President Umaru Yar'Adua recently called on medical doctors in the country's civil service to desist from turning down postings to rural areas. The President who gave the advice in his message to the annual general conference of the Nigeria Medical Association (NMA) in Abeokuta, the Ogun State capital, said one of the identified challenges confronting effective primary health care delivery in the country is the unwillingness of medical doctors and other health workers to accept postings to rural areas. The President, represented at the conference by Dr. Ali Idi Hong, minister of state for Health, noted that the doctors' attitude is particularly difficult for government to ignore because majority of the citizens live in rural areas across the country.
The President's concern is indeed appropriate. This is because Nigerians living in the affected areas will now be at the mercy of unqualified persons who may want to exploit the doctors' unwillingness to work in the rural areas. The possibility of this happening is real because even in urban areas where medical doctors are inadequate to cater to the needs of the population or where the citizenry feels that cost of treatment in private hospitals is beyond their means, an assortment of medical quacks have taken over the duties of the doctors. Although they are exposed at regular intervals, the damage they cause to the unsuspecting public is unquantifiable. Many have died prematurely while others are battling to overcome the perilous effects of wrong diagnosis and treatment.
The health situation in the nation's rural areas is quite perilous. It is compounded by the widespread incidence of poverty and superstitious beliefs among rural dwellers. Rather than seek medical aid from qualified medical personnel even where they are available, most rural dwellers prefer to patronise herbal practitioners who rely essentially on trial and error to diagnose patients. Women and children who form the majority in rural areas are more affected by the situation. When the time of delivery for a pregnant woman living in the rural area is imminent, primitive methods which failed to guarantee the safety of the mother and child are employed. This explains why in the face of technological advances in child delivery, Nigerians still ranks among the countries of the world with the worst cases of maternal maternity.
The record of infant mortality in the country is even worse. Even though the Federal Government has recorded tremendous progress in the effort to ensure that all children in the country are immunized against various diseases, conditions in the rural areas continue to undermine this effort. Child mortality rate in the country is still at an unacceptable level mainly due to setbacks in the rural areas. A child who falls ill in the rural areas of this country will in most cases owe his recovery to the soundness of his genes and not the timely intervention of medical personnel. Certainly, proper recognition should be accorded to herbal remedies but the lack of standardisation in their administration makes them unreliable. Rural dwellers also deserve adequate medical attention like their urban counterparts.
Although the government has a significant role to play in making rural areas attractive to medical personnel, doctors too must recognise that the medical profession requires a huge amount of commitment and sacrifice from practitioners. Health practitioners, and other professionals, rightly regard the rural areas as places where they will find it difficult to maximise their potentialities especially in terms of additional earnings from private practice to augment their meagre salaries. Yet while it is true that professionals have the freedom of movement and the right to domicile and work or do business where they choose as enshrined in the constitution, there is also a duty imposed on some professionals, especially health professionals, to administer to their fellow citizens wherever they are found.
If the medical practitioners are sincere and committed to their Hippocratic Oath as expected of them, they would have no excuse not to work in the rural areas. According to the Hippocratic Oath, doctors are expected to put the consideration of their patients first above all other factors. And doctors swear to this oath when they become doctors. Perhaps it is germane to mention here that, Late Dr. Olikoye Ransome-Kuti, as health minister stressed the imperative of primary health care as the basic level through which to effectively reach majority of Nigerians who dwell in the rural areas. He championed the spread of health care to those in the remote parts of the country not minding the social facilities available in those areas.
The medical profession by its peculiar nature, demands that the practitioners serve the rich and the poor, the urban as well as the rural dwellers, without discrimination. Admitted that in a civilised nation-state, all the villages should be developed and have all the necessary infrastructure and modern medical facilities, the absence of the relevant infrastructure in the rural areas is not enough excuse for medical practitioner to abandon rural dwellers. It is therefore imperative that medical doctors and other medical personnel should heed to the counsel of the President and accept postings anywhere in the federation. If the country is to reverse the rural-urban migration in favour of rural areas, the call for attitudinal change in this direction should also extend to other professionals, especially those in government service who would rather influence their postings to urban centres. For instance, youth corps members, police officers, bankers, civil servants, among others, would not willingly accept postings outside the major cities.
It is a sad fact that most villages lack electricity, potable water, good roads, standard schools and modern communication facilities, among others. This is the area where the government takes the greater brunt of rural to urban migration. It is the duty of government to develop every part of the country so that people would be attracted to live and work in the rural areas with relative comfort. When this happens, it would check migration of people from rural to urban centres.