THE STRATEGY AND TACTICS OF THE PEOPLE’S REPUBLIC OF NIGERIA: Social objectives

Continued from last week

IT is pertinent to point out, by way of compa:ison, that the calorific intake per head per day of a worker in the United States of Amenca is 3,130, and his total protein intake is 90 gms. It follows that for a

family of three (father and mother and a child), in the manual worker class, the cost of good and adequate food will certainly not be less than about 6/-per day; that is, 42/- a week. We all know that no  working or farming family of three in Nigeria today have anything near this figure to spend on their food. But this is the height at which we must aim, if we would improve the health of the masses of our people, and substantially raise their productivity and standard of living. To achieve these important ends, the Government must also embark on a housing revolution throughout the country as well as foster the means by which people can procure better and more adequate clothing.

In the fourth place, the Government must introduce full-scale and countrywide preventive health services which will give every Nigerian citizen a wholesome and healthy environment, and immunity against diseases. ‘Prevention is better than cure,’ so runs a popular saying. But all the medical authorities in the world agreed that prevention is also much cheaper than cure.

In his Paper entitled’ Health, Housing and Social Welfare,’ submitted to the IBADAN Conference on National Reconstruction and Development in Nigeria, on page 9, Mr. P.O. Ahimie, Deputy Permanent Secretary in the Federal Ministry of Finance, quoted a passage from Medical Care in Developing Countries-a Symposium from Makerere as follows:-

‘A health centre is a health unit which provides a family with all the health services it requires other than those which can only be provided in a hospital. An essential aspect of such a centre is that it takes its services and exerts its influence outside its own precincts right in the very homes of the people themselves …. It undertakes preventive services like immunization, environmental sanitation, better child care, early diagnosis, etc.’ Mr. Ahimie then commented, on pages 9-11 as follows:-

‘According to the information available at the symposium, a health centre in Kenya built for £8,000 and run for £4,000 each year would cater adequately for 10,000 persons while a bed in an equipped hospital was reckoned to cost £3,000 in capital expenditure and a recurrent cost of £300 for 68 inpatients a year , In his contribution to A Health Programme for the Nation, 1966, Dr. F. A. Odeku recommended that there should be ‘large investment in preventive as opposed to curative medicine. With regard to -tuberculosis prevention, it will be cheaper in the long run. It costs £1 a day to take care of a tuberculosis patient in hospital. If this patient stays 4-6 months, it will cost £120 to £200 to treat him. This sum will immunize a village with B.C.G. against tuberculosis.’

‘In the same document, another Nigerian authority on these matters, Dr. G. A. Ademola in his paper on Environmental Sanitation revealed that bronchitis and pneumonia were the commonest causes of death; that 79,000 cases of dysentery were reported in 1964 while 10,000 cases of tuberculosis were diagnosed annually and that these conditions were in the main due to poor housing and bad environmental sanitation. More recent statistics el1 much the same story. In 1966,43.1 per cent of all deaths reported in Lagos (former Federal Territory) were due to a number of preventible causes like pneumonia, malaria, dysentery and diarrhoea, tetanus, malnutrition, tuberculosis and measles. This is It is the bounden duty of the Government, therefore, to make not an exhaustive list, but one selected for illustrative purposes’ornprehensive plans for the education and guidance of every citizen only. A year later the percentage of all deaths brought about by these same causes had risen slightly to 44.6% These percentages his is a titanic undertaking and because the so-called civilized hide the real significance of these diseases. In absolute figures countries of the world have not succeeded in this all-important 2,407 people lost their lives in 1966 as a result of diseases that, ensure, this is no reason why we should refrain from embarking on could have been prevented, while 2,629 suffered the same fate into 1967. In other words, in just two years, about 5,000 people died In the sixth place, since no health services can succeed without from diseases which are easily preventible through immunization., active direction and participation of those trained and experienced the use of prophylactic drugs and general improvement in health medical science, it is imperative that the Government should education and environmental sanitation introduce schemes for the training of Nigerian doctors in large

‘These medical statistics are for Lagos, which enjoys perhaps the1umbers. If we have the will to do so, and lay our plans to that effect, highest standard of medical care in the whole country!’ extensively from Mr. Ahimie’s Paper on this point, because I do not want to presume to improve upon the graphic presentation which he has made of the authoritative opinions of Drs. Odeku and Ademola.

I only wish to emphasize that, under the new dispensation, health These objectives speak for themselves and require no comment. It officers would take the place of the dreaded and sometimes notorious however, necessary to make two brief observations. sanitary inspectors, and would, in the words of the Makerere Firstly, it is clear that the introduction of a comprehensive and Symposium, take their services right into the homes of the people:ompulsory social insurance scheme would place all employed and themselves, visiting surrounding villages, and undertaking;elf-employed persons in the same category, in so far as the payment preventive services like immunization, environmental sanitation,)fretirement or old age pension, and relief for sickness, is concerned. better child care, early diagnosis, etc.

To be continued