From Idu Jude Abuja
Dr Chukwumezie Okechukwu Okolo, a pharmacist with expertise in public health services, waterborne diseases, and neglected tropical diseases, has challenged the Federal Government on the need for clean drinking water that meets international standards in the country.
Okolo studied pharmacy at the University of Nigeria, Nsukka, and Public Health Epidemiology at the University of Ibadan before heading for England and then the United States to major in primary health care and leadership studies.
In this interview, he talked about what needs to be done about water-borne and neglected tropical diseases in Nigeria, noting that these diseases remained a burden because political leaders in Africa have become insensitive like leprous hands that feel no pain.
Considering that you are a pharmacist, what inspired your crusade on clean water?
Before I picked up the Clean Water Project, I thought of bringing drugs from China. If I import drugs for typhoid, for example, knowing that the water my mother drinks is bad water that causes typhoid, then it is not a permanent solution. The best solution is to find a permanent cure to the cause of typhoid. We need drugs, but my approach to pharmaceutical practice is guided by my belief and the mindset that there are lots of legitimate ways of making money without comprising or without letting our interests go before public interest. You know that there is business, both in water and in the pharmaceutical industry and both can work together in the interest of public health. This is why professionals must be in charge of professional spaces, especially the areas related to health, which cannot be allowed to be dominated by profit motivated business people who have no professional health background training. Public Health should be first over profit any day.
In Nigeria, we have so many agencies that take care of the similar project you are bringing, such as NAFDAC, SON, Consumer Protection Agency, and the rest. Do you think you are not duplicating them?
We are saying the same thing here, non-governmental organisations compliment agencies. These organizations have been there, but we still have neglected tropical diseases in Africa. I can say that the agencies are doing their best owing to their circumstances, given their manpower, their resources and strengths, but the reality is that no agency can solve all the problems for us within their space. There are still very hard-to-reach people in several communities, and there is still some kind of sabotage of the agencies in ways that tend to undermine them like when someone uses a fake NAFDAC number. The agencies need the support of communities to help us address the issues we have in the communities. So, the work the NGOs do is to augment what the government agencies have done and get to those rural, hard-to-reach areas. We will educate the communities and mobilize champions to supplement the works of the agencies. So, I think that the government agencies will be more than happy to work with us.
Funding is very key in this project; how do you go about it, or are you open to a partnership?
We are very open to partnerships. We do not have funding directly from anybody yet, but in what we do, there are development partners who will be interested in working with us especially when they see the credibility we have, and the quality of what we are bringing to the table. There are grants and funding opportunities out there that we are going to be applying for, and from our little knowledge of development and humanitarian industry we are convinced that we will be able to attract substantive support from both national and international agencies, and hopefully politicians and elected officials who see the value of what we propose. Our water solution will definitely be perfect as constituency projects and rural water projects. This can as well be a good call for partnerships and sponsorships; let’s make history happen!
There is this allegation that CSOs always present Africa in a substandard way to attract donations. What is your view?
No, Chimamanda Adichie wrote on the dangers of a Single Story. There will always be two sides to the coin. I have lived in the West long enough that if I want to show you the dirty side of America, you won’t want to go there. If I want to show you the dirty part of England, you will withdraw your passport from the embassy. In other words, if I want to show Africa in a good light, I know where to show it. Having said that, I think Africans themselves can do better. Neglected tropical diseases are not in the West. It is within us; neglected means a people, not just disease itself. What it means is that the people are neglected and the whole world calls it “neglected”, including us within Africa. It is not rocket science to change the narrative, and that is why I said that it calls for leadership within the African space, and we need leaders at all levels not just in government houses. Leadership is the problem we have across the board; we need to show leadership at all levels and to take ownership. When we begin to realize that Africa is the home we have, we should begin to work for posterity and to leave legacies. An American would think of America first without apologizing; we can do that as well.
Given these shortcomings you have identified, where will you find Nigeria in the next 50 years?
From a leadership perspective, I can say that if the present trajectory continues not just in Nigeria but in Africa, we will make it difficult for the next generation. I would have loved to see Africa take a leadership role in global affairs, but any role Africa must play in global affairs must start from home. Some of the politicians seem not to properly understand the vision or to have lost it along the way because when we take a look at what is happening where everyone wants to win the next election, how to hold on to power, how to enrich himself and cronies then it is obvious the vision is not clear. And again there is an article I wrote entitled: “Leadership Leprosy.” I used leprosy as a disease to illustrate leadership, and I accused African leaders of leprosy. Our African leaders are like the disease because when you put the hand of a leprous man in fire, he wouldn’t feel the pain because he has lost all sensitivities at the extremities. So, when leaders are insensitive to the plights of the people, to the challenges and real issues that leadership should be addressing that cannot be anything better than leprosy. But the fact again is that our people are leprous too because we still count what does not count. We make excuses for leaders who are not doing well. So, we have lost the objectivity of what we require from our leaders and those we send to represent us. Otherwise, why don’t we recall people who waste opportunities? But think about it, bad leadership is a reflection of bad people because they come from us and remain among us. So, when we start holding our political leaders and our religious leaders accountable, we will make progress as a people, and if we don’t imbibe those attributes as a people in the next 50 years, we cannot progress. Something in our mindset about Africa must definitely change now for us to see the results we desire 50 years from now. We must be intentional about it. The same is applicable in Nigeria. I am not sure our founding fathers would be happy at our stunted growth so far. We can do better as a people across the board.
Do you subscribe to the belief of a conspiracy by the international community to keep Africa underdeveloped?
On conspiracy theory, I can tell you that the international community has its own roles. Remember what I told you, if I am talking to you as an American, it is America first; it is not going to be Africa first. So, why should I blame the international community who came to the table and represented themselves while we came and failed to represent our people? How can we blame the international community entirely? We must take responsibility for our progress and failure as a people, then can we hold ourselves accountable. Without accountability growth and progress are elusive.
You have the background of a pharmacist, and now you are propagating the need for good drinking water and proper primary health services. What is the connection between these three?
Well, the answer is not far-fetched; My background studies took me from pharmacy to public health to leadership. Over these years of studies, I have done a lot of research work and publications within the areas of inequality, and my interests have been on access to care, especially among countries like Nigeria, Burkina Faso, Chad, Mali, Togo, and Cote d’Ivoire.
So, to answer the question, it is all these years of studies and research in public health that have brought me this far. All of that has formed my humanitarian perspective and my interest in access.
But I am not just talking about access because my interest in water is beyond access. Though I began with access, now I am beyond access, and now we have to look at quality. I have been calling on the need for quality in access since 2011 when I published a seminal work on the poor and under-served. There, I made a statement that health services to the poor must not be poor health services, and this is because when we allow health services to the poor to become poor health services, we promote and exacerbate inequalities. It is unfair, it is unacceptable. That is the background of how I have moved from pharmacy to primary health, and my interest in primary health care services because that is the one available to the poor.
Do you know that most poor people don’t approach the hospital until near death? They can’t even afford the privately owned hospitals. So my argument is that if we make the primary health facilities function well, then the people will receive better care without going far or paying exorbitantly. Our primary health centres need trained personnel and proper equipment. So many of them don’t have water even to wash their hands and take care of patients, and that is why cases of diarrhea and cholera among adults and children which are rampant may not even be adequately and timely managed before they lead to death.
So my interest in water is at different levels. The first one is the level of water we all drink. Is there a quality guarantee in it? The second one is water that people use within the communities for other wash activities which could cause what we call neglected tropical diseases. We have to guarantee quality there too. And then, we move to the primary health facilities, and ask ourselves what efforts we are making to guarantee that all the water that is available in all these health facilities is of high quality. So that is how far I have come. Can you see the connection?
Let’s talk about the political aspect of your proposal, and how you handle the bureaucratic, ethnic, and religious norms that may hamper your programmes.
Yes, I can confess that I don’t have all the sure professional strategies on how to deal with Nigeria and Nigerians. First and foremost, don’t forget that I have not lived in this country for the past two decades, so I am kind of reintroducing myself into the system, and so I have not carved out the perfect understanding and tolerance of the bureaucracy that is obtained working in Nigeria. That could be a plus and it could be a minus. But I grew up here and studied here, so I am somehow very familiar with the system, and I understand the challenges.
First, I am going to move with the standard practice and how things are done elsewhere in the world to determine who is ready to work with us, as a prudent man of business. And if we succeed, it will be fine, but if we don’t, then we will make a comeback. So far, we have gotten positive responses, and I can say that we are not yet discouraged, even though some people have predicted that we are going to be frustrated at some point. We shall see. As far as educational preparation, academic qualifications, and international and local exposures are concerned, I think we are properly equipped and empowered to have this kind of robust discussion and to advance something different yet contemporary. Then, the political will to do what is right we will always solicit, so whoever catches the vision we have, we work with. That is one of the reasons we say we are not going to limit ourselves to one particular state. The issues we are addressing and the solutions we are proffering are not limited to a particular state. Ultimately Africa is our catchment. Let me say, for example, when it comes to water provision in Nigeria, the onus is on the states but lots of federal initiatives help to advance this area of public health importance. So when we release our ambassadors, they will be all over the place, including states and local government areas, working with those who are willing to work with us. What we will be doing is that we are going to leverage all our contacts and local intelligence.
Another strategy is Beyond Access quarterly magazine that we are talking about. The magazine will catalog areas that are worst hit by waterborne diseases, and then if there are counts that are being missed with regards to waterborne diseases or neglected tropical diseases, we will be able to capture those based on that, we would be able to reach out to development partners or credible people who are ready to work with us. We can reach out to philanthropists, even local people here. If in the process we can save one person in a state from waterborne diseases or neglected tropical diseases it is a success story.
How do you plan to succeed in making use of ‘Volunteers’ as ambassadors in a country with endemic hunger and joblessness?
For the projects we are working on, each project determines what they are paid. From the volunteer agreement, it was specifically made clear that the position is unpaid, but certain projects may attract remuneration to the volunteers who will know about the project beforehand and what goes to them in terms of logistics and allowances, which cannot be called statutory salary.
We are not going to pay salaries because we cannot afford to pay over 1000 volunteers across the country but we can pay per diems. We did specify though that serving is an honour and a great privilege especially to be part of the solution to the problem of waterborne diseases and neglected tropical diseases in your local community. Part of the benefits is that the ambassadorial opportunities will expose the volunteers to other training and certifications that we will offer in Rite Place Health, including free attendance to our webinars and the leadership academy we run. These include training in humanitarian service, project management, and leadership.
We anticipate that the training they will get and the training they have will enhance their professional profiles and position them for national and international recruitment when the opportunity comes. So, we are hoping that the volunteer opportunity not only exposes the individual but prepares the individual to be able to fit a certain job description in humanitarian space as opportunities arise. Let us assume that a partner of ours wants to execute a project within a local community, we would reach out to them and negotiate with them on behalf of our volunteers within that space so that they recruit those of our volunteers, who have been trained in data collection and analysis, humanitarian services, leadership, project management, and all those kinds of stuff that they have already acquired in-house. They would be eligible to be hired maybe on part-time, or full-time employment. So, at the end of the day, they are not just helping us but also empowering themselves to be employable; that’s the way we look at it. Volunteering helps in skill acquisition. Everybody wins.
Does your organization intend to set up a drug manufacturing company to fight this scourge as you discover it, or how do you intend to deal with different problems in different communities?
Rite Place Group, of which Rite Place Health is an integral part, has other future interests in business, research and pharmaceutical spaces. But those will come up in years to come. At this moment, we focus on the humanitarian aspects, which I direct. We have partners who promote several different technologies for water treatment and distribution both for individual homes, estates and whole communities and cities. We promote eco-smart homes and cities and we have promoters of these technologies in our league. We plan to call on them when need arises. We also plan to partner with agencies, ministries and the private sector as needed to achieve results and guarantee quality in water supply. We believe that partnership and collaboration are the strategies of the moment. All hands must be on deck and technology must be leveraged.
Can we talk of the permanent solutions to these diseases?
When you talk about a permanent solution, it has to be multi-faceted. Number one, if you are looking at the curative arm, the pharmaceutical industry should now come in. For example, people who have guinea worm, they need a cure for that. Permanently, the first thing we do is to treat the disease and again do something to prevent the occurrence because you could treat it, and it comes back afterward. So some of the permanent bases are checking out their water sources and knowing if they are drinking from contaminated water sources, and if so, we must provide alternative safe sources. The technology and solution to do that without breaking banks are available and within reach.
Just as we have cholera all over the place, there is nothing we can do to stop it without taking care of the water source the people have. As I told you earlier, some of our partners are involved in water treatment. So we have access to partners who can treat and guarantee quality water for families, for individuals, for estates, and a whole city. That is part of the reason why, in this upcoming conference, we are inviting real estate managers, community leaders, and environmentalists to come and hear and to know because our technical partners from the United States will be talking at the conference. They will be talking about emerging technology that guarantees clean water. And that is on the preventive side, but on the curative side, as the days go by, we will unveil our pharmaceutical partners because the plan is already there in incubation.
You are coming from America, and you are here to invest in a different clime where religion, ethnicity, and government bureaucracies are inevitable?
Everybody needs clean quality water regardless of religion, ethnicity, or political affiliation. I hope I understand what you mean by playing games. I can tell you that we are not here for game playing. We can’t even play games. We will bring to the fore areas of need and to the attention of everybody that things are being neglected which is affecting our public health outlook, whoever catches the vision and buys into it then we work with but those who wait for who plays games or who hands envelopes may have to wait for a longer time. We don’t have brown envelopes. But the reality is that not everyone will accept our proposal. We must understand that in life, frustration is the difference between expectations and reality. So, if you keep your expectations low and you understand that you are going to get pushback, then you will be able to engage more constructively and be able to accept pushbacks happily.
For me, I have two options, either I stay here and work until I see results, or I get frustrated and carry my bag and go back to the US. So, it is left to me to choose what I want to achieve, and I think that decision is already made.
Someone also said the project looks too huge, and I told her that if the project was not huge, I wouldn’t be here to pursue it myself. I can’t abandon my family and my career in the US and come here to chase rats. It wouldn’t make sense. So at this age and stage of life I am in, and after 20 years abroad, I am about giving back to society and being part of a trans-generational solution. Yes, sometimes in the past, life was about buying cars and buying houses and stuff, but at this stage, it becomes a matter of legacy. Suddenly you realize that within a couple of decades you retire and you think of what you left behind for the next generation to move on with. So, I am at that point where legacy is needed and to that effect, I won’t be frustrated. I have also decided that I cannot be cajoled knowing full well that Nigeria is our country of birth and everyone must contribute something in his own little space to advance humanity here. So if this is my little way of contributing to advance Africa, the next generation of our people can pick from where I stop, so be it.
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