Thought Leadership

Medical missions with a difference

All over the USA and UK, the annual mobilisation of Nigerians to donate towards “Medical Missions”is in full swing. 

The fund raising of the Anambra State Association, USA is in full swing. They raise hundreds of thousands of dollars each year and spend time in several health facilities in Anambra State. From Nimo, to Oko, to Ogbaru…they will be all over Anambra State, supporting existing health facilities. What we find unique in these missions is the broad spectrum of medical professionals involved. In addition to the routine list of doctors, nurses and pharmacists, they have on their teams counsellors, data managers, fundraisers, and even engineers recognising the broad nature of our health care challenges. In 2008 we blogged about their mission. We challenged them on the capacity building and advocacy aspects of their missions. We challenged them to confront Governor Obi with the scenes they found in the hospitals, and what could be provided as institutional solutions.

The long term goal of medical missions should be to make missions unnecessary!

At another recent fund raiser; a dinner held in New Jersey, Professor Akinnaso who attended the event reports that the New Jersey chapter of the Association of Nigerian Physicians in the Americas is planning its next mission where they will be  “Improving healthcare in Nigeria, one person at a time“. At the dinner,  a speech by Dr. Ferdinand Ofodile, who is a clinical Professor of Surgery at Columbia University and Chief of Plastic Surgery at Harlem Hospital in New York compared the Nigerian health system to a foreigner’s first impression of  Murtala Muhammed International Airport, where “chaos and urban decay come flying at visitors like paper scraps in a windstorm“. He went on to say that…

If we want things to change, we in the Diaspora can no longer wait for the people at home. We must take the lead. We must be engaged in sufficient numbers and we must be prepared for the long haul…

Committing to doing this is no small matter. Nigerian doctors on medical missions have often paid with their lives. Last year the tragic story of Dr Enyi Okereke comes to mind. This colleague was, until his untimely death on 25 November, 2008, the Chairman of the ANPA New Jersey Chapter. He was in Enugu in Eastern Nigeria preparing to participate in a arthroscopic seminar with a team of colleagues at the University of Nigeria Teaching Hospital when he suddenly took ill, and there was not even the most basic functional resuscitation equipment available to save his life. He had been appointed to the Penn Faculty in 1993 where he was an assistant Professor of orthopedics and the Chief of Foot and Ankle Services at the University of Pennsylvania, Philadelphia, USA. His death was a loss to his family, the teaching hospital, Nigeria. Everyone loses because we have failed to do the basics.

Dr Kpaduwa the President of the Association of Nigerian Physicians in the Americas described the incident graphically. ..

In fact it was on one of these selfless services to our nation, in Enugu awaiting the seminar on arthroscopic surgery that death cruelly snatched him (Enyi) away from us.   He was first carried down to the lobby of the hotel that he was staying at when the heart attack struck.  A taxi was flagged down to carry him to the nearest hospital.  There are no emergency response systems in Enugu, no ambulances, no paramedics to administer crucial first aid to a heart attack victim.  There was no emergency room to act as second response; no clot busters’ in the hospital, and no cardiac catheterization lab for crucial diagnoses.  Our friend was aware of these inadequacies.  He had to call for help.  He picked up his phone and called his dear wife, who was thousands of miles away.  He must have seen the worst case scenario coming.” 

If this can happen to Enyi – what hope do we or any of our family members have when confronted with medical emergencies in Nigeria.

To those that commit their time, energy and resources to do the little that they can do….we say thank you, as there are many others out there that really don’t care about the country from where they got a medical education….virtually for free. But also, I wonder if we are missing a trick with missions. The natural instinct that we all have is to try and solve problems ourselves. Organising a health care system to truly serve the people is a complex problem (as we are learning from the USA). The solution, lies to a large extent in the government’s commitment and capacity to organise the system to serve the people. We challenge our colleagues to spend as much effort to advocate to the governments as they spend in directly providing care. Let us seek access and offer not just clinical services but expertise in management and leadership. Let competent Nigerians from all over the world speak up, show our governments and the world the state of affairs on the front-lines of our health care facilities.

This is the key to the success of the world’s largest medical NGO – MSF. They have a dual role that they take as seriously as the other…firstly providing emergency medical assistance to populations in danger and to act as a witness, speaking out, in private or in public about the plight of populations in danger.

We can and should do both!

What do you think about medical missions?

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.

2 replies on “Medical missions with a difference”

I cannot agree more- we must do both : organise medical missions but also do advocacy to educate our leaders on the simple fact that they must put their money where the mouth is . They must invest in Health care because the type of care that takes the leaders to shores afar is never cheap. As an Efik proverb says, ‘when the soup is palatable and nice, it is because time, effort and importantly money has gone into its preparation!. And Nigeria can afford to do more of investment in health if it is ever to achieve the kind of quality health service that we all dream about.
As a diasporan who returned to Nigeria in 2004, to assist with doing something on the ground on a sustained basis, I have captured in my book, ‘Whole System Change of Failing Systems’, our experience when we started the re-engineering and improvement change in Cross river State. The book, I believe is a very good guide for all diasporans who wish to tredd the same path.
I have since extended the experience to Bauchi State since 2008 where the Governor was ready to imbibe the ethos and practice of Clinical Governance, Quality and Safety. I worked with his adviser on health matters, Dr Baba Gana, a consultant Urologist in Carmarthen, Wales, UK.

Joseph Ana.

I am so glad this was blogged. Being an ANPA (Association of Nigerian Physicians in Americas)member has really exposed me to the leading roles our profrssionals have taken up however they meet a lot of road blocks. This does not deter them. I was actually involved with the New Jersey fund raising, we attempted to get Enugu state involved so we can organize the next medical mission to be at Enugu. I personally tried to reach the governor but my effort was stalled. I have not stopped yet.
I feel this happens because people at home do not appreciate the effort “their brothers” in diaspora make and would not be a part of it as it does not seem to be a money yielding venture.
After all said and done some individuals in Nigeria are willing to be part of these medical missions but we need the government to be part of these programs and invest in the people’s health. Healthy people —->Healthy nation—> progress!

Leave a Reply

Your email address will not be published. Required fields are marked *

14 − seven =