Thought Leadership

How many lives have BUILDINGS saved

(again apolgies for the earlier post for those subscribed by email)

Health in the Nigerian polity is often discussed in terms of “hospitals built“, “health centres renovated“, “Xmillion drugs purchased” or “health equipment bought or donated“.
While all these are important to some extent…no building has ever saved a life. However…it is convenient for politicians to brag about these. Find below an advert in newspapers, placed by the Governor of Bayelsa State, and the hopsital his Government his building.

Now..the State Governments are trying to out-bid each other with their “Building projects”

  • Benue okays renovation of 10 hospitals …In a bid to ensure quality healthcare delivery to the people, the Benue State Executive Council, has approved the commencement of comprehensive renovation of 10 general hospitals. This is planned across the state, just as it also gave approval for the construction of seven new hospitals in various local government councils of the state.
  • Imo State claims to have built the first e- tertiary hospital at Imo State University Teaching Hospital.
  • Lagos completes 100-bed children’s hospitals

Nigerian medics in the Diaspora have also joined the race to “BUILD”…read some stories here:

Foriegn Governments too have joined the frame…

…and you you might even remember our previous post about a fully-equipped hospital that lay unused for two years, and has burned to the ground in Maiduguri as it was awaiting commisioning! The General Hospital in Maiduguri was built in 2006 but the state government refused to open it until the president came to cut the ribbon.

Now…we are not saying that shiny buildings are not nice (at least for the first 6 months after commissioning). We are not saying that we do not like the lush green grass at the National Hospital… It does make a difference.

However, we suggest to our politicans to make 2009 a year to improve the quality of health care provided in our hospitals. Let one Governor tell us that he guarantees that when you drive into the Accident and Emergency Centre in Birnin Kebbi, the capital of Kebbi state…that Doctors will RUN to your attention.

…that if you go into the out-patient department in Ebonyi State University Teaching Hospital in Abakiliki, that doctors will be on their consulting tables by 8 am, and that patients will not have to wait 5 hours to be seen….

…that when a patient goes to Ado Ekiti Teaching Hospital…and is prescribed basic antibiotics….that he/she can get them without going to the market…

Who will take the lead in guaranteeing the quality of healthcare for Nigerians, and not the buildings….and honestly…I dream of attending the nice old colonial buildings at the Federal Medical Centre in Owerri, if I’ll be seen quickly and efficiently. I am sure most other Nigerians will share my dreams. Let 2009 be a year of quality, and let us get over the delusions of grander that often cloud our thinking.

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

By Chikwe Ihekweazu

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.

1 reply on “How many lives have BUILDINGS saved”

Dear All,

The best way of measuring the effectiveness of health services in through health indicators or statistics. The Society for Family Health in Nigeria is starting a programme for curbing the awful maternal mortality resulting from childbirth. At an average of 800 deaths per 100,000 deliveries, the range is from about 600, the best in the south-west Nigeria, to around 1,500 in the worst areas found in the north-east of the country. The figure for Ghana is less than 400. In other words, Nigeria performs worse than other countries in its economic/developmental region, despite its better endowment with both material and human resources.

In advanced countries, maternal mortality is zero, or less than 5.

It is true that building hospitals, giving them the basic infrastructure and equipment, and getting their staff on duty will improve things, but not significantly if primary health care is not made the foundation of the health services of developing countries. Consider this statement from WHO at the launch of the most recent edition of the World Health Report in October 2008:

“High maternal, infant, and under-five mortality often indicates lack of
access to basic services such as clean water and sanitation, immunizations
and proper nutrition,” said Ann M. Veneman, UNICEF Executive Director.
“Primary health care, including integrated services at the community
level, can help improve health and save lives.”

Do anything else, and you are worsening the situation. I do not think many people recognise this fact.


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