“We gotta make a change
It’s time for us as a people to start makin’ some changes.
You see the old way wasn’t working so it’s on us to do
What we gotta do, to survive.”
– Tupac Shakur
Next month, just two days after Valentine’s Day, Nigerians, 18 years and above, will be participating in the general elections which may reelect the incumbent president or a former VP that has consistently vied for the country’s highest office.
Even though it is almost certain the winner would be either of the two candidates, several Nigerians daily complain about the limited choices and why the country cannot achieve the much desired progress without making some abrupt changes in the types of persons being elected. But, after looking at the major stories in the past couple of days, I’m coming to the realization that nothing has changed, and nothing will – at least anytime soon.
We finally published a breakdown of what the Nigerian government is proposing to spend on health in 2019. And, as usual, health was in the backseat. The 2 leading items that the government wants to spend money on in the health sector are the Nigerian Health Act and counterpart funding for GAVI and Global Fund.
If you don’t include the 1% of the budget that has been set aside for the Basic Health Care Provision Fund, Nigeria, according to the publicly available data, is only proposing to spend around 1% of its 2019 budget on health which is a very disappointing trend since the country hosted and agreed to the Abuja Declaration where African countries pledged to be spending a minimum of 15% of their national budgets on the health sector. You can check out the interactive breakdown of the 2019 proposed health budget here.
To have an idea of how bad the Nigerian situation is, we recently reported that in Zimbabwe, doctors went on strike to demand that the government should increase its health spending to 15% from the current 9%. Nigeria is not anywhere near what Zimbabwe currently has, neither is anyone, including the ‘top strikers’ – the Nigerian Medical Association (NMA) nor JOHESU, attempting to compel the Nigerian government to do what is right.
Beyond the reluctance to actively increase health budget, Nigeria is also faced with deeply engrained cultural norms that create largely insurmountable obstacles to certain aspects of healthcare. One of such is mental health.
For generations, Nigeria’s cultural practices, religious beliefs, folktales and indigenous ideologies have portrayed mental health in the worst light possible, threatening those that are suffering from mental ill-health such as depression, anxiety disorders and several others.
Recently, I spoke to representatives of Translations Without Borders – an organization that is currently working in Nigeria with the International Organization of Migration (IOM) to provide translation services to those helping with the humanitarian crisis in northern Nigeria.
I was made to realise that in the widely spoken Hausa language, the direct translation of mental health is “services for mad people”. That alone is enough to prevent people from seeking help since the Hausa language and cultural beliefs present mental illness as madness.
I played around with Google Translate afterwards and I realised that the trend is the same for several other Nigerian languages. No wonder many Nigerians take their mentally ill relatives to spiritual houses for esoteric practices instead of the hospital.
How can this be addressed without making serious changes at all levels to how mental health is defined?
While I don’t expect much to change, I know that for the desired progress to be achieved in Nigeria, much needs to change. Unfortunately, I don’t think this will influence the forthcoming general elections since our review showed the two leading candidates are not prioritizing healthcare and they are not being compelled to prioritize the sector.
Only time will tell whether this will change.