Healthcare in Nigeria: Medicine in a container clinic

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July 6, 2012 By specialguest

The medical infrastructure in Nigeria has been largely neglected, particularly in Northern areas. Patients have little confidence in the quality of their services, also due to bad practices. Nigeria is one of the worst statistics of WHO-membership countries. The indicators show a high maternal mortality. Besides Pakistan, Nigeria is the only country where polio is not eradicated yet. The shortage of doctors is the result of “brain drain”. 61% of Nigerians, a total of 100 million people live in absolute poverty on less than $ 1 a day. Poverty has increased since 2004 by 10%.

In Adamawa is 75% of four million inhabitants. It is the fifth poorest state (36 provinces). The two secondary care centers have limited capacity to supply the region. The Specialist Hospital Yola (SHY) has 300 beds and 15 doctors, the Federal Medical Center has 120 beds and 100 physicians (in theory – some “ghost employees”). Christians and Muslims are compensated in Adamawa. It borders the Muslim-dominated provinces that have adopted Sharia law. Adamawa could stay out of religious conflict. When one walks through the door in Northern Nigeria, the desert wind is felt. The indoors feeling is like that of any German hospital. A Munich-based company intended to modernize a Regional Hospital in Nigeria by adapting the container clinic approach. The containers are completely pre-assembled, complete with operating room, intensive care, laboratory and X-rays. It was decided to create an innovative model that can ahead be financially sustainable.

The medical professional’s mission was to train nurses in Nigeria in modern techniques for two years. The Governor, Admiral Nyako is passionate about improving health delivery in his region. “Made in Germany” is still valuable for him in the remote area on the border to Cameroon, a former German colony. The contract to see this through, was awarded to a German consortium by the Nigerian government. These clinics became the symbol of their efforts in the health sector. These “Specialist Hospital Yola” (SHY) as they are called has proven to be an affordable solution to healthcare provision in Nigeria since the local “healers” applied questionable methods in their treatment. Thus the people accepted the clinic as a day care unit. The pilot project aimed to establish a prefabricated clinic for third World conditions. These containers were originally developed as an interim solution while rebuilding the hospital, however, it still is in operation years after. The plan in Yola is based on prefabricated construction. These are manufactured in Magdeburg for transport by sea. Supply Lines and medical technology were already installed. A German team of experts put the clinic in operation Nigerian teaching professionals until the clinic can be taken over by the Ministry of Health.

An innovative technology is expected prefabricated export opportunities in other emerging countries, where resources are limited. The times have been changed: no more major development projects, but intelligent solutions to the current demand. The priority, in the first year was the completion technique, in early 2012 two buildings were in operation, the “Diagnostic Center” (CD) and laboratory (LABO), the building for tomography is under construction. After the bomb attacks on churches in Christmas 2011 in Yola had caused delays for security reasons. Due to the tense situation there was a 24-hour armed guard. Our team consisted of one doctor, two nurses and two medical technicians reaching 40 employees. The “German Adamawa Medical Center” (AGMC) began in March 2012.

The first patients were derived from the Regional Hospital, in whose land is located the AGMC. Every day from general medical and surgical consultations, with two days a week for operations, an anaesthesiologist was assigned from SHY. In the first three months the team managed more than 100 patients in total. The clinic had daily 50 consultations, 30 laboratory studies and 20 radiographs. A part of Plasters Of Paris (POP) pain therapy and nursing services were done. Patients also came from neighbouring provinces of Adamawa and the border of Cameroon. Health checks were made popular in the local elite. Hypertension and diabetes mellitus are very frequent (There is a genetic predisposition for the Bantu). Orthopedic injuries were in the foreground, various deformities and contractures, besides diabetic foot, ill-treated children such as congenital clubfoot. AGMC developed a fruitful cooperation with the Regional Hospital. The Central Hospital of Adamawa also assembles all public health institutions .

The AGMC was linked functionally, but administratively independent. The Board was in the hands of Mrs. Yakubu (a experienced head nurse). The benefits were used to meet recurrent expenditure in order to operate without subsidies. They were based on the usual prizes, although patients and their families like to bargain. Even some of the nomadic peoples of the Sahel were willing to pay for high quality medicine. The project meets customer expectations. The visiting delegations remain surprisingly happy.

Willi is a humanitarian Surgeon currently working in Nigeria

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