What innovations did you bring to the health ministry based on experience?
The number one thing that I did bring in when I came on board as the Commissioner for health was the sense of duty of every medical and nursing practitioner in all our hospitals. Before I came there was the lazy attitude of coming to work anytime they like, even in the ministry that was the trend but now that they know that even the commissioner gets to the office at 7.30 am and is the last to leave, so the sense of duty and attitude to work is very important and that has changed and that is not limited to the ministry of health, it is the tradition for civil servants to do whatever they like but in the ministry of health, we have changed that attitude, even among practitioners across all our hospitals because life is precious, we are dealing with lives, not commodities.
Having said that, let me now tell you what we have achieved since we came in, the first is the health insurance agency board which is a board that is set up to monitor and make possible health insurances to all cadres of people resident in Oyo state regardless of tribe. The reason health insurance is important is because no government anywhere in the world can do it alone even in the US, Britain and Canada that people run to, this is because health is capital intensive, it costs a lot of money, a cast scan machine costs about N500m, an MRI machine costs close to N800m, so no matter where you are, government cannot do it alone, that is why all over the world, health insurance is given to people who can buy into it to make sure that they have supplemental money to use whenever they go to the hospital. So we have done that, even a very poor man from Ojaoba where I come from with N650 per month or N7800 at the end of the year can buy insurance and can take it to any hospital in Oyo state or even outside Oyo state to purchase care and that care is not limited, it includes emergency surgery. The second thing we have done under Governor Ajimobi’s administration is that we have got about two million dollars worth of equipment from the United State, it was in the news and all our hospitals are no longer mere consulting clinic where there are no machines or equipment to work with, we are still distributing them because we are inscribing the name of the government on them so that nobody will cart them away. Thirdly, which should make you happy are the Primary Health Care (PHC) Centres. In the past few years, before 2011, PHC used to be controlled by the local government service commission but based on a law that has been passed by the House of Assembly, right now everything about PHC is being done by the Ministry of Health to make sure that nobody would give excuses about who is in charge of any health center no matter where it is located. Number four, there is a center now that the federal government has approved for Oyo state, it is called Vesico Vaginal Fistula (VVF) centre. It is a centre that helps in treating young females who have complications of labour because of poor or discrepancies between the pelvic diameter and the head of the baby which can compress the uterus and vagina to start leaking urine and fecal materials in the vagina. It is a very debilitating complication for any young lady that has it; divorce and sometimes suicide. Oyo state is the centre for the six south western states and the minister of health will come and inaugurate that center before December. Other miscellaneous we have done include reduction in malaria incidents because Oyo state distributed about 8.4 million long lasting insecticide treated nets about six months ago, malaria incidents have been reduced to 43 per cent in Oyo state compared to other states of the federation. We have not had a single incident of polio which used to kill people in the last seven years.
So it is a misconception to say VVF is a northern issue. Do we have VVF in Oyo state?
We do. And that is why I always tell people when they say we don’t have breast cancer here, we have it, it is only because we don’t look for it. You know, the Ojaba woman will say somebody poisoned her breasts because she is fighting with somebody in her local environment, so somebody put juju there. So to answer your question, yes, there is VVF in south western Nigeria, the reason it is more common in the north is because the northerners tend to marry early before the pelvic develops to the level that the head will not compress it. But we have a lot of young southerners that are getting married. But whatever the age you get married, if you have compression of the head of the baby against the pelvis, you can have VVF, so it depends on the anatomy of the lady. Anyone can have VVF but it is more common with those that have children early; it is mainly about a small pelvis and a bigger head
PHC is the most important to the grassroots; can you assess the state of PHC centres in Oyo state now? What would give people confidence to patronize them?
Before I came on board, you can call it the locust years, in fact before Governor Ajimobi came on board in 2011. I always tell people a building does not make a hospital, what makes a hospital are the staff; nurses, doctors paramedical and equipment and materials, not the building. In the last one year, we have put in place a lot of thing; nurses and doctors are now being posted to those PHC centres and we are restructuring. Oyo state has 624 PHC centres and 57 General hospitals, we don’t want to have PHC centre that will not be manned by adequate staff, we are reducing them by half, by the end of this year, the 624 will become 321, same thing with the general hospitals. So that we can equip and man them, we don’t want hospitals that where they will use lanterns to perform surgeries or phone touch to treat people.
200 hernias were said to be operated in a recent medical outreach, how successful was the outreach and how were beneficiaries selected?
They were not selected; it was random based on anyone that is interested, anybody that wanted to come came and they were all attended to because this is not a government that believes in random selection. Sickness does not know whether you are PDP, APC or Accord. Our hospital is free to all Nigerians resident in Oyo state. The outreach is going to be on quarterly basis. The government believes that you cannot continue saying no to people without giving them a yes. We are running quacks out of business, so we must bridge the gap and give residents viable options of being treated. That is why we are doing free medical missions and by the grace of God, in September, another one will take place.
What is the health endowment fund about, who benefits and how sustainable is it?
What brought about the endowment fund is the need to involve people in the health sector, all over the world that is how it is done; I have a practice there so I know how it operates. We discovered that in Nigeria, nobody wants to help the government but we are the government. Democracy is government of the people, for the people and by the people. So, you and I are the government. In other parts of the world where we run to, people help their government. Harvard University where I trained, 40 per cent of the hospital finances is by the public, same thing for Lane Clinic, same for Mayo Clinic and the London Kings Hospital, they are being funded by members of the public. I went round; saw the 624 PHC centres that we have, I saw the 57 General Hospitals and I wasn’t happy with what I saw, I thought how can we change this? federal government does not have money; that is the genesis of the endowment fund. Oyo state government used to draw about N5.1billion from the federal government on a monthly basis but because of the drop in oil reserve, the state now gets N2.1bn and health is very capital intensive. Are we going to fold our hands behind our backs? We have to look for ways, it is a foolish man that sits fat and continues to hold on to wrong things the fact of the matter now is that at all levels now, in about 28 states, states cannot pay salaries. Government has to pay salaries of workers, infrastructural development, they cannot just ascribe all the money they have to health and people are dying, sudden death in Oyo state and throughout Nigeria. So I went to the governor to tell him how it is being done all over the world and that we shouldn’t deceive ourselves that we can do it when we have no money, let us call on high network individuals on a public private partnership basis because I said earlier on, most governments throughout the world collaborate with their people to sustain health. We don’t have the revenue that will sustain standard healthcare that will make Nigerians not to flee to India or London because they are not better than us, that is one of the reasons we set up the health endowment fund and we believe by the grace of God that by the terminal date of this administration in 2019, we will open a cardiovascular centre at Ring road to prevent capital flight from Nigeria, people go on medical mission, we want to stop it and the reason is because this is the pacesetter state, not just in name; first university in Nigeria is University of Ibadan, the first sky scraper was here, so we don’t just want to be talking cheap, we have three teaching hospitals, Lautech, Bowen University, UCH collaborating with Oyo state to stop capital flight, that is why we are doing this. And who will benefit? All PHC centres in Oyo state regardless of where they are located will benefit, all general hospitals and specialist hospitals will be renovated and brought to international standards. Above all, because this is about people and Nigerians don’t believe in innovations, they think some people just want to embezzle. Ajimobi came in as a rich governor, so is the commissioner for health, we aren’t interested in government money, so what we are trying to do is that we have sent up a board of trustee of eminent Nigerians led by Professor Akinkugbe, one time Vice Chancellor of University of Maiduguri and University of Ilorin, a metro professor of medicine to be the chairman of this board of trustees, followed by some high network of individuals who have seen money and are interested in moving the health sector forward in Oyo state, which is a Mecca of medicine in Nigeria. That is why this endowment fund is open to the public to come and help and we are not begging for money, we are only asking Nigerians to come and help themselves.
With these efforts, would you say APC has delivered the dividends of democracy to the people?
Absolutely, you know I have been in different parties before, the locus years of the PDP; 16 years that Nigeria is in a shambolic state, same thing with other parties; if I am able to leave a comfortable environment to come and sit down to run a ministry in Ibadan, you know that is a good government. APC is the best party that anybody can join at this point in time because a lot of well meaning Nigerians interested in moving Nigeria forward are in the party. Yes, we have delivered the dividends of democracy.
Major problem in governance seems to be continuity. What happens to these projects after 2019?
By the grace of God, I will more or less govern Oyo state in 2019. I am counting on almighty God for that God does not make mistakes, God will not allow the efforts of governor Ajimobi to be wasted. We are praying. No matter what happens, we will ensure there is sustainability. Having said that, power belongs to God, the only one that knows who is going to govern but we are supremely confident in Almighty God that I, Dr Azeez Popoola Adeduntan will be the next governor of Oyo state.
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