Health & Education

The Wonder of Nigerian Silence and Playing to the Gallery -By Loretta Oduware Ogboro-Okor

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There are certain phenomena that in both the ancient and modern times, have been termed the wonders of the world. Some of us must have heard of the seven wonders of the ancient or the modern world. Whereas the numbers do not matter, their relevance however, may differ and hold different meanings to people depending on locale and socio-eco-cultural priorities. Nonetheless, one thread consistently runs through and true with all these wonders. Their common factor is that they astonish the mind!  Be they the Great Wall of China, the Hanging Gardens of Babylon, the Ancient Pyramid of Giza, the Moat of Great Benin Kingdom, the Colosseum of Ancient Rome, the Statue of Liberty, Man landing on the moon, Victoria Falls or Robotic Surgery, you will agree with me that they astonish the mind.

Recently, in our evolving world, certain astonishing events are occurring and becoming the norm. The fact that these things are occurring is not so much the problem, it is the phenomenon that they are becoming the norm that is astonishing! So astonishing that one can class this as one of the wonders of this world today! It is the situation where “rulers” or “heads” of institutions, cannot take responsibility for their actions plus or minus the goofs and failings in their area of jurisdiction. From my adopted country in the United Kingdom (UK) where the Prime Minister(s) could not take responsibility recently to my home country Nigeria where the unelected wife of our President is apologising for the shortcomings of Governance while our number one elected citizen keeps mute.  While the people in the United Kingdom refuse to accept this as the norm – something evident from how the door of Number 10 Downing Street has become a revolving door, sadly, my people in Nigeria are still deciding if to un-normalise our mis-norms!

Over this past weekend, I encountered a phenomenon that astonished my mind, and I am sure it would astonish the minds of many other people. A situation whereby a supposed leader of the people cannot take responsibility but rather, gaslights the sub-sect of his people seeking solutions and places the faults at the feet of those he should be responsible for. More astonishing was that the audience, who on the altar of politeness which the aforementioned individual has no clue of anyway, was sat in dignified docility, normalising his attitude.

This weekend, I was one of the panellists at an annual gathering of Nigerian Healthcare Professionals across Great Britain. Present was one of the “heads” of Nigeria’s healthcare professional regulatory bodies. In my opinion, he is unfit for the appellation of “lead” and you my dear readers are free to decide otherwise. The event was a timely one, that was seeking collective solutions to some of our major challenges as Nigerian providers in healthcare and our healthcare eco-system across borders. It was all going well, until the introduction of this almighty “head” of one of Nigeria’s professional regulatory bodies was made.

Immediately, he gets on his feet, begins to point his fingers at all of us and make his own perceived points at the top of his voice to the discuss thus far, throwing “his own LED light” on the issues. His sentences from start to finish and his non-verbal communication poise begins to burn a hole in my brain and thought processes. He begins by stating that since we have all been speaking, only one person made a point of starting the overhaul from the basic training schools of healthcare professionals in Nigerian Universities. I made an excuse for him in my mind that he probably arrived late and did not meet the earlier part of the discuss where other persons had also spoken about their works in some Nigerian Universities. However, I have since gone back to watch the recording of this event – and this man was there!

Next, he comments that he does not know who or what is pursuing healthcare professionals out of Nigeria to suffer the challenges of maltreatment in the UK and other resource rich nations. However, now that some of them are having problems in the UK, that is not to say, the Professional body he heads will not try to help. In my mind, I am glad that at least, he is professional enough, to acknowledge his obligation and that of his organisation’s to help. He goes on to state how he has utmost evidence that Maiduguri is the safest place in Nigeria. That he goes there every other week and that those of us in the Diaspora should not believe all that we hear in the media. In my brain, that was a non-issue. He can make his own informed decision and make his bed in Maiduguri, North-east Nigeria for all we care; after all, I have great friends that reside there with accommodation to spare. He goes on to brag a lot more at the top of his voice, to a stunned very polite “oyinbonised” audience. Then, he hit my raw nerve: he stated, that the issues with healthcare professionals from Nigeria, lacking certain core skills and competences when they arrive in the UK or other resource rich nations with proper modern day healthcare standards was their “individual” deficit/problem. The skill and competence in question at this point, was doing, understanding, and interpreting within the patient’s clinical presentation context an ECG (Electro-cardiogram) used to check the hearts rhythm and electrical activity. From his statement, it can be inferred that doctors from Nigeria who cannot perform and or interpret the ECG did not attend classes, did not apply themselves to the process of learning the skill when they were being taught.

God have mercy! I looked at my fellow members in the audience. They had “British smiles plastered across their lips” while this man was “speaking at us” with an assumed confidence, at the top of his voice “Nigerian politician style”, chanting what was not true. Astoundingly, here was someone, who was supposed to be the solution finder, denying that there was a problem at all. Here was the head of a healthcare regulatory body in Nigeria, not admitting first to himself that input in terms of overall training determines output of skills and expertise. One key to problem solving, is to first do an unbiased root cause analysis, devoid of emotional attachment to identify the problem and then, as a team, begin to work to find domesticated solutions. It was clear this man must have thought he held a spell over some of the most brilliant minds from our country – otherwise, why would he contort the truth?

At that moment, I decided that my fellow audience may have stories different from my own real-life experiences determining how they respond. However, I was not going to sit there and allow the truth to be nailed on the wonderful cross of Nigerian silence. I was going to speak up because I could not stomach the gallery of civility response to the provocative stimuli before us. I know that I never saw an ECG machine when I attended the University of Benin (UNIBEN) and trained at University of Benin Teaching Hospital (UBTH). I had a certain bald lecturer who was supposed to be a guru professing the concept of ECG throw some didactic lectures on this subject matter my way at the time. Whether I understood what he taught me was another matter. At some point down the line, an ECG machine appeared in UBTH when I started my Houseman year. However, it was locked in a special room, I was considered neither important enough to use it nor was I privileged enough to see some more important people utilise it. Suffice it to state here without any equivocation, the truth which is that I first learnt to do an ECG, saw the actual paper tracing, and understood the principles when I attended preparatory classes for my UK medical licencing exams in London.

Fast forward to modern times – that is if we are to postulate that I attended school in ancient times in Nigeria. Only a couple of weeks ago, one of my old Professors attended the UBTH emergency centre with chest pain. Thankfully, there was now an ECG machine and he had a tracing done. My dear readers, hold your breath because there was no ECG tracing paper. How do we train people against these backdrops described? Again, my dear readers, if a doctor from this setup, I have described above cannot do or interpret an ECG tracing, is it the individual doctor’s fault or is it that we have a systemic problem that needs to be addressed as soon as possible? For not just the sake of the doctors and other healthcare professionals leaving Nigeria in their droves, but more importantly, for the sake of the Nigerian Patients who are worth it, we must call a spade a spade and not an instrument for abrading the surface of the earth. Sadly, here we were, this past weekend, watching a Healthcare Professional Regulatory body head from Nigeria, telling us, in the hitherto described audience, that the problem was that of the trainees/students.  On the altar of politeness, the audience without knowing it, were norming this phenomenon. Their silence was validating what my mind found astonishing. This was a new world wonder!

I could not take it any longer. I had to let this demi-god know that his denial approach, his economy with the truth and his gaslighting of the people is not where the solution lies. It did not make sense to me, that all of us should employ the “British method”. Some of us know that sometimes, an equal and opposite reaction is needed as postulated by the laws of physics. I told the man, classical “Nigerian style”, that the problem is a systemic one with symptomatic manifestations being what we are seeing now. He screamed and I screamed! Behind the sanctuary of his locked doors, let him look himself in the mirror and reflect on his statements this weekend. Hopefully, he learns from the incident that there is a growing critical mass of Nigerians who have evolved, who are making sacrifices only each can relate with and are not ready to norm the wrong which is our approach that trivialises value for human life at all levels. For some of us, the immediate wonder of the world we seek to manifest now, is a revamping of our Nigerian Healthcare system. Where amongst other changes we must make, are radical, far reaching progressive reforms of our regulatory institutions because, the healthcare providers making sacrifices despite all limitations in Nigeria and the Nigerian Patients are worth it.


Dr Loretta Oduware Ogboro-Okor is Author of the Book My Father’s Daughter

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