Opinion
Raising The Bar, Accelerating Access To Safe Surgical Care, By Dr Juliette Tuakli
In order for “Health for All” to become a reality, access to safe, timely, and affordable surgery and ongoing surgical education must become a priority in Africa
Access Multimedia Content
We celebrate World Health Day on April 7th, 2023, and I thought it is a good time to reflect on what “Health for All” means on the African continent.
In 2015 and 2017, the World Health Assembly (WHA) passed Resolution 68.15 (https://apo-opa.info/3ZJUuUf), and decision 70(22) (https://apo-opa.info/4387vtl) respectively. Resolutions which recognised surgical and anaesthesia care as essential for universal health coverage and required the director-general to report on the progress of its implementation.
While much progress has been made to document and elevate the status of surgical and anaesthesia care internationally, things have unfortunately not progressed equally on the African continent. Life-transforming surgery has a massive impact, not just on the patient, but on their caregivers, direct family, their community, and beyond.
It is now more important than ever to ask, how we can we improve this? How do we do this better?
Neglected surgery is a huge problem in Africa. In order for “Health for All” to become a reality, access to safe, timely, and affordable surgery and ongoing surgical education must become a priority in Africa. The truth is very few people on the continent have received the life-saving surgery they need. An ASOS study showed that surgical operations conducted in 25 countries were 20 times lower (https://apo-opa.info/3nN6GWU) than the crucial surgical volume required to meet a country’s essential surgical needs each year (defined as 5,000 operations per 100,000 people). African surgical patients are also twice as likely to die after planned surgery than the global average, with 94.1% of those deaths happening in the 24 hours after surgery.
Universal Health Coverage (UHC) means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
To make that happen, a number of things need to be in place. For starters, we need strong political leadership to prioritise the acceleration of access to surgical, obstetric, and anaesthetic care across Africa — not just because it’s the right thing to do, but because from a socio-economic standpoint, Africa can’t afford not to. I do believe that COVID, like nothing else, showed us the economic costs of ill health of a population.
We also need greater education, not just of the surgical and medical practitioners, but of the African population at large, so that they understand their basic rights to care. By educating individuals and communities, they will be able to demand access to the health services they need, without falling into financial hardship, or potentially losing their lives because they did not know their ailment was surgically treatable, or how to access necessary surgical care.
One thing that does speak loudly to me right now is how we need to accelerate women’s access to obstetric and non-obstetric surgical care. When I’ve walked past the line of patients waiting to come on board Mercy Ships, I am always struck by how few women are coming there for their own care. The women I see are clearly in the role of carer, coming to support family members.
We have seen improvement on the continent in relation to obstetric outcomes as more women are able to access safe Caesarean sections, but there is a need to focus on a wider array of conditions and procedures that could have life-changing impacts on women. We also need to ensure that when funds are allocated for care, we make a point of ensuring that women’s care is specifically included, rather than them getting what is left over.
Understand, I’m not saying let’s forget about the men. I’m saying that safe surgical care is tremendously important, but it is tremendously important for both males and females. Everyone deserves a basic level of health care. It always amazes me how health is often not seen as a national developmental issue; but it is as important as security, economic development, nutrition, defence, because it underpins every one of those things.
“Health for All” means just that. It means every man, woman, and child should be able to access high-quality surgical care and post-operative care, regardless of age, race, ethnicity, gender, income, or religion.
We need to raise the bar of expectation across the African continent and hold each other accountable and we need to accelerate access to quality surgical, obstetric, and anesthetic care across Africa. It is possible to do, there are numerous governments who are implementing strategic plans not just talking about them, and there are incredible organizations like Mercy Ships, who are providing ongoing surgical education, as well as safe surgical care, free of charge to patients in the countries they serve that are making a significant impact on the African continent. But we need to do more.
When you talk about “Health for All” or “Surgical Care for All”, it needs to be more than a slogan; it needs to be meaningful and authentic and backed with intention and tangible actions.
Dr Tuakli works with Mercy Ships
Heineken Lokpobiri, minister of state for petroleum resources, says the federal government plans to commence implementing the drill-or-drop provisions of the Petroleum Industry Act (PIA).
Section 94 of the PIA gives operators a period of three years to begin oil production or relinquish the assets to the federal government.
Speaking during the Cross Industry Group (CIG) meeting held on Tuesday in Florence, Italy, Lokpobiri said it is in the best interest of the country that all inactive wells go to work.
He said the federal government, under the leadership of President Bola Tinubu, has provided every necessary incentive to ensure international oil companies (IOCs) in Nigeria run smoothly and profitably.
“Now, it is imperative for these industry players to match the government’s efforts with increased investment by announcing final investment decisions (FIDs),” he said.
Furthermore, Lokpobiri discussed “the challenges, expectations, and measures to enhance the sector’s contributions towards domestic energy needs and regional expansion across Sub-Saharan Africa”.
He emphasised that while IOCs have highlighted engineering, procurement, and construction (EPC) contractors as a challenge, “EPCs will not come unless they see strong commitments from industry players”.
“The government has done its part to provide the requisite and investment-friendly fiscals, the ball is now in the court of the IOCs and other operators to make strategic investment decisions that will drive increased production and sustainability in the sector,” he said.
“We must also recognise that domestic crude supply is essential to national energy security. The best solution to this challenge lies in increasing production, which will ensure a balance between domestic supply obligations and external commitments.”
The minister further urged industry players to explore collaborative measures, such as shared resources for contiguous assets and the release of underutilised assets to operators ready to invest in production.
The Progressive Students Movement (PSM), a leading Pan-African student body, has commended the leadership of the Nigeria Police Force (NPF) in Ogun State under Commissioner of Police (CP) Lanre Ogunlowo, PhD, for its commitment to security and community engagement.
In a statement released on Thursday, the President of PSM Nigeria, Comrade Ambassador Okereafor Bestman, highlighted the CP’s efforts in strengthening collaboration between the police, stakeholders, and other security agencies to maintain peace and stability in the state.
“It is worthy of note that CP Lanre Ogunlowo, PhD, has further fostered a harmonious working synergy between the police, stakeholders, and other security agents aimed at ensuring peace and tranquility in Ogun State,” Okereafor said.
The student leader expressed confidence in CP Ogunlowo’s leadership, stating that Ogun State is on track to becoming one of the most peaceful states in Nigeria under his administration.
He also praised the professionalism and dedication of the Ogun State Police Command in tackling crime, regardless of its scale.
Additionally, PSM acknowledged the Ogun State government’s continued support for security agencies, particularly in providing mobility and logistics to enhance their operational efficiency.
The commendation comes at a time when security remains a top priority for residents and authorities in the state, with ongoing efforts to curb crime and ensure public safety.
BY ABUBAKAR YUSUF
On assumption of duty in January, 2025 , the new Universal Basic Education Commission, UBEC, Boss and well grounded World Bank expert , Aisha Garba envisaged the need to reposition the Basic Education through interfacing with the critical stakeholders.
Amongst them is the office of the National Security Adviser , NSA, led by Malam Nuhu Ribadu whose achievements in the last few years in the area of security has become distinct and outstanding.
Therefore, seeking to cooperate and collaborate with the office became germane and needful particularly the protection of lives and properties of actors in the promotion of Basic Education ranging from the pupils , teachers , workers and facilitators to enable it drive the new wave to curb Out of School Children OOSC in the country.
Aside providing the basic security arrangements for schools , the need to engage the security apparatus at the level of National Security Adviser NSA became needful, so as to address the sophistry of security problems in the country, to nip in the bud any unforseen circumstances.
With the high rates of kidnappings, abduction , banditry, cattle rustling, ritual tendencies among many other vices, the idea of bringing on board , the security architecture of the country in all ramifications will assist the commission to consolidate the implementation of Basic Education policies and programs, also introduce new ones .
Since pupils at the Primary, Junior Secondary and Secondary Schools are prone to such ugly development and security issues , the need to be proactive on the part of the commission became timely and desiring.
This led to the success story of the bilateral interface between the management of the commission and NSA, to streamline, perfect and chart a new course on the issue of security of actors in the Basic Education.
The visit described as timely and long overdue, discussed fruitfully the way forward and the immediate and long term intervention of both agencies in the area of collaboration.
According to the Executive Secretary, Universal Basic Education Commission UBEC, Dr Aisha Garba she stated by discussing” strategic initiatives aimed at enhancing educational access and security in Nigeria. ”
She further said” the engagement focused on strategies to address challenges such as the safety of schools, particularly in vulnerable regions, and the promotion of equitable education for all children.”
“the meeting highlighted the critical intersection between education and national security and the need for collaboration between UBEC and Office of the National Security Adviser (ONSA), on improving access to basic education and safety of safety schools across the nation. ”
“This collaboration underscores the government’s commitment to fostering a secure and inclusive learning environment as part of its broader agenda to strengthen the nation’s educational framework,” it added.
“UBEC boss had pledged to engage critical stakeholders to break down barriers to education and create inclusive learning opportunities for children across the six geopolitical regions of the country.”
“She said: “My goal is to deliver on this mandate which includes strengthening collaboration, partnerships and institutional learning for effective service delivery. ”
“Together, we will work to increase access, improve quality, provide conducive and safe learning environments, supply adequate teaching and learning materials, and adopt the concept of ‘best fit’ in addressing specific basic education challenges, state by state and region by region”.
Highlights of the program which included the engagement of both bodies with a commitment to ensure the introduction of security architecture in schools in Nigeria is achievable.
Written BY ABUBAKAR YUSUF on yus.abubakar3@gmail.com.