The room was almost full at 8 a.m., as advocates, leaders of civil society organisations and senior government officials gathered in Abuja to learn from each other how to increase the effectiveness of their advocacy efforts. Nigeria Health Watch, the Health Reform Foundation of Nigeria and ONE Campaign convened the event as part of a new dialogue series on health issues in Nigeria.
It began with a screening of two short films that set the tone for the rest of the day. The first film was a TEDxEuston talk by Vuyiseka Dubula, one of the founding members of the Treatment Action Campaign (TAC). We listened as she shared her journey of how she educated herself about HIV, after she found out that she was infected. Then, from a position of knowledge, she joined the leadership of TAC to become one of the strongest and most effective advocates for life-saving anti-retrovirals in South Africa. The advocacy work done by TAC, and similar organisations over many years, is one of the main reasons people living with HIV on the continent now have access to ARVs.
However, the most emotional part of the early session was the screening of an interview by the musician Waje with a Mr. Udebu who narrated a heart-breaking story about how he lost his wife as a result of alleged negligence by the staff of the Lagos University Teaching Hospital (LUTH). Even before the panel started, the audience was deep in thought, wondering how things could have been allowed to get this bad in the Nigerian health sector.
The theme for the day was “Making our Voices Count: Active Citizenship for Health”. The panel consisted of Mr. Edwin Ikhuoria (ONE Campaign), Mr. Charles Usie (Christian Aid), Dr. Ben Anyene (HERFON), Mrs. Fadekemi Akinfaderin-Agarau (Education as a Vaccine) and Mr. Stanley Achonu (BudgIT). The dialogue started with little protocol as we sat down to the business of the day.
First to speak was Edwin Ikhuoria who lamented the apparent dis-empowerment of people on health issues. He shared with the audience the new campaign just started by ONE campaign themed #makenaijastronger. He pointed out that this campaign will build on the very successful “doagric” campaign that showed a different perspective on agriculture and won over many converts. He asked attendees and everyone to join the campaign by signing up to a petition asking the government to ensure implementation of the National Health Act and the Abuja Declaration, expend more resources and organize spending to ensure all Nigerians, including the poorest, are able to access health care. ONE plans to get 1 million Nigerians to sign up, we think he can get much more. His key message for advocates was to focus on what he referred to as the four “Ps”: Policy, Politics, Public pressure, & Popular mobilization.
Charles Usie started by framing health primarily within a social context. He shared the work that his organisation has been doing, working primarily through community organisations, and focusing on the poor. He summarised by saying that the poor are often presented just as recipients of help and not as participants. His primary point was that for advocacy to be successful, we have to work through the people we claim to be representing and go through the often tedious process of building consensus and forming collaborations. He shared examples of the work Christian Aid was doing in Anambra and Kaduna states, empowering the community through existing community structures with tools to organise themselves to demand more from their states, which they are doing successfully. He stressed that accountability is at the heart of advocacy, and that accountability has to be owned by those we are serving, not the advocates.
Kemi Agarau started by noting that Nigeria is primarily a country of young people. “In Nigeria, everyone has been affected by our failed health system, but this is especially the case for young people”. Kemi leads Education as a Vaccine (EVA), one of the most active youth organisations in Nigeria. She shared her experience in leading youth to raise their voices on issues such as the Anti-stigma bill and the National Health Act. She challenged the notion that young people do not care about health. Kemi summarised by saying that young people are interested in health but there are structural barriers that prevent them from holding government accountable, recalling how sometimes young people are brought into the room but asked to shhhhh – keep quiet. Apparently it’s considered good enough for young people to be in the room, but speaking may be just too much to ask. She concluded that the challenges were too big to run away from, and ultimately we must include young people in the conversation about reproductive health.
Dr. Anyene was more circumspect on the value of a gathering of this, lamenting that he had been to several in his lifetime and Nigeria had remained intransigent to change. He also wondered whether the advocates in the room were really ready for the long haul, describing how it took ten years of tenacity to get the health act to be passed into law. He ended by reminding Nigerians that we now have a National Health Act, which acts as a legal framework but that we need to implement it, and to do that, we urgently need guidelines, policies and processes. He ended by warning about focusing too much on the 15% in the Abuja declaration, stating that if 4. 3% of annual budget to health doesn’t get to the poor in Nigeria, how are we sure 15% will?
Stanley Achonu, the operations lead of BudgIT, was a guest from outside the health sector. He described how much time and effort it had taken for BudgIT to reach national consciouness. Critical to this was showing that BudgIT is not precious about ownership of their materials or techniques, rather only care that their material is being used to seek change across Nigeria. He explained that when they design advocacy materials, their aim is for anyone, irrespective of level of literacy, to understand the information contained, and the need to act. In addition to social media advocacy, they now send out teams to the field to verify that projects that are in the budget actually exist – an approach he recommended to the rest of us. Smiling, Stanley shared several stories of attempts to “make them go away”… but they are still here, and he added that they intend to stay.
When the discussion was thrown open the number of hands up was an indication of just how passionately Nigerians feel about the issues in the health sector. Dr. Ngozi Azodoh of the Ministry of Health reminded us that the country belonged to all of us and we should all lend our voices, urging participants to use social media as a tool to be heard. Mike Egbo narrated the heart wrenching story of six doctors who had recently died in a car accident. He pointed out that the 6th victim survived, and was alive until two kilometres out of Kaduna. Unfortunately, there wasn’t even the most basic of emergency services available. The doctor died pleading for blood to save him, being fully aware of what was happening to him. Egbo called on Nigerians not to stay in our comfort zones. “We must be ready to fight for the health of our people”, he said.
This conversation has started. Let’s make our voices count for better healthcare for all Nigerians. Let us continue to hold our government accountable to their promises. Today we started building alliances of knowledge and partnership. Join us as we seek to #makenaijastronger. Join us to ask for an #OpenMoH. We must not be afraid, or despondent. The situation in our health sector is critical.
Thank you to all that attended, and thank you to our partners. On our shoulders lies the responsibility of taking the conversation further into our networks and communities.
Find here some pictures from the Health Watch Forum…enjoy