– Prof. Olusola Fasuba, Commissioner for Health
What is the driving philosophy behind the provision for free health care in Ekiti State under this administration?
I think by the time Dr John Kayode Fayemi was planning to become the Governor of Ekiti State, he knew the terrain, he knew how poor the region is and this is why I guess, I want to believe, you know that if someone who is a student of International Politics… I guess it is the level of poverty of Ekiti that made him to think about free health service for the people. And not only in health, but different developmental welfare schemes that we have adopted being the only state in the country and if you have travelled far and wide you have a lot of aged people who were very poor.
Predominantly, the people of Ekiti are farmers. Seventy per cent of them are rural dwellers and farmers. And until recently, there was not much that farmers derived from their productivity. And I guess this is why he has this free health mission for the under-five, the pregnant women, for the elderly and for the physically challenged. And the fact that he does not want people to die carelessly, one of the philosophies is to include widespread immunisation and expanded maternity coverage. I think it is the high level of poverty that has made him to think about this approach. Even though Baba [Obafemi] Awolowo tried it in the late 70s and early 80s, his own is beyond that one. It is an advancement of what we had between 1978 and 1992 because I remember the thing is up to 1991 and a lot of people benefitted that time.
So what benefits make it different from that of Baba Awolowo?
It is the welfare package. The welfare package for the elders was not there that time. And so many reforms that we have in our own free health were not there like medical intervention. Now we are doing surgical festival. We are giving medical assistance to people that could not afford the cost of health care. We are even assisting people to travel for renal transplant right till today. We have a lot of people with chronic illnesses and many of them just die carelessly because there is no care. So this type of medical intervention, this type of welfare package were not part of the Awolowo health care. That is the truth because I was a doctor. I became a doctor in 1981. I did my house job in Akure in 1981/82. I knew the things that were involved. Though people were given free health, it was not as comprehensive as this. And the rating that we had at that time was nothing compared with the health improvement that we have now.
In the last three years, with studies conducted by the World Bank, we begin to have very good health rating. We are one of the highly rated states with the best life expectancy. We are one of the states that have the lowest maternal mortality. We are one of the best states that have highest number of their pregnant women attended to by key birth attendants. And even the number of registrations in our hospitals has gone up considerably because of this health policy and agenda. And the mortality rate of under-five there decreased in the last three years.
You mentioned free surgical festival. How many of such have you done?
We have done quite a lot. We have done surgical festival for the eye, for cataracts. We have done for hernia and we have done selectively for abdominal operations with cancer. Like in 2013 when we had our cancer awareness when the state deputy governor invited some experts on cancer awareness scheme. We really operated about seven on the visit of the experts. The cancer of the cervix, the cancer of the ovary, and other people came with breast cancer. And it is a continuous process. Like now we are going to embark on the ninth Health Mission, which I believe we are going to do very early in May. I just await the approval. For each free medical mission, we have free surgical mission.
What about the rural areas?
We go round to different constituencies. Like in Ekiti State we have 26 constituencies so we have to go from one constituency to the other so that a lot of people can benefit. In this free health mission today, from inception in 2011 to the one we did last April, we have got about 687,000 people which is almost about 25 to 30 per cent of the population of Ekiti State that have benefitted both from medical and surgery.
How have you been able to finance the programme?
This is another miracle considering the fact that we are never high on the resource allocation status. But I think the fact is that there is nothing impossible if you have good governance. Dr Kayode Fayemi has been able to block leakages. And I begin to wonder where was the money we are using now? Were they not there in 2009? Were they not there in 2007? Were they not there in 2006? The underlying factor there is that there is good governance. A lot of wastage has been blocked so we are ready to guard the resources together. Like today, for this health mission, he just approved N88 million.
Apart from finance, what other challenges are you having in the sector?
The problems that we have, most of them have been on ground because people did not think about it. One is organisational problem. There are ideas but there are few people to get it organised and then push it forward and it is about focus as well. Now, the governor said he wants free health for the people. That is a focus. Then how do you now go about it? It is you that will know how to go about it so that there could be a reduction in some very bad areas.
How about human resources?
There are very few doctors and few nurses.
Why?
This place is very far from Lagos; it is far from Abuja; it is not like Port Harcourt where you can have professionals and benefit from good things. Light is a problem here, isn’t it? Water is a problem here. And all the social amenities are not available.
Those people that left Ekiti like five or six years ago, if they come back now, they will realise things are being modernised. There is now rural and urban development, there are schools that are good schools, there are hospitals that are image-friendly. The standard of living is coming back right now. But again nothing is insurmountable before God and we are there.
What package do you have to encourage the development of workforce in the state? How do you want to motivate the workforce?
I told you [earlier] that we have some problems in employing some professionals because of the distance from here to Lagos and the distance from here to Abuja. You know the geography of the environment. But I think Dr Kayode Fayemi is addressing the issue. We are having good schools around, good market, even in the next few months now, by God grace, our Shoprite will open. You know things that will attract more people, the hospitals, all the things that will improve the social environment.
What kinds of facilities are now in the three levels of hospitals in the state?
Let’s start with the primary, because our approach is to concentrate more on primary care because that is the bedrock of services everywhere in the world. And with primary health care you can take care of different kinds of ailments – malaria, diarrhoea and so on. We have to be very strong in the area of primary health care. Like I told you, we are one of the best rated in the area of primary care. We are well referred at the federal level. At the international level we are well rated because of the primary health care. If you go round, you will see that our physical structures in Ekiti in health care delivery comparable to any international health care standard in terms of functionality, structure and other aspects.
As at today, we have 313 primary health centres scattered in 137 wards and in these primary health centres, though we are in need of human resources like I said, we have minimum requirement. We have nursery,we have senior health officers, what you need in a primary health care is a senior health officer and in many of these health care, we have three, four or more of them. We have nurses and laboratory technicians even though that is not the maximum requirement. We have one or two doctors in each local government that go round the primary health care facilities and this is okay.
And if you go to our primary health syllabus, there are two doctors who treat and there are 16 nurses that treat. There is something we call job sharing. And it has helped us a lot because that is the way we can cope. Ekiti State is far better than states like Borno, Sokoto and Kebbi in terms of health. Each time we go to National Council, they cannot even boast of a doctor in any of their local governments. We have been doing all the basic things in the primary health care structure: oral rehydration, immunisation and monitoring nutrition. You know, that actually deals with all these major problems that we have. And at least we are forging ahead in all these areas.
Our secondary health care, we have 20 facilities, even though some of them are on strike as we are talking. The major achievement of Dr Kayode Fayemi is that we are working to make these hospitals friendly. We are renovating 18 of the hospitals as I am talking to you now and they are in different stages of completion. If you have been to Oke Imesi, Ikere, Ikole, Aramoko, Efon, you will see what I am talking about. We are renovating all the 18 General Hospitals at the same time and that costs over N1 billion. We have paid more than 30 per cent of the contract sum through special project to the contractor because that is the arm supervising the projects. And that is our major strength for now. And that is our major strength for now. And again, there is an Oba Adejugbe Hospital, a 300-bed hospital. I went to Mr. Governor for the past few weeks because he is a very busy man he has a lot of engagement, and he told me he just paid the money some days back. So, N50 million should be enough to get the contractor start working.
As I said it is a 300-bed hospital, so we are making arrangements to equip it. The equipment will cost over N1 billion. We are planning that that place should be a specialist centre to take care of chronic illnesses like cancer, diabetes and hypertension. And they are going to do very good surgery there. I have contacted a consortium from England to assist us to get a radio therapeutic machine to the place.
Few weeks ago, I was in Ghana to look at the National Ghana Cancer Centre in Kumasi and Accra, to see if we can get their prototype, because the consortium that I approached in England have worked for them in Ghana. And even though we are sub-national and those people deal with nations while Ekiti State is a state under a nation. So we are trying to see how it can work out. Incidentally they are here with us to assist us. We are forging ahead in that area. We are making improvement and we also equip them. These hospitals were built as far back as 1968/72 during the military era and no renovation has taken place in any of them. It is a very good initiative from Dr Kayode Fayemi.
Our tertiary hospital and teaching hospital that is another area where we are making progress. We are doing a lot of construction and renovation work there and a lot of re-equipping. About three weeks ago, we just approved the consignment of medical equipment worth over N420 million through a consortium in America, Atlanta precisely. And again another screening centre is there where we have been focusing on cancer because of the Cancer Centre built in memory of the former Deputy Governor. It has an FO, it has an ACG, it has a treadmill which is meant for people to exercise and some other materials. We have laboratories. And we are providing structures that were not there before. We are modernising the place. We are providing equipment in many of the institutions. You know the institution is a specialist area where we take care of ophthalmology, where we can share with gynaecologist, health medicine, surgery and such specialist assignments like diabetology, renal, hernia, among others. We are putting more attention to ensure that that place becomes a world-class teaching hospital comparable to UCH or Ife where I came from.
How would you describe the present state governor?
What word could I use for a gentleman that is so gallant, that is so accommodating, you know, an intelligent person that is a good administrator. You know for someone to be able to propose eight agenda in areas of Agriculture, Education, Health, Urban Development, and a governor that is doing all these things all at the same time. Working diligently, ensuring that people are living well. What good words can you use for such person? He is a good mentor. He is a workaholic to the core. I just pray that God continue to strengthen him. He is a man of many parts.
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