The narrative that tends to dominate Africa is that of a supposedly ‘dark continent’ where, perhaps, life remains very brutish, nasty and short. The temptation to concur is very high, what with the imageries of war, hunger, disease and deaths that daily assail the sensibilities of those with access to media.
In sharp contrast, critics hold up the model of the much-talked about advanced economies as standard bearers, shoving into our sullen faces romantic pictures of good life, defined by easy access to food, shelter, clothing, health and every other thing that makes living meaningful.
This is certainly not a time to begrudge the developmental strides recorded in other climes, as the world has long equated the gains of human progress with the rising level of life expectancy in various societies.
This is why it may also serve little purpose to continue to push the argument of ‘how Europe underdeveloped Africa’ when most of the continent’s emerging leaders have shown poor vision and little capacity for harnessing Africa’s enormous human and material resources. The only consoling factor being the weather-beaten claim that Africa remains the cradle of civilization. But how true?
Back to the subject of life expectancy, therefore, it is important to take a shot at how Africa has fared over time, and why the seeming positive shift leaves little room to cheer.
This is what I found. Though Africa has, since 1925, seen a steady rise in its average life expectancy, climbing to about 60 years in 2015, having stayed at 26.4 years of age for over a century, the performance still leaves the continent at a comparatively lower rung of the ladder.
Indeed, while, by 2021, it was reported that the average life expectancy globally was 71 years for males and 75 years for females, Africa posted an average life expectancy of 63 years for males and 66 years for females. A further data query showed that life expectancy for the continent in 2020 was 63.24 years, a mere 0.46% increase from 2019.
Africa’s comparative tale in the healthcare system means more needs to done to close the gap between it and the rest of the mature economies. Perhaps, the marginal gains of the past few years may have been accounted for by the ‘Abuja Declaration’ of April 2001 during which African governments resolved to dedicate at least 15 per cent of their annual budgets to the health sector.
Nearly two decades later, a cursory search indicates that only about seven countries namely: Rwanda, Botswana, Niger, Zambia, Malawi, Burkina Faso and Togo, have met the Abuja target. Sadly, in 60 per cent of the continent, the World Health Organisation reports that health sector share of total government expenditure remains below 10 per cent.
For instance, Nigeria, adjudged as one of Africa’s biggest economies, failed to match its 2001 resolution when, in its 2021 annual budget, it allocated less than 10 per cent to the health sector. In fact, the budget for 2021 proposed N547 billion for healthcare, representing about seven per cent of the budget’s total of N13.08 trillion.
A simple arithmetic shows that the amount translates to about N2,735 per Nigerian, given the country’s population of about 200 million people.
That 60 per cent of African countries are unable to deliver, on a healthcare promise made about two decades ago, shows a clear lack of will on the part of most, and should leave no room for celebration of any sort.
The call to sobriety is informed by concerns that more Africans may slide into the danger zone if its political leaders continue to pay lip service to the health sector, even as the world rises to the scare posed by autism and malaria.
So, let us not be corralled into a premature dance party. Autism is a growing scourge and, just as the world had done in the last 15 years, April 2 was marked as the annual World Autism Awareness Day, with a theme, ‘Inclusive Quality Education For All.’
How is Africa positioning to tackle this troubling health disorder? In the wake of poor infrastructure, one can only hazard a guess or build scenarios. What is, however, clear is that many African children with autism are kept away from prying eyes —sometimes tied up, almost always undiagnosed and stigmatized. The situation is not helped by the fact that no cure exists for autism spectrum disorder (ASD).
Beyond the pervasive adhoc measures instituted by most governments across Africa, it is time to nudge corporates in the continent into action through well structured partnerships that would complement other global interventionist efforts.
The other health scare which gained global mentions in April is the malaria pandemic which effectively ravages 91 countries of the world. As World Malaria Day took front seat April 25, nations of the earth were reminded that every two minutes or so, a child dies of malaria. But no where is this more prevalent than Africa.
Indeed, UNICEF reports that of the 1-3 million deaths recorded each year, the overwhelming majority are in children aged 5 years or younger, and 80-90% of the deaths each year are in rural sub-Saharan Africa.
In terms of spread, the report also holds that four out of five malaria deaths occur in one of 15 countries: Nigeria, the Democratic Republic of the Congo, India, Mozambique, Ghana, Angola, Uganda, Mali, Burkina Faso, Kenya, Tanzania, Cameroon, Niger, Guinea and Chad.
Bringing the issue closer home, more than one in three malaria deaths reportedly occur in two countries: Nigeria and the Democratic Republic of the Congo.
Africa’s health horizon, no doubt, looks cloudy even as the continent strikes marginal gains in the area of life expectancy. Buffeted by infrastructural challenges across many fronts, the biggest obstacle to rapid growth and development appears to be the lack of political will to sustain the gains of today.
The continent’s leadership must, therefore, thread with cautious optimism and resist the urge to roll out the drums in celebration of meager achievements when the larger pursuit should be to scale Africa’s capacity to leverage its enormous endowments and stay competitive against the rest of the globe.
UK-Rwanda relocation plan for asylum seekers is a hot potato by Charles Onyango-Obbo
In 2019, Rwanda agreed to take in hundreds of African immigrants held in horrid conditions in detention centres in Libya under an agreement with the UN refugee agency, UNHCR, and the African Union.
There was applause.
In August 2021, as America’s 20-year-old military and state-building campaign in Afghanistan unravelled into chaos, in Africa —Rwanda and Uganda — agreed to take in Afghanistan refugees.
Among the Afghans who relocated to Rwanda, escaping the Taliban’s well-known hostility toward education for women, were all 250 students of the famed Afghanistan Leadership School (SOLA), Afghanistan’s only boarding school for girls.
There were cheers and extravagant praise for Rwanda and Uganda. Today, Rwanda hosts nearly 140,000 refugees and asylum seekers. Uganda, on the other hand, hosts 1.5 million refugees, making it the top refugee-hosting country in Africa.
In April this year, hell broke loose. The UK announced that it had a plan to send illegal asylum seekers to Rwanda, where they would either stay or move on to other countries.
The Boris Johnson government insists the programme is aimed at disrupting people-smuggling networks and deterring migrants from making the dangerous sea journey across the English Channel to England from France.
Critics have come out swinging with fury, calling the plan immoral, racist, and several arguing it is risky because several of the human rights found in liberal democracies are absent in Rwanda. This new “democracy test” for resettlement, has opened up a tricky window into the protection business.
The UK asylum affair, meanwhile, has muscled its way into the headlines about the Commonwealth Heads of Government (Chogm) meeting being held in Kigali.
The high emotions the UK-Rwanda asylum plan has kicked up, are a pointer to how complicated, immigration and refugee have come. There are several contradictory things that are both true at the same time.
If Donald Trump’s election victory in the US in 2016, and his turbulent racist-fuelled term tell us anything, it is that the western world has reached “peak” migration.
Uncomfortable to confront, but it is probably no longer sustainable for, especially, people from the south to continue emigrating and fleeing to the West in large numbers. Domestically, the fear of people of colour “replacing” white communities is reaching a fever pitch, and fuelling extreme right-wing politics.
We’ve to grant it. The demographic make-up of the West is changing, and by the end of this century, white people will be minorities in nearly all the major European countries. Not too many people will take their disappearance with great fortitude.
For the western left and progressives, migration and the diverse nations it makes possible is where they see the future of their play in politics. For businesses, migrants provide a new pool of cheap labour, ensuring their profit in a world where China is eating their lunch. Things like the UK-Rwandan plan, do have long-term political and economic consequences.
Yet, that doesn’t explain why the resettlements of immigrants from Libya and Afghanistan in Africa weren’t attacked. The difference could be because Libya’s and Afghanistan’s crises are partly outcomes of western — NATO and the US — interventions that went horribly wrong. The repatriations are a much-needed clean-up of the mess — and there is some consensus of the western left and right on that.
Charles Onyango-Obbo is a journalist, writer, and curator of the “Wall of Great Africans”. Twitter@cobbo3
Tanko Muhammad, Ekweremadu and health of Nigeria by Suyi Ayodele
What happened to the Nigerian judiciary under the now retired Chief Justice of Nigeria, CJN, Justice Tanko Muhammad, is a symptom of an ailing nation. We must all come to admit that Nigeria is a country that needs moral transplant. Who will be the donor is what we don’t know. That the aeroplane-driving CJN retired after his “brother justices” accused him of misconduct is never news to celebrate. The resignation itself is never a part of the diagnosis of what ails the country. And I sincerely do hope that the General Muhammadu Buhari administration will not because of the belated retirement roll out the drums to celebrate his tough stance on the fight against corruption! The judiciary is expected to be the healthiest of the three arms of government. Its chronic illness under Tanko is a pointer to the general well being of the government in power. The undertakers should not be far away as their services may be required soon.
In Africa’s worldview, a healthy man is a wealthy man. The saying, “health is wealth,” underscores the importance human beings attach to sound health. Without sound health, man becomes useless. This is why sane countries of the world don’t play with their healthcare delivery. But it is not so in Nigeria, a country which prides itself as the “Giant of Africa”. By that sobriquet, one would expect that Nigeria would tower above other African countries in all ramifications of life. If you are wondering why we are this low in all aspects of life as a nation, just take a look at our health care delivery system. If Nigeria’s health is failing, or has failed, the citizenry cannot be healthy. For those who care to know, Nigeria is not just ill, it is terminally ill.
Some two years ago or so, I had the misfortune of rushing an ailing church member to the University of Benin Teaching Hospital, UBTH. At the close of service that fateful Sunday, a friend and I had planned to go out with our spouses. We drove out of the church premises and saw the ailing woman being aided to the road to get a taxi to the hospital. We picked her up in my friend’s car while I joined him and asked the women to use my own car. By Ehaekpen Road, the woman gave up the ghost in the car. But we continued the journey to the UBTH. At the Accident and Emergency section of the hospital, she was confirmed as BID (Brought In Dead). That was where our ordeal began. The relation in the car contacted other family members and agreed that the remains of the woman be deposited at the hospital’s morgue. To our utter embarrassment, UBTH had no BID form to take the woman’s profile and have her corpse deposited in the morgue. For over two hours, the corpse was left in our car. I had to ask one of the hospital attendants in charge to copy the information of a used BID form at the back of another used form and fill in for the dead woman. I knew then that we had bigger problems than anyone could imagine. If a teaching hospital, as big as the UBTH, had no ordinary BID form, one can imagine the state of the General Hospital at Afrikpo, or Balewa Village or at Itawure!
This is why, at the slightest discomfort of headache, the locust masquerading as our leaders jet out of Nigeria to seek medical help abroad. From personnel to equipment, infrastructure to medications, hospitals in Nigeria are killing fields. In his 2017 article titled: ‘Africa’s presidents keep going abroad for medical treatment rather than fixing healthcare at home,’ published in Qartz Africa, an online publication, Yomi Kazeem has this to say: “The preference for an international doctor’s appointment is steeped in irony as these leaders often make promises about improving local healthcare a central part of their campaigns while seeking office. But by looking beyond the continent for medical solutions, African leaders maintain a vicious cycle which keeps faith in public healthcare low while channeling substantial state resources to hospitals abroad rather than plug local healthcare gaps. In many African countries, this reality is all too apparent. According to the World Health Organisation estimates, with a shortage of 4.2 million health workers, Africa is the region with the world’s second-worst health worker shortage”. Zeroing down on Nigeria, Kazeem quoted WHO as saying that: “In Nigeria, Africa’s most populous country, the shortage will be less severe if the health system could call on the services of the up to 15,000 Nigerian doctors estimated to be working outside the country. But there’s little motivation for doctors practising abroad to return home with crumbling infrastructure, lack of drugs and poor compensation.” If in 2017, we had 15,000 Nigerian medical doctors working outside the shores of the country, your guess is as good as mine on what the figure will be now.
Nothing, in recent time speaks to the parlous state of our healthcare delivery system more than last Thursday’s arrest of Senator Ike Ekweremadu and his wife, Beatrice, by the Metropolitan Police in far away United Kingdom. According to the reports of the arrest, the former deputy senate president was accused of trafficking a child to the UK for organ harvest and slavery. A statement issued by the Met police says “Beatrice Nwanneka Ekweremadu, 55 (10.9.66) of Nigeria is charged with conspiracy to arrange/facilitate travel of another person with a view to exploitation, namely organ harvesting. Ike Ekweremadu, 60 (12.05.62) of Nigeria is charged with conspiracy to arrange/facilitate travel of another person with a view to exploitation, namely organ harvesting. They have both been remanded in custody and will appear at Uxbridge Magistrates’ Court later today. A child has been safeguarded and we are working closely with partners on continued support. As criminal proceedings are now under way we will not be providing further details”. Ever since, the senator’s team has responded to state that the alleged “organ harvest victim” is not a 15-year-old street lad, but a 22-year old adult who volunteered to donate one of his organs for Ekweremadu’s daughter, Sonia, who is having challenges with her kidney. My thrust here is not to probe into the veracity or otherwise of the claims that the supposed organ donor, David Nwamini Ukpo, was shipped to the UK legally. I would also not bother to interrogate whether Ukpo is on his own an opportunist, who, according to claims, when he realised that he would be shipped back to Nigeria after his organ failed to match that of Sonia, decided to raise false alarms of abuse and what have you. No, my focus is why, in the first instance, Ekweremadu had to depend on a UK hospital for an organ transplant operation for his darling daughter.
The problem with the Enugu-born senator is the problem with all our political leaders in Nigeria. Like the saying goes: “all are thieves but he who is caught is the barawo”. For crying out loud, Ekweremadu has been in the corridors of power since the time lizards were few. He is a confirmed “omo ijoba” (government child). Two years before the advent of the current political disaster we call democratic governance, he was elected chairman of Aniri Local Government Area of Enugu State on the platform of the defunct United Nigeria Congress Party, UNCP. He was elected into the Senate in 2003 and was deputy Senate president for 12 years, beginning with the era of David Mark, through to Bukola Saraki. In his 19-year stay in the Senate, like his other political leeches feeding fat on our patrimony without a whim of concern for the common good, Ekweremadu did not see any reason why Nigeria should have well -equipped hospitals where ailments like organ failure of any shade could be treated. Unfortunately, Ekweremadu is not the only culprit in the league of Nigerian leaders engaged in medical tourism. The league, as we all know, is led by General Muhammadu Buhari, who holds the life trophy of spending 104 days at a stretch on a London hospital bed at our expense, with the presidential jet parked at Heathrow Airport, accumulating demurrage! When we add the BTA of his personal aides who accompanied him to the UK, Buhari will go down in history as the man who spent what could have built for the nation a decent hospital for the use of the people on a single medical trip abroad. So, when news of the arrest of Ike and Beatrice Ekweremadu filtered in, what easily came to my mind is the saying that when the head is rotten, the tail will be home for maggots! Cumulatively, an August 5, 2021 report by the Premium Times of Nigeria, puts the number of days General Buhari had spent on medical tourism to the UK at 200. You may wish to ask: did Buhari not talk about the parlous state of the nation’s health institution while seeking our votes in 2014? Did he not assure us that he would not go abroad for medical attention? Kazeem, quoted earlier, answers the posers.
That done, as humans, we may also wish to look at the desperation of the father-figure Ekweremadu presents as he seeks a medical solution to his ailing daughter’s health. There is a deep prayer among my people which says: “ki Oluwa ma fi ina omo jo wa” (May God not allow us to be scorched by the death of our child). This is where I believe that our thoughts should be with Miss Ekweremadu as she battles for survival at this critical moment. It is even more important for us to spare a moment of prayer for Sonia, now that the most important caregivers of her life, the parents, are in detention. The thought that her parents are locked up in cells in the UK because of her is devastating enough for the poor girl. While we have the assurance that, unlike what we have in Nigeria, the UK Government would not allow Sonia to be left unattended to, we cannot overemphasise the importance of the presence of her parents at this crucial time. Again, that the Ekweremadus were picked up on their way to Turkey is an indication of how desperate they were to bring their daughter back to sound health. We may frown at the method employed to achieve that. We may interrogate why the replacement for the failing organ was not sourced within the family circles. In all that, we must have it at the back of our minds that every mother hen uses her back to shield her chicks from the ravenous hawk. We therefore call on the Almighty God, our Healer, to stretch His healing hands on Sonia and make this storm to pass. We pray that she surmounts this mountain before her and becomes useful to Nigerian society and humanity in general. We also pray that after this, every Ekweremadu in leadership in Nigeria will see the need to build up our health institutions and other decayed infrastructure in the country as doing so is also in their own interest. May Sonia live!
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