This was inevitable. Awaiting the first result from any polling unit

BENEFIT OF DOUBT. what if its because of the rain. If no one has voted then which result would they announce

As a nigerian, i cant bear watching this embarrasment on cnn. inec and logistics

This is very embarassing, for over 49 minutes Gej has been standing

BOTH OKE AND JIMOH HAVE HELD SWAY IN PDP PRIOR TO MIMIKOS DEFECTION, I WOULD BE SUPRISED IF THEY LEAVE.THE PRESEDENTIAL RESULT IN ONDO IS CLOSE TO CALL, IT DOESNT AFFECT CHANCES AT GUBERNATORIAL ELECTIONS NEXT YEAR.

A lot of lagosians wouldnt vote tomorrow.

I agree, Its a close race slightly in favour of buhari but wirhin the margin of error

The polls, inadequate though they are, indicate a substantial Buhari lead throughout the country, even in some sections of the predominantly Christian south. But, Jonathan’s government has access to virtually unlimited amounts of money for campaigning purposes, and disproportionate, if not absolute, control over the electoral machinery.[b][/b]

@ olamieseun I didnt say Gej would win osun state, but he would berfom better than projected. Most of the pundits are really underestimating Gej. Apc was fresh in osun state in 2011. Aregbe had cult following then , that favoured ribadu. workers are currently owed 5 months although its expected that gmb would win but not bythat margin.

maybe some of d dollars didnt reach his hand. He has no weight.

passingshot your analysis is fair. Buhari cant get 30 percent in Imo. GEJ would do much better in Ondo, lagos, osun, ondo and the north central than you have projected. Buhari would perform worse than you have projected in the north east due to insecurity and electoral fraud. 6 weeks has changed a lot

BUHARI WOULD NE A DISASTER TO THE ECONOMY, 4 more years of Gej is depressing ,we have two bad choices.

propaganda

[b][/b]RUN OFF

Why Lagos concessions N5b cardiac, renal centre

In recent times, there has been an epidemiological shift in the disease pattern with an increase in Non-Communicable and Mental Health disease burden that are seen across the state. I am talking of chronic diseases, especially hypertension, Diabetes Mellitus (DM), and cancers – a state of affairs that is increasingly telling on available statistics from the state’s public hospitals.

It is an acknowledged fact that cardiac and renal diseases constitute a growing health burden globally. These diseases, if not adequately managed, progress to end-stage organ damage thereby contributing significantly to morbidity and mortality indices. Identified risk factors are hypertension and diabetes. This is again buttressed by available state hospital statistics, which also show an increase in end-stage renal diseases. On a yearly basis, the state sponsor renal and cardiac disease patients requiring financial assistance for treatment and/or transplant surgery abroad, with most of the cardiac cases being children with congenital heart diseases.

This cardiac and renal centre is to handle all these cases including their complications. That is why this centre was constructed and equipped. It is capable of doing very many things – detecting and investigating causes of renal diseases and address them too.

It is a three-floor building; properly equipped to handle virtually all cases of heart and kidney problems. We have clinics where doctors will take history and make diagnosis; we have counseling rooms, consulting rooms, diagnostics room where electrocardiography can be done. There is also echocardiography laboratory for further diagnosis. Cardiac catherization lab; a specialization lab that can diagnose as well as treat (the second of such laboratories in the country). Here they can inject specific diet into your blood stem; trace all the blood supplies either to the arm or legs, to see if there is any blockage and if there is any, without any surgical operation, there can be maneuvering to open up that blockage. And if there is any need to do surgery, that section also has two theatres where it can be done, either for the heart or cardiac. We can do both kidney and heart transplants at the centre.

Why did the state government concession the facility to a private company to manage?

We realized that we have challenges with human resources especially in key specialties to handle this facility and that is why we adopted the Public Private Partnership (PPP) initiative. We threw it open to bidders and at the end we signed an agreement (a Limited Liability Partnership) with Renescor Health Limited, represented by Dr. Ladi Awosika.

Why we opted for Renescor is that majority of these people (staff of the centre) are Nigerians in Diaspora. Though they are experts based overseas, they are willing to come back to the country, to treat these problems and also build expertise.

You would also recall that we have had some cardiac missions in the past; nine to be specific, with about 56 beneficiaries, mostly children. A lot these children have what is called congenital heart problems; problems of the heart that they were born with and requiring surgical correction. We could not handle all of them because of the constraint of resources. So, they were sent to India. The best is to bring those expertise here.

One of the agreements in the partnership is that there must be proper skills transfer; we must be able to use the expertise that they are bringing in to train local people – our medical students, the residents, some consultants who require expertise in cardiology or renal problems. And the training is not limited to doctors alone, but also our nurses in intensive care management either for heart or kidney care. We can train technicians that can also handle some of those equipment on ground. With the agreement, we are using one stone to kill many birds.

We also have some experts in cardiology and have their clinic in Lagos and are part and parcel of this arrangement. They have seen cases of pulmonary haemorrhage in six years that they have stayed here than what they had seen abroad and those cases were treated successfully. They have seen more cases now, even from outside of Lagos because of the expertise that they have.

You know what, some people have been referred abroad wrongly, but because they are lucky, they have went to these guys before going on the trip, and they found that there is nothing wrong with the person. They have a culture of confidence that we must also put around here.

What is the statistic really like for these kidney and heart diseases in Lagos?

From what we have seen, 20 per cent of our people are hypertensive and that figure nearly tallies with experiences of some literatures. Four to five per cent of those cases are diabetic. It a bit difficult to access the trend because we don’t have sufficient data locally. With respect to renal disease, this is even worst. Because most of these cases are not diagnosed early enough, they don’t go to hospital until they get to end stage of the renal disease.

Apart from not being detected early, when they are detected, they need to go through dialysis, which is the ‘cheapest’ form of treatment in this category. Ideally, a person needs three dialysis sessions per week. It is very expensive and because many cannot afford it, they are left with one or twice sessions. Unfortunately too, we don’t have too many units that carry out dialysis. From statistics we have, I think we have only 60 of such units in the country. 30 per cent of those units are in Lagos and for those in Lagos, 80 per cent of them are in the private sector. Very few tertiary facilities are doing transplant, with St. Nicholas doing the highest number. What we are doing in Lagos state is to create that avenue for people to use and that is the essence of this new facility.

It is also a fact that people have been referred overseas for treatment or transplantation. Some were successful while some were badly treated and had to come back. That is the reality.

With hypertension, there are severe complications. One can get blind, have stroke, gangrene of the leg, which diabetes too can cause. Hypertension too can kill your kidneys, even when there is no hypertension, but because the kidneys are dying, it can lead to hypertension. They are very serious problem and that is why we have to start keeping records properly. Hypertension or low blood pressure can cause palpitation of the heart and if not properly treated it can lead to shock and there are different types. These are not the kind of conditions that can be diagnosed in just any hospital. This is where this facility is very important.

How many hearts and kidney patients can this facility cater for?

We will try as much as possible to address as many as come. Just one facility cannot deal with the problem of Nigeria. In any normal country, this kind of facility is done by the private sector. Because it is expensive to build and maintain. More so, that kind of maintenance revolves around the staff. Look at our country, how many cardiologists; heart doctors do we have? Because of the complexity of Lagos, both (two cardiologist) are here and a lot of people come from outside Lagos to see them. So, the many of this centre that we have, the better.

Government is showing that we can do these things here. We need more of this facility but government cannot do it alone. Again, it is not a facility anyone can just walk into and ask for treatment, otherwise people working in there would not be able to carry out those services for which you (patient) have paid for. People have to be referred there.

What are your plans to reduce the cost of kidney transplants, currently at over N3m, given this new facility?

That is affordability and will be affordable. But don’t forget that the facility has been built with serious money and it is going to cost even more to maintain the key equipment. What we have done in the agreement, especially for the poor people, is that anyone that must go from out teaching hospital has to be referred there, and 10 per cent of every case that they see in that place per month will be treated free. Anything in excess, if they conform to the protocol, will be borne by the state government under our insurance scheme.

There is a bill pending in the House of Assembly to address things like this. It has passed First, Second Readings and also through Public Hearing. Once they passed that and it becomes law, then these issues can be addressed properly. But if I tell you that every bed would be declared free, is a lie. If we try that, the place will packed up in less than one year. We will try as much as possible, within the limit of resources, to address those issues.

To get the services cheaper, the concessionaire is talking directly with international manufacturers of consumables and gets them as the most affordable rate. Sustainability is also tied to the economy of the country.

We look forward to doing two renal transplants every week by the time we are six months into operation. Dialysis will scale up to about 60 a day in the next few weeks. Opening of that facility will nearly double the number of critical care bed available in Lagos at this point in time. So, it is not only about the cost but also for people that are currently dying without the opportunity for treatment.

It is known that NHIS packages are often silent on renal or cardiac issues. Is it any different with the state-own insurance scheme?

What we have are different packages for different people and based on the package that is chosen, there are fees that you have to pay. For those people who are poor, there are certain things the government will do on their behalf, provided they go through the processes and procedure on ground. There must be protocol and referral; otherwise, the whole essence will be defeated. If we can go to other people’s countries and sit-down for the process to take its course, why can’t we do it here? So, there are people that will be taken care of by the government on account of their status.

The original estimate for the facility is N5billion. Has it in anyway increased and by how much?

There are other issues and cost that came with the facility, like raising the topography of that place, addressing the issues of drainage, road accessibility and power. If we are to add that, it is definitely more than N5b. But those are public records you can have access to. There are so many dimensions to cost. To say it cost N5b that will be an under-statement.

How would you explain that this facility has been concessioned, given the fact that the government solely paid for it construction?

This people are paying concession fee to the government and not the other way round. So, it is incumbent on them to do these things properly the way it should be done. There is a monitoring clause and others to ensure that they are done properly. If concessions are not being done, it then means again that we have bastardised the process in this environment. It is a concession that specifies the role and responsibility of each partner. So, if partner A defaults, partner B knows what to do. In any case, the concession is for five years. If they perform very well, there will be a renewal for another fivet years. If they have enough need locally, there may not be any need to review. This is just one out of what we need here. Ghana has more CT scanners in their country than we have in Nigeria, not to talk of the number of MRIs, and not to talk of South Africa.

Would the state be making campaigns for renal donors?

Generally, donor is an ethical issue. Donor issue is patient specific. We cannot say we want hearts or one kidney. All these have to be matched to a particular patient’s need. And to match, they test blood and all manner of things to be sure that they are compatible. If I graft you now, your body will reject it. The closer the patient is to the donor (sibling, at best) the better for compatibility and successful transplantation. We will leave the issue of donor to the concessionaire to manage.

NO the doctorb ought to inform her, once the doctor writes vct, the patient should be counselled prior to the test probably in the lab. I have heard of a case where a patient denied her status and declined testing. The nurses cleaners and doctors taking her delivery were not extra cautious , Today the cleaner is with Full .blown aids. he status was only discovered a year after when she presented with diarrhea.

rubbish. 50:50

south west votes woukd be very.close 50/50. johnathan has made some inroads

RIP DJOLA. i see people blaming doctors, whereas the focus shud be on goverment investing more in healthcare. They are some conditions that have poor prognosis no matter what is done the outcome is usually the same, eg the ceo of apple with cancer of the pancreas had access to the best healthcare and yet succumed. Lets pray for Djola

uba

The Ondo State Governor and South West Coordinator of the Jonathan Campaign Organisation, Dr Olusegun Mimiko, on Monday faulted the comment of the former president, Chief Olusegun Obasanjo, that President Goodluck Jonathan influenced the postponement of the election in the interest of himself and the Peoples Democratic Party (PDP).

Mimiko, who spoke during an interaction with journalists  in Akure, Ondo State capital said the available evidence on ground knocked out the former president’s postulations on the shift of the election.

The governor noted that if the Independent National Electoral Commission (INEC) had started the election  on February 14 as scheduled, a lot of eligible voters would have been disenfranchised.

Specifically, Mimiko  explained that a greater percentage of voters from the South-west region would have been disenfranchised in the election, noting that only 52 per cent of voters from the region had collected their permanent Voters’ Card (PVCs) while a greater percentage have obtained same in the northern region.

Mimiko said “What is the evidence on ground, it is when you place the evidence on ground, side by side with the postulations, you will see that the postulation cannot hold.

“Talking about the South-west, let’s put the security reason aside, let’s look essentially at the possibility of disenfranchising some voters in the South-west region because as at February 5, the record that Jega gave at the council of states on all the geo-political zones, South-west scored the least in terms of people who have collected the PVCs, whereas the average in the North-east was 77.8 per cent, while South-west was 52 per cent.

“As a matter of facts, in all the zones, it was only the South-west that scored below 60 per cent. So, we are an interested party in the sense that if the election had continued or taken place we would have been disenfranchised.

“When you look at the totality of Nigeria, there were still 34 per cent of the cards yet to be collected which is about 23 million Nigerians, and if it took INEC about four years of preparation to distribute only 60 per cent of the voters’ card and you had one week to election and even by admission of Prof. Jega himself who said if they had more time it would be better for them to perfect the arrangements,” Mimiko said.

The governor noted that some people that were claiming to be protecting the South-west were not truthful about the issue on the ground because with what was on ground at the time of the postponement, the South-west had been short-changed in terms of distribution of PVCs.

“ Look at Lagos State and Ogun State. Lagos State was 38 per cent, Ogun was 36 per cent and some other states in Nigeria, in this same country are higher. Adamawa was 80 per cent, Yobe was 74 per cent, Sokoto was 81 per cent when Lagos was just 38 per cent.

“Yet if anybody claims he can protect the interest of the South-west and would prefer that we go into that election with only 38 per cent of registered voters ready and with the PVC, then I leave the judgement to you, so the postulation falls flat on the face of evidence before us,” Mimiko said.

Mimiko said with what is on ground, the people of the South-west region will not only vote for Jonathan but will vote “handsomely” for President Jonathan in the presidential election based on the achievements recorded by the president during his first term in office.

Mimiko said Jonathan won in the South-west states in 2011 despite the fact that the Peoples Democratic Party  (PDP) had no governor in the region then.

“Now, Jonathan has two governors in the South-west and I keep telling people that the South-west is politically sophisticated and nobody can run away from that fact. If you want to get the support of the South-west , it must be based on substance, it must be based on your political antecedents and records. It must be based on empirical evidences.                      

“I don’t have any doubt in mind that because of the level of sophistication in the South-west and again the people are discerning, they will be able to put the candidate of the APC side by side with Jonathan and they will look at their political antecedent and their records,” he said.

He said he had no doubt in his mind that Jonathahttp://www.thisdaylive.com/articles/mimiko-faults-obasanjo-on-election-shift/202043/n will win handsomely in the South-west.

Tags: Politics, Nigeria, Featured, Election

Boko haram in 6 weeks

The electorate deserves a debate, we need to hear from all presedential aspirants. What a shame. THIS IS NOT CHANGE. Nigerians shine your eyesane vote wisely.

ondo is a swing state, kwara is for apc.

The Minister of State for Works, Adedayo Adeyeye, has described the All Progressives Congress, APC, presidential candidate, Mohammadu Buhari, as “the number one enemy of the Yoruba people of the Southwest Nigeria”.
He said Mr. Buhari must be rejected by all true sons and daughters of Oduduwa, (the progenitor of the Yoruba race).
Mr. Adeyeye said the presidential candidate of the APC did incalculable damage to Lagos State and the entire Yorubaland with the cancellation of the Lagos Metroline Project and the late Chief Obafemi Awolowo’s Free Education Programme, in which pupils only needed to buy school uniform to go to school.
He challenged Mr. Buhari to mention a single project that he delivered in the Southwest when he was head of state and later Chairman of the Petroleum Trust, PTF.
“Buhari did not only cancel the Metroline Project, he went ahead to pay what was enough to complete the project as compensation to the French Company that handled the project,” the minister said.
“The idea of developing rapid transit in Lagos dated from the 1980s with the Lagos Metroline network conceived by the Alhaji Lateef Jakande during the Second Republic. The Metroline project was scrapped in 1985 by Buhari at a loss of over $78 million to the Lagos tax payers. Information on the Metroline Project is on Wikipedia for everyone to see.
“If Buhari had not cancelled that project out of hatred for the Yoruba people, transportation in Lagos would have been better than it is now and one can begin to imagine the number of lives and investments that had been lost to Buhari’s wickedness.”
Mr. Adeyeye said Mr. Buhari reversed everything that Mr. Awolowo did for the Yorubaland.
He alleged that the former head of state was even planning to merge the University of Ibadan with Obafemi Awolowo University, Ile-Ife when he was removed.
The minister said, “He stopped free education, thereby preventing many of our youths from going to school. Many of the youths that were victims of Buhari’s wickedness are now being begged by the APC to vote for the same man who cut short their bright future.
“Unlike Buhari, President Goodluck Jonathan has demonstrated his love for the Yoruba people by giving us a university in Ekiti, constructing the abandoned Lagos-Ibadan Expressway; among roads, approval for the construction of two seaports in Lagos and most importantly, by resuscitating rail transportation.
“Therefore, no real Yoruba person, who is sincerely interested in the progress of the Yoruba race will support a return of Buhari, who set us back by more than 50 years as president of Nigeria.” http://www.premiumtimesng.com/news/top-news/174776-buhari-number-one-enemy-yoruba-people-minister-state-works.html

jimi, u have a great chance of becoming the next governor. i can assure you that a lot of people like you. we need to free lagos from the hands of tinubu. you need to work at the level of the state. the presedential election coming up first however is d only limiting factor as apc momentum would rub off your votes.

Professor Afekhide Omoti is the Chairman, Nigerian Medical Association (NMA), Edo State Branch. In this interview with MICHAEL EGBEJULE in Benin City, he x-rays the challenges and proffers solutions in the hitherto comatose health sector and the lingering feud between health professionals, which has crippled a section of the health sector. Excerpts:

WHAT is your take concerning the position of CMD wherein government in a Memorandum of Understanding (MOU) recently signed and emphasized the position of CMD should be taken from hospital based professionals and that advertisements to that effect should not be skewed in favour of one profession?

Firstly, I think it is unfortunate that some health professionals are going on strike over who becomes the CMD of a hospital. Kindly note that Medical Doctors are not currently on strike. Doctors are working. It is time we resolve all areas of disagreement and work together in harmony.

At a time when the government is trying to improve on health services to the average Nigerian and when the National Health Bill has been signed into law, all hands should be on deck to render quality care to all Nigerians. The act of National Assembly clearly prescribes that a medical consultant should occupy that position. This is evidence based.

In the USA where some hospitals are run by non-doctors and others by doctors, those hospitals run by doctors have been scientifically proven to be better managed and perform much better. This is obvious because only the medical doctor has sufficient training in every aspect of medicine and surgery as well as all other support activities of the hospital. All other professions are grossly deficient in all aspect especially in surgery.

I can tell you that no health professional will deny that the doctor is the natural leader of the health team. Doctors will accept that all health professions are important. Patients come to the hospital to see a doctor, and that is not in dispute. In any case, a high powered panel, the Yayale Ahmed Committee has just submitted its report on this issue. All health professions submitted and defended their memoranda.

Let us await the white paper on their report. At present we have no idea about their recommendations. We hope it will be objective. Delivery of health service is a team work and all professions have their roles to play. All are important but there cannot be two (2) captains in one ship. Nigeria has got this one right. Doctors should head hospitals.

On the CONHESS 10 skipping, other health professionals are denied being promoted from CONHESS9 to 11. Rather, they have to go through CONHESS 9 to 10 as against what has been in practice since 1981. However, NMA benefited following the CONHESS10 skipping that gave rise to the adjustment in the salary structure of the NMA. Sir, what is your position as it seems there is a big discrimination in the health sector?

Let me put the issue in the correct perspective. NMA never supported the skipping of any level. In our opinion, it was illegal. A mistake was made some years ago when moving from one salary structure to another that resulted in skipping. The other health professionals benefited from this but medical doctors did not. So NMA asked the government to extend it to medical doctors if they were not willing to reverse it.

It was initially applied to medical doctors at the same level as other health professionals, but it was realized that, that was the entry point of a post NYSC doctor. Since you cannot skip your entry point, the government, against the will of the doctors moved it to the next level. In fact, the doctors actually rejected this. Now we hear from JOHESU that it is discrimination against them. This is an irony. There was no deliberate act to discriminate against anyone. Doctors had no choice in the matter.

In fact, most doctors did not benefit from this including me. Another misinformation being spread to whip up sentiments is that this was the adjustment in salaries received by the doctors recently. Nothing can be further from the truth. What the senior doctors (not all doctors) were paid was a corrected error in tabulated allowances of some doctors as an adjustment in allowances due to relativity which was breached many years ago.



In fact, in the interest of peace, the doctors had to forgo many years of arrears and agreed to start from 2014. Doctors neither ask for, nor did they get an increase in salaries, and I want to emphasize that. To show how cooperative the doctors are with government, they accepted only 2 months relativity allowance for now for the whole of 2014.

How do we come out from all the series of strikes in the Health sector and save the health of the public who are at the receiving-end each time JOHESU or NMA embark on strike?

It is my personal opinion that strike in the health sector by any group should very rarely be heard of. Now we have a situation where all the professions in the health sector have ganged up against the medical doctors and are demanding essentially things that are unacceptable to the doctors. This has resulted in a vicious cycle where each group alternately goes on strike. I must emphasize that most of the hospital staff on strike have nothing to benefit from this JOHESU strike.

Most of the professions on strike know that they cannot become CMD's or Consultants, yet they are on strike. Many of them have been misinformed about the purpose of this strike. Just interview the ordinary health worker and you will discover that they have the wrong impression of the reasons they are on strike. Most of them are just being used for the benefit of a few.

The solution to this problem needs to be comprehensive. Take a look at the private hospitals, also take a look at company hospitals including NNPC, Shell and even Military hospitals. Why do these disputes not occur even though these hospitals are being headed by the doctors. The problem is only in government hospitals. This is because the various unions now know that government will grant their requests even if it is unreasonable, if they go on strike.

The answer may be in privatization of the non essential services. Currently, a few services have been privatized and strikes have stopped in those sectors. Alternatively, all the health profession must be willing to accept international best practices and put selfish interest aside while the government improves the working conditions of all the health professionals while maintaining relativity in payment of allowances.

Government should either set up or encourage the private sector to set up regional pharmaceutical companies and regional laboratories where drug research and manufacturing as well as high tech medical research and laboratory tests can be performed. By doing this, other health professionals can have institutions that they can head, be able to practice their profession and have job satisfaction.

It will also benefit Nigerians by saving foreign exchange used to import drugs and do paternity and other tests abroad as well as providing employment for our teeming unemployed populations. Professionals must stick to their training and respect professional boundaries. Anti quackery laws should be strengthened and enforced and the regulatory bodies should be reduced in number.

It seems NMA is not sympathetic to the plights of Nigerians even in the face of daring situations like other unions in the health sector recently shelved their strike in the case of the Nyanyan bomb blast, also when the Chibok girls were abducted and when Nigeria was hit by the Ebola crisis but NMA went on strike despite the national emergency?



This is cheap blackmail which has been used as propaganda against doctors. Firstly the Chibok girls were kidnapped long before the doctors strike (July 1st, 2014). The other unions (JOHESU) are currently on strike and the Chibok girls remain kidnapped.

Secondly, during all the bomb blasts, the NMA directed all doctors in the affected states to respond immediately and they did. JOHESU is on strike, and bomb blasts are still occurring and Doctors are on ground to attend to the victims. This can easily be verified. NMA may not have called off its nationwide strike but directed doctors to provide full services in all national emergencies.

I admit that there were calls on NMA to call off their strike during the Ebola crisis started in Lagos state and much later in River state while NMA did not call off their strike. NMA directed doctors to volunteer to assist. I ask, who managed the Ebola patients? Was it not the Nigerian doctors?

Doctors were not invited from any country to assist Nigeria? In fact, in my state, Edo state, over 80 doctors volunteered and joined our Ebola response committee. In addition, NMA Edo State made the most significant contributions to the Ebola fight while the other unions did nothing. Edo NMA powered Ebola screening tents, PPEs, sterilizers, infrared thermometers and even published health education books and pamphlets in various Nigerian languages and distributed them to the major hospitals and to the public.

We spent millions of naira on this project and the news was carried by the Guardian newspaper and other national dailies as well as the National T.V Networks. I challenge any other union to tell us if they did anything beyond the normal call of duty like us. All over the country, the doctors were involved in public health enlightenment programmes which assisted in no small measure to effect the behavioural change necessary for the control of Ebola.

Reports have it that healthcare professionals when eventually promoted to directorship, are not given free hands to operate usually because they are not university staff which can be seen as against the law.

Doctors are not against the promotion of any health worker to any grade level. In the Federal Ministry of Health, I don't think there are up to eight directors. Now you are asking for a situation where each hospital will have over 100 to 300 directors.

How? Firstly, almost all medical consultants will have to be made directors because they are on the same salary grade as Directors or Permanent Secretaries. In my hospital (The University of Benin Teaching Hospital - UBTH), for example, there are about 170 medical consultants. Then in every other profession, pharmacy, laboratory scientists, physiotherapist, optometrists etc. you have to make many Directors.

To function properly as a director, you need to create directorates with all the paraphernalia of office and support staff. These Directors will also stop practicing their Professions and focus on administration. Can you begin to imagine the chaos and disservice to the Nigerian Populace? Can Government even afford to fund these hospital Directors in spite of the current economic hardship? Answer is no.

Nigeria and Nigerians will suffer for it. Promote them to any level, but they don't have to be directors. In hospitals, there are only two directorates, one is the director of clinical service who is a medical doctor and the other is the director of administration, who is not a medical doctor.



I must emphasize that doctors are not against any health profession rising to any salary grade. An example is the optometrist who can rise to level 17 and are designated as Chief Optometrist. Medical doctors also rise to level 17 and are designated Chief Consultant. Why can't other health professionals do the same thing and maintain professionalism rather than everyone becoming administrators.

I must let you know that many JOHESU members are our wives and husbands. Many of my best friends in the hospital are non doctors who head other unions and I have an excellent personal relationship with them and we respect each other. What is being portrayed by a few vocal JOHESU leaders is that there is war in the hospital. This is not true. We work together as a team.

There is no discrimination based on profession. In fact many doctors also complain of discrimination. Many doctors feel they are more commonly disciplined in the hospital by their doctor CMDs than members of other health unions. The kind of offences they get away with, doctors will not. Also being a University staff does not confer any advantage to anyone in the hospital.

Professor Afekhide Omoti is the Chairman, Nigerian Medical Association (NMA), Edo State Branch. In this interview with MICHAEL EGBEJULE in Benin City, he x-rays the challenges and proffers solutions in the hitherto comatose health sector and the lingering feud between health professionals, which has crippled a section of the health sector. Excerpts:

WHAT is your take concerning the position of CMD wherein government in a Memorandum of Understanding (MOU) recently signed and emphasized the position of CMD should be taken from hospital based professionals and that advertisements to that effect should not be skewed in favour of one profession?

Firstly, I think it is unfortunate that some health professionals are going on strike over who becomes the CMD of a hospital. Kindly note that Medical Doctors are not currently on strike. Doctors are working. It is time we resolve all areas of disagreement and work together in harmony.

At a time when the government is trying to improve on health services to the average Nigerian and when the National Health Bill has been signed into law, all hands should be on deck to render quality care to all Nigerians. The act of National Assembly clearly prescribes that a medical consultant should occupy that position. This is evidence based.

In the USA where some hospitals are run by non-doctors and others by doctors, those hospitals run by doctors have been scientifically proven to be better managed and perform much better. This is obvious because only the medical doctor has sufficient training in every aspect of medicine and surgery as well as all other support activities of the hospital. All other professions are grossly deficient in all aspect especially in surgery.

I can tell you that no health professional will deny that the doctor is the natural leader of the health team. Doctors will accept that all health professions are important. Patients come to the hospital to see a doctor, and that is not in dispute. In any case, a high powered panel, the Yayale Ahmed Committee has just submitted its report on this issue. All health professions submitted and defended their memoranda.

Let us await the white paper on their report. At present we have no idea about their recommendations. We hope it will be objective. Delivery of health service is a team work and all professions have their roles to play. All are important but there cannot be two (2) captains in one ship. Nigeria has got this one right. Doctors should head hospitals.

On the CONHESS 10 skipping, other health professionals are denied being promoted from CONHESS9 to 11. Rather, they have to go through CONHESS 9 to 10 as against what has been in practice since 1981. However, NMA benefited following the CONHESS10 skipping that gave rise to the adjustment in the salary structure of the NMA. Sir, what is your position as it seems there is a big discrimination in the health sector?

Let me put the issue in the correct perspective. NMA never supported the skipping of any level. In our opinion, it was illegal. A mistake was made some years ago when moving from one salary structure to another that resulted in skipping. The other health professionals benefited from this but medical doctors did not. So NMA asked the government to extend it to medical doctors if they were not willing to reverse it.

It was initially applied to medical doctors at the same level as other health professionals, but it was realized that, that was the entry point of a post NYSC doctor. Since you cannot skip your entry point, the government, against the will of the doctors moved it to the next level. In fact, the doctors actually rejected this. Now we hear from JOHESU that it is discrimination against them. This is an irony. There was no deliberate act to discriminate against anyone. Doctors had no choice in the matter.

In fact, most doctors did not benefit from this including me. Another misinformation being spread to whip up sentiments is that this was the adjustment in salaries received by the doctors recently. Nothing can be further from the truth. What the senior doctors (not all doctors) were paid was a corrected error in tabulated allowances of some doctors as an adjustment in allowances due to relativity which was breached many years ago.



In fact, in the interest of peace, the doctors had to forgo many years of arrears and agreed to start from 2014. Doctors neither ask for, nor did they get an increase in salaries, and I want to emphasize that. To show how cooperative the doctors are with government, they accepted only 2 months relativity allowance for now for the whole of 2014.

How do we come out from all the series of strikes in the Health sector and save the health of the public who are at the receiving-end each time JOHESU or NMA embark on strike?

It is my personal opinion that strike in the health sector by any group should very rarely be heard of. Now we have a situation where all the professions in the health sector have ganged up against the medical doctors and are demanding essentially things that are unacceptable to the doctors. This has resulted in a vicious cycle where each group alternately goes on strike. I must emphasize that most of the hospital staff on strike have nothing to benefit from this JOHESU strike.

Most of the professions on strike know that they cannot become CMD's or Consultants, yet they are on strike. Many of them have been misinformed about the purpose of this strike. Just interview the ordinary health worker and you will discover that they have the wrong impression of the reasons they are on strike. Most of them are just being used for the benefit of a few.

The solution to this problem needs to be comprehensive. Take a look at the private hospitals, also take a look at company hospitals including NNPC, Shell and even Military hospitals. Why do these disputes not occur even though these hospitals are being headed by the doctors. The problem is only in government hospitals. This is because the various unions now know that government will grant their requests even if it is unreasonable, if they go on strike.

The answer may be in privatization of the non essential services. Currently, a few services have been privatized and strikes have stopped in those sectors. Alternatively, all the health profession must be willing to accept international best practices and put selfish interest aside while the government improves the working conditions of all the health professionals while maintaining relativity in payment of allowances.

Government should either set up or encourage the private sector to set up regional pharmaceutical companies and regional laboratories where drug research and manufacturing as well as high tech medical research and laboratory tests can be performed. By doing this, other health professionals can have institutions that they can head, be able to practice their profession and have job satisfaction.

It will also benefit Nigerians by saving foreign exchange used to import drugs and do paternity and other tests abroad as well as providing employment for our teeming unemployed populations. Professionals must stick to their training and respect professional boundaries. Anti quackery laws should be strengthened and enforced and the regulatory bodies should be reduced in number.

It seems NMA is not sympathetic to the plights of Nigerians even in the face of daring situations like other unions in the health sector recently shelved their strike in the case of the Nyanyan bomb blast, also when the Chibok girls were abducted and when Nigeria was hit by the Ebola crisis but NMA went on strike despite the national emergency?



This is cheap blackmail which has been used as propaganda against doctors. Firstly the Chibok girls were kidnapped long before the doctors strike (July 1st, 2014). The other unions (JOHESU) are currently on strike and the Chibok girls remain kidnapped.

Secondly, during all the bomb blasts, the NMA directed all doctors in the affected states to respond immediately and they did. JOHESU is on strike, and bomb blasts are still occurring and Doctors are on ground to attend to the victims. This can easily be verified. NMA may not have called off its nationwide strike but directed doctors to provide full services in all national emergencies.

I admit that there were calls on NMA to call off their strike during the Ebola crisis started in Lagos state and much later in River state while NMA did not call off their strike. NMA directed doctors to volunteer to assist. I ask, who managed the Ebola patients? Was it not the Nigerian doctors?

Doctors were not invited from any country to assist Nigeria? In fact, in my state, Edo state, over 80 doctors volunteered and joined our Ebola response committee. In addition, NMA Edo State made the most significant contributions to the Ebola fight while the other unions did nothing. Edo NMA powered Ebola screening tents, PPEs, sterilizers, infrared thermometers and even published health education books and pamphlets in various Nigerian languages and distributed them to the major hospitals and to the public.

We spent millions of naira on this project and the news was carried by the Guardian newspaper and other national dailies as well as the National T.V Networks. I challenge any other union to tell us if they did anything beyond the normal call of duty like us. All over the country, the doctors were involved in public health enlightenment programmes which assisted in no small measure to effect the behavioural change necessary for the control of Ebola.

Reports have it that healthcare professionals when eventually promoted to directorship, are not given free hands to operate usually because they are not university staff which can be seen as against the law.

Doctors are not against the promotion of any health worker to any grade level. In the Federal Ministry of Health, I don't think there are up to eight directors. Now you are asking for a situation where each hospital will have over 100 to 300 directors.

How? Firstly, almost all medical consultants will have to be made directors because they are on the same salary grade as Directors or Permanent Secretaries. In my hospital (The University of Benin Teaching Hospital - UBTH), for example, there are about 170 medical consultants. Then in every other profession, pharmacy, laboratory scientists, physiotherapist, optometrists etc. you have to make many Directors.

To function properly as a director, you need to create directorates with all the paraphernalia of office and support staff. These Directors will also stop practicing their Professions and focus on administration. Can you begin to imagine the chaos and disservice to the Nigerian Populace? Can Government even afford to fund these hospital Directors in spite of the current economic hardship? Answer is no.

Nigeria and Nigerians will suffer for it. Promote them to any level, but they don't have to be directors. In hospitals, there are only two directorates, one is the director of clinical service who is a medical doctor and the other is the director of administration, who is not a medical doctor.



I must emphasize that doctors are not against any health profession rising to any salary grade. An example is the optometrist who can rise to level 17 and are designated as Chief Optometrist. Medical doctors also rise to level 17 and are designated Chief Consultant. Why can't other health professionals do the same thing and maintain professionalism rather than everyone becoming administrators.

I must let you know that many JOHESU members are our wives and husbands. Many of my best friends in the hospital are non doctors who head other unions and I have an excellent personal relationship with them and we respect each other. What is being portrayed by a few vocal JOHESU leaders is that there is war in the hospital. This is not true. We work together as a team.

There is no discrimination based on profession. In fact many doctors also complain of discrimination. Many doctors feel they are more commonly disciplined in the hospital by their doctor CMDs than members of other health unions. The kind of offences they get away with, doctors will not. Also being a University staff does not confer any advantage to anyone in the hospital.

Professor Afekhide Omoti is the Chairman, Nigerian Medical Association (NMA), Edo State Branch. In this interview with MICHAEL EGBEJULE in Benin City, he x-rays the challenges and proffers solutions in the hitherto comatose health sector and the lingering feud between health professionals, which has crippled a section of the health sector. Excerpts:

WHAT is your take concerning the position of CMD wherein government in a Memorandum of Understanding (MOU) recently signed and emphasized the position of CMD should be taken from hospital based professionals and that advertisements to that effect should not be skewed in favour of one profession?

Firstly, I think it is unfortunate that some health professionals are going on strike over who becomes the CMD of a hospital. Kindly note that Medical Doctors are not currently on strike. Doctors are working. It is time we resolve all areas of disagreement and work together in harmony.

At a time when the government is trying to improve on health services to the average Nigerian and when the National Health Bill has been signed into law, all hands should be on deck to render quality care to all Nigerians. The act of National Assembly clearly prescribes that a medical consultant should occupy that position. This is evidence based.

In the USA where some hospitals are run by non-doctors and others by doctors, those hospitals run by doctors have been scientifically proven to be better managed and perform much better. This is obvious because only the medical doctor has sufficient training in every aspect of medicine and surgery as well as all other support activities of the hospital. All other professions are grossly deficient in all aspect especially in surgery.

I can tell you that no health professional will deny that the doctor is the natural leader of the health team. Doctors will accept that all health professions are important. Patients come to the hospital to see a doctor, and that is not in dispute. In any case, a high powered panel, the Yayale Ahmed Committee has just submitted its report on this issue. All health professions submitted and defended their memoranda.

Let us await the white paper on their report. At present we have no idea about their recommendations. We hope it will be objective. Delivery of health service is a team work and all professions have their roles to play. All are important but there cannot be two (2) captains in one ship. Nigeria has got this one right. Doctors should head hospitals.

On the CONHESS 10 skipping, other health professionals are denied being promoted from CONHESS9 to 11. Rather, they have to go through CONHESS 9 to 10 as against what has been in practice since 1981. However, NMA benefited following the CONHESS10 skipping that gave rise to the adjustment in the salary structure of the NMA. Sir, what is your position as it seems there is a big discrimination in the health sector?

Let me put the issue in the correct perspective. NMA never supported the skipping of any level. In our opinion, it was illegal. A mistake was made some years ago when moving from one salary structure to another that resulted in skipping. The other health professionals benefited from this but medical doctors did not. So NMA asked the government to extend it to medical doctors if they were not willing to reverse it.

It was initially applied to medical doctors at the same level as other health professionals, but it was realized that, that was the entry point of a post NYSC doctor. Since you cannot skip your entry point, the government, against the will of the doctors moved it to the next level. In fact, the doctors actually rejected this. Now we hear from JOHESU that it is discrimination against them. This is an irony. There was no deliberate act to discriminate against anyone. Doctors had no choice in the matter.

In fact, most doctors did not benefit from this including me. Another misinformation being spread to whip up sentiments is that this was the adjustment in salaries received by the doctors recently. Nothing can be further from the truth. What the senior doctors (not all doctors) were paid was a corrected error in tabulated allowances of some doctors as an adjustment in allowances due to relativity which was breached many years ago.



In fact, in the interest of peace, the doctors had to forgo many years of arrears and agreed to start from 2014. Doctors neither ask for, nor did they get an increase in salaries, and I want to emphasize that. To show how cooperative the doctors are with government, they accepted only 2 months relativity allowance for now for the whole of 2014.

How do we come out from all the series of strikes in the Health sector and save the health of the public who are at the receiving-end each time JOHESU or NMA embark on strike?

It is my personal opinion that strike in the health sector by any group should very rarely be heard of. Now we have a situation where all the professions in the health sector have ganged up against the medical doctors and are demanding essentially things that are unacceptable to the doctors. This has resulted in a vicious cycle where each group alternately goes on strike. I must emphasize that most of the hospital staff on strike have nothing to benefit from this JOHESU strike.

Most of the professions on strike know that they cannot become CMD's or Consultants, yet they are on strike. Many of them have been misinformed about the purpose of this strike. Just interview the ordinary health worker and you will discover that they have the wrong impression of the reasons they are on strike. Most of them are just being used for the benefit of a few.

The solution to this problem needs to be comprehensive. Take a look at the private hospitals, also take a look at company hospitals including NNPC, Shell and even Military hospitals. Why do these disputes not occur even though these hospitals are being headed by the doctors. The problem is only in government hospitals. This is because the various unions now know that government will grant their requests even if it is unreasonable, if they go on strike.

The answer may be in privatization of the non essential services. Currently, a few services have been privatized and strikes have stopped in those sectors. Alternatively, all the health profession must be willing to accept international best practices and put selfish interest aside while the government improves the working conditions of all the health professionals while maintaining relativity in payment of allowances.

Government should either set up or encourage the private sector to set up regional pharmaceutical companies and regional laboratories where drug research and manufacturing as well as high tech medical research and laboratory tests can be performed. By doing this, other health professionals can have institutions that they can head, be able to practice their profession and have job satisfaction.

It will also benefit Nigerians by saving foreign exchange used to import drugs and do paternity and other tests abroad as well as providing employment for our teeming unemployed populations. Professionals must stick to their training and respect professional boundaries. Anti quackery laws should be strengthened and enforced and the regulatory bodies should be reduced in number.

It seems NMA is not sympathetic to the plights of Nigerians even in the face of daring situations like other unions in the health sector recently shelved their strike in the case of the Nyanyan bomb blast, also when the Chibok girls were abducted and when Nigeria was hit by the Ebola crisis but NMA went on strike despite the national emergency?



This is cheap blackmail which has been used as propaganda against doctors. Firstly the Chibok girls were kidnapped long before the doctors strike (July 1st, 2014). The other unions (JOHESU) are currently on strike and the Chibok girls remain kidnapped.

Secondly, during all the bomb blasts, the NMA directed all doctors in the affected states to respond immediately and they did. JOHESU is on strike, and bomb blasts are still occurring and Doctors are on ground to attend to the victims. This can easily be verified. NMA may not have called off its nationwide strike but directed doctors to provide full services in all national emergencies.

I admit that there were calls on NMA to call off their strike during the Ebola crisis started in Lagos state and much later in River state while NMA did not call off their strike. NMA directed doctors to volunteer to assist. I ask, who managed the Ebola patients? Was it not the Nigerian doctors?

Doctors were not invited from any country to assist Nigeria? In fact, in my state, Edo state, over 80 doctors volunteered and joined our Ebola response committee. In addition, NMA Edo State made the most significant contributions to the Ebola fight while the other unions did nothing. Edo NMA powered Ebola screening tents, PPEs, sterilizers, infrared thermometers and even published health education books and pamphlets in various Nigerian languages and distributed them to the major hospitals and to the public.

We spent millions of naira on this project and the news was carried by the Guardian newspaper and other national dailies as well as the National T.V Networks. I challenge any other union to tell us if they did anything beyond the normal call of duty like us. All over the country, the doctors were involved in public health enlightenment programmes which assisted in no small measure to effect the behavioural change necessary for the control of Ebola.

Reports have it that healthcare professionals when eventually promoted to directorship, are not given free hands to operate usually because they are not university staff which can be seen as against the law.

Doctors are not against the promotion of any health worker to any grade level. In the Federal Ministry of Health, I don't think there are up to eight directors. Now you are asking for a situation where each hospital will have over 100 to 300 directors.

How? Firstly, almost all medical consultants will have to be made directors because they are on the same salary grade as Directors or Permanent Secretaries. In my hospital (The University of Benin Teaching Hospital - UBTH), for example, there are about 170 medical consultants. Then in every other profession, pharmacy, laboratory scientists, physiotherapist, optometrists etc. you have to make many Directors.

To function properly as a director, you need to create directorates with all the paraphernalia of office and support staff. These Directors will also stop practicing their Professions and focus on administration. Can you begin to imagine the chaos and disservice to the Nigerian Populace? Can Government even afford to fund these hospital Directors in spite of the current economic hardship? Answer is no.

Nigeria and Nigerians will suffer for it. Promote them to any level, but they don't have to be directors. In hospitals, there are only two directorates, one is the director of clinical service who is a medical doctor and the other is the director of administration, who is not a medical doctor.



I must emphasize that doctors are not against any health profession rising to any salary grade. An example is the optometrist who can rise to level 17 and are designated as Chief Optometrist. Medical doctors also rise to level 17 and are designated Chief Consultant. Why can't other health professionals do the same thing and maintain professionalism rather than everyone becoming administrators.

I must let you know that many JOHESU members are our wives and husbands. Many of my best friends in the hospital are non doctors who head other unions and I have an excellent personal relationship with them and we respect each other. What is being portrayed by a few vocal JOHESU leaders is that there is war in the hospital. This is not true. We work together as a team.

There is no discrimination based on profession. In fact many doctors also complain of discrimination. Many doctors feel they are more commonly disciplined in the hospital by their doctor CMDs than members of other health unions. The kind of offences they get away with, doctors will not. Also being a University staff does not confer any advantage to anyone in the hospital.

Omoni dont worry. Your hair is fine, and u look good, why do u have to use her as an excuse to post your pic on if, ? Pa to who sef

Am more worried about Mali, if it enters through the north then that might be terrible.

Op just.delete d first two lines of your post.

NB, Jonathan is worth much more