by crossriverwatch admin
Dr. Iyam Ugot has since 2000 been in government in Cross River State. He started as the Commissioner for Health and later, Special Adviser on Roll Back Malaria under Mr. Donald Duke. In 2010, Senator Liyel Imoke, occasioned by his commendable performance appointed him the Special Adviser on Community Health. In this interview with crossriverwatch, he enumerates the challenges the community health initiative is facing and says, Imoke has taken health care to the door step of the people.#
What is your philosophy of life and how has that impacted on your work?
My philosophy for life is humility and the fear of God in the service of mankind –that is my watchword. Anywhere you find yourself, you should realise it is God that has placed you there and you should be humble and do what you are supposed to do, be humble remembering that God is the ultimate and it is what he wants that would happen.
How has this impacted on your work while in service all these years?
Basically, I am a medical doctor; I have a passion for health, a passion for the wellbeing of people- and through the knowledge I acquired in school and the wonders that God has done in the human body, those have guided me to do anything I do with a passion. My responsibility has been to implement the policies and program of primary health care in the state and I do it with a passion. When we have some commodities and items that we distribute to the vulnerable groups like pregnant women and children below the age of five years and I have a responsibility to ensure those items get to the less privilege; that is those they are meant for. Talking about the insecticide treated bed nets which we had to distribute, we were the first state to attain the 60% distribution target of bed nets in line with the Abuja pronouncement then that at least a minimum of 60% of the population of children less than five years should own and use insecticide treated nets, and 60%of the population of pregnant women should own and use insecticide treated nets and also 60% of the population should have access to insecticide treated nets. We did that distribution and attained the 60% target in 2008 because after the distribution we had a survey by independent bodies which saw that we were the first to attain that distribution level. There were temptation on the way as some people came to me asking me to sell the nets to them but I refused, there were claims that we sold net and when they came and checked and said we sold some nets, after they investigated they caught the people and discovered that the nets came from another state and found their way into Cross River State. Even when we had, in quote, excess nets, we kept them for routine distribution. When we finished distribution we used the balance to cover the unborn children- women who were pregnant and were registered in any of our health centers were given a net and when the child is born she get another net for the child.
What is the scope of community health in the state?
The scope of community health in the state, malaria control is a component of primary health. His Excellency Senator Liyel Imoke in his wisdom created the department of Community Health in 2010 to coordinate primary health activities across the state. Tulsi Chanrai Foundation Which has been working in parts of the country for over twelve years.
With the consultants from the Foundation we had to setup a structure which allows for all the activities of the Primary health care in the state to ride on. This has translated to having a health posts in each community, a health center at the clans and primary Health Care Centers at the Ward level and the Comprehensive Health Centers.
The health centers serve as referrals from the health posts, while the primary health care centers take referrals from health center while the Comprehensive Health Care Centers are the apex. These serve as referrals for the lower health centers but basically in each of the centers and in each of these apex centers we have employed a doctor to coordinate the program, and he is supported with staff nurses, midwives, community health officer, laboratory, pharmacy, and equipped with an ambulance and a utility vehicle this is to make sure the health centers and the referrals function effectively and take care of diseases, register births and other emergencies. At the lower health centers, we have staff nurses who are resident in the center to take care of cases and emergencies. So specifically, the government has taken health care to the door steps of the people of the state.
How would you rate the performance of the free health care services in the state?
At inception we had challenges with electricity which was needed to function the computers for bio data registration but we have since over come that with manual registration. The program is going on well because we have in partnership with Tulsi Chanrai Foundation, Ministry of Women Affairs and Social Development carried out a manual registration of those who are qualified for the scheme, children under the age of 5 and pregnant women. The structure has been set up and services are being provided in health centers and hospitals across the state while government is paying for those services through the Ministry of Women Affairs and Social Development.
How about the Malaria Vaccines, have you put them to use in the State?
Currently there are no vaccines. The vaccines are undergoing trials we are hoping they would be put to commercial use soon because we live in an endemic area –where infection is all through the year which means every day you are exposed to having malaria –that is why we have different activities to combat malaria. Our target is the most vulnerable group, the children under the age of five. We have discovered that there is what we call over diagnosis where people are placed on drugs without adequate diagnosis. This means there must be adequate tests to prove that one is infected with malaria before treatment.
Has roll back malaria been able to reduce mortality rate in the state?
Yes, I say so confidently. Quite a lot has been done and the heavy burden of death that we used to have in the past has reduced. Not just in the state but in most African countries this burden has been reduced and a number of countries are on the verge of being declared malaria free-it has been quite encouraging. The issue is about compliance. We are emphasizing the use of nets, clean environment, window netting, taking adequate treatment and carrying out tests before treatment. We are discouraging human resistance – that is the wrong believe that everybody can treat malaria. We are doing more enlightenment campaigns to create awareness.
What is world malaria day for and what does it seek to achieve?
A few years back, it used to be Africa Malaria Day. This started in year 2000 when African heads –of-state came together to make the heroic Abuja Declaration stating their commitment to fight malaria and that was done on the 25th of April but a few years down the line, it was extended to World Malaria Day because malaria does not reside only in Africa. Many partners came to join the fight against the scourge: World Bank, World Health Organisation, African Development Bank, Redcross, UNICEF, Norvatis and other big multinational pharmaceutical companies are all part of the key players towards combating and eradicating malaria. Currently, we have over twenty four countries working towards achieving malaria free status in the world.
What is the theme for this year’s celebration?
Malaria Day celebration is a day set aside to create awareness, to remind the people that we all have one thing or the other to do towards controlling malaria scourge in our society. This year, the theme is Invest in the Future, Defeat Malaria and the slogan is, the time is now. If you look at the theme, it is telling us that if we do not take care of our future now, we stand a chance of having problems. Investing in the future means making sure our children survive so that we have a future. It means taking care of things that will help us later. We are talking about using insecticide treated nets and the current therapy, ACT based drugs in the treatment of malaria. We can go a step further by cultivating more of the plant from which ACT is produced and taking care of our young ones and looking towards the future and the time is now that we should do it. Some people believe that we coming with tablets and treatments that are not part of the traditional herbs and drugs they are familiar with but the truth is what we used to treat malaria with in the past, the Parasites have become resistance to those drugs. In the past one jab of chloroquine can keep you going but over the years we have abused the drug and the parasites have become resistant to them.
What challenges are you currently faced with?
The greatest challenge is the attitude of our people. We also have issues with manpower-trained personnel. For me the attitude of our people need to change. We have to be serious. For instance you employ somebody to do a job but the person wants to be paid without doing any work. It is an issue we are really working on and through giving our staff the right training and orientation; we are getting the right results. In the past, staff won’t give you reports and if you insist they cook anything and give to you but we have made them realize that for everything they do they should be documentation – it all takes patience and we are getting the correct reports and when we cross check them we see the right thing has been done. We have issues with our professionals retiring so we are working towards recruiting new ones. We have community health extension officers who are working at the grassroots in the health centers but the experienced ones are retiring so we have to get new ones. Apart from those, the communities are embracing the program and today we have established over 400 health centers across the state. Apart from these few challenges, the community health initiative has been a major success in Cross River State. We have distributed nets to virtually every household in the state to the extent where we carried out a hang up campaign. We took treated nets to people and hung the nets for them. Presently we are doing a School based Distribution where we give nets to children who are of the age of enrollment and in primary 4 they get another which takes them through primary school and at JSS One they are given another net and in SS1 this is to ensure that every child own and uses a net throughout school period.
follow us on twitter @crossriverwatch
Since You Are Here, Support Good Journalism
CrossRiverWatch was founded on the ideals of deploying tech tools to report in an ethical manner, news, views and analysis with a narrative that ensures transparency in governance, a good society and an accountable democracy.
Everyone appreciates good journalism but it costs a lot of money. Nonetheless, it cannot be sacrificed on the altar of news commercialisation.
Consider making a modest contribution to support CrossRiverWatch's journalism of credibility and integrity in order to ensure that all have continuous free access to our noble endeavor.