Prologue

The great and respected world leader, Nelson Mandela of South Africa, once stated: “There is nothing I fear more than waking up without a programme that will help me bring a little happiness to those with no resources: those who are poor, illiterate, and ridden with terminal disease.”

In my search for a compassionate leader who have taken this statement of this great statesman not only to heart but in practice, God answered my prayer when I came across the Mission Statement of a new leader in Nigeria, Engr Dave Nweze Umahi, the indefatigable Governor of Ebonyi State, who has resolved to live out the stand of this great man when he stated: “Our mission is to enhance the welfare of our people, and empower all Ebonyians to be self-reliant, through the compassionate delivery of transparent and God-fearing governance, based on integrity and dignity.”

In another development, another renowned leader, Mohandas K. Gandhi of India, made this famous statement: “It is health that is real wealth, and not pieces of gold and silver.” And, in agreement, Robert Alan Silverstein, stated: “Good health is one of the most important ingredients for a happy and productive life. And, yet, many people do not have access to health care, but live in conditions that spread disease.”

On what he feels should be the policy thrust of Umahi’s administration as regards health matters, Dr Howard Akuma Daniel Umezurike, Ebonyi State Commissioner for Health, said: “My humble suggestion for the policy thrust of this administration is that everything should be anchored on God, and captioned ‘Ebonyi Systems Strengthening Initiatives (SSI).’ This is because the coming of this administration is divine, anchored by the ‘Divine Mandate Organisation’. So, the day-to-day running of the government should continue in that manner. Furthermore, many leaders in the past had used and over-flogged such terms as reformation, transformation, rebranding and point agenda, without much emphasis to the will of God. But, I feel that God blesses and strengthens us and our systems. And so it is proper to summarise the policy thrust of the administration with the above.”

It is in recognition of the stand of these great men that I tasked myself to present to the reader the records and efforts of the administration of Governor Umahi, to ensuring that his people not only have access to quality but qualitative health care obtainable in any other developed state.

Strategic Steps Towards Quality Health Care Delivery

The major steps the administration of Ebonyi State under the watch of Engr. Dave Umahi took in achieving this were the appointment of Dr Umezurike as the Commissioner for Health, declaration of state of emergency in the health sector and setting up of a baseline survey of what was in the health sector before the coming in of Umahi’s administration, to know what was on ground and the area that the state can intervene to fill in the gap. The report and recommendation based on the baseline survey aided the administration to take this all-important next step of presenting bills that will enable the realisation of the governor’s vision and mission.

Appointment of Dr Howard Akuma Daniel Umezurike as the Ebonyi State Commissioner for Health,

Dr Umezurike a seasoned medical personnel, sound administrator and an accomplished Author was appointed on 1st July, 2015, by His Excellency, Governor Dave Umahi, to drive his vision of a better health sector in Ebonyi. Umezurike was born on 18th August, 1971 in Agugwu-Umunaga, Uburu in Ohaozara Local Government Area of Ebonyi State, to the family of Mr Augustine and Elizabeth Umezurike of blessed memory. He schooled at Abia State University, Uturu, where he studied medicine and surgery. He graduated with MBBS degree in 1999. In his quest for knowledge expansion in his chosen career, he acquired the following higher certificates and fellowships in the field of Medicine and Surgery: Fellow, West African College of Surgeons (FWACS) 2010; Fellow, International College of Surgeons (FICS) 2015; Part I in Surgery – West African College of Surgeons, and Part I in Surgery, National Post-graduate Medical College, 2007; Primary in Surgery, West African College of Surgeons, 2004. He served as Senior Registrar in General Surgery 2009 – 2010, Federal Medical Centre, Abakaliki; Consultant Surgeon in FETHA, from 2010 - June, 2015. He was also a consultant-lecturer in the Department of Surgery, Ebonyi State University, 2012 – June, 2015, among others.

His publications in the medical profession include:(1) The Incidence of Hepatosplenomegauly in malaria in paediatric age group, submitted to the Department of Community Medicine and Primary Health Care, in partial fulfillment of the requirements for the award of MBBS degree; (2) Recurrent Goitre in Ibadan – Annals of Medical Journal, UCH, Ibadan (3) Neo-natal Depressed skull fracture: Ebonyi Medical Journal (December, 2011) Vol10, 2, 139 – 141 (4).Prostrate Enlargement – paper presented in a seminar/workshop organised for the Heads of Federal Establishment in Ebonyi State in September, 2012. (5).Breast cancer – paper presented in a two-day seminar/workshop on capacity-building organised at Iboko, in Izzi LGA from 10th to 12th September, 2013 (6).Hypertension – causes, management and prevention. A paper presented at a seminar/workshop organised by the Association of Heads of Federal Establishments on 19th September, 2013.

Umezurike’s Vision

The Health Commissioner captures his vision in the following words: “We want to have a good healthcare system in Ebonyi, because that is very important, and this involves organisation of people, institutions and resources to deliver the health care to the people.

We want a good healthcare that should be self-sustaining, and will not depend on ad-hoc measure. What we have on ground is ad-hoc, and when we have emergency, people start running around. But if you have a good system, you will achieve the goal and it will be self-sustaining. We want to upgrade all the facilities in our general hospitals and health facilities in the state and make them functional. We want to do this in stages as our resources can carry, because if you carry everything along, the tendency is that you will not get it right.

“If we can get the right professionals to man those institutions that will be good for us. And, if we find out that we can’t staff the 13 general hospitals, we can start with 6 that will have full complement of staff. We have 431 primary healthcare centres in the state, and some of them have few staff. If we can’t staff them, we can start with five healthcare centres in each council and make them render service 24/7, with enough facilities to function well. Primary healthcare is the foundation of the health sector, while the blocks and concrete walls will be the secondary healthcare, and the roof is the tertiary healthcare.”

Proposed Bills to the State Assembly

The ministry, since it came on board, has sent series of proposed bills to the governor, to be sent to the house, urgently, as executive bills to enable our agencies have legal backings to operate. They include:

a. Bill for the establishment of the Ebonyi State School of Health Technology, Ngbo

b. Bill for the establishment of the State Primary Healthcare Development Agency

c. Bill for the establishment of the Ebonyi State Health Insurance Scheme, among others.

Throwing more light on the bills, Dr Umezurike stated: “To make sure our health foundation is very strong, and that is what we are doing, by strengthening the primary health care in Ebonyi. Ebonyi State, prior to this administration, was one of the few that had not passed this law on primary healthcare, presently.

“There is a bill now being discussed, for it to be passed into law, so that Ebonyi State Primary Healthcare Development Agency and the Local Government Primary Healthcare Development Authorities will function as a body, because you can’t do any interventions in the primary healthcare without synergy. Presently, primary healthcare is under the local government and all the staff are being manned by the local government. Before you can do interventions in those areas, you have to go through the local government. But when this bill is passed into law, it will be functioning as a body under one roof.

“Our target is to have one standard healthcare in each of the 431 medical wards. We are looking at what we can offer effectively, starting with five primary healthcare facilities in each council that can give services 24/7, coupled with welfare and facilities and full complement of staff, including midwives and nurses. It will be better for us, and we will still continue to upgrade as time goes on; until we reach our desired goals of one standard primary healthcare centre in each health ward in the state. With that, we will achieve the universal coverage we are talking about.

“There is this saying that ideas rule the world. So, if you have good ideas, you can spend little and achieve the desired goal. Most of this primary healthcare centres have standard buildings, like MDGs projects. What you need to do is to organise them well: putting the right manpower there, providing dedicated energy source (solar or generator), then put up to four nurses cum midwives. With the facilities in place, they can provide the services in 24 hours. This is what we want to achieve and the governor is also very supportive and wants to invest in health. We know there are challenges, but I believe the government can do it.”

Peace in Ebonyi

According to Carol Bellamy, “Creating a world that is truly fit for children does not imply simply the absence of war. It means having the confidence that our children would not die of measles or malaria. It means having access to clean water and proper sanitation. It means having primary schools nearby that educate children, free of charge. It means changing the world with children, ensuring their right to participate, and that their views are heard and considered. It means building a world fit for children, where every child can grow to adulthood in health, peace and dignity.”

In achieving a society and state fit, where every child can grow to adulthood in health, peace and dignity, the administration of Umahi, apart from building and supporting a qualitative education sector, has ensured peace among warring communities in the State.

REMARKABLE FEATS

Baseline Survey of Health Facilities

The Ministry of Health, in its quest to ensure that every Ebonyian is captured in the health plan, conducted a baseline survey of all health facilities in the state. This is to enable us know what is on ground and discover the gaps so as to determine the interventions needed. This has greatly assisted the ministry in its activities all over the state, as it serves as a road-map in achieving a laudable healthcare system.

The menace of Lassa Fever epidemic in Ebonyi state and the magic Wand of Umahi.

In 2005, Lassa fever killed five health workers. In 2008, it killed three health workers and affected many others and sadly two of these three health workers were Medical Doctor while in 2012, it affected about 12 health workers with one person died. In 2013, there was also isolated case where one person died. These affected numbers exclude other citizens we don't have their records.

This menace was a real terror and caused a lot of havoc in our state and the major challenges we had in curtailing it was the fact that the treatment of this disease is very costly, two; is that the Virology Laboratory in the State a Federal health Institution qualified to treat this ailment doesn't have isolation ward with only three rooms. In this case, if we have more than three victims at a time, others are kept in the general ward thereby endangering both patients and health workers. The State can’t also confirm the diagnosis of victims until samples are sent to Irrua Special Hospital in Edo State for confirmation of the diagnosis.

It takes about five days to get the confirmation report from Edo which means treatment of the victim will be delayed and if proven positive the symptoms becomes very bad. If you commence early treatment the patient has chances of survival as the disease is curable and preventable provided the needful are done at the appropriate time

Umahi and his magic wand/Construction/Equipping of Virology Centre

When the above ugly scenario and challenges was presented to Governor Umahi, he immediately charged the Ministry of Health to commence the building of a Virology Centre in Ebonyi State within a month and to equip it accordingly. Based on the Governor’s charge, the ministry has completed the construction and equipping of a multi-million naira modern virology centre in FETHA II, Abakaliki, where suspected cases of Lassa Fever and other acute hemorrhagic fevers will be diagnosed and managed This is the first of its kind in the South-east. This project started because of the governor’s love for his people, who before this period has lost so many lives due delays in sending and receiving sample results from Irrua Specialist Hospital in Edo State.

The Minister of Health, Prof. Isaac Folorunso Adewole, who commissioned the centre stated that with the establishment of this centre that it will enhance a great partnership between FG and the state government and will among other benefits, lead to the provision of more equipment and grants to the Centre. Adewole expressed hope that the centre would help curb the menace of Lassa fever ravaging the zone, assuring that the purpose of the centre would never be defeated.

Checking Epidemic Outbreaks

The ministry, since May 29, 2015, has put in professional competence in management of outbreak of epidemics in the state. It has strengthened the epidemiology unit and its emergency response unit to ensure that all cases of outbreaks are brought under control. This is evident in the way the ministry managed and controlled the cholera outbreak that was ongoing in different parts of the state, starting from February 2015, prior to the inception of this administration in May 2015. This deadly disease was successfully controlled within two weeks of Umahi’s intervention. The ministry also, during the recent outbreaks of the dreaded Lassa fever, controlled it to barest minimum, and ensured free treatment of 83 patients who had fully recovered and discharged from the hospital. The state government, in partnership with the Ministry of Health, has also approved that the treatment and diagnosis of malaria, in all government-owned hospitals, is free of charge. This has drastically reduced the morbidity and mortality associated with malaria.

Elimination of Malaria through Distribution of 1.7 million Bed Net

The Ministry of Health, in partnership with United States Agency for International Development (USAID), distributed 1.7 million insecticide-treated bed-nets, as part of measures towards preventing and eliminating the scourge of malaria. Malaria is still a major public health problem in Nigeria, and the Tropics, affecting about 5 million people across the globe annually, especially women and children

In the same vein, the ministry also attracted medical equipment worth N47 million from USAID in February 2016. EU-SIGN also donated N121 million worth of direct-drive solar freezers (38 in number) to the state, to support and strengthen immunisation activities. It is worthy to note also that Ebonyi State took first position as the ‘Best-Performing State’ in malaria elimination in the whole country and our governor was decorated as USAID Ambassador.

Medical Outreach

One of the most recent achievements of this administration is the medical outreach, called Akubara-oha Free Medical Outreach, conducted at Ezzeama in Ezza South LGA and Agugwu-Uburu in Ohaozara LGA. The results of the exercises are quite successful. Over 2000 medical cases were seen: 98 surgeries, 26 tooth extractions, and 262 eye glasses issued to eye patients. Most of our people who because of economic situation could not access medical care were treated free of charge. The joy of these people knew no bounds as they prayed for God’s guidance and long live for the governor. His Excellency, having seen the success of these exercises and its attendant benefits, gave the ministry the mandate to conduct such free medical outreach in all the 24 constituencies of Ebonyi. The ministry is already concluding arrangements to kick-start the exercise. The whole essence is to ensure that the poorest of the poor get medical care of all ailments, and to reduce their disease burden and, ultimately, prevent untimely deaths to the rural people.

Incinerators

The ministry, under this administration, attracted 2No modern giant incinerators from the National Primary Health Care Development Agency, which is used for the management of medical waste. Such medical wastes had posed treats and constituted public health hazards in the past in Ebonyi State, as what we have been using is local crude methods of medical waste disposal. The ministry has completed the construction of the concrete base platform for the installation of these incinerators. One of the incinerators is located in Onicha General Hospital, and the other one at Ezzamgbo General Hospital, and they will service the whole of the state and beyond.

Construction of Chest Clinic at Mile 4 Hospital

The ministry also, through our informal connection with Chevron and Agbami partners, attracted an ultra-modern Chest Clinic, for the treatment of drug resistant tuberculosis and other related chest pathologies. The construction, which is ongoing in the Mile 4 Hospital, Abakaliki, will be completed in the next three months.

Upgrading of General Hospitals

The ministry, because of its report to the governor on the state of general hospitals, got his attention and subsequent approval to commence upgrading of the general hospitals. This upgrade will be done in phases, considering the economic situation of the state. We are starting with two per senatorial zone, while five Primary Health Centres will be upgraded in each local government area.

Purchase of Medical Equipment to FETHA

This ministry attracted a Cerumo Cell Harvester worth N10 million to the Federal Teaching Hospital, Abakaliki. All these are courtesy of Governor Umahi. He rightly believes that though FETHA is a federal institution, the patients being treated are still predominantly Ebonyi people.

Immunisation

The ministry has also sustained our immunisation activities, as enumerated below, to ensure that no Ebonyi child die of vaccine-preventable diseases. These activities are as follows:

Second round of Maternal, New-born and Child Health Week: December 14 - 18, 2015, and preparation are in top gear for yet another fantastic outing for the first round of these biennial events in May 2016.

Integrated measles campaign in Ebonyi State: 28^th January to 1^st Feb 2016.

Round 2, Maternal Neo-natal Tetanus Elimination campaign (MNTE) in Ebonyi State 11th – 15th March 2016, among other routine immunisation activities in hospitals. There have been task-force meetings headed by the deputy governor, where all stakeholders were specifically charged with responsibilities to ensure success of these activities.

National immunisation plus days (NIPD) in which Ebonyi State participated actively and recorded more than 100 per cent coverage.

Saving Three Million Lives

Dr Umezurike explaining this stated that it was anchored on the resolution of the International Development Associations to loan $500m to the Federal Government to invest on Health through the World Bank and to be spent within four years as grant to States. Because it has been discovered that the Federal Government cannot effectively handle our health institutions without involving the States, because the primary health centre are under the Local Governments and they are the people that are under the States. They are the people that the facilities will take care of in Africa.

Teaching Hospitals is a Tertiary Health Institution under the State; many people don’t even have access to them. That is why this money is channelled to the States’ Health Sector. So it is coiled also from the name, because we have up to one million deaths of women and children annually in Nigeria and most of the deaths are preventable.

It is presumed that if this money is spent on health that they will save those One Million lives. That is why the name was coiled; ‘to Save One Million Lives’; because we have been losing annually one million lives of women and children due preventable deaths. But when we access these funds and spend it on health, it will save these people.

Governor Umahi has gone further to say that in addition to Saving One Million Lives, that ‘Ebonyi State will Save Three Million Lives’; because if we have the Universal Health coverage in Ebonyi State all the indigenes will have good health and their lives will be secured and we will have three million plus Ebonyians to save. So, meaning that, if we have those Three Million Lives to save in Ebonyi we are saving three million persons. That is why His Excellency added in addition two million to the one million lives, he also added to Save Three Million Lives in Ebonyi State per annum.

Arresting the Scourge of Cholera

Dr Umezurike explained that there was cholera outbreak in the state, resulting in loss of lives in 2015. The cholera outbreak started in February and this government came in May, and the cabinet was formed on July. When I came on board, I wrote a memo to the governor notifying him of this disease. He quickly mobilised the ministry and gave us matching order to control it and its spread in one week. We swung into action and within the time-frame, we were able to control the outbreak by taking intensive management of the people already infected and also instituting preventive measures, by providing hospitals with materials and other anti-biotics.

For the prevention, we did public awareness, using the media to educate people on how to prevent it, because it is preventable and curable. We taught people how to prevent it, what to do if they contact it. We set up a task-force to ensure that they abided by what we taught them. We also taught them personal hygiene: for example, washing hands after using the toilet, before eating, when they come back from work, keeping their environment clean, and stopping open defecation.

For the control, we are now doing long-term preventive measures. We are working in collaboration with other ministries; like Water Resources, to provide portable water to all the citizens of the state, because water and drinks must be contaminated before you talk of cholera. The other thing is the toilet facility, which has been with the Ministry of Environment. All households must have proper toilet facility, and they are enforcing it, because when people defecate openly, flies can perch on it and contaminate foods and drinks: people get cholera through these.

We are doing all these and more to make Ebonyi a healthy state.

Conclusion

Let me conclude this treatise by bringing in the man God sent to deliver Ebonyi State at this crucial period, Engr. Dave Umahi to throw more light on his vision on the health delivery in Ebonyi State even as he launches N1 billion comprehensive health programme for the state.

Governor Umahi who announced the donation of N1billion for comprehensive health program in the State during a meeting he held with major health stakeholders in the state, and development partners at the Government House in Abakaliki stated and I quote, “With gratitude to Almighty God and appreciation of your commitments and partnership and support, I wish to flag off a comprehensive health programme of Ebonyi State with the sum of NI billion. This money has been set aside and transferred to the account of the Ministry of Health.” He further stated that his administration had already set aside over N500 million for its Save One Million Lives in the state.

“Let me remind you that we have about $1.5 million for Save One Million Lives. It is already there in the account which in my calculation is about N500 million plus. So, we have a total of N1.5 billion in the account,” he said in a statement on Friday by his Chief Press Secretary.

Umahi pointed out that under the programme, 285 primary health centres in the state would be properly equipped to meet international standard, especially in laboratories and storage facilities.

He said: “What we want is to start a programme, like it is done outside this country. We have 13 general hospitals and since we came on board, we have been working on them. Regrettably, when you go to these general hospitals, like my caretaker chairmen have been going, you will discover that they can make you feel sick. In fact, if you are healthy and you go there you will automatically become sick and so it is something of regret; it is not acceptable to us.

“We emphasise the need for laboratory. We want to look at our staffing, we want to look at equipment, we want to look at drugs, and we want to look at their maintenance. These are what we also want to do with our six mission hospitals. We believe that the most important thing for us as a government is the health of our people. It doesn’t matter what means to deliver good health facilities to our people.”

Finally, these modest achievements in the health sector by Governor Umahi, were achieved in less than two years in office and today, Ebonyi State can boast as the only State in the entire South East region that have a Virology Centre and based on the successful efforts to eliminate malaria from Ebonyi State, Umahi was decorated as USAID Ambassador and the State is declared as the ‘best state’ in compliance with efforts to eliminate malaria from Nigeria. Today, Ebonyi State under the watch of indefatigable Umahi has become a sort of Mecca and Institution where Governors and Federal Government Agencies come for tutorial and study on how to develop and embark upon gigantic projects with limited funds. .

In conclusion, I salute Governor Umahi for his resoluteness in ensuring good health for our people and to Dr Umezurike congratulates for proven that you are a worthy tool in the hands of the Governor in his revolutionary and bold moves to provide quality health to the Ebonyians.

•Monica Ada Chidinma Eze is Technical Assistant (TA) on Media to Governor Dave Nweze Umahi and can be reached through 08136056524, dunaebonyitransformation001@gmail.com and quintrelking@gmail.com. Photo shows Ebonyi Health Theatre Complex.

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