In popular parlance, wherever you turn, you hear: “Naija no dey carry last”. That’s the Nigerian’s way of self-consolation, even self-motivation. In whatever circumstance he finds himself, a Nigerian is supposed to come out tops, whether the playing field is level or not. It is that self-assurance that other Africans mistake for arrogance. It is true that a Nigerian will not tolerate being treated as a second class being, but that’s all there is to his persona. The only problem is that Nigerians are ubiquitous. And that is not their fault. There’s plenty of them – 220 million-plus!

Whether abroad or at home, Nigerians keep an eagle eye on what their government is doing. They are not difficult to please, if one must be honest. Indeed, in most cases, what a Nigerian needs to excel is for the government to get out of his way! When I shared that view with one of Buhari’s ministers about four years ago, he thought it was blasphemous. He has since changed his mind like everyone else in Citizenville.

You Are The Government

Governments succeed or fail on the wings of the behaviour of public officials whose duty is to run the shop. In many cases, those who work for the government don’t know how sacred the trust vested in them is. They think it is just another job. Unfortunately, as far as the people at the receiving end of policies or programmes being implemented by specific officials are concerned, those functionaries are the government. Their actions or inactions determine how their principal or employer (in this case, the government) is perceived.

So, when the citizens are not well served by a particular department of government, for example, they’d say, “This Tinubu government is not competent.” For all they care, if the government was competent, its departments would also be – or, rather, its operatives would be. In these climes, we get used to poor services to such an extent that we almost get embarrassed when we are well served (or ‘over-served’) when we find ourselves in countries where service delivery is top notch.
No patriotic Nigerian would be thrilled to hear that his country is among the 11 worst-governed countries in Africa. However, by the time the doubter passes through one or two police checkpoints, he would probably simply shrug and hiss. There’s so much rot to clean up.

Governance Rating

According to the highly regarded Ibrahim Index of African Governance (IIAG), 2024 edition, Nigeria has quite a bit of catching up to do when rated among its peers.
“For 13 countries – Congo Republic, Côte d’Ivoire, Egypt, Equatorial Guinea, Eritrea, Gabon, Libya, Madagascar, Malawi, Morocco, Somalia, Togo, Zambia – hosting over 1/5th (20.5 percent) of the continent’s population, there has been progress over the decade and the pace of this has even accelerated since 2019.

“Meanwhile, for 11 countries – Botswana, Burkina Faso, Eswatini, Guinea, Mauritius, Mozambique, Nigeria, Senegal, Sudan, Tunisia, Uganda – home to almost 1/3 (29.3 percent) of the population, there has been deterioration since 2014 and the pace of this is even worsening over the second part of the decade.”

Mercifully, Nigeria is not among the 10 most deteriorated countries which are listed as Comoros, Tunisia, Mali, Mauritius, Burkina Faso, Botswana, Namibia, DR Congo, Niger, and Eswatini. However, the report saw Nigeria slump three places from 30th on the continent to 33rd, making it one of the worst-ruled states since 2014.

National Hospital

One institution that has not failed to arouse my curiosity over the years is the National Hospital in Abuja. I have had varied experiences at the institution but none as harrowing as some of the more controversial cases that were reported by the media. Imposing from the outside like any institution claiming to number among the best in the country should be, it suffers the same affliction that many public institutions endure due to organisational spanners thrown into the works.

Anyone familiar with government establishments knows that there is always an in-built self-destruct valve whose activation depends on the disposition of the overall boss. In Nigerian medical institutions, professional and administrative competence sometimes take the back seat because of politics as politicians insist on infesting whatever they touch with their vermin.

The job of medical personnel is difficult enough without adding human barbed wires into the bargain. Without making any excuses for the bad eggs in the sector, one must be candid enough to admit that Nigerian medical personnel routinely wring water out of stone, considering how they still manage to remain sane enough to treat their patients, exuding that practiced neighbourly friendliness as if they didn’t have a worry in the world.

Admitted that some of them advertise their personal problems on their faces, but then, that’s only being human. We have different levels of tolerance. Every challenge that makes like nightmarish for the average citizen makes it doubly so for the medical personnel because in addition to her personal stress, she has to help other people carry their own crosses as well, especially when those crosses are more emotional than physical.

Ali Pate’s Call

It is in this connection that I think that Prof. Muhammad Ali Pate, the coordinating minister for health and social services, should step in to clear the human problems negatively affecting service delivery by medical personnel at the National Hospital which has the negative distinction of the following:

Consultant doctors are engaged as locum for several years without any hope of being confirmed as permanent staff while politically connected new staff are routinely engaged.

Some consultants on Level 15 earn less than their subordinate senior registrars who are on Level 15 Step 8. All over the country, consultants are on Level 16.

Morale has been broken by the act of management bringing in FRESH consultants on transfer on level 16 from federal medical centres and teaching hospitals, whilst older consultants who could have supervised their training are kept on level 15, on locum basis. So, the tail wags the dog!

Over the years, tribalism has been entrenched in the administration of the hospital as different ethnicities struggle for dominion. In a medical facility, that ought to be anathema.

The most important challenge confronting the hospital today is not the uncompleted 200-bed extension but improving the welfare of the staff. Unbelievable as it may sound, some of the staff spend the night at the hospital, going home only on weekends. They mix easily with the crowd, so it is difficult to know if they’re on duty or not.

Instances of naked tribalism, nepotism and poor staff welfare may soon be latched on by international rating organisations such as the IIAG to lump us with the wretched among nations. I don’t agree that that’s where we belong. As they argue in Warri, Naija must not carry last.

The National Hospital features in a blog for workplace conversations (glassdoor.com) where a former patient wrote the following review about the facility:

“Some toxic staff, toxic management, bullying culture, poor resources, unsupportive environment, poor compensation and salaries, nepotism and favouritism, some staff are so lazy and well-connected that they get away with bad behaviour. Advice to Management: Could do with reviewing the work culture there.”

A time bomb is ticking. Hon. Minister Ali Pate has the required global exposure to help us civilise the National Hospital before it becomes another beautiful abattoir.