Cry my beloved Nigeria


I cannot forget reading the epic “Cry the beloved country” in my early teens, and the impact it had on my life. This novel by Alan Paton is the deeply moving story of characters in apartheid South Africa, set against the background of a land and a people ravaged by racial injustice, of unfulfilled dreams, broken promises and humanity’s inhumanity. For some reason, I have woken up this morning, the date marking 50 years of Nigeria’s independence thinking about this book. Of injustice, (not just racist but by a political ruling class), of unfulfilled dreams, broken promises and our inhumanity – of my beloved country – Nigeria. Yet, mixed up in this are stories of love and hope, courage and endurance of the Nigerian people. How can one feel so despondent about a country yet feel so much love for its people. Probably the same way Alan Paton felt about his country at the time he wrote Cry the beloved country.

Today, the 1st of October 2010, the only thing there is to celebrate really is the love, hope, courage and endurance of the Nigerian people, despite 50 years of rape of our natural resources by an unperturbed ruling class. It seems that they cannot have enough, and the draw to power for them is so irresistible that they keep coming back for more. No sector has suffered more than the health sector….

We can celebrate some relative successes in sectors driven by the free market such as the growth in the financial sector, telecommunications, Nollywood and the rest of the entertainment industry. We have even  recently seen improvements in the aviation sector however, the health sector  has remained in the dark ages. But what does this mean for you and I ? The lucky few in a population of over150 million people who are in a position to have access to electricity, a computer, and time to read this blog ?.

It means that anytime one is in Nigeria, and we have a real medical emergency, a heart attack, a motor accident, a serious asthmatic attack, difficulties in child birth, a gun shot wound… the chances are – we are going to die

I do not want go on about measles, cholera, lead poisoning, diseases that most people in other countries only read about in medical history books….

Ah…I hear you shout! It is not that bad!

Now this is what really worries me. How come we are no longer willing to stand for hours in a bank, no longer willing to wait for months for a land line, no longer willing to drive on bad roads? We shout about the air crashes, lack of electricity….why do we then seem to accept that it is normal for our children to die from diseases no one else is dying from anymore? Why do we accept that we can go to a hospital, and no one seems to care, why do we accept that there is still no integrated ambulance service anywhere in Nigeria. I will proffer a reason for this situation, as was similarly described by Donald Rumsfeld so eloquently as “unknown unknowns“. We cannot demand what we do not know exists. Most Nigerians have never known how a functional health care system looks like, and therefore there is no political imperative to demand better.

So after 50 years all I can really do is cry for my beloved country….

But you are right. Crying is not enough. What can we do?

I will proffer 3 broad directions of travel. For government, for professionals and for us …the people.

Firstly, our governments at the federal and state levels must invest more resources; financial, human and infrastructural investment in health. The graph on the right shows the allocation to the health sector last year. This was just 4%. This is an indication of what our government is willing to allocate from its pool of resources to health. These are the choices they make on our behalf. So when next we are building a 4-lane  highway, buying 3 new presidential jets or spending 6 Billion Naira on celebrating a birthday – we have to ask our politicians – at what cost? How many women need to die in child birth to finance this highway. How many? But its not just financial resources. It is also about professionals and infrastructure, but maybe most importantly its about management and leadership. The picture below is of the beautiful edifice costing millions of dollars, built by Delta State – the Delta State University Teaching Hospital in Abraka. What do you think is missing from this picture? You are right …people!

Now to the professionals. How often have you heard the Nigerian Medical Association stand up to proffer solutions in public or respond to any national issue. They appear dis-empowered and emasculated. The only time their voices are heard is when there is a strike over doctor’s pay. This has not always been the case. I remember the “good old days” when colleagues like Dr Beko Ransome Kuti led the struggle not just for salaries but for social justice.  On all critical national matters, the silence of medical colleagues has been deafening. The “professionals” have gone silent. The professionals that have had the opportunity of public service – Dr Peter Odili, Dr Chimaroke Nnamani etc have joined the looting of the people. So how then do we restore some credibility in the eyes of the people. Our professional bodies must wake up to the challenge of leadership.

Finally, for the people…Wake up guys! Wake up! Your doctor is not GOD!

The reverence with which doctors are treated in Nigeria has led to a horrible conspiracy of silence. Nobody holds anyone accountable for anything. No it is not normal that your child should be dying of measles, or that your wife should be dying in childbirth. is not right that the doctor does not tell you what the diagnosis is, nor the name of the medicines you are being prescribed. No it is not okay that the doctor does not explain the side effects or the possible complications of surgery. Wake up people. It is your life! Don’t throw it away!

No…No….No…Your doctor is not GOD!

Finally while I spend today reflecting on the last 50 years, I am quietly optimistic about the future.

There is a growing critical mass of Nigerians determined to put to bed the last 50 years in Nigeria. Every day I meet inspirational people doing amazing things….not with support from the government, but in spite of the lack of support from the the government. They are finding solutions by whatever means. In the cities, in the villages, in the diaspora. They are not seeking publicity. They cannot wait for government. They are the “Cheetah generation” described so eloquently by George Ayiteh in his TEDTalk. Therein lies my hope for the next  50years….the hope for my children …and I hope.

Nurses in a primary health care centre 
Picture credit  Femi Sunmonu
A nurse seeing a patient in a primary health care centre 
Picture credit  Femi Sunmonu
A doctor seeing patients in a primary health care centre
Picture credit  Femi Sunmonu

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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