Updated: Apr 3
FEATURED: Watching Paul Farmer’s YouTube video in my “Introduction to Interdisciplinary Studies” class, gave me an understanding of what economic growth is. For Paul Farmer, while discussing Rwanda’s rise from the 1994 genocide, he explains why health care (most importantly) and education are the most essential things a government should focus on before thinking of Gross Domestic Product (GDP) growth.
This conversation extends to many other countries in Africa, including Nigeria who recently re-elected the incumbent, President Muhammadu Buhari for the second time on the promises of taking the economy to the Next Level. But what is a thriving economy without good health and educational sectors?
Rwanda in 1994 and Now
According to World Without Genocide, the 1994 ethnic genocide in Rwanda lasted for 100 days, from late April to July. The Hutu ethnic group carried out the acts of genocide against the Tutsi ethnic group. This genocide led to the death of about 800,000 to 1,000,000 people in the country. Likewise, in the Tutsi refugee camp and neighbouring refugee camps, there was an increase in the breeding and transfer of diseases like Tuberculosis, Malaria, and HIV. The Atlantic noted that the genocide affected Rwanda’s economic growth, as workers were also infected with diseases and that, life expectancy dropped to 30 years a year after the genocide.
Twenty-three years after the genocide, today, Rwanda records one of the best healthcare systems in sub-Saharan Africa. “Deaths from HIV, TB, and malaria have each dropped by roughly 80 percent over the last decade and the maternal mortality ratio dropped by 60 percent over the same period,” noted The Atlantic. What did Rwanda do differently after the genocide?
After the genocide, the Rwandan government began with a vision 2020, which is turning “Rwanda into a middle-income country.” Included in this vision, is the creation of an inclusive healthcare system that caters for the poor. In 2016, The Economist reported that sustainable healthcare delivery includes a subsidized co-payment care plan, where the government pays a part of a patient’s health bill. This co-payment plan is under the Rwandan national health insurance, where everyone has access to healthcare delivery. Also, The Economist noted that “Well-trained gatekeepers have made a big difference in Rwanda. Health workers from villages were trained to give primary care . . . Today there are 45,000 of these community health workers.”
Today, Rwanda’s life expectancy ratio is 68.0 years (Male 66.1, female 69.9), it is a country with one of the lowest maternal mortality rates in sub-Saharan Africa and it ranks as one of the best countries in sub-Saharan Africa that fulfill the United Nations Millennium Development Goals (MDG). As noted by The Atlantic, “Dr. Agnes Binagwaho, Rwanda's Minister of Health (who served from 2011-2016), explained that ‘health is a key pillar of our development’ and that without improving health, they will never alleviate the country's poverty.”
Healthcare Today in Nigeria
It is no longer news that the healthcare system in Nigeria is on the verge of collapsing. With the persistent strikes by health workers, continuous emigration of medical practitioners abroad, lack of improved medical facilities in the state and federal hospitals, the lack of an inclusive healthcare system for the poor, dysfunctional community and public health system. Sincerely, the list goes on and on.
According to World Life Expectancy, the life expectancy ratio in Nigeria is 55.2 (Male 54.7, female 55.7) years. An undercover investigative report on cancer treatment from ICIR notes that “According to statistics from World Health Organisation (WHO), over 100,000 Nigerians are diagnosed with cancer annually, with 80,000 of them dying from the disease — an average of 240 Nigerians/day or 10 Nigerians/hour. As if that wasn’t enough, WHO has predicted that Nigeria can expect a 75 percent increase in cancer-induced death by 2030.” Likewise, the World Bank statistics show that Nigeria ranks as the fourth largest country with 814 per 100, 000 live births maternal mortality ratio.
The State of Education in Nigeria Today
The Nigerian educational system is in an abysmal state, from the dearth of infrastructural amenities, teaching aids, of teachers at both the primary and secondary schools to the dearth of university lecturers coupled with the incessant strike actions by the Academic Staff Union of Nigeria Universities (ASUU). Many young Nigerians today want to study abroad, and this makes Nigeria rank as one of the countries with the highest number of youths seeking studies abroad. In addition, poor funding and the lack of motivated educationist are other problems of the Nigerian educational system.
Last year, statistics from UNICEF details that Nigeria has the highest out of school children in sub-Saharan Africa with 10.5million children whose majority are girls from northeastern Nigeria. This number is said to be the highest number in the world. To eradicate poverty, the 2010 United Nations magazine publication known as the UN Chronicle has affirmed that an investment in women’s education which includes higher education, helps to promote the economic growth of a nation. This also sets women off the exclusion track but into the inclusion track that makes them invest their earned income into the education of their own children and the economy.
Paul Farmer in the Skoll World Forum 2015 YouTube video stated that by 1995, Rwanda was by every indication the poorest country in terms of GDP, national contribution to education and health. But today, reverse is the case, as the country has been able to invest in health, by focusing not on prevention as many countries do, but on prevention and cure through community health practice that includes health insurance for the poor and the training of community health workers without leaving the treatment of patients to only doctors and nurses.
The investment in education by the Rwandan government after 1995, has been recorded as a tremendous work to economic development; UNICEF in 2015 noted that it is one of the top-performing countries in education in sub-Saharan Africa. In the educational plan, everyone, including the poor and the girls and women have access to education. Today in sub-Saharan Africa, Rwanda has the largest female cabinet.
It is necessary to note that the Rwandan government established an inclusive system that catered for the poor and marginalized in terms of health and educational provision. Daron Acemoglu and James A. Robinson cited in their book Why Nations Fails, that “a more equitable distribution of resources, facilitating the persistence of inclusive political institution:” This means that equal access of citizens to basic human rights as health and education creates a political environment where everyone is revered and involved.
To conclude, I think it is very important that President Muhammadu Buhari’s Next Level plan takes into cognisance the significance of investing in health and education, as the nation’s way of treating the root causes of problems often associated with development.
Paul Farmer: He is an American anthropologist and Physician.
Written by Fisayo Ogundoro. Read more by Fisayo at www.fisayowrites.com