60-year-old Rachel Yisa’s constant visits to the hospital started when she first noticed a swelling on her neck.
However, her endless visits to the primary health center in her community, Wushishi, in the Wushishi local government area of Niger State did not yield promising results.
As her swelling grew, she was told that the health care center could not carry out the surgery to repair the abnormality.
Also, she was told that it would cost her a lot of money, which she did not have at the time, so she lived with the condition for another two years.
“Anywhere I went, they told me they couldn’t do it. One day, my daughter, who stays here (in Kontagora), called me excitedly, saying that some people could do it for me for free.“
Yisa would later undergo a thyroidectomy, a process that involves the surgical removal of all or part of the thyroid gland, at the General Hospital in Kontagora.
A goiter is an abnormal swelling of the thyroid gland, a small butterfly-shaped organ located in front of the windpipe (trachea) and at the base of the neck below the Adam’s apple.
Some of the symptoms of goiter include difficulty breathing, a feeling of tightness in the chest, and difficulty swallowing, which may result in a change in the patient’s voice.
Usually caused by an iodine deficiency, goiters are more common among women than men in Nigeria.
An underfunded health system leaves rural dwellers at a disadvantage
With more than half of Nigeria’s population, or about 70 percent, living below the poverty line, Nigeria’s citizens grapple to be catered for by an underfunded health system assailed by years of neglect, especially in rural areas.
A 2022 report published in the Surgery in Practice and Science journal observed that while 88 percent of Nigerian health facilities were considered to be listed under the primary healthcare system, most of these centers are unable to provide surgical care for patients due to the absence of adequate facilities and even trained personnel.
The report also observed that an estimated five billion people do not have access to quality and life-saving surgical interventions.
The majority of them are poor and reside in rural areas.
Similarly, a public opinion poll conducted by NOIPolls revealed that most Nigerians pay out of pocket for healthcare at various healthcare facilities across the country.
In the study, only 17 percent of all adult Nigerians interviewed claimed to have access to health insurance.
This could translate to more people who require urgent medical treatment being unable to access them because they cannot pay for such services.
A foundation comes to the rescue
Very few Nigerians can afford surgeries such as Yisa’s own at a time of increased living costs and non-commensurate earnings.
An even smaller number have any form of health insurance that would have covered such medical expenses as would have been needed in Yisa’s case if this outreach was not available.
On one hand, while the country’s public health service is largely considered inadequate and poor, private hospitals, which are increasing in number daily, offer services way beyond the earnings of an average Nigerian.
To tackle this problem, the Sani Bello Foundation, Kontagora, in north-central Nigeria, partnered with another foundation in Kaduna State, the Graceland Healthcare Development Foundation, to carry out free surgery to help lessen the cost of treatment for the less privileged who otherwise would not be able to afford such treatment options.
While the foundation provides the funding for the surgeries, its partners at Graceland provide the healthcare professionals who usually cater to the needs of the beneficiaries during the week-long ‘surgical festival, as it is termed.
Once every year, a team of surgeons, nurses, and other medical professionals make the trip down from Kaduna State to the Kontagora General Hospital, where they engage in five days of extensive surgeries for patients with various conditions.
For the 10th edition of the program, a mammoth crowd litters the corridors of the Kontagora General Hospital.
The beneficiaries who are treated based on a first-come, first-served policy undergo a screening, after which they are cleared for surgery.
The founder of the Sani Bello Foundation, Col. Sani Bello, said that he feels indebted to give back to society in the best way he can, which is by paying for the cost of healthcare for the less privileged.
“Every time I walk there and I see those people with smiles on their faces after they are treated, I get fulfilled, and I appreciate myself and the kind of favors God has done to me.
“These are the people who, in normal circumstances, would not have been able to provide for it or afford the treatment we are getting there. They have never seen me. I don’t know them; I don’t know any one of them, but they are treated.”
The Chairman of Graceland Healthcare Development Foundation, Dr. Thot Joseph Dogo said that the foundation has performed over 13,000 free surgeries since the commencement of the outreach program.
“We got to know each other because we do similar things; while this is the only thing we do, the Sani Bello Foundation does more than that.
“These surgeries include major and minor surgeries as well as eye surgeries. We also give eyeglasses.
“This foundation has given an open check, and we are willing to do the same. We will continue to collaborate. Our relationship is open-ended.”
The Director General of the Sani Bello Foundation, Dr. Zakari Ikani, said that the foundation has taken it upon itself to ensure that those screened and billed for surgery who turn out to need extensive treatment are referred to the appropriate quarters where the foundation foots the treatment bill.
“What we cannot do here, we sponsor you to a place where it can be done. Even when we leave, we try to reach an agreement with some of the doctors here to help us continue with their treatment if necessary.”
Dr. Dogo adds “Just yesterday, we were supposed to operate on a patient with thyrotoxicosis but it’s not yet controlled so the vice chairman said we should treat. So we are treating the patient for the next six months. Depending on if she does well, we can take her in for surgery.”
Improving Nigeria’s health care indices
Despite pledging to abide by the ‘Abuja Declarations’, a commitment that African leaders made to set aside at least 15 percent of their annual budgets for their respective countries’ health sectors, underfunding of the health sector remains a bane for actualizing universal health coverage.
The country’s primary, secondary, and tertiary health institutions each have their own peculiar challenges.
The inadequacies at primary and secondary health institutions have placed a significant strain on tertiary health institutions.
This is coming amidst a lack of sufficient healthcare workers.
Even when such primary and secondary health facilities exist, they are usually ill-equipped, lacking in essential drugs, and lacking in the presence of healthcare practitioners.
Every year, Nigeria’s budget grows bigger, but little to no impact is felt by its health sector. The country continues to maintain its position as one of the countries with the poorest health indices worldwide.
Preventable deaths are common, with maternal and child mortality topping the list.
Although the federal government has moved to reduce out-of-pocket expenses in the health sector in a bid to improve access, only about 10 percent of the population has been covered by the National Health Insurance Scheme (NHIS).
More people are now in need of humanitarian assistance, which includes healthcare services, primarily due to conflict in some parts of the country as well as the effects of climate change.
The government must first fix the disproportionate amount of funding allocated to the health sector.
Health insurance schemes have proven to be a viable model to take many people out of healthcare poverty through a model where the rich foot the burden of such services for the poor.
Foundations such as the Sani Bello Foundation and the Graceland Healthcare Development Foundation are supporting the very noble cause of reducing the burden of healthcare costs for indigent Nigerians.
There is a need for other stakeholders in the private sector to support Nigeria’s quest to leave no one behind, as envisioned by the Sustainable Development Goals (SDGs).
The Vice Chairman of the Sani Bello Foundation, Usman Sani Bello adds ”As individuals, we can’t say every single thing has to be done by state. Individuals must come in to help.”
