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
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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
By Suleiman Hassan Gimba Esq
I do not speak for Buni, for I am neither the voice nor the vessel of government. I do not speak for the flyover, for I am neither its foundation nor its asphalt. And I do not speak for the detractors of the flyover, for I am neither their echo nor their intent.
But I do speak for myself—as a citizen who will drive on this flyover and the existing roads in Yobe.
I speak as a husband, as a potential father who understands that government policies shape my ability to provide for my family. The roads I travel, the infrastructure around me, and the decisions made in government halls all influence my capacity to build a future where my child can grow in safety and my wife can nurture them in a stable, supportive environment.
I do not speak for power, nor for opposition—I speak for the everyday man whose life is shaped by these choices, for the citizen who desires not just development in name but development that truly serves the people.
As a child, I struggled to grasp the saying, “He who fails to plan, plans to fail.” One of my teachers at FECOET Demonstration Secondary School, Prof. Adam M. Abubakar, used to say it often.
It was plain, simple, and straightforward, yet my young mind could not understand how failing to plant during the rainy season meant sowing the seeds of hunger in the dry season. But I have since come to understand that development that truly serves the people is built on planning.
I have followed the political career of His Excellency Mai Mala Buni, and I hope to write a book about him one day, for his is a career rooted in planning.
Everywhere he goes, he excels. There was a clear plan when he was a Special Adviser to the Governor, there was one when he led the APC, and there is a bold one in his leadership of Yobe State. The APC enjoyed its best days under his watch; he was National Secretary of the first and only opposition party in Nigeria’s history to defeat a sitting president; he was Chairman of the Caretaker Committee that rescued the APC from implosion.
The importance of planning is best illustrated when comparing Abuja and Lagos. Both are Nigeria’s biggest cities, but in terms of road convenience, Abuja is far ahead. Why? Because Abuja was built with a master plan to last the ages, while Lagos has had to adapt as it grows. The roads in Abuja were constructed before congestion set in, with flyover pillars pre-installed in strategic locations, waiting for activation. Lagos did not have that foresight. Today, its people sleep in traffic, and all remedial efforts are expensive and disruptive.
It is no different with Damaturu. As urbanization increases, road congestion will become a major challenge. A flyover can significantly ease traffic, reduce travel time, and improve road safety by minimizing accident-prone intersections.
It will also enhance the work of agencies like YOROTA, YEMABUS, fire services, police, and other security bodies by allowing them to move more efficiently.
I cannot speak for the flyover, but I can speak for large infrastructure projects. I have been around long enough to know that such projects create employment, directly and indirectly. The flyover will not only provide construction jobs but will also stimulate economic activity by improving connectivity. It sits on roads that link at least three other local governments, another state, and three neighboring countries. Property values around it will rise, increasing local wealth and boosting Internally Generated Revenue through modernized property taxation under YOGIS.
And what is Damaturu if not our own Abuja, our own FCT? Whether we acknowledge it or not, the city will experience population growth and commercial expansion. What we can decide is whether we prepare for it—and H.E. Mai Mala Buni is doing just that. Strip Dubai of its infrastructure, and it is nothing but a Yusufari in the Middle East. We, too, must build the kind of infrastructure that attracts investment.
What many may not realize is that the flyover will actually save them money—on fuel, on vehicle maintenance. Smoother traffic flow means lower fuel consumption and less wear-and-tear on vehicles. It also means reduced carbon emissions due to less idling in traffic, aligning with the governor’s environmental sustainability plan and the broader Damaturu Development Plan.
What we can hope for is transparency in budgeting, procurement, and contract execution to ensure that the project is completed on time and to standard.
To close this write-up, I return once more to my childhood—boring, I know. I grew up seeing the NPN shops in Potiskum. Built in the late ’70s and early ’80s, they were the first all-concrete, fire-resistant shops in Nigeria. At the time, many saw them as wasteful and too ambitious. But today, development has caught up with them. No one stands at Kasuwan NPN and questions whether we were ready for them.
The same will be said of the five modern markets built by His Excellency Mai Mala Buni, the Potiskum Cattle Market, and now, the flyover. These projects will stand the test of time. And though I can never speak for Buni, they will speak for him—because they were planned with the people in mind. And when they start improving lives, the people will listen. The people will rejoice. Years and decades may pass, but these projects will remain, honoring the man who built them and serving the people he holds dear.
By Jumai Ahmadu
It is no longer news that there was an altercation between Senator Natasha Akpoti-Uduaghan and the Senate President Godswill Akpabio, but what it underscores is how women in elective positions in Nigeria continue to face severe under-representation.
Senator Natasha Akpoti, who was almost suspended from parliament by the Senate President, is just one out of similar cases in the recent past. Sen. Ireti Kingibe and Sen. Remi Tinubu (now First Lady) all had bitter experiences at the upper chamber.
It is in the light of these awful experiences that Seat Reservation for Women Bill by the Deputy Speaker of the House of Representatives, Benjamin Kalu, becomes urgent to only boost gender parity, but to unlock national prosperity of which women are a critical segment of.
Nigerian women’s political engagement in Nigeria has quantitatively shown that there is grossly low levels of female election to the National Assembly. The issue of female electiveness is one of myriad of issues women face in Nigeria – poor economic power, discrimination, cultural and religious inhibitions as well as societal biases.
The very notion that the country’s political sphere since 1999 has not witnessed any seismic shift in terms of gender equity and parity rather has remained largely dominated by men despite several efforts by both government and the private sector to enhance women participation and representation in elective politics does not inspire confidence in terms of inclusion and diversity.
A statistical report in 2017 on women and men in Nigeria shows that representation of high-ranking government officials with decision-making powers is heavily lopsided in favour of men. The representation of women in the 9th Assembly is not a significant improvement from past Assemblies.
In 1999, sixteen (16) women were elected into the National Assembly with thirteen (13) in the House of Representatives and three (3) in the Senate. The total number increased to 25 in 2003 with twenty-one (21) in the House and four (4) in the Senate.
The highest number of women ever to be elected into the National Assembly is thirty (36) in 2007 with twenty-seven (27) in the House and nine (9) in the Senate. Since then, there has been a steady decline to thirty-two (32) in 2011, twenty-nine (29) in 2015 and seventeen (17) in 2019.
In the 9th National Assembly, there were eight (8) female Senators (7.3%) and thirteen (13) female Members of the House of Representatives (3.6%), which represents 4.5% of the entire Assembly.
The 10th Assembly has women occupying four (4) out of 109 seats (2.7%) in the Senate and 17 out of 360 seats in the House of Representatives (4.7%), which represents 4.2% of the 469-member Assembly.
Therefore, after seven general election cycles since 1999, the number of women in the Senate has dropped to what it was at Nigeria’s return to democracy in 1999.
It is thus significant to note that the cumulative percentage of women in the two chambers of Nigeria’s incoming 10th National Assembly is below 5%. It is also important to note that no woman was elected in 15 out of Nigeria’s 36 State Houses of Assembly following the state level general elections in March 2023.
With current figures for the 10th National Assembly, Nigeria shamefully places at the lowest neighborhood of the ranking of countries on women in public leadership especially African Parliaments.
The National Assembly must take action to support increase in the number of women represented in government by passing the specific Constitution Alteration bills to achieve this.
The Temporary Special Measures bill, with more than 80 other House of Representatives members co-sponsoring it, was debated but failed to pass in the 9th Assembly. It is instructive that women groups are continuing work on the bill in the current 10th National Assembly and needs to work harder not to lose this opportunity again.
Women’s lack of adequate participation in legislative processes has negatively impacted promotion and enforcement of their rights, and despite the low representation of women in the National Assembly, the bills sponsored by female legislators has had significant impact on the lives of all Nigerians. Men’s efforts, if any, to promote these rights are not sufficient, because they are not direct beneficiaries.
Structural biases and barriers to women’s political participation indicate that the few women who show active interest in politics are discouraged by factors that include prevailing gender stereotypes, cultural/religious reasons, unfavourable political environment, lack of financial capacity, electoral violence and restrictive party structures and processes, amongst others.
Political hurdles, socio-cultural issues such as patriarchy, religious dogma, and conventional views of women in politics and socio-economic hurdles such as low income, lack of resources, electoral processes and political party structures, have all been identified as barriers to women’s political engagement.
While women are making significant contributions to Nigerian politics, their representation in political and decision-making positions needs to be improved.
And 30 years after the Fourth World Conference on Women and adoption of the Beijing Declaration and Platform for Action (1995) we are nowhere near the 35% affirmative action.
Women groups plan to participate in the 69th Session of the United Nations Commission on the Status of Women Conference scheduled to hold March 10 to 21, 2025.
The main focus of the sixty-ninth session will be on the review and appraisal of the implementation of the Beijing Declaration and Platform for Action and the outcomes of the 23rd special session of the General Assembly.
It is therefore recommended that the country’s 35 per cent affirmative action for women’s representation in politics be codified into law. Having legislation that requires government at all levels to have at least 35 per cent representation of women in appointive public service positions will be a good way to engender greater participation of women in politics.
Considering the importance of their presence in governance, we urge women in public leadership to stand firm and continue representing their constituents. They should never ever lose their voice, but rather continue to stand strong in your commitment to citizens and prove that representation matters.
Dr. Jumai Ahmadu is the Acting Director, Reform Coordination and Service Improvement Department, of the Federal Capital Territory Administration.
BY ABUBAKAR YUSUF
The history of abandoned nation’s city centre roads by the previous administration’s was brought to a halt, soon after the assumption of office of President Bola Ahmed Tinubu and appointment of Hon Minister, Nyesom Wike as the handler of the FCT in May , 2023.
Not long after his announcement and swearing as Minister of FCT, Wike visibly disturbed with the state of decayed infrastructure in the Federal Capital Territory FCT, particularly the state of roads across all Areas, sessions, districts, Zones and locations swung into action by embarking on major roads repairs , resumption of construction, embarking on new ones that was commissioned during the first year anniversary of President Bola Ahmed Tinubu under his Renewed Hope Agenda.
The massive repairs by the Nyesom Wike led Federal Capital Territory made both major and linkages of roads weared a new look and brought fresh air to motorists, travelers, pedestrians among many other road users across the FCT.
As at January 2025, Wike had not only completed most of the nations city roads , but connecting them with high capacity fly over bridges across areas abandoned for many decades as part of the master plan and opening up roads in the rural areas of the six area councils of Abaji , Kwali, Gwagwalada, Kuje , AMAC and Bwari areas.
Major and adjoining roads across the six area councils with those abandoned for many years close to a decade have been reconstructed between weeks and months returning back to these areas good life of motorable roads to the area councils.
His style of leadership in the area of roads construction across the nooks and crannies of FCT including the interior part of the councils was the engagement of construction companies in each of the six area councils, with allocation of roads to be constructed in batches with no time limit, but to ensure good motorable roads in the six area councils with a dedicated funds of about 300Billion approved by President Bola Ahmed Tinubu to revive rural roads across the six FCT area councils.
Twenty one months down the line , the improved infrastructure and roads construction has improved and competing favorably with those of the nations city, that was once a cynosure and shadow of itself due to leadership without foresight in the previous administrations.
The implications of the provision of good roads across the nations city and area councils has reduced to the barest minimum the influx of people from all walks of life into the city centre, as people now found comfort at area councils as a result of good network of roads and Infrastructural development.
Wike road projects all over the FCT has also linked many towns and villages to the FCT from Nasssarawa, Niger , Kogi among many other states reducing the high cost of renting houses in the city centre, as people have found refuge in area councils with network of good roads and cheap accommodation against the cut throat prices at the city centre.
The FCT Minister under Nyesom Wike has changed the narration of construction of one fly over for many years in the city centre, and construction of only one rural road in the area councils as FCT intervention projects.
Currently over ten flyovers are undergoing construction, reconstruction and completion in the FCT, while area councils has witnessed roads construction of more than ten areas in each councils with the stationing of construction companies in each area councils.
Nyesom Ezenwo Wike has brought a new lease of life to residents and occupants of FCT through the infrastructure upgrade by reconstructing and re-awarding and construction of new roads in the nations city.
Written BY ABUBAKAR YUSUF on yus.abubakar3@gmail.com.