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Last updated: 22 December, 2008 - Published 13:51 GMT
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Nigeria: Back to Basics

Picture the scene, an ill person paddling a canoe for two days across the world's richest oil fields for access to the most basic healthcare or children walking five to ten miles in search of medical care only to find a crumbling building and not a doctor in sight.

Doctors perform an operation with scant resources

These scenarios may sound far-fetched but for many in Nigeria's Niger Delta they are a reality.

In 2007, Human Rights Watch highlighted that most primary healthcare centres have no access to even the most basic medical resources and are in a dilapidated state.

Medicines are in short supply and many centres have been abandoned by disgruntled staff members who have not been paid by local governments for months.

To the rescue

The dire state of Nigerian healthcare has prompted two UK-based Nigerians to form a non-governmental organisation known as the Ibelaw Community Health & Social Care Foundation.

 They shot me in the chest as they were leaving
Lawrence Ndulor

Through the foundation, Dr Ibe Nathans, a medical doctor, and Lawrence Ndulor, a clinical psychologist, offer free primary healthcare to the poor and needy in the Niger Delta - their home region and an area torn apart by poverty and violence despite its oil revenues.

With the benefit of a UK-based education Dr Nathans and Mr Ndulor feel they should be helping other Nigerians who are not as privileged as them.

Funding for the project comes mainly from the pockets of the two founders as well as donations received from friends or pharmaceutical companies.

Although both men have visited the area for over a decade, the service will now be more structured with a plan to extend the model to states outside the region and then hopefully, to neighbouring countries in West Africa.

However, their first mission to the city of Owerri in the southern Imo State in March 2008 brought mixed fortunes.

"We tried to see as many patients as we could, and were warmly welcomed," said Mr Ndulor.

Map of Nigeria indicating the Delta region

"My job was to give them pre-medical counselling to help them prevent disease in future, but also for things like stress and anxiety," he added.

However, tragedy struck just before the team left to return to London.

"In the house where I was staying, in the middle of the night some armed robbers broke in and demanded money, I gave them what I had but they shot me in the chest as they were leaving," said Mr Ndulor.

Stabilised at a local hospital in Nigeria, he was rushed back to London for treatment and had 32 pellets removed from his chest.

"I haven't been back to Nigeria since, but I hope to go back soon," said Mr Ndulor.

On a mission

This has not slowed his partner down and during the past year alone Dr Nathans has visited Nigeria three times, seeing 500 patients on each trip, dealing with health complaints ranging from abdominal pain to measles and malnutrition.

A child plays in an empty oil drum
Almost a quarter of children die of malaria before the age of five

In Nigeria, the average life expectancy for both men and women is less than 50, and 24% of children die of malaria before the age of five.

Almost half the population say that healthcare beats hands down financial problems, housing or crime as their main worry.

Pregnant women who have had no antenatal care, quite often turn up to Dr Nathans's clinic and not surprisingly, Nigeria has some of the highest maternal mortality rates in the world.

You would expect the government to coat these statistics in a thick layer of syrup, but even Professor Abdul Salami Nasidi, Nigeria's director of public health, acknowledges that primary healthcare is failing but insists that they are now taking the issue very seriously.

"We know a lot of centres have closed down but we are doing all we can to get these back up and running," said Professor Nasidi.

The Nigerian government has now set up a presidential task force to sort out healthcare in the country.

A good example

In Delta State, which Dr Nathans recently visited, there at least appears to be some movement in the right direction.

Here, the federal government has started running primary healthcare centres in rural areas.

 Anybody can do anything and get away with it
Dr Ibe Nathans

The programme has been helped along by the injection of money and infrastructure from yet another commission - the Delta State Oil Producing Areas Development Commission - which is setting up its own health centres.

"This is the first step towards helping the people in the Niger Delta," said Dr Nathans.

"They should make primary health care a legal requirement and this service should be state funded if necessary," he added.

Nigeria is a nation permeated by corruption, so it is understandable that Dr Nathans is adamant that if money is assigned to some commissioner or governor to carry out this work, the process must be closely monitored to ensure that the right amounts go to the right places.

"I must say, quite candidly, that Nigeria's healthcare is most certainly not in safe hands," said Dr Nathans.

"Anybody can do anything and get away with it, anybody can even claim to be a doctor or a nurse," he added.

For the founders of Ibelaw this attitude strikes at the heart of the problem and is an issue they hope to address.

Belinda Otas is a BBC journalist based in London.

*This is a free online version of the article that appears in the January - March 2009 edition of BBC Focus on Africa Magazine.

focus on africa Focus On Africa
The magazine for Africa from the BBC World Service
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