Tuesday 19 January 2016

INTERVIEW: Akpabio, 20th Anniversary Hospital & I - Dr. EmemAbasi Bassey

Dr Bassey
Dr. Emem-Abasi Bassey is the immediate past Commissioner for Health in Akwa Ibom State. He is a Medical Doctor and a lecturer in the University of Uyo Teaching Hospital. In this interview with THE INK crew, he speaks on some fundamental issues affecting the health sector in the State, highlights his achievements while he served as Commissioner for two years as well as reaffirms his support for the Peoples Democratic Party (PDP) and Governor Udom Emmanuel. Enjoy the excerpts! 



Sir, after leaving office as a commissioner, how has it been so far?
Well, first and foremost I will say that I am very grateful to God for the privilege he gave to me to have served as a Commissioner in Akwa Ibom State Executive council because when you look at the population of Akwa Ibom people, you will realise that so many people are qualified to serve as a Commissioner. So for me to have been singled out by the immediate past Governor was a privilege, so I thank God. And also I will say that from the first day I got into office, I knew that one day I will certainly leave so as a person I started preparing myself so that it would not be a shock and as a professional, it was very easy to return to my professional life.
It is about seven months now since I left office and I have had enough time to rest and also to reflect on a lot of issues. It was barely a week after the dissolution of the State Executive Council that I returned to my primary employment which is the University of Uyo as a lecturer after being on leave of absence. Although I took a leave to travel so that I can try to rest and also during that period of time, I also try to develop myself so that I can get back professionally. I have gone for courses outside the country trying to fix myself up especially since I had not lectured for a long time when I served as a commissioner, so what I missed as a professional when I served as a commissioner, I got it back after my commissionership days.  But politically, I’m still a member of the Peoples Democratic Party (PDP) family; I’m still a supporter of the current administration and in whatever capacity my services are needed, I will be very willing to assist.                 

What are those spoils of Government that you are missing?
Let’s be very honest, it was hectic. At times, it was as if life was a blur; you wake up in the morning, you leave your house you don’t know when you are coming back and you have to catch some important activities especially His Excellency’s appointments and all that. I was a Commissioner that believes on hands-on. I was on the field almost on a daily basis, I will have to go out to see something and also do something. I would say one of the things I miss is that activity because currently to be very honest, I don’t think I have enough things to fill my free time, I think I have too much free time. Well, the other part of it is that it’s always nice being a Commissioner but then it comes with a lot of stress too as well as a lot of responsibilities. People then who are your friends will feel upset if they invite you for something and you don’t show up irrespective of the fact that you already had other things to engage your time. Nobody bothered whether you have another engagement or not. So I will say it was a nice experience and I am grateful to God.

What were the challenges?
The challenges I had; one I came in towards the end of the administration, the last two years. By the time I came in, there were a lot of challenges on ground in the health sector. Let me start by saying that first and foremost, there were challenges in terms of infrastructure. If you look at the health sector now, you have to understand the way it operates. There are three tiers of health; we have the Primary, Secondary and Tertiary. At the State level, we are operating basically the Primary and the Secondary. The Primary Health Care level is basically under the Local Government administration and unfortunately, I will say that it has been totally neglected by the Local Government administration. So the Primary Health System is actually a very major challenge, it was totally run down. Now the second major Health Care challenge I think was a problem of facilities, I looked at ensuring that all the Health Centres have their own facilities and a lot of that because a lot of these health facilities were run down and some were dilapidated. It was always a major challenge to ensure that it was functional. Then another challenge we had was in terms of training schools. By the time I came on board, almost all the ten schools under the Ministry of Health; four Schools of Midwifery, four Schools of Nursing and the School of Health Technology as well as the School of Psychiatric Nursing, most of these schools had lost their accreditations for training, they were not admitting students so it was really causing a lot of man power gap and others were over due for accreditations so that was other challenge. Another major challenge we had in the Health Sector was man-power. If you look at the recommended level of man power, the level of staffing and unfortunately we were not having recruitments. Recruitments in the health sector should be dynamic; one, the total number of hospitals you have, you have to employ more people and as people were retiring, more people should come, so at this point, I believe that especially the nursing staff, it was terrible. Imagine when you have 400 people leaving the service and you are not bringing new ones. Already we were having a challenge of man power and then we did not have enough doctors, pharmacists, radiographers and so on so that was another very major challenge we faced in the health sector.

Cuts in...But we have people graduating from these fields?
Yes, but it was an issue for recruitment, when we talked about recruitment, one of the things we tried to do was that of man power in the health sector because at that time, we had those issues of man-power, but I would say overall, the major challenge we probably would have had was that of financing because we came in at a time there were very major short falls in the revenue of the state and already a lot of expenditures and a lot of projects were already going on in the State. The most interesting part is that health sector is not a revenue generating sector but is all about providing services to the people. The truth is that no African Government can spend what they ought to spend to achieve certain MDGs target, they would be expecting to spend at least 16% of their expenditures but in Nigeria we are talking about 4 or 5%, already we were not even spending what we ought to have spent. I would say those were some of the challenges. And again, other challenges have to do with the mindset of the people for whatever reason. I would say motivation was very poor at the point amongst the staff, people will come to work late and not even like that, so a lot of things had to be done; so in a nutshell I would say those are some of the challenges I faced. But I thank God, I was able to surmount them and the Governor then His Excellency Chief Godswill Akpabio was very cooperative and supportive.

Sir, if you are to give in  percentage, what will you tell us was the degree of the percentage of your achievements in the Health sector and at what percent did you leave the Health sector of Akwa Ibom State?
The truth is that we never did any baseline before I could say this is the percentage I met and left. We never did any baseline, but by and large; one of things I tried to do, I sat down with my management team and then try to outline my vision; It wasn’t as if I came to do anything new, there was already a National Health Plan and based on that, we had Akwa Ibom State Health Development Plan, it was basically trying to see in all these areas what are things that we feel are achievable, that was what we tried to do and I tried to make them share in this vision. So in effect what I always did was that we brought in a programmatic approach to management because we set target for ourselves as a Ministry and Health Sector and at the end we tried to ensure that we met those targets and we tried to have certain indicators to measure; for example; what and what did we achieve, at the end of the day I will think, if I have to sound modest, I would say based on what we met and based on the available resources that were available to us, I would say that we did a lot above average.

Would you agree on the postulations of your kinsman and your immediate successor who had said that he inherited poor and dilapidated health sector in Akwa Ibom State?
You see I think he was misquoted and or quoted out of context. I have had an interaction with him after he made that statement and I think he was misquoted. Now to be very honest, remember that earlier on, I have told you about the challenges we had. We had these challenges but what you must know is that to fix these challenges is not something that you do in one day. In fact, the challenges are not something that you do in four years because when you look at the area of things that you have achieved, I would even say that when I came in that I met total dilapidated heath sector, I cannot say that because if I say that it means that I do not appreciate the effort of my predecessors in office, they all tried but they were limited. But as a Commissioner you do not have a vote (money), you have to go to the governor and if the money is not available or was not budgeted for it cannot be approved except on very serious emergency issues. So you cannot blame the sitting Commissioner or your predecessor to say this was done, what you need to do is to see during his or her tenure of office, what and what was achieved and what is left and then you would now work on those ones. To be very honest, I’m just thinking that maybe he meant that he met the health sector that was not optimal and I will agree because even as at the time I left, there was so much to be done. Because if I came into office in the last two years, and I realized that I could not do everything and so what I did was that I actually had to choose those things that are realistic and then while trying to maintain clinical services. But then, it is not by words that things are changed, change is a conceptual action which you need to have the appropriate advocate, mobilize resources and also implement policies.

Tell us your achievements as a Commissioner in the Ministry of Health?
Remember I told you that I set a target for myself, when I came on board we tried to do an assessment on some of the things that were wrong, remember that the mandate of Ministry of Health is not just the provision of health, but about health policies; which is the provision of services and training.
 So what we looked at was these systemic areas. First of all, let me start with infrastructure; during my tenure, we were able to upgrade three of our hospitals. When I say we, it means some of those things were done with the little resources we had in the Ministry. We upgraded Immanuel Hospital, Eket, Ikot Ekpene General Hospital and General Hospital, Iquita Oron. On-going projects that started before I entered office, we tried to ensure that working in close contact with other various agencies and the Ministry, they are completed. We brought in a lot of equipments and tried to make them functional. A hospital is not all about having equipments but making sure that there are functional. So we brought in specialists and we tried for the first time since the creation of Akwa Ibom State to get accreditation to train House Officers. That was done under my time, to train House Officers in Eket, Ikot Ekpene and Iquita Oron, the programme was a huge success.

Cuts in...What happened to Hospitals in Uyo, no government attention?
Uyo doesn’t have a State Government owned Hospital. Some public Hospitals in Uyo are owned by the Catholics, there are not owned by the State Government. Although some of the hospitals were owned by the missionaries but they handed over to government except the Catholics that did not handover. Then again; we also tried to ensure that in terms of infrastructures, if you go to Infectious Disease Hospital in Ikot Ekpene, (IDH) the hospital is one of the oldest hospitals in the State, with the little money we got from the government; we were able to put up new structures and modernized the hospital. You may be surprise that a small thing of hundred thousand naira can make a hospital not to function and we had to fix them. Other things like fixing generators, boreholes and even the roofs, these were not major projects but we had to do it just to keep the hospitals functioning. Also if you go to the State Secretariat, we were able to build a very large warehouse. And of course, let me talk about the 20th Anniversary Hospital, by the time I took over office, the hospital was just a mere roofing, but in the last two years, The immediate past governor put a lot of pressure, working with the Commissioner for Special Duties then, Barr Emmanuel Enoidem to ensure that the hospital was more than 80% completed and was commissioned. In terms of training, like I mentioned earlier, by the time I took over, some of our schools of Nursing and Midwifery were down, but to the glory of God, I would say that by the time I left office, at least three schools of Nursing had regained accreditations. The only school of Nursing that we were not able to make it regain accreditation was the one at Ituk Mbang. It wasn’t a very major issue, they just asked us to fix some things and what happened was that the Inter-ministerial contractor that handled that job did not finish some of the required facilities on time. Let me tell you a small story so that you will understand my mindset, when I took over, all the schools had lost their accreditations and so I had to work hard to ensure that the schools regain their accreditations. The only school of Midwifery that we could not give accreditation was the one at Essien Udim Local Government Area and that was because of the structural deface of the school and it was not something the Ministry could handle, it was something the State Government would award contract of hundreds of millions of naira for total rebuild of the school and the accreditation had been lost for over ten years so it was not something I could fix at the time. The School of Psychiatric Nursing in Eket, we did what we can, but I realized that we could not do enough that was why we leave it at that level but I pray that the present government will do something about the school. Another school was the School of Health Technology, Etinan, there were six programmes running for over six years and accreditation had been lost but by the time I left, we were able to do accreditation for four out of six programmes. Again the problem was that there was no money, the then governor had approved money but that was never released as at the time I left office so we start looking for money from another source to ensure that the school regain accreditation and train House Officers

Sorry sir, before you proceed, are you saying that the School of Psychiatric Nursing in Eket had lost accreditation?
No, they haven’t, but I don’t know what the current situation is now, but they had placed embargo on further admission. So basically in terms of training those were the things we did. Then in terms of service delivery, we tried as much as we can to ensure that hospitals were functional, we provided drugs and we tried to ensure that there was a monitoring team that would go around visiting hospitals and through that, people began to sit up when they realized that some of the teams working with the Hospital Management Board are going around for inspections. So in that way, we tried to make people go to work early. Looking at the Free Health Care policy, I will like to talk about it, it was only about 60% across the State that were offering Free Health Care but as at the time I took over office, I learnt that the service had stopped because there were no drugs. It was not the fault of my predecessor because for you to buy drugs, money needs to be released. In my usual way, I went to the then governor Chief Godswill Akpabio and explained to him that we do not have drugs in our hospitals and the governor said is that true? I said yes, so he facilitated some funds and we were able to increase from 60% to about over 200%. What we tried to do is to ensure that in every Local Government Area, there should be at least six government facilities that are running that programme and again as at the time I left office, we had run out of money to buy drugs so I cannot say whether that programme is still ongoing. Another area that we tried to intervene was Human Resources for Health, we sat down and we did a very objective analysis, looking at man power and all of that and based on that again I walked to the governor and I told him how bad things were and he graciously approved the recruitment of about a thousand and seven hundred health workers who had resumed work. Again it is very dynamic because people are retiring every day, for me, recruitment should be yearly and constant, it does not have to be in thousand at least three or four hundred yearly would be good. Another thing was that when I took over office, the then governor had built cottage Hospitals and was commissioned but some were not functioning, but to God be the glory through my efforts the doors of Cottage Hospitals in Ika and Eastern Obolo LGAs were opened and there are still running till today. Another major thing was that we maintained full immunization coverage in the State even when the Local Government administrations were reluctant in supporting the programme financially. We always tried to ensure that public health was our major priority and I am happy to say we achieved a lot as a Ministry of Health.

But it has been noticed that the 20th Anniversary Hospital is not working, what is really the problem?
I can’t speak for the government because I’m no longer in government, but I will say that the hospital is working. Let me explain; as at the time I took over office one of the major contactors gave us a lot of headache probably because we were owing him, so even if we had brought in equipments, if that area was not prepared, you cannot install such equipments so we were having that issues and again the issue of funding was a major challenge. But I am telling you that contractors have been on site and they are working, probably not working optimally as they ought to have worked but they are on ground. What I will say is; let government hold contractors to the MoU that they had signed with them. Although, I am no longer in government but I know that government has done all that ought to have been done. The intension of government was to bring in foreign operators because government was looking at the sustainability of the hospital. I’m speaking because during my time that everything was signed. We did not want a situation whereby if government does not release money there would be problem, the hospital was to sustain itself with the revenue that would be generated which was to be used by the operators to pay salaries and to maintain the hospital. And again, the equipments that were brought in are not available in Nigeria, so we were looking at brining in people to operate the equipments. So I would say that the hospital is functioning, probably not the way it ought to. But again you must realize that when you are starting a hospital especially of that nature you don’t expect that everything start at once. So I would say people should have patience in the next few months and government should put more fire in ensuring that those handling the project complete it so that it would be put to use optimally.

What are those programmes you initiated you would love your successor to sustain?
Government is continuous, a lot of the things I did, I inherited them from my predecessor and I continued some of them. The truth is that you will never see anybody who would come in and say that you are doing anything new. In everything, there is already a master plan; the problem is always that of implementation. I would say the present government should focus on service delivery especially the Free Health Care should be properly funded, in terms of infrastructures, hospitals should be renovated, more accreditations should be done for our schools, recruitments, public health care should be a priority. But for me, I have the confidence that the present Health Commissioner will do his best or if possible surpass what we did.

You have returned to your primary duty which is the University of Uyo, in what capacity did you return?
First of all, I’m a lecturer and of course I lecture. I have to wake up in the night and prepare lectures. I have to read very well because when you have not been lecturing for sometimes, you need to make sure that you are giving to the students the right stuffs. I also return as a Chief Consultant and whatever responsibility that I will assign to by the Chief Medical Director, I will do the job to the best of my abilities. But before we end this interview I would like to suggest that government should have an emergency ambulance services stationed at major points. Another major thing we as a State needs to take advantage of is the National Basic Health fund, our State should implement it. It is going to be used to fund the Primary Health Care and Health Insurance. When I was a Commissioner, I tried my possible best to implement it but I did not succeed so I will suggest the present administration to have the Primary Health Management Board, because many States have already done that. Health Care Insurance will go a long way in helping the State to succeed in the Free Health Care programme.

What is your message on Politics?
 I would say I remain a member of the Peoples Democratic Party (PDP). I do not have any reason what so ever irrespective of whatever rumour people are peddling to leave the PDP. Because I have heard some rumour that I have defected to the opposite political party.  I just want to state very clear here that I am still a member of the PDP. I was brought up to be very respectful and you will never see me not even as a Commissioner insults anybody, irrespective of the person’s political affiliation. I have also tried to maintain my personal relationship irrespective of that person’s political platform. So having said that; I still maintain my relationship with my friends, for me as a person, I have had no reason to leave the PDP family. I believe in power shift to Eket Senatorial District. The zoning should be on the Senatorial Districts and not by ethnic groups.

Are not worried about the level of penetrations the APC have done for the past weeks, they seems to be taking over Akwa Ibom State?
Well, I was in Eket for the PDP rally I also saw the number of people that came out for the rally. For me, I would advise the governor to be focus. I like the way he is working and his vision for the State. Even though I was not re-appointed, my support still goes to the State Governor, Deacon Udom Emmanuel and the PDP because even if I don’t benefit today, tomorrow my bother may benefit. The sooner the political tension in the State is over, the better for our development. But I am confident that at the end of the day, the will of God will be done.         





                                    

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