This disclosure was made by the Medical Director of the Federal Neuropsychiatric Hospital (FNH),Yaba, Lagos, Rahman Lawal.
SOURCE: http://pulse.ng
21 million Nigerians are currently living with psychiatric disorders, according to an expert.
This disclosure was made by the Medical Director of the Federal Neuropsychiatric Hospital (FNH),Yaba, Lagos, Rahman Lawal.
Dr. Lawal also spoke, in an interview with ThisDay,
on the misconceptions surrounding mental illnesses in Nigeria and the
incessant strikes by medical professionals in the country.
Excerpts below:
Inadequacies of Neuropsychiatric hospitals in the country
On
the federal government's part, I will say they have done a lot. We were
previously having three neuropsychiatric hospitals in Nigeria, but
today we have eight. I think going by our population, it's now up to the
state governments to set up neuropsychiatric hospitals in their various
states. I know some of these states have, but they are very few. If
every state set up neuropsychiatric hospitals then the burden of
patients not able to access treatment promptly will reduce drastically.
For
the state governments that can't establish any, they can have a
neuropsychiatric department in their various general hospitals or health
centres and then provide specialists to manage the department. Because
there is no way the few psychiatric hospitals we have in the country can
cater for the entire population. That is why we must bring treatment
closer to the people. The number of qualified psychiatrists every year
is increasing, so we should take advantage of that and increase
psychiatric facilities all over the country. It's not that we have
enough doctors, but let's maximise the ones we have to capacity by
putting more facilities in place.
With the
population of persons in Nigeria who needs psychiatric attention, it is
worrisome that we have only few neuropsychiatric hospitals and trained
psychiatrists in the country making it difficult to meet the medical
needs of the people.
It is cost effective, if
specialist hospitals like ours are located in every area of the country.
Most times we admit people here who come from the eastern and northern
parts of Nigeria. The distance itself is enough to discourage any
patient. Even though we don't have enough psychiatric hospitals, but we
have general hospitals all over. I would recommend that each general
hospital establish a neuropsychiatric unit so that psychiatric treatment
will be closer to the people than the current status.
On subsidizing neuropsychiatric treatment in the country
Infrastructure
and finance are also major challenges of every psychiatric hospital in
the country. Financial challenge is the biggest issue of any specialist
hospital.
To have psychiatric illness in our
country is to carry a stigma. Such a person will likely not have enough
to maintain himself in terms of treatment, because majority of these
patients are unemployed, or some may have lost their jobs, because of
the ailment, some may have been deserted by loved ones. Even the ones
employed may have low earning power. So, like in any other parts of the
world, Nigeria has also subsidized treatment for psychiatric patients so
that the poor can as well benefit from quality treatment.
Our
patients are being fed here free-of-charge while they are also given
bed space free-of -charge. So what they are only payingfor is just the
actual treatment. We have really subsidised treatment. In as much as
people still want more subsidy such that treatment won't be much of a
problem to especially the poor members of the society, I will say
government has reduced cost of treatment such that patients don't pay as
high as they used to.
I hope you know the money
paid for treatment in this hospital is not even enough to run the
administrative activities of the hospital. So government is not banking
on that to run the hospital. We have over 300 staff here and their
salaries are not coming from the money generated through treatment.
Government is paying salaries and putting up infrastructures and other
facilities itself, so that we will be able to offer quality service to
the public. That is also subsidy. I wonder how much patients can pay
that will take care of the salaries of 300 staff in this hospital.
It
is not when we tell patients to pay N10,000 instead of N50,000 that
we'll be said to have subsidised treatment. All other things we have
done is even more subsidy.
Today, we have over 500
bed space in the hospital and no patient is asked to pay for space or
even feeding. This is because that area has been subsidised by 100 per
cent. So, government is doing its best.
Even on
several occasions we end up paying medical bills for the patients that
have over stayed and nobody is forth coming to pay their expenses or
discharge them.
On number of psychiatric personnel in the country
Though
the numbers of professional psychiatrists we have now have increased
compared to before, the country still needs more personnel. I am
advising that more doctors specialise in psychiatry. Let it not be that
we don't have enough personnel to man neuropsychiatric hospitals or
neuropsychiatric units of general hospitals, when eventually we have
more psychiatric centres in the country.
According
to statistics, about 12.5 per cent of Nigerians have one form of
psychiatric disorder or another, which is about 21.2 million Nigerians.
This is why we need more hands; more psychiatrists, more health workers
and more health facilities, so that we will be able to cope with
treatment and management of psychiatric issues in Nigeria.
On brain drain in the profession
One
of the major challenges we are having is that a lot of our trained
psychiatrists are practising outside the country. If we have a lot of
them in the country, we wouldn't say our personnel are not enough. They
are out in search for greener pasture in countries where they are paid
more. In as much as government is doing enough, I will advise that the
profession should be made more attractive in terms of renumeration so
that we won't continuouslyhave issues of brain drain. At present, we
only have about 150 practicing psychiatrists in the country which is
grossly inadequate.
Misconceptions and myths around psychiatric illness
There
are lots of myths and misconceptions surrounding psychiatric illness in
Africa, especially in Nigeria. There are people who refuse to visit the
hospital or bring their sick ones for treatment, because they believe
psychiatric illness is a spiritual issue. Hence, they would prefer to
take such patients to spiritual healing homes or faith organisations so
as to get cure through spiritual means. Majority only take
neuropsychiatric hospitals as their last resort. And you know when cases
are not presented on time, they are often more difficult to treat.
This
is one of the reasons people don't present their cases to the hospital,
thereby preventing such persons from getting proper medical attention.
So, what I do is that when I come across such persons, I tell them to
bring their sick loved ones to the hospital whilst educating them that
there are drugs for the treatment of the illnesses.
People
should understand that psychiatric illness is also like other illnesses
which require medical attention. And now we have good drugs just like
the ones in developed countries.
On incessant strike action by health professionals
Workers
in the health sector have no reason going on strike, because of the
importance of the sector. Imagine the police or military saying that
unless the government gives them what they want they won't go to work.
It is the same for workers in charge of electricity in the country.
There are some services that must not go on strike and this is the group
the medical sector belongs. Continuous strike will destroy the sector.
If
health professionals are on strike and someone has a road traffic
accident and has a broken leg, it therefore means no hospital will
attend to that person and this will encourage them to patronize
traditional homes or faith healers who are unprofessional in
administering these treatments.
To avoid these
continuous strike actions and for the health sector to move forward,
there should be a working relationship between every professional in the
hospital ranging from doctors, nurses, pharmacists and other health
workers.
The disharmony among health professionals
didn't just start today. The issue has been there for a long time and
that is why a radical and comprehensive solution needs to be found.
