Nigeria’s healthcare system is plagued by several challenges that include poor access to quality health care and insufficient financial investment resulting in poor health infrastructure, meager remuneration for health workers, and lack of sufficient health personnel. A lot of these factors have been laid bare by the devastating coronavirus pandemic, which is beginning to gain a foothold in Africa’s most populous nation.
Recently, Nigerian doctors in state-run hospitals went on strike over complaints of welfare and inadequate protective equipment. Despite risking their lives at the front line battling the pandemic, health workers – more than 800 of whom have been infected by the virus according to the Nigeria Centre for Disease Control – earn only ₦5,000 a month as hazard allowance.
With most corporate and individual support towards the fight against the coronavirus neglecting the need of health workers, crowdfunding platform Giving.ng initiated a ₦1 billion fund, backed by Sterling One Foundation, to support them at this critical moment while they help those sick with the virus get better. The Health Workers Fund will be disbursed to front line healthcare workers a Hazard Allowance of ₦100,000 monthly.
As the coronavirus spreads further across Nigeria – the country has recorded more than 16,000 virus infections, over 400 deaths, and has seen no less than 400 new cases per day over the past week – Ventures Africa spoke to Dr. Olaokun Soyinka, Board Chair of the Health Workers Fund, who discussed at length the vision of the fund, objectives, challenges, and achievements so far, as well as how health workers in the country can further be supported.
Ventures Africa (VA): What necessitated the creation of the Health Workers Fund?
Olaokun Soyinka (OS): It is an initiative of the Sterling One Foundation probably in conjunction with the bank. We started a little bit after the pandemic had hit and after everyone had come up with different initiatives such as sourcing ventilators, building isolation units, and buying large amounts of masks and sanitizers. The way it was put to me by the MD was that they wanted to look carefully and do something impactful that might have been neglected.
So the bank and the foundation got together to set up the fund. And that was when he reached out to me if I would chair it and of course, I accepted the opportunity because I was locked up at home doing the usual stuff. So this was an opportunity to join a project that would hopefully have an impact. And unknown to him, it was something close to my heart. Anyone who knows my preoccupations, it’s mainly with the fact that we have all sorts of issues around human resources for health. In terms of what the impact was to be, it’s supposed to act as an incentive and a reward for the attitude of the heroic workers.
VA: The Fund has a target of paying front line healthcare workers a Hazard Allowance of ₦100,000 monthly. Given the number of health workers in the country, how many do you hope to reach?
OS: We have a target for the fund which would be ₦1 billion and obviously we are making great progress but not close to that figure. In terms of the number of healthcare workers we want to support, every Naira goes to the workers with Sterling Bank providing the logistical banking support, Peju (Peju Ibekwe – Head of Sterling One Foundation) and her team providing the administrative support while board members make decisions and very importantly, work out where the money goes.
But the point is none of that puts any charge on the fund. Every Naira donated goes directly to health workers. So based on that you can easily calculate how many workers we will reach. What we have right now is just under ₦60 million which is a good start. Sterling Bank primed the donations and the public has been coming in to help. So ₦60 million would enable us to pay 200 workers but of course, we are not stopping at that, we can just keep raising. So if you ask for a target, I would say I wouldn’t be happy until we’ve supported every health worker.
VA: Are there measures in place to identify those who really need this support?
OS: Yes, there are and in fact, it’s one thing we very confidently and happily can beat our chest about. Not only does all the Naira go to the workers but they are genuinely deserving workers. I think for a very good reason the average or cynical Nigerian would say half of the money will go missing somehow. But actually we have a great system in place.
First of all, we use personal contact to identify the facilities. The giving.ng platform allows individuals to apply so in addition to the board using its contact to find facilities, we look at the applications and identify which facilities and states they are from. And then when we see that obviously, a number of people are applying from a particular place, we don’t just limit it to those that applied. We contact that facility which could be an isolation unit or an emergency department in a hospital. And we contact the management so we don’t have the need to go right to the top though we inform the governors and health commissioners.
We contact the facility, and usually one of the board members will know somebody in the facility then we talk directly to them and ask for the frontline people. Anybody who by virtual being there is taking a risk with their health, those are the people we want to incentivize. By definition, those are places that if someone was feeling a bit shaky would run away from, call in sick or say literally they’re not working there. So we identify every single facility and confirm that indeed the workers there are frontline workers putting themselves at risk.
So we can happily say every naira that goes out is going to reach the person. Sterling sends the money to their banks directly so we know it gets to the beneficiary. A lot of people think we just take a lump sum and give it to the facility. So that’s the measure in place and I can confidently say board members have seen every name of every facility and we’ve confirmed.
Finally, Sterling does the paperwork cheque. So even if people have assured us that’s where you are, we have to see letters of employment and posting roasters to prove that you are on duty. So it’s very thorough but we believe that helps with the fundraising because we can assure people that all your money goes to the right place.
VA: What has been the response from members of the public and corporate organizations?
OS: It’s been really good. We only need one indicator and that’s the amount of money that has been raised. Just under ₦60 million so far is excellent given the few weeks we’ve been going. But this chat with you is part of our ongoing attempts to raise awareness.
The response has been good based on the amount we’ve been able to raise in the short period but given that the pandemic is still with us, however, people are psychologically getting that feeling of relief which could be dangerous as they might be a bit careless about safety measures. But also an unfortunate effect it will have is they would think things are easing up all round when in fact they’re not in the areas we’re talking about where health workers are still having to put themselves at risk. The numbers keep going up and half of those are in Lagos. Hospitals and isolation centers are still trying to get the message to the public more than ever.
The other thing which I think we can stress is that what you do want as an individual if you are going out more, you want hospitals to be working and isolation centers to keep the infected people away from you. So it’s in your interest to protect yourself by contributing to making sure health workers do their bit.
VA: Considering the economic difficulty the average Nigerian citizen or business is currently faced with, how would you appeal to people, for them to buy into the Health Workers Fund vision?
OS: Definitely, it’s not going to be for everybody. People are going to be looking at priorities. But what I would say is that don’t underestimate what a priority this is. Like I said earlier, it’s important to help protect yourself by making sure health workers can do their jobs.
Also, it’s money well spent because you’re not risking that money going to something you don’t approve of, it’s going to what you have chosen which is to encourage individuals. People should also remember that health workers are not really well paid so they’re part of people who may be struggling financially. So if you have a little bit extra, they should remember that it could just go to the workers.
All of the workers that have given testimonials, written on social media, or contacted Peju and the team, they stress the fact that it has helped them look after their families. That’s the biggest thing on their minds when they’re at work: “I’m doing this to support my family, I’m putting myself in harm’s way because I just have to do it.” So when that money comes, it’s the family you’re supporting. So I think those things might give people joggling with priorities to have a little bit of money they can give away when they’re asking what should do with their money. That’s something they can bear in mind.
But I don’t have any magic for people who have taken a hit during this period and struggling to just meet their basic needs. It’s obviously going to be difficult to squeeze money out of those but I would stress it’s all about widow’s might, there’s no sum that’s too small.
VA: As the Fund’s board chair, what have you found to be the single toughest nut to crack in this project?
OS: It’s been fantastic. Obviously the biggest problem is going to be raising the funds but that’s because the need is almost endless, we’re never going to be happy. We double it by tomorrow, we’d still be out there fundraising so that we can shuffle more funds in the direction of more workers.
But fundraising is probably the most tricky part followed by decision making. It’s quite difficult sometimes making decisions but even that isn’t so bad. Because if you’ve got a certain amount of money and you’re choosing a facility over another, you know in a few weeks you’ll be able to bring the other facility on board. So you’re never really canceling anybody from ever getting benefits from this. So even that isn’t so difficult. It’s all been fairly straightforward.
And then chasing down the facilities, sometimes it takes a while to get an answer. The very same people who have to answer you that the names you’re giving them are genuine workers. You know extracting them, phone numbers and bank details, it can take a while and some of the board members get involved in that. But it’s mostly the Sterling One team.
VA: What are some of the achievements of the initiative so far?
OS: The achievement is basically we are getting the money to the people. I’m very happy because sometimes the theory is different from practice but so far we’ve managed to satisfy ourselves. There are no big areas where we’ve got panic or worry about so we can face donors and say we’ve achieved this and that. That’s something that has pleased me as an achievement.
Also, when you give the money, you realize that it’s supporting more than just the individual you’re giving it to. So that’s something worthwhile.
VA: In light of the pandemic, Nigeria has gone from a full to partial lockdown amidst other measures aimed at cushioning its impact on the economy, what do you think we can all do individually and collectively to beat COVID-19?
OS: There’s a lot more we can do. We want to support the health workers because there’s no easing of anything for them.
The other thing is to remind people that you’re going to dangerous environments and we have to do what we’ve been advised such as social distancing, wearing masks, taking care of hygiene with handwashing using soaps, and sanitizers.
I’d add that people should still keep the mentality of avoiding unnecessary events and not try to travel too much and limit interacting with people physically to a minimum.
Also, the virus is going to be with us for a while even by the time we have a vaccine. So that is another thing people can do, be socially responsible to protect yourself. Let’s try and educate ourselves, get information from reliable sources, talk to experts and people, read online, access credible sources online, and take responsible measures.
VA: In your opinion, what are some of the other areas through which health workers in Nigeria can be supported?
OS: One thing that the Covid-19 pandemic has highlighted is obviously the inefficiencies in the health system. If you see a health system that’s a bit rocky then as soon as it’s strained or stretched, all the flaws that you didn’t even realize were so bad will come to light.
Of course, one of the flaws is the terrible conditions many health workers have to endure. It’s not just Covid-19, that has only brought it to light, this has gone on for long. People understand that local government administrations are not paying even salaries they’ve agreed to pay. They’re behind by months.
The pandemic has shown the value of health workers but it shouldn’t take a pandemic for people to realize the value of health workers. They’re in front lines at all times and all hours of the day and under all sorts of conditions. I think they need to be respected more and looked after better.
The other thing that came to light is not just in terms of salaries, but work conditions. Lack of equipment, training, support, and poor working conditions. Our health system has been chronically underfunded.
We shouldn’t let this Covid-19 come and go and we all feel good and love our health workers for a brief period and we move on and forget. No, this has to have a lasting impact. Besides the fact that the private sector was needed to come in and help, it would be nice to think that the government is also doing its bit. The private sector will always chip in and the government can’t do everything but it should be up to a basic standard.
For me, that lasting message should be don’t let Covid-19 go and our good feelings to the health workers go with it. They should stay and persist.