Health

Strategy to contain community spread of COVID-19 defective – JOHESU chair

Comrade Joy Josiah Biobelemoye is the chairman, Joint Health Sector Unions (JOHESU). In this interview with APPOLONIA ADEYEMI, he discusses how ineffective lockdown contributed in the spread of infection, resulting in spike of the pandemic and the provision of fair incentives to health care workers, among other measures to curb COVID-19 Excerpts:

The number of persons that test positive to coronavirus infection is on the rise. Why is this happening?

The Joint Health Sector Unions (JOHESU) will attribute the increasing number of cases to two major factors. First, the National Strategy to contain the community spread of COVID-19 was procedurally defective. I am hinging this on the premise that rather than lockdown only three locations viz: Lagos, Ogun and the Federal Capital Territory (FCT) Abuja in the first instance, the Federal Government should have gone ahead with a total and compulsory nationwide lockdown during that period. It was that restriction to only two states and FCT, Abuja, which encouraged the free shuttles to the other 34 states by some reckless and lawless Nigerians.

Evidence based data confirms that the index cases in almost all the other 32 states where we now have infections were from Lagos State and FCT, Abuja. Community spread would have been better curtailed if we had a national lockdown. However, I give kudos to the frontline health workers who risk their lives to save others in this unfortunate pandemic.

This includes ward maids, cleaners, ambulance drivers, security men who between them evacuate and transfer the extremely dangerous medical wastes as well as samples in the hospitals and isolation centres on the country. I must also salute the courage of the Medical Laboratory Scientists, Pharmacists including those at community level, doctors, nurses and key personnel who have put up a dogged fight to counter the spread of coronavirus (COVID-19). In addition, we should thank the Federal Government and some of the very proactive State Governments, especially the Babajide Sanwo-Olu administration in Lagos State for their sense of responsibility in this war against Coronavirus.

JOHESU’s visit to President Muhammadu Buhari

When the JOHESU paid President Buhari a courtesy visit on February 16, 2020, which was a teething dispensation for COVID-19, we had advised the Federal Government to urgently consider closing the ports of entry via the seaports and airports. For the records, JOHESU was the first organisation that advised the government in this regard. Government probably did not see the wisdom in the admonition early enough and we began our walk into calamitous dimensions before government eventually yielded to our February 16 counsel. You must appreciate that the compressed enclaves in aircraft, offices, cars and others remain some of the most fertile grounds for infections like COVID-19 to thrive. The recent inter-state border clampdown is coming a little late. Unfortunately, the economic and social consequences of the lockdown in Lagos and Abuja took its toll on the citizenry, particularly a wider spectrum of the people who rely on daily income. As it is, it has become a much tougher call, but I know we shall win this war.

Recommendations on reversing the trend?

In no particular order, I will posit that the Federal Government must incentivise all health workers who have a part to play in this pandemic. This is not a time to segregate or discriminate along whatever lines – seniors or juniors, health professionals or workers and similar phraseologies.

Hazard allowances and special COVID-19 benefits must be same to all healthcare staff because the risk factor in terms of exposure is same. I am calling on the Federal Government to extend the recent Presidential compassion, which necessitated payment of the salaries of Academic Staff Union of Universities (ASUU) members who did not comply with the registration on Integrated Payroll and Personnel Information System (IPPIS) to JOHESU members through payment of withheld April and May, 2018 salaries.

The Federal Government has not taken maximum advantage of collaborations with health professionals in the Private Sector. This is very germane in terms of testing with the rank and file of our population. If the USA and lesser endowed African countries allow tests in Community Pharmacies and Private Laboratories, why are we not towing that line? It is worrisome that as at May 8, 2020 we have conducted far less than 25,000 tests nationwide. This might imply that the slightly over 4,000 officially confirmed figure may even be in greater multiples if we were conducting more tests.

What measures do we need to put in place to strengthen the health system in Nigeria?

In building capacities and adequate competences in the Nigerian Health System, one ugly phenomenon that continues to play out in this era of coronavirus pandemic is that Nigeria has failed woefully in the quest to entrench competencies and adequate capacities in its health system. Rather strangely, the country has encouraged a structure whereby the various professions in the health sector grow haphazardly. In Medicine, the training is lawfully grounded at undergraduate and post-graduate levels to run through the tertiary health facilities (Teaching and Specialist Hospitals/ Federal Medical Centres). Other health professions are denied this same privilege by managements of the federal health institutions (FHI)’s in collaboration with the Federal Ministry of Health (FMOH).

While we allow Doctors in our health system to easily specialise through the West African or National Post-Graduate Colleges of Medicine, the Federal Government through the FMOH and the Office of the Head of Service of the Federation (HOSOF) frustrates postgraduate programmes for other health professionals.

The Joint Health Sector Unions (JOHESU) in very apocalyptic terms wishes to recommend some measures to strengthen the Health System in Nigeria specifically. Government at all levels must begin to invest significantly into Primary Healthcare with emphasis on preventive therapy through maximum engagement of Environmental Health Officers. It is a statement of fact that Government at all levels must tinker with their budgets to feature preventive care therapy at the expense of curative therapy.

Government at all levels must create the atmosphere for health reforms, which will focus on maximising the potentials of its workforce. Healthcare is a globally inclined endeavour driven by international best practices. This is why each health professional specialises all over the world.

In the quest to open the restricted borders of progression in healthcare in Nigeria, we strongly urge the Presidency to direct unhindered access of training facilities to all health workers in training at undergraduate and post graduate levels.

The Federal Government must recognise and approve the Consultancy Cadre for Pharmacists and other deserving health workers to improve competencies/capacities in emergencies and other times. JOHESU specially wishes to draw the attention of Governor Babajide Sanwo- Olu to the suspension of the Consultancy Cadre of Pharmacists in the employment of Lagos State Government after same was approved by the State Executive Committee in 2018 during JOHESU inspired nationwide health workers strike. This was only due to the opposition posed to the approval by the Nigeria Medical Association.

We call on Federal and State Governments to improve the manpower needs in healthcare by immediately facilitating the commencement of a degree programme in more universities through the establishment of faculties for the training of personnel in all the cadres in healthcare immediately.

Finally, we call on President Muhammadu Buhari to give needed approval to the clamour of the JOHESU by approving the withheld April/May, 2018 salaries of health workers under the banner of these Health Sector Unions who constitute over 95 percent of the health workforce in Nigeria. In similar spirit, the Federal Government needs to motivate health workers by making available requisite funds to take care of adjustment of CONHESS scale as was done with CONMESS since 2014 in line with terms of agreement consummated since September 30, 2017.

Is it true that the FG has ordered for the acclaimed Madagascan Herbal Tonic to be distributed to states after tests by NAFDAC?

I am not aware of that directive. Ordinarily, one would wonder why the FG would start with a Madagascan Herbal Tonic. It is better to make further enquiries on this matter for informed decision making.

Do you support this?

We have an emergency on our hands right now. Naturally, people want anything that brings a remedy at reasonable cost. Our attitude should be to allow any remedy that has successfully passed through due process of the scientific evaluations/protocol at NAFDAC to be used at this time. So, whether it is a Somalian, Chadian or Nigerien tonic would not really matter for as long as it brings relief without adverse reactions or other negative consequences to a consumer.

What is your take on Prof. Iwu’s claim?

It is still in the same realm as the last insight I provided. Prof. Iwu’s claim was one of those I referred to earlier. Iwu is an internationally acclaimed researcher, so he is more familiar with this terrain than I am. Science is about facts and not magic like some will like to relegate it to become. It is on this note that I am encouraging all researchers in herbal medicine to subject their formulations to clinical trials for eventual registration for use.

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