The Executive Secretary (ES) Enugu State Primary Health Development Agency (ENSPHDA) Dr. George Ugwu is an interviewer’s delight. He opened up on various issues presented to him at a no-hold-barred interview he granted Sam Nwanze, member Editorial Board in his Enugu office recently. He spoke on his duties, state of primary health care in the state which he said is ‘one of the best in the country’, NMA politics amongst other issues.
Who is Dr. George Ugwu?
I am a medical practitioner and currently the Executive Secretary, Enugu State Primary Health Development Agency (ENSPHDA). Before this I was Associate Dean Student Affairs, College of medicine, University of Nigeria. I am also a consultant gynecologist and Public Health expert with a Masters Degree in public health. I was also chairman Nigeria Medical Association (NMA) Enugu State branch, a Rotarian and other positions. I am married with children.
What is the current state of the State Primary Health Development Agency which you head?
First of all, I want to use this opportunity to thank His Excellency Rt. Hon. Ifeanyi Ugwuanyi who in his wisdom found me worthy to be appointed to head this agency which is the fulcrum of health matters at the primary level in the state. To ensure effective and healthy operation of the Agency, Governor Ugwuanyi relocated it to a befitting and well furnished office complex with generating sets and well furnished conference room. The required N100m counterpart fund to enable Enugu State participate in the basic healthcare provision fund of the Federal Government was also graciously paid to the Ministry of Health. With these massive supports and revitalization of some existing Primary Health Care (PHC) centres by the Ugwuanyi led administration, the governor had pushed the little known agency that had before now struggled to meet its mandates, to that which is the centerpiece of the health sector service delivery in the state. Within a year, the management of the agency aligning with the governor’s vision had overturned every known poor previous record and performance of the agency to make massive improvements and breakthroughs. The agency has rapidly improved its programmes, especially the day to day running of the PHC centres setting of three special therapy feeding centres (centre for acute management of malnutrition) to tackle infant/child malnutrition as well as routine and continuous immunization exercises. On immunization which is a cardinal function of the agency; the state government had set-up State Task Force on immunization (TFI) headed by the deputy governor, Hon. Cecilia Ezeilo, to ensure 100 percent mobilization and coverage of all routine and special immunization exercises.
The abysmal record of 63 percent of coverage per exercise about a year ago has been upturned to 100 plus percent coverage per exercise. This was attested to by the wife of the governor, Her Excellency Mrs. Monica Ugwuanyi and others who were beneficiaries of the exercise. The National PHCDA, WHO and other partners had applauded Governor Ugwuanyi, the State TFI Team and the Governor’s wife, who is also known as polio immunization champion, the Executive Secretary and the entire PHS workers for the renewed zeal and result-oriented immunization programmes in the state. The routine and special immunization included that of pneumonia, measles, tetanus etc as well as polio and recently added meningitis “A” which was flagged off by the governor at Abakpa Health Centre. The governor had through the agency added additional two days of mop-up in the areas that failed to achieve 100 percent target in each immunization carried out in the last one year to ensure that no child was left out in the statewide vaccination/immunization. The sub-national immunization plus we just concluded and other special immunization have always been very successful. I can categorically say we recorded 101 percent, even exceeding the numerical 100 percent each immunization.
From what you have enumerated, your job is quiet huge. But does the Agency have all that is required to tackle this large responsibility in terms of personnel, equipment, and structure?
Yes we do to a large extent, especially since the current administration came into office. As a matter of fact, we are lucky to have a governor in the person of Ifeanyi Ugwuanyi who sees primary health care as a priority. He understands fully the importance of primary health system that takes care of the less privileged at the rural level. However part of the success could be attributed to the renewed enthusiasm among local government vaccination officials/team to compete with each other and to outperform each other in their reach and target of the children to be immunized. I must thank UNICEF, WHO, and other partners for their trainings and technical supports towards the huge success of the various immunization exercises. However, in a bid to reposition the agency and its PHC workers on the maintaining target on routine and special immunizations, we ensured extensive and continuous training and retraining of PHC workers within the State and at national level. Meanwhile, stipend payment for immunization and other programmes of the agency had been enhanced and paid timely. Interestingly, apart from providing all that is required to make the health care system in the State one of the best in the country, the governor had personally attended some of our programmes to see things for himself. This is unprecedented in the State. Occasionally, he called me on phone to brief him on certain issues apart from seeing him physically. That shows a governor who is really interested in the wellbeing of his people on health and other matters. On our side, we have no choice than to be constantly on our toes to achieve his aim.
Recently, there was reported outbreak of yellow fever disease in some parts of the state what is the situation now?
The recent case of yellow fever outbreak in the state has been curtailed. When the disease broke out and people were dying, we quickly moved in, in collaboration with the national emergency response team, took samples for investigation which turned out to be yellow fever. The outbreak was a sudden and surprise case because we have been carrying out immunization in all parts of the State. We saw people dying and this attracted our immediate attention and the attention of the federal authorities in charge and international partners to offer immediate help. It started at Igboeze North Local Government Area, at a border town called Ette. It later spread to four (4) other local government areas. We moved in for treatment and massive vaccination. We also employed enlightenment strategy on environmental control. We needed to tell the people that it has nothing to do with spiritual matters as some of them earlier believed but an infection. We embarked on massive vaccination in the local government areas where the outbreak occurred and later to six (6) other LGAs close to the initial four (4) on what we called reactive vaccination. We are also getting ready to carry out massive vaccination in the entire state. It has been curtailed now but we are expanding our action for massive vaccination.
What is the number of death during the outbreak before it was brought under control?
As a matter of fact, the death level of yellow fever outbreak is usually high, between 50-100% of the affected ones if action is not taken immediately. But with faster intervention, treatment, massive vaccination and health education the figure could be reduced. This is why it is better to engage in preventive measures to avoid unexpected outbreaks. Regular health education on basic health issues is the proper and better way to go than fighting outbreak. But with modern health centres being built in the state (type 3) to be equipped with modern medical equipments, drugs, other consumables and required trained health workers including doctors, disease outbreak can be avoided in the state.
What are the challenges you are facing or is every thing alright?
As I said earlier, our governor has done everything possible to see that all health facilities in the state including primary health care institutions are properly positioned to take good care of the people. We are better than we used to be but like Oliver Twist, we need more to move higher than where we are now in the 17 local government areas of the state and 291 health wards. I can assure you that by the time the current government comes to an end, tremendous achievements would have been recorded by the primary health care system of Enugu State and other areas of health needs of our people.
As the former chairman of the Nigeria Medical Association (NMA) in the state, how did you manage the affairs of that strong body to a successful end?
Indeed it was an interesting period for me from the start to the end. I made sure I carried everyone along. My team after winning the election went on our knees before our elders, pleading with them to give us the needed support so that we could succeed on our plans and programmes and happily they did. We also made sure we involved the state government in our programmes. All this contributed to our success. The day we went to see the Governor of the state, we went with a document we prepared on how to improve the health condition of our people. The governor was excited about the document we prepared on how to assist the state rather than only coming to make one request or another. These are some of the steps we took that made our tenure a success.
How did you feel when you saw the disgraceful conduct of your colleagues at Okpara Square a few months ago during their attempt to elect new officers?
It was highly regrettable, I must tell you because our profession is a highly respectable one. We should show example to others in all our conducts. This is why our national president came out to apologize to Nigerians on what happened but the issue is being resolved.
What is the condition of service for medical doctors in the state now and also the health workers in your Agency?
To start with, everyone is aware that His Excellency Governor Ugwuanyi is worker friendly. Doctors in the employ of Enugu State government are now equal with their counterparts in the federal service or even more comfortable. They don’t complain again because most of their grievances have been taken care of. Also the governor makes sure that workers in the state are paid between 23rd and 25th of every month and what is now known as the 13th month salary after December salary. Pensioners are also paid as well regularly. That is why at various occasions workers in the state have gone to governor’s office to show appreciation.
Why is it that medical doctors and other health workers avoid working in the rural health facilities. How can government change this situation?
The situation is worrisome I must admit. It is not a case of one state alone but it is virtually the same case across the country. The only way to solve the problem is to put in place a special package that could attract and retain medical personnel in the rural areas. There should be special allowance for them, housing for residential, selection for training, promotion at the right time amongst other things. The communities where they work should also show interest in their wellbeing. This will make them feel at home. The rural health facilities should also be well equipped with medical consumables etc. This will make medical doctors and other health workers especially the younger ones to feel comfortable working in the rural areas. As a matter of fact, every doctor needs rural experience to make him or her a better professional in their future careers. At least if a doctor stays 4-5 years in the rural area, he or she can be posted to the urban area to continue his or her work.