Nigeria is a populous nation of about 150 million people. This country occupies a landmass of 923,768 sq km. She is blessed with abundant natural resources but sadly ranks as one of the poorest nations of the world. The average Nigerian lives below the poverty line. Corruption, greed, years of military rule, unstable economic polity, lack of political will, poor planning are some of the reasons why Nigeria remains poor.
The health sector is not spared. The health indices are poor. A 2003 estimate puts Nigeria’s infant mortality rate at 71 per 1000 live births and life expectancy at 51 years. In 1993, there were 5,208 persons per doctor and for many years, less than 3% of the GDP was spent on health care. Infectious diseases remain a major problem and preventive measures are rudimentary, almost non-existent. Public health institutions are mere spectacles of what they should be: most are under-staffed; the out of stock syndrome is rampant; health workers embark on work to rule campaigns incessantly and many health centers are death traps.
The need for alternatives, for other viable options to the existing health care framework was borne out of necessity, out of the quest for survival. There was no intention to compete with public health institutions. Faith-based health institutions provided that viable alternative to rescue the masses from the doldrums prevalent in the nation’s healthcare system.
The ECWA (Evangelical Church of West Africa) medical directorate (EMD) has for many years provided quality healthcare to the ordinary Nigerian. It is a beacon of hope to many. It is a well-planned department of ECWA intended to be efficient in healthcare delivery. It adopts a holistic approach to the care of the person. Thus the recruitment process to the leadership of the EMD is a very thorough and competitive one.
The director of the EMD reports to the leadership of ECWA. He has several deputy directors reporting to him. These deputy directors head various health organizations run by the EMD. The EMD anticipated the problems being encountered by the public health institutions and set out to serve as a model that will bring sustainable healthcare development. Several consultations were made. Existing health policies were critically examined. The reasons for successes and or failures of several health programs were debated. A common standpoint was reached. Several departments were set up to meet different needs.
The School of Health Technology was set up to train community health extension workers. 55% of Nigeria’s populace lives in rural areas with significant health needs. Graduates from this school are trained to meet these peculiar needs.
The ECWA Community Health Program is spread through many states of the federation and is made of primary/secondary health centers. This program often traverses very difficult terrain to bring healthcare to the grassroots. It is a ready employer of graduates from the School of Health Technology.
The ECWA Evangel Hospital is a center of excellence for residency training in family medicine. There are several consultants (local and foreign) in different fields of medicine who facilitate this training. This hospital also serves as a referral center for many hospitals (including government teaching hospitals) in northern Nigeria. It is at the moment undergoing transformation to become the Bingham university teaching hospital.
The Vesico-Vagina Fistula (VVF) center is located within the Evangel hospital premises. It is one of its kinds in the country. It was borne out of necessity as many women develop fistulae due to a complex interplay of several factors. According to a retrospective study done on 899 women with obstetric VVFs in this center (check American Journal of Obstetric and Gynecology, 2004, April), the typical VVF patient was small and short; had been married early but was now divorced or separated; was poor, uneducated and from a rural area and had developed her fistula as a primigravida during a labor that lasted at least 2 days and which resulted in a stillborn fetus. This center has significant overseas sponsorship and the latest technology and expertise are employed in the repair of the VVFs of these helpless women.
The Family Health program is sponsored by the Packard foundation. It seeks to provide viable options for the family as a whole. It trains health workers and collaborates with many health institutions especially in northern Nigeria. It aims to reduce maternal morbidity and mortality especially in northern Nigeria. It organizes training workshops for emergency post-abortion care, seminars on family planning, universal precaution, cost-effective ways of managing sexually transmitted infections and so on.
Christoffel Blindenmission (CBM) supports the ECWA Eye hospital, Kano. It is a large eye referral center sited in the second largest city in Nigeria. There are consultant ophthalmologists and others, who help dispense health and train doctors from Nigerian universities undergoing their fellowship training, theater nurses and primary eye care personnel. World-class surgeries are done here. It is a resource center for many eye care projects spread throughout the West African region.
The School of Nursing and Midwifery supplies well-trained and much-needed nurses to the depleted workforce.
The ECWA Hospital, Egbe, also serves as a center of training for family medicine. It has for a long time collaborated with researchers from other Nigerian university to carry out groundbreaking studies. It provides affordable quality healthcare to people in its community.
The EMD has other subsets, which has for a long time been serving the people.
The EMD is involved in several collaborations to achieve its objectives. There is no disconnect with other institutions. It collaborates with the WHO, UNDP, the Packard foundation, EngenderHealth, the Netherlands TB and Leprosy program and so on to bring quality healthcare to Nigerians.
The EMD is not alone in its quest to provide sustainable healthcare development. There are other faith-based initiatives that aim to serve this purpose. This pool of faith-based health organizations provide succor from the turbulence experienced in healthcare delivery in Nigeria.
The lack of space will not allow us the luxury of elucidating the impact the EMD has made on the ordinary Nigerian. The results, however, as overwhelming as they seem, have not made EMD rest on its oars as new opportunities to influence the health polity are continually being sought after.
We present our example. We present this viable option for developing countries.
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