21 million Nigerians are currently living with psychiatric disorders, according to an expert.
This disclosure was made by the Medical Director of the Federal Neuropsychiatric Hospital (FNH),Yaba, Lagos, Rahman Lawal.
Dr. Lawal also spoke, in an interview with ThisDay,
on the misconceptions surrounding mental illnesses in Nigeria and the
incessant strikes by medical professionals in the country.
Inadequacies of Neuropsychiatric hospitals in the country
On the federal government's part, I will say they have done a lot. We
were previously having three neuropsychiatric hospitals in Nigeria, but
today we have eight. I think going by our population, it's now up to the
state governments to set up neuropsychiatric hospitals in their various
states. I know some of these states have, but they are very few. If
every state set up neuropsychiatric hospitals then the burden of
patients not able to access treatment promptly will reduce drastically.
For the state governments that can't establish any, they can have a
neuropsychiatric department in their various general hospitals or health
centres and then provide specialists to manage the department. Because
there is no way the few psychiatric hospitals we have in the country can
cater for the entire population. That is why we must bring treatment
closer to the people. The number of qualified psychiatrists every year
is increasing, so we should take advantage of that and increase
psychiatric facilities all over the country. It's not that we have
enough doctors, but let's maximise the ones we have to capacity by
putting more facilities in place.
With the population of persons in Nigeria who needs psychiatric
attention, it is worrisome that we have only few neuropsychiatric
hospitals and trained psychiatrists in the country making it difficult
to meet the medical needs of the people.
It is cost effective, if specialist hospitals like ours are located in
every area of the country. Most times we admit people here who come from
the eastern and northern parts of Nigeria. The distance itself is
enough to discourage any patient. Even though we don't have enough
psychiatric hospitals, but we have general hospitals all over. I would
recommend that each general hospital establish a neuropsychiatric unit
so that psychiatric treatment will be closer to the people than the
current status.
On subsidizing neuropsychiatric treatment in the country
Infrastructure and finance are also major challenges of every
psychiatric hospital in the country. Financial challenge is the biggest
issue of any specialist hospital.
To have psychiatric illness in our country is to carry a stigma. Such a
person will likely not have enough to maintain himself in terms of
treatment, because majority of these patients are unemployed, or some
may have lost their jobs, because of the ailment, some may have been
deserted by loved ones. Even the ones employed may have low earning
power. So, like in any other parts of the world, Nigeria has also
subsidized treatment for psychiatric patients so that the poor can as
well benefit from quality treatment.
Our patients are being fed here free-of-charge while they are also given
bed space free-of -charge. So what they are only payingfor is just the
actual treatment. We have really subsidised treatment. In as much as
people still want more subsidy such that treatment won't be much of a
problem to especially the poor members of the society, I will say
government has reduced cost of treatment such that patients don't pay as
high as they used to.
I hope you know the money paid for treatment in this hospital is not
even enough to run the administrative activities of the hospital. So
government is not banking on that to run the hospital. We have over 300
staff here and their salaries are not coming from the money generated
through treatment. Government is paying salaries and putting up
infrastructures and other facilities itself, so that we will be able to
offer quality service to the public. That is also subsidy. I wonder how
much patients can pay that will take care of the salaries of 300 staff
in this hospital.
It is not when we tell patients to pay N10,000 instead of N50,000 that
we'll be said to have subsidised treatment. All other things we have
done is even more subsidy.
Today, we have over 500 bed space in the hospital and no patient is
asked to pay for space or even feeding. This is because that area has
been subsidised by 100 per cent. So, government is doing its best.
Even on several occasions we end up paying medical bills for the
patients that have over stayed and nobody is forth coming to pay their
expenses or discharge them.
On number of psychiatric personnel in the country
Though the numbers of professional psychiatrists we have now have
increased compared to before, the country still needs more personnel. I
am advising that more doctors specialise in psychiatry. Let it not be
that we don't have enough personnel to man neuropsychiatric hospitals or
neuropsychiatric units of general hospitals, when eventually we have
more psychiatric centres in the country.
According to statistics, about 12.5 per cent of Nigerians have one form
of psychiatric disorder or another, which is about 21.2 million
Nigerians. This is why we need more hands; more psychiatrists, more
health workers and more health facilities, so that we will be able to
cope with treatment and management of psychiatric issues in Nigeria.
On brain drain in the profession
One of the major challenges we are having is that a lot of our trained
psychiatrists are practising outside the country. If we have a lot of
them in the country, we wouldn't say our personnel are not enough. They
are out in search for greener pasture in countries where they are paid
more. In as much as government is doing enough, I will advise that the
profession should be made more attractive in terms of renumeration so
that we won't continuouslyhave issues of brain drain. At present, we
only have about 150 practicing psychiatrists in the country which is
grossly inadequate.
Misconceptions and myths around psychiatric illness
There are lots of myths and misconceptions surrounding psychiatric
illness in Africa, especially in Nigeria. There are people who refuse to
visit the hospital or bring their sick ones for treatment, because they
believe psychiatric illness is a spiritual issue. Hence, they would
prefer to take such patients to spiritual healing homes or faith
organisations so as to get cure through spiritual means. Majority only
take neuropsychiatric hospitals as their last resort. And you know when
cases are not presented on time, they are often more difficult to treat.
This is one of the reasons people don't present their cases to the
hospital, thereby preventing such persons from getting proper medical
attention. So, what I do is that when I come across such persons, I tell
them to bring their sick loved ones to the hospital whilst educating
them that there are drugs for the treatment of the illnesses.
People should understand that psychiatric illness is also like other
illnesses which require medical attention. And now we have good drugs
just like the ones in developed countries.
On incessant strike action by health professionals
Workers in the health sector have no reason going on strike, because of
the importance of the sector. Imagine the police or military saying that
unless the government gives them what they want they won't go to work.
It is the same for workers in charge of electricity in the country.
There are some services that must not go on strike and this is the group
the medical sector belongs. Continuous strike will destroy the sector.
If health professionals are on strike and someone has a road traffic
accident and has a broken leg, it therefore means no hospital will
attend to that person and this will encourage them to patronize
traditional homes or faith healers who are unprofessional in
administering these treatments.
To avoid these continuous strike actions and for the health sector to
move forward, there should be a working relationship between every
professional in the hospital ranging from doctors, nurses, pharmacists
and other health workers.
The disharmony among health professionals didn't just start today. The
issue has been there for a long time and that is why a radical and
comprehensive solution needs to be found.
Most every Nigeria demand/request result to strike before the necessary actions are been taking.
ReplyDelete