ABUJA WILL SOON BECOME THE HUB OF PREMIUM HEALTHCARE IN NIGERIA- FASAWE

The Federal Capital Territory (FCT) Health and Environmental Sevices Secretariat is charged with the statutory responsibility of the provision of quality healthcare services as well as environmental management within the Territory. The Secretary, Dr. Adedolapo Fasawe, in this interview with Abuja Digest Crew; the Managing Editor, Mr. Anthony Ogunleye, Editor, Victoria Agorom and Reporter, Prudence Okonna in Abuja spoke extensively on the activities, achievements and challenges of the Secretariat over the past two years. Excerpts:

Abuja Digest: A lot has happened over the past two years. Can you tell us some outstanding achievements this Administration has recorded in the health sector?

Fasawe: When we first assumed office, his Excellency, Barr. Nyesom Wike gave us marching orders: that if we are not able to meet our expectations, he will send us packing, and in saying that, he got everybody on their toes. We call him Mr. talk and do; if he says something, he does it. You have no choice but to follow that pattern. I will tell you that a lot of infrastructural development has happened in the FCT. You may think that it does not concern health, but it has because it has increased our health indices by more than 60 per cent. What do I mean? All these new roads, the arterial roads, have now made it easy for the transfer of patients from rural to urban areas.

So, the infrastructural development that has happened in the city as a whole has had a very positive impact on the health systems. In health, we talk about accessibility, affordability and sustainability, and efficient services.

In terms of accessible health, the massive infrastructural growth on the roads in the FCT has made health more accessible. A journey that will take one hour from Abaji to General Hospital, Asokoro, or Maitama for referral will now take only about 20 minutes, and in that time, a life can be saved.

Then we talk about affordability, this Administration under the Administration of Barr. Nyesom Wike has made health insurance free for all pregnant women, and the child they will give birth to and for the first year of their lives will have health insurance, including cesarean section.

There are testimonies. There is a woman who gave birth through C-section, but she didn’t believe the doctors when she was discharged to go home. They said she could go because Wike had paid, but she didn’t believe it. She turned back upon reaching the gate because it sounded unbelievable. According to the woman, her husband sold their property to pay for CS for their first two children. So, in terms of affordability, Wike has made that happen.

We have data to show that our last immunisation exercise was 101 per cent by the National Centre for Disease Control (NCDC)  and World Health Organisation (WHO) Before the advent of this administration, it was 35 per cent; in the first year of this administration, it was 70, in the first round, second round, 85, third one, 100, and 102 per cent, and so it just keeps getting better.

I remember an interview the Minister gave, and they asked him why he wasn’t doing anything in health. In health, infrastructure is the last thing, even though we need new equipment and standing hospitals. If we don’t take care of human resources in health, even with the finest hospital, grass will grow there, and I have seen it happen in many places.

So, Wike is looking at human resources in health, for instance, I will talk about the accrued the uniform allowance, for the past seven years, no one has paid the accrued allowance, but since he came, he paid it and paid in arrears of it.

Secondly, when we first came, locum doctors were earning an unreasonable amount of money, and other locum staff were earning less than the minimum wage, 18 or 19 thousand naira. I wrote a memo to him saying this is minimum wage, explaining the situation. Barr. Wike doubled that amount; it is on record that for the first time, locum doctors were earning what is comparable to their permanent colleagues.

Abuja Digest: In recording these successes what measures were deployed and how do you intend to sustain them to improve service delivery?

Fasawe: Sustainability and doctors’ welfare, I am happy to say that when we came here, I visited all the hospitals as directed by the Minister to see what was happening, some of the call rooms I saw, and showed the Minister. He was appalled at the state of the rooms and said that they were not fit for animals not to talk of humans. We went to work and have successfully renovated 85 per cent of the call rooms in FCT, so that now some of the doctors can work with comfort, even female doctors who are breastfeeding can bring their babies to the hospital. We have pictures of before and after, because it is now world-class.

 I also proposed for a conducive ward for patients, which led to the Nyesom Wike Amenity ward. That place is booked till September as we speak. We had to increase the fee, yet people keep coming to book. These are some of the quiet revolutions happening behind the scenes.

For the first time in the history of FCT hospitals, we have mobile X-ray machines. The Minister approved the procurement of X-ray machines, and these were a fallout of the tanker explosion. The Minister paid for every single patient who was a victim of that explosion. He asked me to go to the hospital to see what was happening, and when I was giving him feedback, he said I should give him their bills. I took some of them to the National Hospital, and they said to us that they were used to being owed for treating such casualties, just like that of the UN house bomb blast. I assured them that the Minister had provided the bill. They had to write him a letter commending him and thanking him. Not only did he pay for the patients, but he also left a deposit for their future care. These are some of the revolutions that have been happening. A lot has been recorded.

Abuja Digest: Can you explain how people can access the FCT Health Insurance Scheme in the rural communities, what are the modalities, and immunisation too?

Fasawe: When children are immunised, they do not die from preventable diseases. Immunisation is what reduces the infant mortality rate.  

This administration has zero tolerance for maternal mortality, and that is why the Minister has said all pregnant women should be on free health insurance. The number of women dying during childbirth is reducing, as we can see, because when they come to our hospitals, they get the best care.

The measure deployed is that sustainability is the keyword. Mr Wike is not a touch-and-go kind of Minister.  At times, we would write a memo, and he would write inside “what happens after?”, that is, if you ask about a certain amount of money. He is very keen on sustainability.  If we employ a hundred doctors because we can pay today, are we be able to pay them next week? Go back and do your homework, and do a long-term spread.

For example, they charged us that in the next four years, we must be able to increase our health insurance base by a thousand patients each year. It is on record here that we have a two hundred and eighty-seven thousand (287,000) increase in one and a half years; that was a presidential mandate. For us in the health sector, our target was the number of PHCs constructed and the number of health insurance policies; how many people on health insurance.

When we first came, we had only a hundred and forty-five thousand (145,000) people on health insurance. As of today, we have over six hundred thousand people on health insurance in two years, and that is what is called sustainability. 

That is how we hope to sustain this tempo, because when you go to our hospitals and you are on health insurance, they are not writing prescriptions for you to go and buy outside. Our central medicine store is becoming one of the best in the North Central, people are coming from even private hospitals to buy medicine from us.  Our Health Management Organisation (HMO) wrote a commendation letter to the Minister, saying that for the first time, they are being paid in advance. They used to owe them, now, because they are being paid in advance, it is only normal that they have to put drugs in the hospital and pay for patients, and because health insurance is in our private hospitals.

They are all listed, so when you go to such an expensive hospital, and the HMO pays your bill, it encourages you to come back; that is how we intend to sustain this tempo.  More people are buying health insurance because they are seeing that, truly, their bills are being paid. And this is part of the wisdom and the strength of our Minister.

Sustainability is key, and our Minister is someone who just looks at what is obtainable today. He looks into the future, and in writing letters to him, he will make you think, and because of that, we have been able to improve service delivery.

Of course, we have not done everything residents want, but Doctors’ welfare has improved drastically under the Administration of Barr. Nyesom Wike.  There was a time they stopped some salaries erroneously, but within 24 hours, the Minister asked for a memo, they approved it, and he directed that the monies be paid.

It is on record that we have only had a warning strike; the doctors in FCTA have not gone on strike since this Minister came on board, and that is because of a good rapport, and they see good intentions, and they know eventually we will get to the promised land.

Abuja Digest: How much has the Minister’s leadership contributed to your achievement?

The way the Minister’s leadership has contributed to our achievement is that his leadership style is firm. I have learnt a lot from him. What I see in him is that if he wants to move from point A to point D, he will navigate around B, C, and D through either conversations or negotiations. He does that by finding the most peaceful way, but if none of that is working, he will wield the big stick according to the law.

He is focused and works with timelines; when he says he will do it within six months, he will do it within six months. I have had to write the same letters to him multiple times; he would write KIV (Keep in View), and I will continue writing because I am following his style. So, I follow that style and I continue to explain to him why doing this will work, and he is a man of reason, very intelligent, he sees reason.

 Therefore, in copying his leadership style, we have been able to achieve a lot. Like I said, his leadership style is focus-driven, and anything that would not get him to where he wants to go, he will find his way around it, all those mountains using the law.

Abuja Digest: The FCT and a few other states have been named as having a diappropriationately high HIV/prevalence. Why do you think this is so and what can be done about it especially in the light  of th US Government’s withdrawal of funds designed to mitigate the spread of the diseases?

Fasawe: In terms of HIV/AIDS, I went for a programme the other day where they celebrated the achievement of the treatments of a hundred thousand (100,000) patients. They started with maybe about five to ten thousand, but now hundred thousand patients are on treatments nationwide.  That got me thinking about people who are living with HIV/AIDs in our midst in that meeting and they all looked nice and robust. The third-generation drugs for people living with HIV/AIDS, that we were getting from the US are so good that their immunity, at times, is even better than people living without HIV/AIDS. They don’t fall ill, they look well. I posed a question, that more people are having HIV/AIDS because of the fact they can now live a healthy life. Mother to child transmission is almost zero, now non-HIV patients can marry HIV, and they can have a child who doesn’t have HIV.

 Technology, advancement in healthcare, and urbanisation are fantastic. However, the prevalence has to go down, and the only way the prevalence will go down is to go back to the roots of what Professor Olukoye Ransom Kuti was teaching, and that is my charge in FCT; that prevention is better than cure.

Now that Mr. Trump has started withdrawing Anti-retroviral therapy (ART), the drugs for a month do not cost less than two hundred and fifty thousand naira. How many people can afford that,  if all these aids are withdrawn from us? So, we have to start the charge of prevention.

There was a time when you would go to hospitals, and there used to be free condoms, free discussions about HIV.

For now, we are working more on child spacing and family planning; we are not talking about prevention.

I wrote a memo to the Minister recently about advocacy, awareness, and prevention, and he approved it. So that prevalence, you see, figures do not lie, and in the next couple of years, that prevalence will have to come down. This is because this Administration is keen on prevention rather than cure.

The World Health Organisation (WHO) has said that twenty percent of a country’s budget should go to health, but if we do that, every other sector will collapse.  So, we all just have to fight to keep things in check. I think that for a preventable disease, we should not be pumping so much money into treating it; we should start thinking about preventing it.

Now we are pumping money into non-communicable diseases like hypertension and diabetes, which a person develops by either lifestyle or even inheritance, nothing you have done wrong. Those are the ones we are focusing on.

So, for the preventable diseases, we are focusing on immunisation. I am also happy to say that when this government came on board, we were able to give out HPV vaccines to prevent cervical cancer to hundreds of thousands of women, if not over a million.

 There was a day somebody went to a radio station to say we are trying to sterilise the girls by giving them that vaccine. I used to have queues of two hundred people in the health center, after that broadcast the line started reducing.

 So, the Minister gave me an open hand to go to the radio station to explain the whole situation, and in the end, with scientific proof, the man said. All of you have heard her. I will not talk again, make your informed choice.  By the next day, the ques were there again.The other thing is that Mr. Wike understands that enforcement is what works in our community. I asked him for approval to close quack clinics, I closed only two, and I put it in the press that Mr. Wike is going to clamp down on quack clinics.  By the third day, the queues were going outside here, which led me to write to him that we need to computerise registration, which he also approved.

So now, if you have a hospital in Abuja and you are not registered in our system, he will find you and shut you down, and for you to be registered, you must have the right personnel.

So, health indices are improving rapidly because of all these interventions, and the health insurance scheme is very easy. Every primary healthcare centre (PHC)   in Abuja  is functional.  Unfortunately, I will say this, people continue to build the centres as constituency projects or donations to the community without coming to discuss with the government; they need to discuss with the Minister.

We are having problems with human resources because some of  them are now occupied by IDPs or chickens, or goats, because we don’t have enough personnel, and you keep building. Instead of that, support the government in paying for staff, bring locums, bring people from your communities, or volunteers, and we would train them.

Every functional PHC have a health insurance stand now.  Because our FCT health insurance scheme is so good now, we have put a desk in all our fourteen (14) general hospitals. you can go there and register.

I want to say to all our civil servants that we deduct money from your salary for health insurance, the uptake of health insurance is so low, and that is because of a lack of awareness.  I am saying this out here, go and re-accredit and re-register, get your PIN, then you can access treatment for free, not only in government hospitals but in some of the hospitals that are paneled, all the way to NISA, even the National Hospital, I have patients on health Insurance that go there. However, knowledge is power, so I am using this medium to tell all civil servants that they have access to health insurance. However, we will not come and look for you to give it to you; you have to go and register and get a PIN, because it is one of the deductions from your salary.

Abuja Digest: Climate change is taking its tol on the ecosystem. In what way is the administration handling this in the FCT? Especially with the predicted devastating effects of flooding?

Fasawe: This Secretariat is called Health and Environmental Sevices, and that is because we have found out that there is a big nexus between our health and the environment.  And I am very happy to say that if you look around, even with all the constructions going on, the Minister is ensuring that greens are planted because trees help us to absorb ultraviolet rays. 

This time last year, Abuja was so hot that people were dying of heat stroke, because of all the construction, but now the trees are starting to grow and the temperature is coming down.

We are also combating climate change, especially the incidence of floods, by breaking down houses that do not have building permits. Very soon, the Minister will ensure that you have an environmental impact assessment license before you are given a building permit. We will soon start awareness on that in this Secretariat because some people do not even understand they are building on flood channels and there are some things called right of way, where there are tunnels and drainages underground. Some people break it and put foundation there. Of course, when the water hits it, it does not know where to pass, so it will go back. Houses will start to collapse or slide up. All of that is reducing now because Development Control Department is more active.

Apart from flooding, let’s even look at security and nomadic herdsmen, the Minister said it the other day that he finds it ridiculous that we will wait for cows to cross the streets in a whole city like the FCT.

You know why this is happening, the food that these animals eat, the grass, we have put concrete there. The cows reared by these herdsmen from when they are young have their routes for looking for food. So even if we have put a road and they are passing, they would still follow that route, and the minister said something very apt at the last EXCO. He said Why can’t we have ranches where we would grow food for them to eat? So, they would not constitute this nuisance. For him to say it, that means he is thinking about it, and they call him Mr. talk and do. So very soon, banditry will reduce.  The security of the state is also due to global warming and climate change, so when we start to have these ranches, this would reduce.

Abuja Digest: What plans does the Administration has under its belt to improve basic healthcare for residents, especially ruraldwellers?

 Fasawe: The Minister has approved that we have medical outreaches to the rural areas. Medical outreaches appear to be touch and go, but with the system he has approved and adopted, when you treat them, whatever you have left from that treatment, put them in the PHCs; Tell them that whatever they have gotten in the field, they will get in the PHCs.  We have done Abaji, Kwali, and we intend to go round all the rural areas.

Abuja Digest: What are the challenges you have experienced over the past two years?

Fasawe: Some of the challenges we have experienced are that knowledge, attitudes, and practices towards seeking health care are very poor. People are not aware of the importance of proper healthcare.  I met a woman in the hospital the other day whose baby was so sick with tetanus, sepsis, among other things. We have a maternal mortality review now, if any woman dies in a private hospital during childbirth, they will explain why that woman died and how she died, if it was a preventable death, they will face the law. We have three cases in the police station now.

So, because of that referral is better now; they would rather let the women go and die with us than with them, and when they come to us, they are not dying. So, maternal mortality is reducing due to enforcement and following the law. So, lack of knowledge, and I think it also has to do with religion; we believe God taketh and giveth, yes, when God is going to take, don’t go like an animal, go in dignity.

That is what we are trying to preach here, that even if your day is written, let us take care of you till the last minute. Awareness is becoming better on traditional practices.

And what I would like you to know is that, very soon, in the health space, Abuja will become the hub of premium health care in this country. There are many private centers coming back to set up in Abuja.

The Afrexim bank recently commissioned the ACME; they have a particular machine, it is called the technotron, and there are only two of those machines in Africa. One in South Africa and one in Abuja. People are starting to come from outside the state and the country to come and do tests here.

We are seeing a lot of doctors coming back to set up clinics, at least this year, we have registered and accredited over twelve. Because they realise that people are coming from Abuja to those places, and they are paying a lot of money they are not getting visas. The oyinbos are just taking their money, and they are bringing their businesses here. This is because Abuja is a conducive space, Abuja is safe, and the road network is good. If we continue at this rate with the support of the Renewed Hope Administration of President Asiwaju Bola Ahmed Tinubu, which the Minister credits all his successes to,  if the support continues in terms of health care delivery and indices, Abuja will be leading the nation.

Abuja Digest: What is the current state of  Utako General Hospital?

Fasawe: The issue with Utako hospital is that a contract was awarded years ago, and it’s just so unfortunate that an environmental impact test was not done. They started building on soil that couldn’t take the structure, and if that is not done, it starts to collapse, and the Contractor took the FCT to court, saying we were not paying him, but how do we pay for a structure that is half standing, half sinking? The other thing is that he claims he has bought equipment, and we have to take the equipment off him. These are facts; however, we are not at fault. It is a very dicey situation, but as soon as we settle the case in or out of court, Utako Hospital will come up.

 The Minister is a law-abiding citizen, he is very much aware of this court case and we are getting rapid hearing very soon, so that it will be beneficial to all concerned and in fairness to the Contractor he has sank a lot of billions there but he didn’t do the right thing so somehow, we will meet half way so Utako hospital will come up.

But I am happy to let you know that the Minister had just approved the completion of Gwagwalada Cottage Hospital, and in the budget, we also planned to employ over nine hundred health workers, so that we don’t just build the hospital and leave it empty. So, it is a very strategic move and I commend the Minister and the health systems, and the people of FCT are happy about that. Utako will come up soon but with the case in court, and we are not at liberty to discuss much.

Fasawe: Garki Hospital, when the Minister came, we took them to court and they paid every single kobo with a premium that they owed the government into the revenue purse. And we renewed the concession where the Minister and the private group signed a very tight agreement, and up till now they have kept to their side of the agreement. 

And because of that, there’s a building in that Garki hospital which is supposed to be for house officers. Before now, FCT was only allocated maybe a hundred and forty officers because they had to be accrediting our centres. But I am happy to say that the Minister has done a lot in our centres by upgrading them.

Contract for doctors’ quarters had been awarded and I am sure that in the next couple of months, that place will be completed. If that place is completed, we would have an opportunity to employ a hundred and twenty more officers, and I think that is a big plus for FCT. We will probably have the largest number of house officers in the North Central once that building is completed.