What does palliative mean to you? Free food items from the government? Subsidized transportation or increased in wages? While other states are distributing food items to their vulnerable and the very poor citizens and some are topping up workers’ salaries with some cash, Akwa Ibom state government is going a step further by taking healthcare to the rural communities and the lessons are instructive. For three days in February, Gov. Umo Eno arranged a huge medical outreach program in Uyo in which an open field in the metropolis was turned into a gigantic hospital and thousands of people trooped into the airconditioned tents to receive treatment for all sorts of ailments, ranging from hernia to glaucoma. Practically, every disease that afflict our people were treated for free and in the three days of the program, over 1,700 patients received attention and medications; 248 surgeries were performed, including caesarean sections; 630 eye glasses dispensed; 102 dental procedures performed and 742 eye consultations done. In all, 200 medical personnel participated.

Encouraged by its success, the government is taking the program to the other two senatorial districts. This week (March 13 – 18) is the turn of the Akwa Ibom North West senatorial district (or Ikot Ekpene Senatorial district) which has 10 LGAs while Akwa Ibom South or Eket Senatorial district (12 LGAs) will take their turn next month. Persons afflicted with hernia, cataracts, glaucoma, malaria, skin infections and all sorts of ailments are receiving attention, and instead of tents in an open field, the outreach in Ikot Ekpene is held at the general hospital and it will last for five days, two days longer than the one in Uyo. In the first two days at Ikot Ekpene, 3,000 patients have received attention and over 300 surgical procedures, including CS, were performed. I have just asked a friend whose mother is suffering from swollen legs (apparently a symptom of renal impairment) to rush the poor woman to the general hospital.

‘’The success is amazing and the government is thinking of organizing the outreach more frequently’’, Dr. Emmanuel John, the personal physician to the governor told me. But why didn’t these people go to hospitals, the government-owned health facilities, all along? Were they waiting for this outreach program? Did they know that it was coming? I asked Dr. John. His answer is instructive. They kept away from hospital because of cost. ‘’You will be surprised to learn that even a N2,000 bill can scare away our people from hospitals’’, he said, adding, ‘’the governor is very concerned about the welfare of our people in the rural areas and he knows about their limited capacity to bear financial burdens, no matter how minor they are, and so he came up with the idea of this outreach which is essentially taking free healthcare to the people’’.

Although Akwa Ibom government is planning to increase the frequency of the program, the most sustainable system of providing healthcare to the people lies in compulsory health insurance scheme. Nigeria has had health insurance since the Obasanjo administration introduced it over 20 years ago, but the coverage has been too low – just about three percent of the population is covered. In the whole of Africa, it is only Rwanda that has a coverage of up to 90%. Said Dr. John: ‘’We need to make health insurance compulsory in Nigeria so that the working class in the country can bear the burdens of the weak and the elderly members of the population’’. I agree. If, for example, 200,000 people in the state contribute N2,000 each in a month, that would fetch N400 million. This is more than enough to cater for the health needs of every sick person for the month. This is a matter for the National Economic Council and the Nigerian Governors Forum to take a keen look at.

There are some lessons to take away from the success of the Akwa Ibom medical outreach. Number one: Our people are so poor that even the thought of a N2,000 medical bill can prevent them from seeking help in government-owned hospitals. The previous administration spent huge resources to renovate and re-equip general hospitals in many LGAs and the incumbent administration is revamping the primary health centers, yet our people do not go there for treatment.

Another lesson is that distribution of rice and food items is not the only way of providing palliatives to the people. Quite often, we hear of governments distributing foodstuffs to ameliorate the cost-of-living crisis in the country. But unknown government officials, more of their citizens are dying of common preventable and curable diseases than of hunger. These people are so poor that they do not even know where to seek help for their ailments. So, while the governors are in Abuja looking for money to provide food palliatives, their citizens are dying of common infections. Truly, humans require food as much as they need medical care to live.

This program may cost Akwa Ibom government up to N300 million or more, in my estimation. Today, a surgical procedure, whether for hernia or appendicitis, even in a government hospital, costs up to N300,000! Whatever the total cost will be, it is worth it. This is the time to cater for the hapless and the helpless amongst us. I commend the governor. Akwa Ibom State is not for the political class alone! To create a more enduring system, I urge the governor to make a law for a compulsory health insurance scheme in which every working person, including the self-employed, will contribute to a pool that would fund medical care for all, especially the weakest segments of the population.