I was in the United States of Nigeria recently and I felt that I needed to go to the clinic. My sister inlaw booked an appointment. When I arrived, I was warmly 
received by a receptionist who gave me a form to fill. He was neatly dressed and after collecting my data, ushered me into a room. Soon afterwards a lady walked into the room to take my vital signs- blood pressure, pulse rate and temperature.This healthcare professional who I got to know was a nurse was decently dressed in a white over coat. But at first he could have passed as a medical doctor. He asked me a few questions and got me ready to see the physician. A few minutes after, the medical doctor also walked in wearing a white overall. He took his time to examine me, asking questions . At some point, he asked me to undress for a thorough physical examination.  Then he left. Thereafter some one I suspected must be a health technologist walked in with an ECG machine and  strapped some wires on my chest. When he finished, he left and the medical doctor returned to discuss the ECG readings with me. Afterwards, the doctor requested some laboratory examination and  I was escorted by a nurse to the Lab. My blood and urine samples were taken by a medical laboratory scientist. He told me to come back and see the doctor in two days time.
On my return, I was again courtesy ushered in to a waiting room. The doctor whom I had seen two days earlier reviewed all the test results and wrote out a prescription. Then he asked me “ what is the name and code of your Pharmacy?”. I asked why and he said, he was going to remit the prescription to the Pharmacy, so I would go and fill the prescription at a Pharmacy. I then told him I was not resident in the USA and would rather fill the prescription when I returned to Nigeria. He insisted that I must begin to take some of the medication immediately while I begin the others when I got back. I agreed and suggested If he could let me have those medicines from the clinic. He said he I could only get any prescription drug in the Pharmacy in town or the Pharmacy in a hospital not from the clinic or elsewhere .I was impressed as thiscontrasted with the situation in my country where you can get drugs ( prescription or not) from anywhere- open markets, kiosks, moving trucks and all manner of clinics and health centers 
That was not just what pleased me most. I was thoroughly impressed by the harmony that existed within the healthcare team. Everybody knew his job, respected each other and kept in their lanes. They all looked happy, contented and proud of their professional duties. And all these worked in my Favour- the patient. Again this seems to contrast with what happens in my Country. I really do not know how it all started but there seems to be so much acrimony within the healthcare team in Nigeria. Thisacrimony came strongly to the fore during the recent health workers strike under the auspices of JOHESU. What was meant to be a protest  by public sector health-workers against their employers - Federal and State Governments turned into a war between Medical doctors and the other health workers- Pharmacists,Medical Laboratory Scientists, Physiotherapists, Nurses,Midwives and Health Technologists. I could never understand why the gain of one group should turn to be the loss of another group. Is it not possible for the gain of one to be the gain of all. I am pleased that the leaders of the different professional groups are working hard to restore the relationship and I commend them. For me we must ensure that this does not happen again. Since healthcare is a team operation, it is not in the interest of the patient for some to he happy and others sad. A demoralized team member can ruin the good work of other team members. It is in pursuit of this objective of restoring inter-professional harmony that  I offer the following suggestions
First, the current practice of having a particular professional group head hospitals must be reviewed. Leadership of institutions is a competency based activity. To make it a birthright of any particular professional group is not fair to all. Let the most competent or most senior professional head the hospital or the establishment. That is what happens in every progressive organization. The best leads! Peace is elusive where there is lack of justice and fairness. It is appalling and almost sounding like apartheid policy when a 5 year old medical doctor becomes the boss of 20 year old Pharmacist for example in a hospital just because the hospital must be led by a Medical officer. Everywhere in the World that a ceiling is placed on the growth or advancement of one group and another is allowed to advance, there will always be discontentment that eventually leads to rebellion. See what happened in America in the days of racial discrimination or in South Africa due to the apartheid system!Alternatively we should return to what used to operate in our days in the hospital. There was a director of Administration who ran the administration while the professional groups had their heads and ran their clinical services without any problems.This made for more harmony among the healthcare professionals. The change in the nineties or so that dislocated the old system bequeathed to us by the British has effectively dislocated inter-professional harmony in our healthcare systems and must be revisited if the much desired harmony must be restored.
Similar to the above is the growing practice of always making medical doctors Ministers of Health and as is so often, the two ministerial positions including minister of state for Health are assigned to medical doctors. Ditto for States where it is almost becoming an article of faith that Health commissioners must be Medical doctors. This is breeding professional arrogance on one hand and on the other hand professional jealousy. Way back, some of the best health ministers we have had were not medical doctors and some like Chief Ugwu in the first Republic were not even healthcare professionals. In recent history, the likes of Professor I.C. Madubuike, Prof ABC Nwosu and Professor Eyitayo Lambo were not medical doctors and during their tenures, professional harmony soared among the healthcare professionals and many left great landmarks. In 1993 when Prince Julius Adelusi- Adeluyi, Pharmacist was secretary of Health for only a few months, he left enduring legacies . So if we must make health professionals ministers in the health ministry, we should rotate it between the different health professions and specifically, we must never make the two ministers come from the same professional group. It is a patently unfair practice.
Thirdly, welfare issues for healthcare professionals should be taken together. The existing dichotomy must be removed. In my days as a pupil Pharmacist I was employed on Salary grade 8, step one and my house officer colleagues were started on grade level 8, step three. And when we had any issues with the hospital administration, we presented our cases jointly and we rotated leadership amongst ourselves, looking for the most competent, blind to our professional groupings.But somewhere along the line, the medical doctors were removed and placed on a different salary grading while the rest of the healthcare professionals were left in another salary grading. This was how the seeds of suspicion and disharmony were sowed. There is no where else in the developed World that this dichotomy exists. To be true thisis the major destabilizing factor in the healthcare team. No body is proposing  that the salary or allowance of any group presently enjoying advantage should be reduced, rather the gulf created between one group and others should be reduced. I do not see how this causes any loss to any group but I see it helping to bridge the current subdued differences and resentment.

 I must conclude that in making the above suggestions, I sincerely do not have any prejudice against any group. I am a very concerned Nigerian who wants our health care professionals to work in harmony for the good of the patient and the improvement of healthcare in Nigeria. The unrelenting poor rating of Nigeria’s healthcare may not be unconnected with this simmering animosity and disharmony among our healthcare professionals. Even the worsening medical tourism out of Nigeria May have its roots in the enthronement of a patently unjust system of compensation and rewards in the health care team.

I call on well meaning healthcare professionals to join me in this crusade to restore inter professional harmony in our healthcare team, keeping in mind the following wise sayings: Injury to one is injury to all; 
Do unto others as you will like them to do unto you.; Where there is no justice and equity, there will be no peace. May God help us to heed this appeal 
Mazi Sam I. Ohuabuinwa OFR


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RACISM, ETHNICITY AND TRIBALISM .... What's the difference?

THE GROWING MISERY INDEX OF NIGERIANS AND THE SEARCH FOR GOVERNMENT Nigerians readily point out what Governments ought to do which they are not doing. Indeed, virtually every problem in Nigeria is blamed on the government. And for many Nigerians, the government to be blamed often is the Federal government. Many are oblivious of the other tiers of government, especially the local governments. It is as if the local governments have no responsibilities or may be the people have come to expect little from them. The many years of over centralization fostered on the Nation by the military now makes most Nigerians think and act as if the Federal government is the only government in Nigeria. The 1999 Constitution sustains this misnomer by granting the Federal government a long exclusive list and the freedom to dabble into every other matter, some of which should better be left with the traditional councils in the states. This has led many Nigerians to allow the local and State governments get away with With 'blue murder' while holding only the federal government to account,even if feebly. While it is justifiable to blame government for poor infrastructure, poor education, poor healthcare, high unemployment, high insecurity, and even for hunger, corruption and traffic hold ups, it is beginning to look to me that this is an orchestrated ploy by some Nigerians to take a permanent flight from being held responsible for our individual and group conducts. In the first place, the governments we blame so frequently for failing us are run by Nigerians. Indeed the irony is that some of those who blame government for everything are in government themselves! Sometimes, it looks like that there is a mystery man called 'government'. But no, government is no mystery man, but a collection of persons who are first citizens and who run the government on behalf of and for the good of all the citizens. For convenience, they are grouped into the EXECUTIVE, LEGISLATURE AND JUDICIARY. And that includes politicians, civil servants, public servants, professionals and non professionals of all cadres and categories; from cleaners,security men and permanent secretaries to ministers; from legislative aids to the House Speaker and Senate President; from the court bailiff to the Policeman, to the Registrar and to the Supreme Court Judge; from the gatemen to the Director Generals of Parastatals and Agencies, they are all constituent parts of the government, agents of the State. And that's why they are paid from the tax payers money.Every action, each one of them takes or omits to take reflects on the effectiveness or in effectiveness of the government they are part of. But it looks to me that this realization does not exist sufficiently. Some how, you get the impression that the President or the State Governor alone is the government and everybody else is either the governed, observer, bystander, supporter,complainant or critic. Perhaps this may explain why there is a woeful failure of the"government " to satisfy the expectations of Nigerians. It is practically impossible for only the President to satisfy the 170 million Nigerians or the Governor to satisfy all the over 12 million people in Lagos for example. Everywhere you go,you meet people who work in the government institutions who act as if they care very little about the success or citizen perception of the government they serve in. When you complain about the poor service you are getting,the same people who are part or agents of the government turn around to blame the 'government', absolving themselves of any blame and often the complaining citizen seems to either agree or empathize with the government employee that the problem is with the mystery ' Mr Government ' Early this year, I wanted to make a trip to the United Kingdom and applied for the UK Visa. Few days after submitting my visa application, I received a call from the British Embassy that there was no space left in my passport to affix the visa. I quickly collected my passport and ran to the passport office in Ikoyi Lagos to get a new one. It took me six visits to the passport office over a period of six weeks to collect a new passport.Reasons ranged from missing file to long queues, mismatch of finger prints, the absence of the engineer and late approval from Abuja. It was an ordeal. Mean while I missed the trip to the Uk and was almost missing a trip to the USA because my subsisting US visa was in my old passport which had been 'quarantined' in the passport office. At the end of this rigmarole I was still expected to show 'gratitude' In August last year, I went to renew my driving license and I was told to fill out forms and make payments. Thereafter I was asked to come back one year after in July this year at the FRSC camp in Ojodu, Lagos for what they called 'capture'. I wondered why it would take a year to come for the 'capture'. I was told that many people were on the queue and their 'capture' equipments were few. I was told that a photocopy of my form on which the July date had been written would serve as my temporary driving license until that date. I shook my head and left. On the assigned date and at the stipulated time of 7am, I arrived. First, it took a lot of pleading to let me drive in through the gate. With one year scheduling, I had expected few people but was shocked by the large crowd milling around the place. I moved from place to place and after several hours when I arrived in front of the 'capture' machine, I was told that my name had not dropped. 'From where ?' I asked. I made three other visits over a period of five weeks, because either, my name was still traveling from wherever to the 'capture' machine, or because there was no 'network' to capture me. I finally got another temporary driving license. And so I will have to return to Ojodu in 60 days when it expires or wait to be called to come and collect the permanent driving license when it is ready and who knows how many more trips that will take, because I saw People who had been called to come and collect, and they came, only to be told that the license was not yet ready. I do not know of any other country in the World where citizens are subjected to this kind of torture just to obtain a driving license. When my son-in-law heard my story, he sympathized with me because he went through an 'agent' and got his with ease! I suffered the same fate in trying to renew my plate numbers as demanded by FRSC. I have completed my registration for the National Identity card at a special unit set up by the National Identity Commission at an interaction in Lagos. I was given a temporary National Identity card. I do not know when I will get the permanent one. Now I have been asked by the Central bank to go to my bank and obtain another Universal identity card. I do not know how many trips I will have to make to obtain a temporary card before I struggle to get the permanent one. I will still go for my voters card and do biometrics and for my Pension, another set of biometrics and identity card. How many Identity cards is a normal law-abiding Nigerian expected to carry?.Why the National identity card can not suffice for all these is what I am asking. I am searching for Mr Government to ask him, because that is what I am asked to do. Can't these government agencies and officers who are asking for these many identity cards share information ? Or is it the fault of Mr government ? Why do we relish in making life difficult for fellow Nigerian citizens and then blame government. Any where Nigerians are to receive service from a government agency, the story of misery and denigration of human dignity is repeated. Who is government? What can be the problem? Is it a matter of lack of a compelling vision, or lack of motivation, or lack of empowerment or plain lack of commitment. What ever it is, I believe that something must be done urgently and in a holistic manner to remedy this anomaly which is creating a lot of problem for the citizens in Nigeria. The unnecessary suffering to which Nigerians are subjected to at every point can not continue this way. What is worse is that the pains intensify when people are doing their best to obey the laws and be responsible citizens. This backlash may seem to promote deviant behavior or corner cutting. Some are 'compelled' to 'settle' police on the highway than go through the torture of trying to get a driving license. All those who are part of government at all levels will need to undergo a fresh orientation to make them understand that point, that a chain is as strong as its weakest link. That Government is not about a single person but a chain of persons who deliver service to the Citizens and that the best President or best Governor will achieve little if all other parties are not playing their roles with the same efficiency and consistency. The leaders of our Governments must therefore take appropriate initiatives on building this consciousness in all persons in government. For empowerment and motivation, the leaders must ensure proper skilling up and motivation of all those involved in the governance process. The right persons must be put in the right positions to ensure the integrity of the chain.For commitment,the leaders must demand evidence of performance down the line. This must be measured and rewarded so that the unskilled for the assignment, the unprepared and the indolent are weeded from the system, so that the impact of good governance can be felt by citizens leading to improved quality of life and the reduction of the misery index. It seems this is perhaps the most critical responsibility of the leaders of the different tiers and arms of government and may actually be the differentiating characteristic of the effective government leaders. Sitting at the capital and hoping that all the 'beautiful' policies, projects and programmes are yielding the desired result will not do. If those who are part of government are blaming the government,one can then understand why some other Nigerians make a past time of blaming government for every problem. If the gutter overflows, it is the government that must be blamed and nothing to do with the citizens who throw pure water satchets and sundry rubbish into the gutter. When the road is blocked, it is the government and nothing to do with the indiscipline of citizen drivers who refuse to give way to each other. In those Countries that we admire and aspire to be like, most Citizens regulate themselves and accept responsibilities for the good order of the society, thus allowing the regulatory enforcement agencies to effectively contain the few deviants. If everybody is a deviant, no government can effectively manage public order. That is my point and it does not in any way absolve the government in power from its statutory responsibilities. There is a role for the government and there is a role for the citizen. Any dereliction on either side will create problems for the society, just as we are having,Period. Mazi Sam Ohuabunwa OFR