‘Ignorance, poverty ‘forcing’ Nigerians to engage in self-medication’

Access to quality healthcare has always been a challenge to many Nigerians. Whether as a result of poverty, ignorance or other factors, many Nigerians have looked away from hospitals and chosen to embrace self-medication. They, therefore, buy drugs from chemist stores and hawkers without prescription or even resorting to taking herbal concoctions. Residents of the Federal Capital Territory (FCT) are not left out. PAUL OKAH reports.

There is no gainsaying that human beings can do anything to stay alive, especially in Nigeria; where the saying that “where there is life, there is hope” and “health is wealth” are regarded as truest words. However, access to quality healthcare in hospitals seems to be the greatest challenge of Nigerians, especially in the Federal Capital Territory (FCT), as many of them now embrace one form of unorthodox medicine or another to stay alive.

All over the country and in different parts of the FCT, chemist stores are springing up for people to buy drugs without prescriptions. Even self-acclaimed professors of herbal medicine are not left out, as many of them are seen in street corners, market places and motor parks in the FCT “enlightening” an enchanted audience on how to treat one ailment or the other with the help of medicinal leaves, roots and stems.

Itinerant hawkers are not left out as many of them are seen in buses plying different parts of the FCT hawking sometimes expired and repackaged drugs they claim to cure different kinds of diseases, including hypertension, asthma, sexually transmitted infections, especially HIV, “in one swell swoop.”

Investigations by Blueprint Weekend revealed that many, especially in the FCT, only visit the hospital when they are so sick and at the point of death, giving excuses of poverty and “long protocols” as reasons for not going to the hospital in the first instance.

In a chat with this reporter, a trader in Lugbe, Mrs Nneka Okafor, said she has more faith in traditional medicine than visiting hospitals, as “native drugs are cheap, accessible and effective than English medicines.”

She said, “When you go to the hospital, you will be forced to buy cards and pay consultancy fees before you can see a doctor. This is after a very long wait. Even at that, you would be given medicine at very high prices. Sometimes, the drugs are not even effective. These are drugs you can easily buy at chemist stores and at cheap prices too.

“But with traditional medicine, which is usually cheap and accessible, rest assured that your diseases will disappear in no matter. They have proven to be effective over time and I usually buy herbal medicine whenever I go to the market for shopping. You don’t need to buy medical cards or join queues before you can buy herbal medicines.”

For a civil servant in Nyanya, a suburb in the FCT, Musa Abubakar, he buys all his drugs from itinerant hawkers in buses and has not had reasons to visit the hospital in the last few years.

 “These drug hawkers in El-Rufai buses are a blessing to us. Hardly can you not find drugs for different ailments being hawked in the buses, no matter the type of disease you may have. They even have contact addresses shared out to passengers; in case you need further medical attention. It is convenient for us, because there is no hassle and you get immediate attention whenever you need it.

“In fact, I can’t remember the last time I visited the hospital. I can’t stand the arrogant nurses and long wait before you can see a doctor. What is more annoying is the high cost of drugs in hospitals. No matter how poor you are, you will spend thousands before you can get medical attention in any hospital here in Abuja. Whether it is Nyanya General Hospital or Abuja National hospital, the story is the same. I can’t go and give them my money whereas I can spend only a small sum as to buy drugs in buses,” he said.

Interestingly, on Thursday, August 8, this year, this reporter stumbled on a crowd gathering before a man claiming to be a traditional health expert just in front of the Federal Capital Territory Administration (FCTA) premises. The charged ‘doctor’ claimed that the different leaves, roots and stems he had on display in a dirty carpet (which was enmeshed in sand and mud) could cure different ailments, including HIV, gonorrhoea, infertility, peptic ulcer.

Needless to say that his customers were the ‘enlightened’ staff of the FCTA, who ought to know better, but who made several purchases, with many of them even requesting for the contact of the gullible vendor; for further information on how to use the different leaves, roots and stems they bought from him.

In a country with average life expectancy pegged at 55 years, health experts have since warned against self-medication, saying it is debilitating. Though many have blamed poverty for rising health challenges, others have advocated value reorientation and government’s intervention to solve the problems experienced in the health sector.

Intervention needed

In a chat with this reporter, a former pro-chancellor and chairman of the governing board of the Obafemi Awolowo University (OAU), Ile Ife, Prof Rowland Ndoma-Egba, said accessing quality healthcare is still a problem in Nigeria.

He said, “Health is important in our daily lives, though access to quality healthcare is still a problem in Nigeria. I am particularly interested in governance and how the people at the local level are affected. How can our local governments meet up with their responsibilities of primary healthcare delivery, if allocations to local governments do not get to them?

“Human capital is important in quality healthcare delivery. Many states have teaching hospitals today, but finance is a challenge, especially because of human capital. The uncertainty of health and pollution of the environment remains a thing of concern. Efforts should be made to implement quality healthcare in Nigeria.

“If government is serious, in one year, we will have all the services we need. Politicians must show concern to resurrect confidence in their followers and not allow the seeming neglect of the healthcare system.”

Wrong orientation

At Misericordia Hospital in Afikpo, Ebonyi state, a nurse who asked to be named in print told this reporter that HIV disease was spreading in different parts of the country “because people were giving the hospital a wide berth.”

According to her, many Africans have been so indoctrinated to believe that they will be less human if they visited the hospital when sick and would rather prefer to bear or ride pains than seek medical assistance, even as she said the situation is affecting many homes.

She said, “An average African man does not visit the hospital until he is critically ill and at the point of death. This is according to research and findings. It is only in America or advanced countries that people go to the hospital for a check-up without being visibly ill. But here in Nigeria, people pretend to be strong and avoid the hospital if they can.

“You can only see them visit a chemist store if the situation is becoming unbearable. It is the mentality: the culture being inculcated in them that they have to be ‘real men’ and immune to pains. So, if for anything, what will prove your weakness and cause you not to be a ‘real man’ is avoided. That mentality is too bad and is inculcated in men at childhood. Parents always encourage the boy-child to be strong and it has been affecting many of our men. I only pray we retrace our footsteps in time. In a nutshell, HIV is not the worst thing that can happen to any man.”

Orientation paramount

Speaking during a national asthma conference organised by the Amaka Chiwuike-Uba Foundation (ACUF) in Enugu on Thursday, July 18, 2019, with theme: “Better Breathing; Better Living: The Role of the Environment and Governance,” a consultant chest physician and professor of medicine, Prof Gregory Erhabor, said that education of the public by medical practitioners is paramount, as it would help in changing their perception about medical conditions.

“In the UK and other advanced countries, medical practitioners educate their patients. When the patient has cancer, asthma or any other ailment, you educate him. The internet is not the best way for education, because you can find many junks there. It is our responsibility to pass the message across to the world. We might not necessarily change the world, but we will change a lot,” he said.

Agreeing with Prof Erhabor in a paper she titled “Environmental Risk Factors for Asthma in Children,” a consultant pulmonologist and pediatrician, Dr Adaeze Ayuk, said more awareness is needed on diseases, especially asthma, as environmental pollution affects both children and adults.

“We should encourage people to go and see a doctor when they exhibit symptoms of being asthmatic. It is not a matter of ‘it is not my portion.’ When they visit the hospital, data will be collected for research and recommendations,” she said.

Poverty, a factor?

In an article to Blueprint Weekend, entitled “Human Rights, Environment and Health Management in Nigeria,” a human development consultant, Larry Oguego, said every problem in Nigeria today can be viewed through the lens of human rights, even as he said that poverty has reduced the lives of people to the level where they no longer have dignity for human rights.

He said: “Chapters 2 and 4 of the 1999 Constitution has upheld human rights as the rights accruing to us, because we are humans and should enjoy them from birth till death. However, by omission or commission, it is common to abuse human rights in Nigeria, especially by security agencies and as a result of poverty. In fact, it is a crime to be poor in Nigeria, as poverty has already taken away some of your fundamental human rights.

“The highest violator of human rights is the police. The average police cell is designed to trigger asthma, as some people die in police cells as a result of asthma complications. This is apart from police using teargas to disperse demonstrations, with many of them being asthma patients. Police arrest and keep people in solitary confinements or in the booth of cars, regardless of the fact that the supposed criminals may be asthma patients.

“Our healthcare system is in a sorry state. If you have a medical emergency, especially as a poor man, you are on your own. Even some healthcare providers lack knowledge of what asthma is all about. However, we must steer Nigeria away from poverty, because poverty aggravates human rights abuse. Some asthma patients die because they don’t have money to pay deposits.”

FCTA intervenes

Worried by the lack of access to quality healthcare by residents, the FCT Administration (FCTA) on Wednesday, August 7, this year, expressed determination to attain Universal Health Coverage (UHC) through provision of free basic healthcare services to the poor and vulnerable residents of the territory.

Addressing newsmen at the inauguration of the Basic Health Care Provision Fund (BHCPF) at the Kuchingoro Primary Health Care Centre in Abuja, the permanent secretary, Mr Chinyeaka Ohaa, said the primary purpose of the BHCPF was “to support effective delivery of primary healthcare services and the provision of basic minimum package of health services.”

He said the fund also covered emergency medical treatment through adequate and sustainable funding that would be efficiently and equitably used to provide health services, and that “the FCTA has met all the eligibility criteria stipulated for the enrollment and operations of the fund.”

He said: “With the launch of the basic health care provision fund in the FCT today, all residents are eligible to enroll to access the basic minimum package of health services. These include free antenatal care delivery and postnatal care for all pregnant women, immunisation, malaria, pneumonia, measles and dysentery treatment for children less than five years and malaria treatment, among others.

“The march toward UHC is achievable and I urge all residents of the FCT to seize the opportunity provided by this initiative and enroll to access the basic health minimum package of services.”

Also speaking at the event, the acting executive secretary, FCT Primary Health Care Board, Dr Ndaeyo Iwot, said with the initiation of the programme, access to primary healthcare services for the first time in 30 years has come under one roof and one basket.

Iwot said the programme would be implemented in 62 primary healthcare centres in the territory, even as he called for collaboration between communities and the primary healthcare centres to ensure the success of the programme.

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