We Want Bread, Not Cake

We need bread, not cake

By Bala Ibrahim

Reading through a study on the quality of life, particularly in the context of health and social protection, I came across the position of Nigeria, as rated in the study. It says, Nigeria has the second largest HIV/AIDS positive population in the World. Nigeria’s HIV/AIDS accounts for nine percent of the world’s HIV burden, and the largest global burden of malaria. These problems combined, indicate Nigeria’s plight in the struggle to maintain the health of its citizens.

As a Nigerian, my heart bleeds every time I think about our mediocracy, especially when it comes to the protection of the poor and the vulnerable, against the harsh consequences of medical neglect.

Since independence, Nigeria has not done anything serious to catch up with the rest of the world in the scope of social protection. Reports say more than 90% of the Nigerian population is living without any health insurance coverage. Successive Governments have made attempts at bringing reforms in the health sector, with the aim of addressing the public health challenges confronting the country, but like a curse, the health system itself, always turns out to be the sickest patient.

Doctors are constantly complaining about the condition of service and increasing exposures to job hazards. Their take home doesn’t take them home, that is to those that even have a home. Nurses are nagging and becoming increasingly annoyed because of neglect, marginalization and professional discrimination in service and the distributing or administration of medical equipments.

The poor patient is at the mercy of death, because he is always without any financial and social risk protection. Except for those lucky to have people with compassion around, whose desire is to promote the welfare of others, some hospital are no better than the registry of death.

Nigeria is in that situation when suddenly Coronavirus arrived, and from the look of things, the disease has arrived with a bang. Everyone is rattled to the teeth, including the rich, who cannot reach out or report abroad.

In a thesis submitted by one Bolaji Aregbeshola, he looked at the issue of the NHIS and the vulnerability of the poor, with respect to free health care in Nigeria, thus, “The NHIS was expected to provide social and financial risk protection by reducing the cost of health care and providing equitable access to basic health services. The most vulnerable populations in Nigeria include children, pregnant women, people living with disabilities, elderly, displaced, unemployed, retirees and the sick. Although these vulnerable groups sometime benefit from free health care services and exemption mechanisms, they largely have to pay for health care services. Free health care services and exemption mechanisms are often politically motivated, are poorly implemented, do not become fully operationalized, and sometimes only last a few years”.

The plight of poor patients in Nigeria is simply synonymous with the position of a hungry man, that is confronted with a choice between bread and cake. No matter how daft one may be, the answer to the hungry man’s choice is automatic-he would go for the bread.

According to the Twitter handle of the Nigeria Centre for Disease Control (NCDC), “confirmed” cases of coronavirus have increased to 276 in Nigeria, after 22 new infections were reported in Lagos, Bauchi, Edo States and the Federal Capital Territory, Abuja on Wednesday. The emphasis on confirmed is mine, and I did so to say, there is the likelihood of the number of unconfirmed cases being much more than that. If in a country of 200 million people, there are less than 20 testing centres that are poorly manned and probably ill equipped, only God can give accurate statistics of casualties.

So even by the statistics of the NCDC, the disease is increasingly injuring the country, in a manner that may mar the effective and efficient management of the menace. The risk factor is on the rise.

Already the lockdown policy is being observed in the reverse, as reports say in some areas, overcrowding, contacts and congregation have only changed location, from one state to the other, or from the public glare to hidden venues beyond the sight of the police. This means as far as the rate and intensity of infection are concerned, Nigeria is only delaying the doomsday.

Yet, the professionals, particularly the doctors, whose lives are the most endangered, whose condition is always our concern, whose number is embarrassingly insufficient, whose population is getting depleted daily because of corruption in the system, who have lost more members due to Coronavirus than any profession, are playing to the gallery, by choosing on whose help to receive and whose to reject. Advising the government against accepting the helping hand from china is illogical, irrational and inconsistent with the plight of a patient in desperate need of oxygene for survival.

“The Chinese do not have the license to practice in Nigeria. And we do not need their hands as we are not overwhelmed and can take care of our patients”-President of the National Association of Resident Doctors of Nigeria (NARD), Dr. Sokomba Aliyu.

We can make such statements from the comfort of our air conditioned rooms or offices, but can our conscience convince us to convey such statements to the dying patient in the hospital, whose lungs were invaded by a virus, and the heart is pounding and fluttering in palpitation? We cant, in all honesty, because to the person in hunger, bread is better than cake.

Three proverbs came to my mind when I read that statement:

1.Need is not governed by the law.
2.A good neighbor increases the value of the property.
3.An intelligent enemy is better than a stupid friend.

So as far as Nigeria’s health situation is concerned, and as far as the plight of the Coronavirus patients is concerned, all the three proverbs are good food for thought, I think.

When you are hungry, don’t refuse a bread, in anticipation of a cake.

Mr. Ibrahim writes from Abuja.



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