The State House clinic as a metaphor

By Lakinbofa Goodluck 

Between January and August 2017 alone, President Buhari has spent more than 150 days outside the shores of this country on medical trip. The last medical trip of the President took him 103 days leaving Nigerians conjecturing the nature of his illness. Well, the first citizen is now hearty and has since continued with the business of government. While the President was away, many wondered why the President could not be treated in the country especially for simple medical check-ups. No one really had answers; and as a point of fact, many Nigerians thought our leaders are just naturally excited to travel to other countries on medical grounds considering that President Buhari is not the only Nigerian leader that patronises foreign medical facilities. Thankfully, the Wife of the President, Mrs. Aisha Buhari has provided answer to our unending questions. The clinic in the State House, the actual seat of power of the largest economy in Africa, lacks basic medications such as paracetamol, and is largely underequipped despite huge budgetary allocations. What I personally enjoy about the First Lady is her readiness to provide answers to tough questions Nigerians seek answers to. This is not the first time she is serving as the revealer of the concealed.

At a stakeholders meeting on Reproductive, Maternal, Nutrition, Child Advocacy and Health and Nutrition(RMNCAH+N), at the State House, Abuja, the First Lady revealed how she was told the clinic’s X-ray machine was faulty when she made a request in that regard. She went further to criticise the clinic for engaging in massive construction without a single syringe. In the end, the Wife of the President called for a probe of the clinic. In a similar vein, the President’s daughter had revealed on a social media platform that the State House clinic lacked basic requirements such as paracetamol, syringes and gloves. She further questioned why patients and staff have to buy what they need at the State House. Indirectly, the President’s wife and daughter have formally called for a probe of the State House clinic. And of course the Permanent Secretary certainly has a lot of answers to provide.

Prior to the revelation by the First Lady, the Permanent Secretary, Mr Jalal Arabi, through the Deputy Director of Information, State House, had released a press statement that the clinic was to be commercialised to ensure greaterefficiency. He revealed that the “the centre is the only health centre in Abuja where patients are not required to pay any dime before consultation.” The Perm Sec further said “the Centre offers free services, nobody pays a kobo for hospital card, consultations or prescriptions and this has taken a toll on the subvention the Centre receives from the government. “We have some of the best equipment in the country. For instance, to maintain the MRI and other scan machines, we spend close to N2 million monthly. Yet we do not charge a dime for those who require MRI scans in the clinic.” The point the Perm Sec attempted to make is simply that the allocation to the State House clinic is insufficient for its operations, hence the reason for the faulty machines and the absence of basic medical aids.To exonerate himself from the allegations of financial impropriety, the Perm Sec said “no sane person will do that(defraud a medical centre), so the truth of the matter is the hospital is being run on subvention and appropriation; if it comes we pile the drugs; but the truth is the drugs are always overwhelmed by the number of people who use the Centre, because it is not controlled.”

In 2016, the federal government allocated N3.8billion for capital projects at the State House clinic, which was more than the total allocated to all the teaching hospitals in the country for the same purpose. After the public outcry that followed the revelation, the Senior Special Assistant to the President on Media, Garba Shehu explained that the teaching hospitals in the country got 50% of the N200billion allocation to the health sector. Although, the SA did not provide a breakdown for that figure, which also included recurrent expenditure for the entire health sector in the country. Mr. Garba Shehu further stated that “the increased spending on government health institutions in the current budget should be seen in the light of the administration’s plan to improve medical facilities at home as a way of discouraging overseas trips in search of treatment by citizens which eat away from our foreign exchange.” In fairness to Mr. Garba Shehu, at the time he released the statement the President had not fallen ill and no memo was written to any government official notifying them of the imminent 103days foreign medical vacation of the President, which obviously ate away from our foreign exchange. If the SA had prior knowledge, maybe he would have been more circumspect in his explanations.

At the legislative level, Hon. Henry Archibong of the House of Representatives, in his submission for a motion to probe the clinic, revealed that in the 2015, 2016 and 2017 Appropriation Acts, the State House clinic was allocated the sums of N3.94 billion, N3.87 billion and N3.2 billion respectively, for upgrading and provision of necessary drugs and equipment. Within the same period the 16 teaching hospitals in the country collectively got capital allocation ofN1.424 billion; N3.333 billion and N1.943 billion for 2015, 2016, and 2017 respectively. In other words whilst the State House clinic had received a total capital allocation of N11.01billion in the last three years, all the teaching hospitals in the country had only received N6.7billion within the same period. Yet the same clinic is about to be commercialised for lack of funds. The State House clinic was primarily built to cater to the medical needs of the President and his family, Vice President and family, government officials and other staff of the State House. On the contrary, the insufficient 16 teaching hospitals in the country are meant to cater to the medical needs of the rest of Nigerians, conduct research and train medical doctors that will serve the country. One would have thought the teaching hospitals deserve more allocation than the State House clinic. But our budget planners think otherwise probably due to the calibre of people the State House clinic is built to service.

Painfully, the huge allocation to the clinic has not translated into quality healthcare. Our government officials still have to travel abroad for medical treatment. I wonder why we should fund a clinic that has not lived up to its primary purpose of treating the President and his family. It is complete waste of resources and a seeming conduit for misappropriation that encourages corruption. It will be really useful for the Medical Director of the clinic to provide a breakdown of the number of patients that have been treated at the clinic in the last one year to, at least, justify the continued funding of the clinic. While we await the President’s body language, speech and action on the matter, it is commendable that the House of Representatives have decided to probe the allocation to the clinic. And we hope something positive will come out of the probe.

Nevertheless, the clinic is just one example of how we repeatedly make allocations for non-existent items in the State House. It is the same State House that proposed N123million in the 2017 budget for catering equipment and materials in spite of the N94million that was allocated for the same purpose in the 2016 budget. The same State House gets allocation for new computers and many other line items every year running into millions of naira. This situation is not limited to the executive arm of government. The same scenario is obtainable in the National Assembly, where our legislators are being regarded as some of the highest paid in the world, yet we borrow to finance our budget at the expense of the future generations. A significant percentage of Nigeria’s annual budget is allocated to meet the wants of our leaders while the larger population is constrained to live with the paltry allocation for the things that directly impact their socio wellbeing.

The State House Clinic is only a metaphor for Nigeria and its leadership. We spend huge amount of money on our leaders counting on them to provide the necessary leadership for the nation, and heal our numerous injuries. But what do we get? A nation that is left to bear an indescribable pain that threatens its continued survival. Our nation is bleeding on all sides, – politically, economically, educationally, socially, morally, and even spiritually – but our leaders surely lack the syringes, gloves and the paracetamol to treat our wounds. We have spent so much on them but they obviously lack the capacity to stop this nation from bleeding. I pray we do not bleed to death.