– The Sun News

Osun free healthcare runs into hitch

…Residents resort to herbal medicine

Omoniyi Salaudeen

No one present at the scene of the tragic incident could leave with a dry cheek. Both the bereaved and sympathizers wept and wailed uncontrollably. The dreaded malaria scourge had stealthily walked in and plucked a promising young lad amid the class of the aged already in the departure lunge waiting for the ultimate hour. Everything happened in a quick succession; what is often described in the local parlance as a brief illness. Brief, indeed, it was.

Perhaps, the story could have been different, but for the prolonged doctors’ strike that paralyzed Osun State hospitals, as well as the nonchalant attitude of other health workers. Yomi, the only male child of a family of five, had set his eyes on picking a career in law profession because of his proficiency in English Language and love of literature. In realization of his lofty dream, he developed a strong flare for reading, especially literature books. Unlike most youths who invest their time on wasteful ventures, he had no time for frivolity. Sadly, he did not live to fulfill his dream. His life was abridged by an illness that is not only preventable, but also treatable.

Like every other day, he was full of life before he left home for school on that fateful morning. No one had the inkling about the tragedy that was lurking. After the close of school, he came back home, took his meal and went for a brief siesta. He, however, woke up feeling somehow feverish and complained to his mother. But the mother, a retired civil servant, who was being owed several arrears of pensions, preferred the option of herbal concoction to orthodox treatment. In spite of her son’s slow response to treatment, she kept faith with the therapy until her husband’s friend came around and met Yomi looking pale and weak. Without wasting further time, he took him in his car in company with the mother and headed straight for the Ikirun General Hospital for medical intervention. Regrettably, there was no doctor on ground to attend to the case. While on the way to other alternative healthcare givers, the hapless boy breathed his last and was confirmed dead on arrival at a private medical centre in Osogbo. The mother almost stripped herself naked, as Mr Tola drove home trembling. Up till this moment, the sad incident remains a puzzle to the family.

It was like opening up a healed wound when this reporter visited the bereaved family to investigate the circumstances of the avoidable loss. For the distraught mother of the deceased, the scar left by the incident remains indelible in her mind. And as she reluctantly recounted the sad story, her narrative was punctuated by bursts of tears and emotion. Her words: “I am yet to come to terms with the reality of the passing away of my son. He represented a hope of a better tomorrow for this family. Apart from being the only male child, he took his studies very seriously with an ambition to become a lawyer. He didn’t tell me that he would not leave to fulfill his dream.

“It all started with malaria. And immediately he complained, I went to the market and bought anti-malaria herbs, which all of us are used to, including his siblings. We did not have the premonition that the whole thing would take a different dimension. When I observed that he was not responding enough to treatment, I sent for his late father’s friend who took us to the General Hospital only to be told that doctors were on strike. From there, we faced Osogbo, but he couldn’t make it.”

According to Mr Tola, the tragedy would have been avoided, if the state hospitals had been adequately managed and funded. Giving his own account of the sad incident, he said: “When I came and met him in critical condition, I knew the illness had weighed him down and I decided we should go to the General Hospital, but we couldn’t get a doctor to attend to us. They had all gone on strike. My greatest shock was the absence of other health workers who ordinarily should be at their duty posts to receive patients. It took more than 30 minutes before one of them came out from nowhere to tell us that doctors were on strike. When we got there, we literally had to go round the mighty structure in search of who to talk to, moving from door to door. At the end of it all, they advised us to go to a private hospital. But then, it was too late. He couldn’t survive it. Probably, if the emergency department had been on hand, his life would have been saved.

“For me, this government is not serious about the state of health institutions in the state. If there is an accident; God forbid, you will see ‘O-ambulance’ blaring siren. When you see that, you will think government is providing adequate healthcare for everybody, but all is just to show that the government is working. When it comes to actual access to healthcare service delivery, this government is not there. Most of our general hospitals and primary healthcare centres are just mere consulting clinics. There are no drugs, they only write prescriptions for patients.

“I witnessed a scenario where some nurses on duty in one of the hospitals here in Osogbo had to practically beg people to contribute money to buy some common drugs to save the life of a patient. If the situation is that bad in the state capital, what do you expect in the remote parts of the state? Commitment of this government to health sector is almost zero.”

However, one of the concerned health workers in Osogbo, who did not want his name in print, while expressing regrets over the unfortunate incident said: “That was due to the strike action embarked upon by doctors,” adding that “it was a general problem throughout the federation. Now, doctors are fully back at work attending to patients.”
Free healthcare programme nose-dives

One of the major campaign promises of Governor Rauf Aregbesola is to provide free healthcare services to the people of Osun State regardless of age categories. However, Sunday Sun investigations revealed that the programme has nose-dived since the inception of his second term. This is primarily due to the dwindling revenue coming from the federal allocation.

Some patients who spoke with this reporter at the state Specialist Hospital, Asubiaro, Osogbo, said they bought their prescriptions from Alcol, a private pharmacy outlets, engaged by the government in place of the old arrangement when drugs were being given out free of charge.

Similarly, a nursing mother, Mrs Bidemi Ajao, who brought her two-year-old boy to Ikirun General Hospital for cough treatment, confirmed the presence of Alcol pharmacy outlet as an alternative to free drug.

She said: “I brought my child for cough treatment and I have bought doctor’s prescriptions from Alcol because government is no longer giving free drugs. I prefer to buy in the hospital for fear of fake drugs.”

In contrast, Akinorun Comprehensive Primary Health Centre, Ikirun, was devoid of the usual activities when Sunday Sun visited the place. One of the health workers, who volunteered to speak in confidence, attributed the lull to the absence of free drugs.

According to her, when the going was good and there was free distribution of drugs across the health facilities in the state, health workers had hectic time contending with daily upsurge in the population of patients trooping in to seek medical attention. But since the programme ran into a hitch, a lot of people have diverted to herbal therapy.

“Government has since stopped supplying drugs. If you go to the pharmacy now, you won’t find ordinary anti-malaria there. Before now, especially during the regime of former Governor Olagunsoye Oyinlola, we used to have all essential drugs in stock both at the Primary Healthcare Centres and the State General hospitals. That time, patients used to troop in for treatment, but since they no longer have access to free drugs, only a few of them present their cases. Instead, they prefer to patronise Elewe omo (herbal dealers).

“For now, we deal largely with pregnant women who have enrolled here for ante-natal, as well as nursing mothers for the immunization of their children. Tuesday is for ante-natal, while Thursday is designated for immunization.”
“Other than those two days, you will hardly find patients here. Many of them have resorted to the option of herbal therapy. This may be because of the level of poverty, as many of them think it is cheaper than orthodox medicine. For the few of them, who still come around for treatment, we write prescriptions for them, counsel and discourage them from self medication or behind the counter drugs.

“We also render free delivery service for pregnant women and the enrolment has been very high. Anytime they come, they always meet our competent midwife nurses on ground who take delivery of their babies at no cost at all. Our labour room is always ever busy. The reason is that delivery in private hospitals goes for a minimum of N25, 000. And as you know, not many people can afford that. Even those who have the money would prefer to deliver their babies here free of charge and divert the N25, 000 for naming ceremony,” she said.

Another nurse at Osogbo General Hospital also confirming a sharp drop in patients’ attendance at hospitals, explained: “It is no longer news that people don’t come to hospitals again for treatment except when they are in critical condition. Everybody knows why our hospitals are no longer functioning as before. The reason is simply because of the failure of the present government to meet the free healthcare service promised by Governor Rauf Aregbesola during his electioneering. Now, it has become obvious to everyone that the state does not have the resources to sustain the programme. You don’t need to tell anybody about this. Even if you ask ordinary market women, they know that government does not have sufficient fund to meet such obligation. You know our people, they like free things. When there was free health service, we could hardly cope with the crowd. The moment the government stopped supply of drugs, they resorted to herbal medication. Most often, they present their cases almost at a dying stage.”

But the State Commissioner for Health, Dr. Rafiu Kusamotu, speaking with Sunday Sun on phone, insisted that the government remained committed to free health care services, but greatly challenged by paucity of funds.
His words: “As you are well aware, we run free healthcare services in the State of Osun. This we continue up till today, but we are greatly challenged. And there is no gainsaying that because all of us know that the nation’s economy has been plunged into crisis since 2013. Revenue allocation from the Federal Government has been dwindling.”

In view of the inability of the administration to make drug supply completely free, he said, concession arrangement had been put in place to involve private pharmacists across all health facilities in the state to sell drugs to patients at subsidised rates, while also providing some basic ones such as anti-hypertension, oral hypoglycemic agents for diabetes, malaria and others free of charge.

“In view of the fact that we know it is practically impossible for us to provide our hospitals with drugs as we used to, we now came up with the idea of concessioning. Pharmacists were invited just like bidding, and all our secondary facilities are now covered with pharmacists who sell drugs to patients. We still give free drugs, but there are certain drugs that patients have to pay for. We still give essential drugs like anti-hypertension, oral hypoglycemic agents for diabetes, anti-malaria and all that free. At the end of the day, those pharmacy when they give out those drugs that are free will now bring their bills at the end of the month, government will now pay them. For those that are not free, what our patients will pay to buy those drugs in our facilities will be lesser than what they will pay if they go outside to buy similar drugs. We are doing that because we just couldn’t provide everything free. We would have loved to, but we don’t have the capacity to,” he declared.

He further clarified that primary healthcare centres were yet to be covered by the concession arrangement.
“We have not covered all our primary healthcare centres. By the time our health insurance becomes operational, we will do that,” he assured.

Dearth of medical personnel

Concerns have also been raised about shortage of health workers in the state hospitals. A reliable source within the sector told Sunday Sun that there is disequilibrium between the number of retired health workers and those still in active service. The development, she complained, is putting a lot of pressure on them.

“There is shortage of medical personnel in the state hospitals because the number of people on voluntary retirement far outstrips the new ones coming into the sector. People are retiring every day, but the government is not replacing them. And, of course, this may not be unconnected with the dwindling revenue coming to the government’s coffers. Even those of us who are still within the system, we are being paid half salary. So, they have no capacity to employ additional workers. But the situation is putting a lot of pressure on those of us still in service. Our consolation is that the tenure of Aregbesola is gradually coming to an end. We can only pray God to give us a better government in the coming election,” she posited.

Commissioner for Health, while not denying the development, said the authorities were being mindful of putting additional burden on the government in the face of the dwindling revenue accruing to the state.
“We have not been able to replace those who have retired like nurses, pharmacists, laboratory technicians, and all that. And the reason is not far-fetched. Those that are in service now are getting half salary. If you want to bring in new people again, of course, that becomes very difficult for the government. But for the doctors, we have an open approval for periodic recruitment. About two weeks ago, we still employed some doctors. But we have not been able to do that for other categories of health workers,” he said.

Boom in herbal patronage

Due to the combined effects of low income level and the state of health sector in the state, Sunday Sun findings showed that there is now a boom in herbal patronage. “Though doctors have called off their strike, you hardly find them in hospitals. They have to do ‘PP’ to augment the half salary they are being paid. Many of them, including those on essential duties, just come in to show face in the morning and disappear. Consequently, many people now resort to traditional herbal treatment as an alternative except for cases that require specialists,” Tola lamented. However, one of the herbal practitioners, Mr Yinusa Olaosebikan, dismissed the claim, arguing that traditional herbs had co-existed with the orthodox medicine for ages. According to him, the seeming boom in patronage of alternative herbal therapy in the state is due to increasing awareness of the people about the potency of roots and herbs. “I don’t think it will be right to say that the patronage now being enjoyed by traditional herbal therapy is due to lack of money or the state of health institutions in Osun State. Herbs and roots are age-old ways of treating diseases. It is the advent of the so-called orthodox medicine that changed our perceptions and attitude to herbal remedy. But now, it appears that our people are coming to the realization that herbs are potent and save. With or without free drugs, we have always had our own share of the market,” he maintained.

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