Prof. Ernst Josef Franzek is a German specialist in neurology, psychiatry and psychotherapy with special interest in Nigeria. In this interview, he speaks about his organisation: ‘Legionnaire for Mankind’s Health,’ passion for Nigeria and brain drain, among other issues. WALE ELEGBEDE reports
Why did you decide to setup Legionnaire for Mankind’s Health?
The population of Nigeria, which is now about 200 million people, is made up of mostly younger, who are less 40 years. This means that life expectancy is far below 60 years. This is caused by many early deaths before age five.
The reason for this is prenatal and early postnatal malnutrition, lack of adequate midwifery and early baby care. Another reason for the high prevalence of deaths before 59 years are diseases which could have been easily treated by a normal functioning health care system. However, proper healthcare is only available for the privileged and upper class people. It is obvious that only the few privileged people in the country have a life expectancy compared to the civilized western countries.
An overwhelming number of people in Nigeria, however, live in poverty or even in extreme poverty with less than one dollar income per day. This means that the great majority of Nigeria’s populace do not suffer from diseases caused by abundance, but in contrast by diseases caused by scarcity like lack of healthy food, lack of clean drinking water, lack of proper sanitation. It screams to the sky that more than 40 million people do not even have functioning toilets and adequate sanitation.
The consequences of this dreadful and inhuman situation are high levels of violence, criminality, insurgencies, child soldiers, mental diseases including addictive behaviours. The problem of Africa is poverty, mismanagement of resources, neglect of the youths and exploitation of natural resources by the highly civilized world. Since more than 500 years, Africa is exploited from its resources; the common population is enslaved with starvation wages and child labour.
The last century’s modern work-slavery took over the place of the ancient slave trading. Charity is often used to cover up crimes on humanity and environment. Legionnaire for Mankind’s Health” is not a charity organisation. Nigeria and Africa does not need charity.
Nigeria and Africa can preserve themselves. What Africa needs is empowerment of its own population. Magic elements of this approach must be respect for the sanctity of every human’s life, free midwifery and primary baby care, available healthy food and clean water, quality education for everybody, free university education for skilled young people, keeping well educated people in the country, making sure that natural resources benefit the whole populace and not only being of benefit for a few privileged and often greedy business organisations.
The status of parents should not determine the life and development of Nigeria’s and African’s children and youths, but talents, skills, ambition and personal effort. These issues should belong to the major tasks of elected governments.
What are the major aims and objectives of this organisation and why do you specifically target Nigeria among other African countries?
The primary starting point of Legionnaire for Mankind’s Health is Africa with a special focus on Nigeria. When I first met Comrade Sunny Ofehe, living in The Netherlands but born in Delta State, I started to immerse myself into the problems of Nigeria. Ofehe informed me about his own story and the exploitation of natural resources through a well-known oil company. My heart cramped and I got constantly thinking about solutions for this great nation of now about 200 million people.
I visited the country together with Ofehe first in December 2017 and then alone in December 2018. I saw the unbelievable contrast of extreme richness and extreme poverty, I saw a country that could be a paradise for its people, but is kept in custody by few selfish and greedy people who are only looking for power and money without respect for basic human rights and the needs of common people. I fell in love with this sleeping beauty and her common people, who are fighting every day for their daily living.
I got inspired by Comrade Ofehe, his deep love and passion for his people in Delta State and his restless activity to bring the state and its problems into the attention of the public. I correlated the situation of Nigeria with the results and conclusions of our studies on the consequences of prenatal malnutrition on somatic and mental health later in life.
I found it conceivable that the consequences of chronic hunger and malnutrition, lack of future for the youth are partly a reason for the high prevalence of violence, criminal and addictive behaviours in Nigeria. We deduced the overall conclusion that criminals, addicted and other mentally ill people must not be the only focus of interventions of governments. However, the underlying problems like lack of enough and healthy food, lack of clean water and adequate housing, lack of midwifery and adequate baby care, lack of adequate sanitation, lack of primary and secondary education, have to be tackled intensively.
As an expert in this field, where do you think the government of Nigeria is failing in their duties to either provide or improve healthcare in the country?
The budgets for healthcare are very low and healthcare institutions are mostly concentrated in big cities. Falling ill is for most people a catastrophe and a fall in even deeper poverty. Suffering from normally good treatable diseases is often life threatening. There are no proper health insurances and if you do not have money, doctors will not treat you.
This means many people die from elsewhere good treatable and preventable diseases. The mortality rate before age five years is about 20 per cent, while in western societies, the mortality rate before age five years is mostly below one per cent. This mean age of the common people is far below 60 years, lowest in the Delta region (about 50years) with its severe environmental degradation as a consequence of crude oil exploration.
A great proportion of doctors who have finished their studies leave the country and start working in the United States, Europe or United Kingdom, because of much better payment and working conditions. Almost none of them ever goes back to work for his/her own people.
In Nigeria, mental healthcare is completely lacking outside big cities. Traditional healers and the church are treating severely psychiatrically ill people. As a doctor who cares for mentally ill people, I feel very sad about this situation.
What is your advice on how we can deal with this situation?
As I already mentioned, this phenomenon is called brain drain. Young doctors leave the country because they find better working conditions and better salaries in other countries. The money doctors are getting for their hard work in Nigeria is not attractive for them. Working in the healthcare sector at all is not attractive, because healthcare has only a low status in politics in Nigeria. Politicians go outside the country when they need medical treatment because they do not trust and rely on doctors and facilities of their own country.
The government must commit increase funding in the healthcare sector and review the salaries and wages of healthcare workers. The starting point should be setting up a committee to review the various purpose of increase brain drain in the country. If the working environment is improved, it will not only lead to decrease in brain drain but will also attract Nigerian healthcare workers abroad to return back to the country.
Will your organisation be working with agencies of the Nigerian government agencies and local NGOs?
Our organization will be working together with both government agencies and local NGOs in Nigeria. Nigeria has to build up her own primary and secondary healthcare system with and for the local people. The aim has to be how to be independent from charity and NGO’s located in foreign countries providing charity. Charity does not help to improve the living conditions of poor people but it keeps them dependent and vulnerable.
Child labour has to be banned, primary and secondary education need to get compulsory, the position of women must be strengthened and forced marriages have to be banned. These are additional areas we shall be offering our services of cooperation among critical stakeholders in this sector. We are hopeful that with the resources and human capacity that Nigeria possesses, the country can achieve the United Nations goal of health for all.
The role of religion has to be redefined when it comes dealing with mental healthcare in Nigeria. The lack of scientifically based treatment of the mentally ill peoples has led to the situation that traditional and religious healers took over the treatment of even severe mentally ill patients. They do their best to improve the suffering of those patients but often worsen their suffering and creating inhuman procedures like chaining up these patients.
It will become a special task to adequately communicate with and educate the traditional and religious healers with modern and scientific based treatment methods. Mental illness is never a punishment of god, or a consequence of devils or witch craft. Mental illness must not be stigmatised but looked at and treated as equally to somatic diseases. The government must embark on public enlightenment campaign to educate the general population on the need to change this general mindset among the people, particularly in the rural areas of the country.