160th Inaugural Ojule Tasks FG On Basic Health Services Fund Implementation

The Federal Government has been strongly advised to commence full implementation of the Basic Health Services Provision Fund contained in the National Health Act of 2014, which provided for a minimum 15 per cent of the country's national budget as recommended by the 2001 Abuja Declaration under the auspices of the African Union.

The National Assembly should also amend the necessary laws to pave the way for recognition and support of teaching and specialist hospitals as tertiary health institutions. This recognition and support, when fully operational would further improve funding for the acquisition of equipment and relevant infrastructure for specialist health manpower training and effective service delivery.

This was the submission of Professor Aaron Ojule of the Department of Chemical Pathology in the College of Health Sciences, while delivering the 160th Inaugural Lecture entitled, Life as a Chemical Reaction: The Clinical Laboratory and the Battles for Life. The lecture which attracted a large audience, held at the Ebitimi Banigo Auditorium last Thursday.

“Life is 'sweet' and however 'tough' life might be; nobody is in a hurry to go to the paradise of heaven. The medical and health professions are engaged in the constant battle for life, with the clinical laboratory and the Chemical Pathologist at the centre of the battle because life is nothing but a chemical reaction,” the 160th Inaugural Lecturer stated. He, however, regretted that life has constantly been threatened by disease and death.

Professor Ojule explained that a “Pathologist is a physician who studies body fluids and tissues in order to help your primary care doctor make a diagnosis about your health or any medical problems you may have, and uses laboratory tests to monitor the health of patients with chronic conditions.” Professor Ojule added that the Pathologist is usually busy behind the scenes, studying body fluids and tissues of patients and providing relevant information that a doctor would rely upon to make accurate diagnoses, monitor the progression of existing medical conditions and provide the best patient care possible.

“Pathology plays a vital role across all facets and specialties of medicine throughout our lives, from the stage of conception to the post-mortem period. In fact, it has been said that 'pathology is medicine.' Unfortunately, many people still erroneously associate Pathologists with only dead bodies and post-mortem examinations. The truth is that Pathologists deal more and are busy in hospital laboratories helping to improve the health of living people.

“All the doctors that see patients in the clinics/hospitals depend on the knowledge, diagnostic skills and advice of Pathologists. Whether it is a general practitioner requesting for blood or urine test or a surgeon seeking to know the nature of a lump removed at operation, the definitive answer is usually provided by a Pathologist,” Professor Ojule, who was the immediate past Chief Medical Director of the University of Port Harcourt Teaching Hospital further explained.

He further explained that “the battle between life and death is life-long and starts from the moment of conception. The medical and health professions prosecute this war for the preservation of life and to delay death for as long as it is possible. Let me, once more, reiterate that life is nothing other than the complex chemical reactions of intermediary metabolism that sustain homeostasis. Any serious embarrassment to metabolism by disease would eventually lead to cell and organ injury and loss of homeostasis, eventually leading to death.

“All causes of cell injury and loss of homeostasis occur at the cellular and sub-cellular levels and cannot be assessed physically with the naked eyes. Only the clinical laboratory and Pathologists, through their laboratory tests, can interface between the doctor and his patient, to guide him in the assessment of the state of the battle at the cellular and sub-cellular levels, thus helping him to make correct diagnosis and to administer correct treatment. The clinical laboratory and Chemical Pathologists participate in these battles for life by monitoring changes in various biochemical parameters in body fluids and tissues that occur with disease, including electrolytes, urea and creatinine, proteins and enzymes, hormones, tumour markers, infectious agents, etc.,” he explained.

The 160th Inaugural Lecturer pointed out that the medical and health professions evolved in order to protect life and health of the citizens, noting that developed countries place much premium on human lives to the extent that they record less of communicable diseases, whereas developing nations such as Nigeria record a higher percentage of communicable diseases as cause of deaths due to poor facilities to tackle illness.

Professor Ojule lamented that Nigeria's three-tier health system (primary, secondary and tertiary) was still bogged down by gross underfunding, poor infrastructure, inadequate manpower, lack of modern diagnostic equipment, poor equipment maintenance and lacking capacity, drugs and other medical supplies. He also listed high prevalence of fake drugs and poor quality medical consumables, lack of health insurance with huge out-of-pocket payment system, very weak referral system, poor capacity for quick response to solitary emergencies or mass casualties, high level of inter-professional rivalry and attendant frequent industrial disputes/strike actions, as some of the reasons for poor healthcare delivery to citizens.

“This general healthcare scenario impacts adversely on the clinical laboratory because it is a critical and indispensable component of the national health system. It is a known fact that any healthcare system can only be as good as its diagnostic services. All the general challenges associated with the Nigerian healthcare system are replicated in our clinical laboratories,” he further lamented.

“Clinical laboratories should provide information and services that contribute to optimising the effective delivery of care in our clinics and hospitals by ensuring that the correct test is performed on the right person, at the right time, producing accurate test results that would enable clinicians to make the right diagnostic and therapeutic decisions,” he stated.

To make the Nigerian health sector attractive, Professor Ojule further listed mandatory national and social health insurance schemes, mutual cooperation among professional bodies in clinical laboratory practice and improved legislation for oversight and regulation of clinical laboratory practice as other urgent steps that would improve access and quality healthcare for Nigerians. 

On his contributions to knowledge, Professor Ojule disclosed that he and other colleagues embarked on a study on health and safety in clinical laboratories and found gross deficiencies in the knowledge, attitudes and practice of laboratory safety by clinical laboratory staff in the use of Personal Protective Equipment (PPE), specimen collection and processing, centrifuge-related hazards, infective waste disposal and provision and use of first aid kits.

In his remarks, the Vice Chancellor, Professor Ndowa Lale, agreed with the Inaugural Lecturer on the precarious state of the Nigerian healthcare system which encourages medical tourism abroad. “In saner climes, the patient is given diagnostic results immediately they are concluded in the laboratory. It is sad that our healthcare delivery system is ranked 187th out of 190 countries surveyed by global rating agencies. It means that we are still far from realising the quality health sector that meets international standards,” the Vice Chancellor stated. He particularly frowned at inter-professional rivalries that have bogged down effective healthcare delivery in Nigeria.

The Vice Chancellor announced that Professor John Ikimalo of the Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences in the College of Health Sciences, will deliver the 161st Inaugural Lecture entitled, Searching for the ‘Fruit of the Womb:’ Science and Technology bridging the gap on Thursday, July 25, 2019.

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