20 June 2011: The Zainab Bangura Exclusive Interview: Part One

Two weeks ago, Sierra Leone’s Minister of Health, Mrs. Zainab Hawa Bangura, was in New York to attend the United Nations High’Level HIV/AIDS Conference. During her stay, she gave COCORIOKO what she herself described as her very first media interview since she was transferred from the Ministry of Foreign Affairs to the Health Ministry. It must be recalled that this newspaper was  the first the new Foreign Minister, Hon. J .B .Dauda, gave an interview.  We bring you the first installment of the Zainab Bangura exclusive interview conducted in New York.  In this first segment of the interview, Zainab Bangura wishes that she had been appointed to the Health Ministry from the beginning and she gives a graphic picture of the crisis of health care delivery in Sierra Leone. We will bring you the interview in series so that you will fully grasp the monumental challenges Sierra Leone faces in providing health care to over 6 million people.

KABS KANU: Thank you very much, Madam Minister for accepting our invitation for this exclusive interview.In November last year, President Ernest Koroma made a cabinet reshuffle which saw you being re-appointed Minister of Health and Sanitation. How do you feel about your new assignment?

MRS. ZAINAB BANGURA:  Thank you very much, Mr. Kabs-Kanu. Since taking office after going through all prepared briefing papers, meeting with various stakeholders , including our development partners ,crisscrossing the country and inspecting all health facilities, talking to all cadres of stakeholders ,I have  been able to understand the crucial and strategic importance of the Ministry of Health and thus I have become emotionally and psychologically attached to the unique role the Ministry plays not only in the life of the ordinary citizens but the overall development of the country. It is the only sector that affects the lives of everybody before their birth and their death. I have come to value the sanctity of life and respect the right to life of every individual. Therefore, by and large, it has been an exciting and interesting experience for me and I have come to love the job so much so that I wish I had been appointed to this Ministry from the beginning , because then I could have been able to do quite a lot more for my people. I have come to learn that there is a lot to be done in the Ministry.

KABS KANU: Everybody knows that the Health Ministry is a crucial and strategically important Ministry as you have said. I can also just imagine the challenges in such a Ministry.

MRS.ZAINAB BANGURA: You are right that there are many challenges , but what I have done is try to be focussed and strategic  and thus to prioritize because of the limited time that remains before the next elections. The first priority is the area of human resources. We have a huge problem with the number of professionally skilled workers in the Ministry. Out of a population of about 6 million, we have about 150 medical doctors , including dentists in the public service. Only 60 of them are clinicians , i.e .those who are really practising in hospitals. We have 4 pediatricians , about 5 surgeon specialists and about 4 gynaecologists . If you take the South and the East, we have only 1 surgeon specialist for the 2 regions. To further complicate the problem, we have a maldistribution of these staff , with most of the staff concentrated in the Western Area. Thus, the huge challenge is that we fall far below the WHO standard for doctor-to-patient ratio. And as if that is not enough, we lack a lot of specia;lizations , e.g cardio-vascular surgeons. Therefore the problem is that with the increase in non-communicable diseases like the various forms of cancer , diabetes , kidney diseases we do not have the capacity to do early diagnosis and thus treat patients at the beginning of their diseases. This is why I am talking to the  Cubans, the  Sudanese , the Nigerians ..how we can augment the services of some foreign personnel to come and help us. The challenge also is with midwives and nurses .Ideally, with the introduction of free health care and the 200% increase in the number of people seeking medical care , we should have midwives in our 1, 270  health posts but we have less than 100 midwives in the whole country. What this means is that we are having in most of these health posts maternal and child health and nursing aides to provide services for which they are not properly trained and equipped, thus complicating the problems for us.

Published by Cocorioko News – The Minister of Health and Sanitation, Mrs. Zainab Hawa Bangura , has warned all concerned to keep their thieving hands off the drugs and medical supplies meant to make Sierra Leone a healthy nation and for President Ernest Bai Koroma’s Free health care for lactating mothers, pregnant women and children under five. The Minister warned that if anybody dares to steal any of the drugs or medical supplies, the government will go after that person.” Whoever you are and wherever you are, we will go after you and drag you out, and believe me, your punishment will be severe.”

The no-nonsense Minister yesterday  gave this stern warning at the Permanent Mission to Sierra Leone to the United Nations in New York where she gave her first comprehensive media interview since her appointment to the Ministry last November. Speaking to the Publisher of COCORIOKO, Leeroy Wilfred Kabs-Kanu, who pulled off yet another vital exclusive interview with a government official, Mrs. Bangura said that the government takes a very serious view of some unpatriotic citizens who instead of helping the government to accomplish its commitments to the people, have decided to engage in unpatriotic acts like pilfering and thieving. She said that the government will not allow any such undesirable acts to undermine its efforts to make Sierra Leone a better nation. “We will teach you a lesson that others will see and fear.”

The Minister was responding  to a question about whether there are challenges in her new assignment. She admitted that  there are many challenges indeed. She mentioned many of the challenges and one of the most important ones she emphasized was what she described as the SUPPLY CHAIN MANAGEMENT OF DRUGS. “The distribution and management of drugs throughout the country is a big challenge indeed. We have discovered that the drugs normally do not reach most of the health posts because no proper monitoring and evaluation mechanisms have been put in place to ensure that the drugs reach their final destination or are distributed according to guidelines.”  Furthermore, the very frank Minister stated : We have not been able to put in place proper systems to get forecasts of the exact  estimates of drugs required for the year, and as a result we have always been working on estimates and creating stock-outs for use.”

Mrs.Bangura explained that some of these problems are manifesting because when free health care was introduced by President Koroma , there was a such a deluge of people accessing the health facilities, with the percentage of people seeking health care trottling to 200% , that the government’s first daunting task  was to address access and the sustainability of the program.

She said that with the serious problems of lack of sufficient skilled workers and staff, overburdened and overworked personnel  due to the dramatic increase in patients and poor infrastructure, there was always going to be  the problem of the drugs not reaching their intended targets . She stated emphatically: “This is an issue that is unacceptable to us and every effort is being made to ensure that prompt action is taken on this, like putting proper monitoring teams in place to control the leakage.  Also, severe action will be taken against anybody who is found wanting  in the handling and distribution of these drugs, irrespective of their positions ,status or where they are.”  The Minister emphasized that it was not right for anybody to pilfer with drugs and medical supplies and she warned that those who do not heed the message will have only themselves to blame when they are caught.

She said medical professionals have an ethical and moral responsibility to respect the sanctity of life, the right to life and to treat all patients with dignity. As for the generality of Sierra Leoneans, she challenged them to to join the government to monitor the implementation mechanism to ensure the successful implementation of free health care, “Because health care issues are non-political, non-religious and go beyond gender boundaries.  This is why we say that health comes first and health is life.”