Posted by By Chinyere Fred-Adegbulugbe on
Dr. Prosper Ikechukwu Igboeli, tells Chinyere Fred-Adegbulugbe the factors militating against quality public health care in Nigeria.
You and your colleagues have been clamouring for a surgeon-general. What will be his duties?
The surgeon-general is like the attorney-general of the federation. He is always the chief judge. He runs most of the technical work of the department of health; that is what happens. The surgeon-general is so critical that the vacuum created now would not have occurred even when a substantive minister is not appointed. But the problem we have is that we sidetrack all these things due to politics, bad politics. But reality is reality. All these people who take our money and move and go overseas, it tells me that they do not believe in our system. It is sabotage. They do not believe in us. I have not seen American president coming to Nigeria to seek medical treatment, neither German, nor French president, even the South African president. But we even go to Egypt and India. How many of them come to Nigeria to seek medical treatment?
What do you think of the Lagos State coroner‘s law?
I have heard about the law and I have requested a copy of the law to review it before I can make a public statement on it. But any law that is needed for preservation of human life, I am sure the majority of doctors will embrace it. If it is to protect human life and the dignity of man, I think any reasonable doctor will accept it. I have requested a copy of the law itself so that I can grade it and make commentary on it, either negative or positive. But I want to let you know that the biggest problem doctors have is that when the government wants to make law, they do not ask for the input of the medical doctors, which the law is supposed to be serving. That is where the problem lies. I think that is a wrong policy. I am planning to basically stage a national health summit that will actually bring a lot of stakeholders together, so that we can look at the problems and proffer solution on the way forward for the health sector as soon as possible.
How do you think assisted fertility could be made more affordable to Nigerian couples?
The National Health Insurance Scheme is the way.
Do you honestly think the government can fund that?
The government can partly put a subvention. In Australia, they give you two or three high cycles free and after that, you are on your own. In the Netherlands, they give you four or five cycles free. There are many things the government can do to make the life of this childless couple a little better. They spend so much money; infertility is expensive, very expensive. It is something that can actually put a lot of stress between a couple that is supposed to be happily married. The least the government can do is to say, we pay 60 per cent for the first trial, 50 per cent for the second trial, 40 per cent for the third trial and after that, you are on your own. That is what I expect the government to do for them.
On the part of couple, what can men or women do to ensure they don‘t tamper with their fertility?
For the women, the biggest factor that leads to infertility is pelvic inflammatory disease. You should not make love to those that are not sure of their health status because you can get diseases.
Even when the person in question is your spouse?
Yes, even with your spouse. Get to a lab, get yourself together, and get yourself tested even before you start making any kind of move. There are annual exams for all reproductive age group individuals. You should not make love to multiple partners, which is very rampant in this country. You should also protect yourself because once you start doing illegal abortion, it is dangerous and I am hoping and praying that the government some day will find a heart for the reproductive rights of women. I am a gynaecologyist/obstetrician and I know that unwed mothers are left unattended to. There is no programme for them. The system requires overhaul. Very little education on sexuality is taking place in our system.
And for the men?
The men too should get education. A lot of men carry diseases and they expose their diseases to women by having multiple sexual partners, who are females. I think, education is the core because it is when people are not ready to get marry that they get into this scenario, they look for where they can abort their babies or give babies for adoption. Then, every other problem now comes from that area. We need to have public education on human sexuality.
On women‘s reproductive rights, isn‘t that another name for legalising abortion?
Is there anything wrong to ask the government to legalise abortion?
Well, it is offensive to some people.
It is offensive because Nigeria has multi religious groups and that is the issue. For that reason, they should allow it to be open. Reproductive rights are reproductive rights. If the government has diverse religions and one of it is saying, ‘no,' and the others say they can tolerate it, then let the women decide what they want under the location they live. I know a lot of women leave certain countries in Europe and go to other parts of Europe to procure abortion.
There are some people who suspect the West has ulterior motive for pushing reproductive rights in Africa. What do you think?
Let me tell you, if you have less number of children with the poverty level in this country, you will be able to train them to become more functional. The more you are able to train your kids and empower them, the better off they will be as members of the society. In 1974, I wrote on population control. I am an advocate of population control, because a lot of Nigerians are living in abject poverty and some of them now have six to eight or nine children. Those children end up in the street either as rogues, beggars or doing menial jobs. That is why there should be free education and free medical care for mothers and children.
What are some of the challenges you have faced practising in Nigeria?
The infrastructure is bad. Insecurity, basically infrastructure, energy infrastructure, road infrastructure, water resources infrastructure, high level of poverty and high level of illiteracy. These are the impediments to medical practices in Nigeria. Of course, health infrastructure, lack of access to the Internet. I have to spend hundreds of dollars travelling every year to travel back and forth to Europe and America to join and level with my colleagues. All these things can be put in place in Nigeria if we have the wealth and the political will.
Why do you think that your colleagues chose you for this position?
Well, I think my colleagues chose me because of the capability they found in me and because of my vision.
You are married with kids?
I am married with a lot of children. I have six children.
But you said you were advocating population control.
I told you that poverty is the main problem; that people should limit the number of their children so that they can be functional in the society.
If you were not a medical doctor, what would you have done?
I don‘t know. Maybe I would be writing. But right from secondary school, I was called a gynaecologist, because I was always carrying my stethoscope with me all the time.
Having stayed abroad for long, how have you been able to cope with Nigeria?
I don‘t go out, and I don‘t eat and it is either I'm in the house or with my colleagues. I don‘t do much. I am afraid of this system because of high insecurity, bad roads, so much accidents. Nigeria is very unsafe if you want me to tell you outright. It is not my wish to remain in my own environment and interact with my colleagues. I want to interact with people, but the environment has put so much limitation.
When you were starting out as a medical doctor, did you think you would be the NMA president?
It just happened. Earlier, I built a house and donated it to them; they began to think. Also, I hosted the best national executive council. So, a lot of them wrote me and said they thought I could lead them and that is what has happened. A lot of people approached me so that I can become their leader.
And you are optimistic that you won‘t disappoint them?
Well, I think I have a very energetic national executive committee. When you work together, you accomplish a lot. When you are brickering among yourselves, you become disorganised. We are much focused and have a vision, so we are bound to succeed.
With your family living abroad, don‘t you miss them?
I miss every one of them and I am begging them to come home. In fact, one of my daughters is in her final year in the medical school in Ohio. She just entered the University of Calabar as a Fulbright scholar to do research in infertility. Maybe she would stay back after.