think that the first thing here is to pay what you value, the value you give to a particular sector. One of the ways you can express these values by wages. There are many other ways, of course, but by wages. The wages are not enough because the economy is bad. The wages are not enough because few right now is somewhere between 250 to 280. Most of the lecturers have children in private schools because the government schools are not bad, the hospitals are not working, so the wages are bad. So what I'm saying here is that if you want to make these wages have value, every other thing around must have value. The health sector, the education, security, all these have value, then the wages will make some level of sense. For the aspect of leadership, where do we start? I think that we need leaders that are homegrown. We need a leader. The health sector will improve at the state level with a governor that has the right team and the right plan and understands that right now, today, you need to press the start button. She's saying 10 years, I think 20. I think 20 years. So 10 years is very nice. I think 20, so but it will be nice for the start button to be pressed and to have legislation that binds it so that whether party A or B comes in, we don't press the refresh button. What has happened in our country over time is that every government that comes clicks on refresh. So they don't look back at what successive governments have done. They just press the refresh button and start all over again. And in the health sector, this is very dangerous. Imagine a health sector where a budget has been brought to build a primary health care center and train setting personnel. A new governor comes in, a new commissioner comes in, abandoned project. At the federal level, the federal level has to understand that the tertiary hostels are the last hope. Now if you have money, you wouldn't send your children to a government primary school. This is the reality. If you have money, you will send your children to a government secondary school. If you can afford it, your children will go to a government tertiary school. But all of us, whether you're in private practice or not, when things get bad, the center where we all believe you can get that care is the government tertiary centers. Even the top tertiary centers, privately owned, would still refer patients to the government. So we need to get that right. And the government has to understand. Well, I want to say thank you, gentlemen and lady. Dr Aloha Roberts is the Vice Chair of the Association of Public Health Physicians Lagos Chapter. And Dr Ibitro Kemi Kurubo is the past chairman of the Nigerian Medical Association River State Branch. Great conversation with you guys. And I'm hoping that as we get ready for the elections, these kinds of conversations will continuously be had because Nigerians need to be informed. But thank you. Thank you, Dr. Roberts. Thank you very much, Dr. Kurubo. Thank you for having me. All right. Well, that's it on the show tonight. I'm Mary Anna Korn. Don't forget, if you haven't picked up your PVC, there's still time for you to do it, because that is your passport to a new Nigeria. Happy holidays and have a good evening.