An interesting time for the Niger Delta and rural areas is fast approaching. One may ask, how can the Niger Delta devastated by oil pollution, unsustainable practices, poor corporate social responsibility and misgovernance without any serious history of remedy be awaiting interesting times? The answer is simple. A major political event is soon to occur, the 2015 general elections in Nigeria.
Nigerian politics as demonstrated by elected and unelected officials as well as those who lost elections or failed to get political appointments has been called many things. “Politics of the Stomach” is perhaps the most generic term and harsher terms like “kleptocarcy” and “cabalocracy” are commonly used even by the major politicians themselves. As Claude Ake stated far back as 1973 at the dawn of the oil boom, the politics of Nigeria is held together by “oil”. “Oil politics” in Nigeria is said to breed rapacity not only greed, sabotage not only inefficiency, irresponsibility not only neglect, all making it fit for the term “Dutch curse”. However, Nigeria was never cursed by oil. How can possessing vast quantities of the richest resource ever used by mankind and that has led to the greatest progress in human history be a curse? I prefer to call it a “heinously abused blessing” complete with crapious exploitation (insider and outsider) and the unacceptable faces of Nigeria politics. Thus the Niger Delta is a region becraped instead of a region flourishing, Nigeria as a whole is no different.
Dr Cal Amayo, head of the Ethiope Foundation, a thoroughly non-political NGO, has a special take on the issue concerning the fortunes (misfortunes) of the intersection the Niger Delta, rural areas, health and politics. A ranking medical professional in London, UK who trained and practiced in Nigeria for several years has become highly concerned about an ever-widening gap in practice. He sees the exceptional improvements in medical devices, equipment, procedures, knowledge, management and safety a as well as medicines, support provisions and practitioner responsibility on the one hand in the West. On the other hand he witnesses of a medical system in changing at snail pace, with short-term or unsustainable attempts (some very grandiose) at its revival and much needed development in Nigeria. The gap has gone from comparable to incomparable.
In leading the work of the Ethiope foundation Dr Amayo has re-identified an avenue to establishing health facilities and systems in Nigeria. Politics! In order to have a good health system there must also be a healthy politics. “Healthy” in this context is no mere wordsmithing. Through the lens of a medical paradigm, governance and government failure is the outcome of a political decay and underdevelopment taking the form of complex disease and syndromes. Politically and otherwise Nigeria is ailing. Only those benefiting from the politics (much less than 5% of the population) may see it as healthy, well for themselves. Politics of the stomach is alive. Metaphorically speaking, how about the “politics of the head” or “politics of the gonads” or “politics of the respiration” or “politics of the liver” or “politics of the circulatory system”? Medically speaking, a well fed or overfed stomach is of no use to a seriously ailing brain, lung, testicle, liver or bone marrow. Political ailment also means ailment in every aspect of daily life. Dr Amayo emphasises that unlike medical problems one cannot treat political problems with antibiotics, chemotherapy, surgery or cognitive based therapy but is curable. He suggests that the cure is possible through progress piecemeal policy changes by politicians, pressure groups, social movements and social enterprises.
The politics of health is the arena whereby Dr Amayo has defined his own contribution to a healthy politics. Why not? Politicians in Nigeria like elsewhere need sufficient votes from people in their various constituencies to win elections. The conditions and well-being under which the voters in a politician’s constituency are born, live and die should be a crucial concern of politicians not just the numbers that turn out to vote for them or that they can buy. The politicians know well that the people are poor and hungry but exploit this by giving rice (and other foodstuff) as vote-winning inducements at election time only. There is nothing worse than poverty and hunger in breeding mental and physical illness. Millions die in Nigeria of tetanus, malaria, septicemia, malnutrition, hydrocarbon poisoning etc. These are all death dealing ailments that could have been prevented by affordable if not cheap jabs, medicines, nutrition prophylactics etc.
In a free marketed world we see countless government interventions in countless public services in the developed world. Health is not an ‘avoidable cost’ for Nigerian politicians as many claim only because they have to appease the dictates of the Washington Consensus, which is now thoroughly dated. Nigeria did once have good and even excellent health systems. Structural adjustment put paid to all that with health services being the biggest hit casualty. The distress this has caused the nation is enduringly unfortunate but can be thoroughly remedied systematically. Health is to be a primary cost for all political parties and politicians who get into power.
The unassessed dangers and risks arising from the absence of adequate health systems in Nigeria faced by millions on a daily basis are unspeakable. The death from malaria like many easily curable diseases at affordable prices (if you live on much more than $1.25 a day) is grossly under-reported. Many diseases cannot even be diagnosed because of a lack of facilities, and where diagnoses are possible treatment facilities are only available overseas. A compounding factor is a steep lack of health awareness among Nigerians. Death and illness are still in the ‘age of superstition’ in the minds of many Nigerians; infections by viruses and bacteria, exposure to toxic materials, anemia due to malnutrition, autoimmune and hereditary diseases have caused many deaths and illnesses that “witches”, “enemies” and “evil ones” are held responsible for often with severe consequences for suspects. The only solution to these unassessed dangers and risks is the introduction of well-perpetuated, sustainable and consistent health systems. We are not talking here of “budgets for health” that are diverted away from proper the implementation of health projects.
Dr Amayo having completed a broad consultation exercise, is in the last stages of drawing up generic guidelines for the development, necessity, planning, implantation and review of a sustainable, workable and affordable health governance in Nigeria with an emphasis on areas that lack medical facilities altogether such as rural areas and the Niger Delta (for its state of emergency in health terms). Dr Amayo’s commitment to health system development is thoroughly non-political and thoroughly medicine focused but he emphasises the nature, size and quality any health systems in any society are ultimately determined by the government of the day. A good health system is excellent evidence of good governance and vices versa.
Politicians should be thinking good health systems and voters should be voting to be provided with good and improvong health systems. That health is wealth even or especially after the experience of serious illness is a popular experience Nigerians should look forward to and thoroughly demand. The ballot box is where it will or should begin. So is it healthy politics or the politics of health? We should all choose and fight for both vigourously says Amayo.