Dr. Shehu Balarabe Kakale is the immediate past commissioner for Health in Sokoto state. He speaks with ANKELI EMMANUEL, the moves by the current administration in the state to better the health facilities and other matters
On assumption of office as commissioner for health, what were your visions, missions and how far did you go in achieving them?
On assumption of office, our vision was that of Governor Aminu Waziri Tambuwal. His policy thrust from the onset remained to revive the entire health care system to put it on a robust quality delivery performance trajectory of a globally accepted and commendable standard.
These are anchored on human capacity and infrastructural development of the health facilities, equipping them, encouraging community engagement, as well as promoting innovations regarding health care financing. The governor’s policy thrust is also on legislation and regulations that will give the health care system a more productive outlook.
I can assure you without any fear of contradiction that the governor has done well through provision of good governance. He has equally done extremely well in turning around the health care system of the state through the major pillars.
How do you mean?
No doubt, anybody within and outside the state will agree with me that Governor Aminu Waziri Tambuwal has through good governance and projected health as one of the top most agenda of his administration. There has never been this level of global visibility of the activities of health in the state like now, hence the issue of health is very central in the development of the state, country and of course the entire humanity. Recall that just recently, Governor Tambuwal hosted the world richest man, Bill Gates, and Dangote who is the richest black man and of course six other governors of Nigeria, with some northern Emirs. The minister of Health and all other heads of International Health Organisations such as UNICEF, WHO, DFID, USAID, with strong collaboration with the Sultan of Sokoto, Alhaji Muhammad Sa’ad Abubakar, were in the state to discuss issues on health. They came to Sokoto on merit because they have all seen that the governor has been implementing positive reforms in the health sector of the state. In that visit, a Memorandum of Understanding (MoU) with more commitment on expending millions of dollars to improving health care in the state was signed as well.
Remember, Sokoto through the excellent leadership ability of Tambuwal and his health promotion governance has hosted more than 10 national and international conferences to draw attention to improved health status in the state. One of such is of course, the national delegates and executive council meeting of NMA. There is that of International Health Green Peace Association. There is that of the Laboratory Scientists Association of Nigeria, There is that of NAM. There is that of Society of Gynaecologists of Nigeria and a lot of them. All of these were meant to really crystallize the policy thrust and direction of the governor’s vision about health where advocacy to policy makers and stakeholders were done. The issue of sound leadership also came just recently when His Excellency added his very, very important voice to the call on the ban of codeine containing syrup, which the state government has put into effect since December last year. And the state has instituted a lot of regulative and enforcement measures, while the governor clearly called on the federal government to ban all codeine containing syrups that is driving addiction amongst our youths. And eventually, of course, the federal government heeded the call and banned all codeine containing drugs in first week of May this year.
These are just a few of what the governor has been doing in leadership and governance. I am happy to say that Tambuwal’s style of leadership has been commended and copied by many states and even the federal government.
What are those policies that you considered unique?
In the areas of legislation and regulations, new laws and new agencies have been made for health from the Contributory Health Care Management Agency which is meant to provide universal health care coverage and reduce suffering of payment by patients. There is the Primary Health Care under one roof and of course, other laws that concern health in the state. The state has also been able to develop its own strategic development plan for 2016 to 2021/22.
On human resources for health, the governor has done a lot to improve the welfare of staff and infuse more professional staff into the health system of the state to help strengthen it. If you can remember the visit of the federal minister of state for health, Dr Ohinare more than 200 laboratory scientists were sent back to school to upgrade their certification and additional 100 were employed.
The government also employed over 300 nurses and midwives. It has also taken up Community Midwifery Scheme to a higher level from 20 to 100.
The state government has also established a College of Midwifery. Tambuwal. It has also continuously employed more doctors. Very recently, more than 10 consultants were employed into the state service. Again, just last week, additional 10 medical officers were approved to be employed into the health system, apart from the regular automatic uptake of indigenes that graduate from medicine, radiography, medical laboratory sciences and nursing and midwifery.
Those in such courses even right from school, in the clinical areas, are usually put on a nominal grade level 7 and once they graduate, they are automatically upgraded.
Therefore, the state government has really infused a lot more staff into the system hence through the leadership of Tambuwal, we have gotten almost a thousand of such health workers.
And remember, with the pioneer strategic MoU with Usman Danfodiyo University Teaching Hospital which was signed in Abuja by the Minister of Health, where UDUTH was to be unbounded with the huge number of its human capacity to really go to the State Hospitals where they will use the facilities and provide services. The MoU has ten components. It was widely covered in Nigeria and the Minister urged other states to copy the MoU between Sokoto State Government and UDUTH.
Governor Tambuwal has also upgraded the School of Health Technology to a College status to produce more of our middle and lower cadre manpower requirement for health. Training and retraining and mastered training has been going on in all part of the human capacity development of the health system.
In the area of infrastructure, the state government under the leadership of Tambuwal has been able to add additional 56 Primary Health Care centres since the inception of this administration. When we came, they were around 750 at the PHC level but now, we have 806 and very soon, we will add another 10 to make it 816 PHC’s. The staffing and equipping of the hospitals is ongoing.
In the area of service delivery, the state government has been able to collaborate with the military medical corps and Sokoto state was awarded to host the Sokoto State Military hospital, which is currently located in Murtala Mohammed Specialist Hospital.
As you are aware, this is the only military hospital across the Niger. That is of the military hospital cadre. We have of course, the Army Reference Hospital in Kaduna. However, the military hospitals were before now only in Lagos, Benin and Port-Harcourt. So the only one that is in the north of the Niger is the one we now have in Sokoto and it’s fully equipped with the support of Sokoto state government. They are currently providing services to the people of sokoto state, which are majorly civilians.
In a bid to reverse medical tourism, the Tambuwal led administration has deliberately invested in these facilities, involving manpower, equipment and staff welfare.
For instance, in the state orthopaedics hospital, we now perform total knee transplant. We have done almost more than six and we are now approaching ten. And we are also going to carry out total hip replacement at a minimal cost compared with what you get outside the country.
Currently, people are trooping to Sokoto from all parts of the country to have a total knee transplant for less than a million naira. However, if you are to go outside Nigeria, it will cost you about ten million naira.
The same thing with the NOMA children hospital which has also been upgraded and its now providing super specialty services of facial plastic surgery, reconstruction of the nose, ear, jaw, eyelids and lips in collaboration with medical teams from the Medecins Sans Frontieres doctors from Germany, Luxembourg and of course, United kingdom. Even now, all the team has just finished a range of surgeries for patients that have severe disfiguring injuries because of accident of fire burnt.
The Mariam Abacha Children and Women hospital has also done greatly with its brand new theater that is the largest and most well equipped in the north. The hospital has done thousands of VVF surgeries, and to the extent that other partners are competing for space to come and use our theatre for training and conducting pull efforts of fistula services.