Dr. Omosigho Izedonmwen is the Executive Secretary of Edo State Primary Healthcare Development Agency (EDSPHCDA). In this interview with Edward Oseghe and Jennifer Osadoh, Dr. Izedonmwen speaks on the mandate of the agency, achievements so far and the plan going forward. Excerpts:
We know your mandate is to manage the primary healthcare centres across the state, but we would like to know more.
That is the beginning. That is not even half the story. It’s good that my younger colleagues are here because we’ll be leaving the stage for them. And I also want them to understand our philosophy.
Yes, let me start by first introducing myself; My name is Dr. Omosigho. I’m the Executive Secretary of Edo State Primary Healthcare Development Agency.
Our full mandate is to manage a system of health that provides promotive, preventive, and curative services up to rehabilitative services to people in Edo State at the primary level. But the way we understand it is translation to providing health care too.
Health care is not just the absence of disease, it includes spiritual well-being, physical well-being, and the mental well-being of every individual.
If you understand it from that perspective, you will see that what you described was just a microcosm or a micro part of a broader picture. Because for you to enjoy health, it means that, for instance, the noise pollution around you should be minimal. For you to enjoy health, you should be in a mental state that is positive and I should help you achieve that.
I can achieve that through different means, by health promotion, which means that I would make things around you positive so that you can enjoy that health and give you some health education to make you enjoy that health and prevention of illnesses to remove anything that would cause that disease, and maybe to give you early screening mechanism to early detect whatever conditions you’re going through.
Invariably, primary healthcare is the repository of people’s health. It is the gateway into the health system and not the way we understand it. Some people would argue primary healthcare is women’s and children’s healthcare. Wrong. Primary healthcare is for everybody. It’s the gateway, the place where you register and have health at your doorstep. When you live in a neighborhood, you should have a registered care provider. That’s your registered care provider, which happens to be primary healthcare, it is where all your health records are situated.
In layman’s words, we will say your facility should know you from cradle to grave. For instance, when a young lady turned 21 years old, nobody sent her an invite to do her PAP smear. Nobody did, because there’s no primary healthcare to date. I doubt if anybody has written to young ladies that they are due for a PAP smear. What is a PAP smear? To quickly find out if one has cancer of the cervix.
Women die from cancer of the cervix regularly, but it is untold and high. How is it transmitted? Is it transmitted through sexual activity? The males do not suffer so much from it, but they help to propagate the Human papillomavirus (HPV). The woman will react to that virus and after her exposure to the virus, come down with cancer of the cervix and die in her prime.
Usually, they start having it around 45 years, but if you catch it early, it’s one of those cancers that can be stopped on the tract. Interestingly, I doubt if any young lady has ever received a letter like that.
For men, there’s what we call colon cancer. At 50, men should go do a screening test, but nobody has invited any man for that nor would they invite you because we do not have functional primary healthcare. Edo State doesn’t know that you’re close to 50 or above 50. Why? Because we’re not attached to any health facility.
You see my task, alongside my team, is very huge. The first step we need to know is to know Edo State citizens, and the way to know it is when you come to us, or we go to you and know you. We need to have your record. We need to know how old you are. So you see what primary health care is.
Those are the things that I need to be able to get across to the people of Edo State that this is what primary healthcare underlines, health is not primary disease care, primary health. Because I am moving before the disease. To know that the disease can come through this way, I need to block it.
That’s the only way we improve our life expectancy. If you’re not doing that, our life expectancy will not go up. What it means is that the disease is moving faster than me. I need to move faster than the disease.
This is how you think as a public health physician, you begin to think like a policeman. Prevention of crime. The disease now is just a crime. I know the attributes. I know how they come, how they go. I need to move in front of it and block it so that it doesn’t affect it. That’s one aspect.
The management aspect is the one you spoke about. How do I organize all my strings of hospitals to be able to deliver that health care to all of us? It is what we do here at the headquarters. We have looked at what we have in Edo State. We have 494 primary healthcare centers, most of them non-functional. They are short-staffed. They are ill-equipped. Their space is bad. It’s not looking nice. One of the things we initially thought of was to make our buildings fancy so that you can walk in your suit and tie, you walk in and see these gentlemen doctors sitting.
But it’s an enormous amount of resources to put in. At the last count when we looked at how much it would take to do that, we had to pull back and say, okay, let’s take it, have a five-year plan, start building small, small.
We intend to have one level three primary healthcare center in 192 Wards of the state. But that’s not going to be possible given the amount of resources it takes to build those things. But what we can have is that we can clean them up to a large extent, with minimal investment in terms of infrastructure, clean them up, make them presentable, and put fine people there. So that’s why the Edo State’s Primary Healthcare is continuously recruiting.
As at the last count we recruited, when we finished this new set, we would have recruited close to 850 people within a year, and they include doctors, nurses, and everybody so that we can man them. Because if you have a fine center and you have good doctors, they will deliver health. Even if you put them under a tree, if I put a young man there, he will deliver health. Maybe not in the best place, but he will deliver help.
So we’re recruiting massively. We’re also trying to use our technology to shorten the time. But again, that’s been a challenge, a big challenge.
We’re trying to put in alternative power because we don’t have alternative power like Solar systems. Trying to engage new equipment, try to bring in new equipment.
Amongst all these is putting in a quality management system so that all our centers are doing the same thing at the same time, following international best practices. These are things that we’re doing, ongoing now to make clinic standards for everybody to come. But they’re not easy, I’ll tell you that it is a lot of investment in time, energy and money.
We’ve talked about the infrastructure, talked about the management. I will try to explain what we are doing.
One of the ways we think we can rapidly achieve that organizational ability is to get our communities involved. So that’s why we’re moving out massively on community participation. We want our communities to own the enterprise, to own our clinics, to own the management, to own everything so they don’t start destroying their own thing. We want community ownership. That’s our major push, community participation.
On the side, we have the ongoing immunization that sadly recently people have been hit by disinformation, severe disinformation on immunization, which is regrettable. For you journalists, you may not be scientists, but let me tell you the reason the world has hit an 8 billion population; is simply vaccines and antibiotics. That’s what is keeping all of us alive. Without antibiotics and vaccines, the world would never have grown beyond 1 billion.
What is a vaccine? Before now it reduces the potential of a virus or bacteria and makes the body fake itself like it’s been healed before so that the body can produce antibodies to it and kill it when it comes again, behaving like a policeman catching the thief before it does misbehave.
Science has improved. We now know specifically the part of the virus that triggers that. So we’ve gone to pick it up, fake it, and inject it into ourselves.
Now we’re about to start the HPV vaccine to prevent cancer of the cervix. Abroad, boys are taking it already. Boys between the ages of 9 and 13 are taking the vaccine already. I know because my two sons took it. One is in university now, the other one is going to the university in a couple of years and a half from now. They’re not dead, but there’s been an onslaught of media barrage. “If you take it, you’re going to die”.
Here we’re saying women first, but abroad the boys are already taking the vaccine because like I said, it’s sexually transmitted. The men don’t suffer anything from it.
They don’t even know if they have it. So abroad they’ve looked at it. Why treat only the girls?
That means the likelihood of the men giving more women, so just give everybody so that the boys don’t have it even though it doesn’t affect them. But let’s just make sure that they don’t become the conduit.
So that barrage of disinformation about vaccines is unmerited, uncalled for. It’s just going to send us back into the Stone Age.
The truth is that we are a big agency, with big potential and minimal resources compared to the tasks we ought to have done.
What are some of the achievements of your agency?
I’ve been here one year, and I can tell you one of the things I’m good at. I’m proud of the latitude to which His Excellency has given us to operate in terms of recruitment. I doubt if any state has been as ambitious as this state, in recruiting almost 1,000 people within one year into the healthcare field.
In one year, we have built, expanded, and renovated 12 PHCs. Some of them are models for the country to see.
You can stop at Aruogba and look at it. Look at Oluku, Ikhueniro, Aduwawa, Evbotobu, just go look at what we have done. They are real models.
We’re building a quality management system that would be technically unparalleled in the country at our finality. We’ve started what they call community home-based care. People go from home, house to house, talking to people at home and telling them about health issues. That is not currently going on anywhere in the country if I remember.
These are things that we’re proud to have achieved, other than the fact that we’ve been able to reorganize the agency, to be forward with it, and have a purpose for everything we do. That for me is a huge task. And some other achievements are small, but I will say they’re not small. In the last year, we won the primary healthcare challenge and first runner-up for the South South Zone. And what is the primary healthcare challenge? They looked at all the primary health care in the South-South Zone and said that Edo State is the second best.
That is not a mean achievement. And for that, they gave us $400,000 and it was done by independent bodies. Bill & Melinda Gates Foundation, Governors’ Forum, UNICEF, and the Federal Ministry of National Primary Healthcare Development Agency, looked at our work and said this. Our immunization coverage remains one of the top in the country.
Staff motivation seemed to be top-notch. We organized the first “Evening with the Executive Secretary” on December 15 last year. It was a night we awarded the local governments for their work in the primary healthcare space. It was a meeting where we sat down, rewarded staff for their hard work, and rewarded local governments that are doing well.
What are your challenges so far?
Challenges are everywhere but it may interest you that one of the challenges that we go through is everybody’s leaving. It’s difficult to keep personnel down now.
Then we don’t have the cooperation of society. That’s a big one. We want the cooperation of communities and societies in this organization and everything. We long to have that cooperation from them. That ownership is a big one. We need to also do that. These are some of the challenges that we face every day.
May we know more about your person?
I don’t know, but there’s nothing. I was born June 21, 1973, to two wonderful people, Jackson Omamure and Elizabeth Izedonmwen. Wonderful parents, the best you can ever have. Both were educationists. Raised us in a middle-class family, but told us what it is, the principles of life, and how to enjoy life in fullness. Gave us all the foundational elements that you need to become a man. Sacrificed their joy and laughter for children to grow. So that’s my story. I haven’t worked any harder. My parents did all the hard work. They did everything for us. And of course, from Edo state, full-blooded.
I’m glad you brought up the HP vaccine. Recently, the Lagos State government announced that they’ve been able to achieve about 40% vaccine coverage as regards HPV. Bringing it home, what has Edo State done so far as regards HPV?
So in the country generally, they were split into segments. For those of us in Edo State, we belong to the segment that will start vaccination in the first quarter of next year. So we don’t have statistics yet.
So that’s why I’m putting this out there as a disclaimer for all that garbage they’re going to churn out, they started churning out, and it’s affecting even our polio vaccination exercise. You know, the fight has already started. I don’t know what they intend to achieve.
