Facing Unrelenting Coups in France’s Unweaned Colonies, Facing Unsparing Cancers and Nigeria’s Unhappy Clinicians
A new wave of coups in Mali, Guinea, and recently, Burkina Faso, all francophone countries, has reawakened West Africa’s infamous nickname - “Africa’s coup belt”.
France still treats the majority of its former African colonies as politico-economic dependents, and this coincides with political instability and a high incidence of coups in these unweaned colonies.
While Nigeria has not witnessed a successful coup since its latest yield to democratic governance in 1999, many still see a steady descent from democracy to civilian autocracy and seek to flee the ensuing state of anarchy.
While socioeconomic disparities between men and women, girls and boys are slowing down in Nigeria, a gap persists with cancer incidence between women and men. The same disparity is apparent in the handling of cases of sexual abuse. The system inhibits the violated female but indulges the violent male, giving rise to medical, mental health, and ethical concerns for girls and women.
Sadly, medics and health specialists who are meant to mitigate these health injustices against women are leaving the country in droves. Like many young persons and professionals in Nigeria, doctors and nurses are fleeing because of economic inequities and general insecurity.
France’s Unweaned Colonies: Battling terrorism and grappling with Coups
Francophone countries in the Sahel region of Africa fight on in a decade-long battle against Islamic jihadists of various sorts. The inability of the elected governments to deal decisively with the protracted insurgency, with its toll of military and civilian casualties, has been given as the reason for the recent coups.
Surprisingly, Burkinabes received the news of the latest coup in their country with cheers. A Reuters reporter saw a group burning a French flag just hours after the coup, while placards read "Together we say no to France. Shit to France!", signalling that the pusche was more about whittling down the influence of France in the government of the country than an unbridled lust for power by some section of the country’s military.
And Mali too, a country that has witnessed 2 coups in the last two years, equally points the accusing finger at France, their presumed ally in the war against the Jihadists. The newly selected interim Prime Minister of Mali alleged that France came to divide the country, and used their time in the country to spy on the country’s newly-built military bases.
Last Christmas, Emmanuel Macron cancelled his visit to the French troops in Northern Mali because the leadership of the country refused to meet with him. Last week Mali expelled a French Diplomat Joel Meyer from the country because France’s “Foreign Minister Jean-Yves Le Drian last week said the Mali junta was "illegitimate" and "out of control”, according to a BBC report.
The BBC report also noted that “Western powers are also concerned about Russia's growing involvement in the former French colony.”
The Greater the French presence in an African region, the higher the incidence of Coups there
West Africa holds the record of the highest number of successful coups, attempted coups, coup plots, and alleged coups in Africa between 1946 and 2004. Coincidentally, the region has the highest number of former French colonies.
France colonised 9 of the 16 countries in West Africa. Britain colonised 4, Portugal colonised Guinea Bissau and Cape Verde, while the United States of America supervised Liberia.
Conversely, within the period, the lowest cases of coups were in Southern Africa, a region where France had no colonial presence.
Between 1946 and 2004, 46 of the 81 successful coup d'etats in the 5 regions of Africa occurred in West Africa alone. Also, 51 of the 125 attempted pusches occurred in West Africa.
The West African subregion also had the highest number of coup plots, with 20 of the total 37 plotted coups. Besides, 23 of the 53 alleged coups occurred in West Africa alone.
The Possibility of Coups in Anglophone West Africa has drastically reduced
There are growing concerns that the new wave of coups in Francophone countries could spread to other West African countries, especially those facing similar political instability and prolonged insurgency like Nigeria.
However, historical data and recent records on coups allays these fears, at least, for Anglophone West African countries like Nigeria.
Records of coups in West Africa between 1946 and 2004 show that 52% of the successful coups in the region were staged in Francophone countries, while 37% of the successful coups were staged in the Anglophone countries.
Also, while 53% of the attempted coups were set in Francophone countries, the figure was 31% for anglophone countries. However, the two blocs had a fair share of plotted coups, with 50% each.
There were also 48% of alleged coups in Francophone West African countries as against 30% in Anglophone countries. France’s former colonies recorded 51% of all the classes of coups in West Africa, while the Anglophone countries recorded 32% of all classes of coups.
It is more assuring that, since 2005, there has been no alleged, plotted, attempted or successful coup recorded in any anglophone West African country or in the 2 Portuguese-speaking West African countries. But the opposite is the case for the francophone countries.
In 6 out of the 9 Francophone Countries in West Africa, there have been 11 successful coups and 2 attempted coups between 2005 and January 2022.
Falling Francophone Democracies, Rising Anglophone Autocracies
While Anglophone countries in West Africa have seen fewer coups than their Francophone counterparts in recent times, their surviving democracies are increasingly becoming autocratic. Nigeria and Gambia for example have experienced tumultuous election seasons and increased autocratic tendencies by their civilian leaders.
Despite Nigeria’s troubled state history with insurgency, secessionist agitations, and other forms of state sabotage, there has been no coup event since 1999, when the country transitioned to democratic governance, except the alleged coup plot in 2004 involving Major Hamza al-Mustapha, Lt. Col. Mohammed Ibn Almar Adeka, Onwuchukwu Okorie, and Navy Commander Yakubu Kudambo.
However, the country’s human rights record has dipped ever since. The notable autocratic stance of the government includes the promulgation of laws and deployment of tools and technologies to stifle freedom of expression, breach citizen privacy, and repress the free Press. This is evident in the Twitter ban episode and arrest and detention of people on account of their posts on Facebook and other social media platforms.
Another horrific spectacle of the Nigerian state is the extrajudicial killings by government agents, a concern that precipitated the #ENDSARS protests. Unfortunately, the protesters were forcefully expelled and exterminated by live bullets from the country’s security forces.
However, the Executive Secretary of the Nigerian Human Rights Commission, Tony Ojukwu said that above all human rights violations in Nigeria is “weak institutions and lack of political will to hold perpetrators accountable for several types of human rights violations.”
In the Gambia, the people witnessed a reign of terror and multiple human rights abuses including the State’s use of death squads also known as Junglers, State-sanctioned murders, torture and rape until the ouster of its former President, Yahya Jammeh, through the ballot in 2016.
A Truth, Reconciliation and Reparations Commission recommended in November 2021 that Jammeh and his accomplices face criminal trial for their acts spanning the 22 years of Mr Jammeh’s rule.
“Malick Jatta, an army lieutenant close to Jammeh, said the former president paid more than $1,000 each to members of his security service who killed newspaper editor Deyda Hydara in 2004, according to the Reuters news agency.
Sergeant Omar Jallow told the commission that in 2005, Jammeh ordered the killing of 59 unarmed migrants that Jammeh thought had come to overthrow him. Fatou Jallow, the winner of a 2014 beauty pageant, testified that Jammeh raped her when she was 19”, Al Jazeera reported.
In all, a lack of commitment to democratic norms and reforms further fuels autocratic civilian rule in Anglophone West Africa.
Facing Unsparing Cancers: Breast Cancer and other Gender-based Cancers
The Gaps in the General Cases of Cancers: Females are more Vulnerable to Cancer than Males
As of 2020, the population of men was higher than women in Nigeria, but cancer incidence was higher in women than in men. And from this fewer population of women, more women died from cancer in the year than men.
Nigeria’ male population was 104.47 million while its female population was estimated at 101.67 million in 2020. But the number of new cancer cases was 51,398 for males while it was 73,417 for females, according to the World Health Organisation’s Country profile for Nigeria.
Besides, 44,699 females died of cancer while 34,200 males died of cancer in the year.
Source: WHO
The WHO report showed that females were at a disadvantage in all the cancer measurement indices such as world cancer incidence rate, mortality rate, and the 5-year cancer prevalence.
The report further showed that women faced a higher risk of developing cancer before age 75 than men. Likewise, there are higher chances that a woman will die of cancer before age 75 than a man.
The Gaps in Gender-specific Cancers: The Cancer Prevalence Ratio of Females to Male is 4:1
Among the 10 most common cancers in the recent five year period, 4 cancers are gender-specific. Breast cancer, Cervical cancer, and Ovarian cancer are female-specific, while Prostate cancer is male-specific. This is more so because these 4 types of cancers affect the generative organs of each of the sexes.
While these 10 commonest cancers make up 67% of all cancer cases, breast cancer tops the list with 26%. That is, for every 100 cancer cases, 26 are breast cancer cases.
Cervical cancer ranks second with 10%, while prostate cancer ranks third with 10% of all cancer cases. Ovarian cancer is the 6th commonest cancer, making up 3% of all cancer cases.
Thus, for gender-specific cancers, there is a ratio of 10% to 39% between the male-specific and the female-specific cancers.
This means for every 10 men battling prostate cancer, there are 39 women battling either breast, cervical or ovarian cancers.
In other words, for every 1 male, 4 females suffer from cancer that affects their reproductive organs.
Cervical Cancer Cases and Deaths dropped between 2018 and 2020, How?
The incidence of breast cancer remained the highest of all new cancer cases at 22.7%, but it has remained at the same level between 2018 and 2020. However, cervical cancer incidence reduced from 12.9% of all cancer cases in 2018 to 9.7% of all cancer cases in 2020.
Ovarian Cancer incidence increased from 2.4% in 2018 to 2.6% in 2020, while Prostate cancer incidence moved from 11.3% of all cases in 2018 to 12.3% of all cases in 2020.
However, the proportion of deaths to breast cancers among other cancer mortalities increased from 16.4% in 2018 to 18.1% in 2020. Likewise, the proportion of deaths from Prostate cancer increased from 8.3% of all cancer mortalities in 2018 to 10.8%.
While the proportion of deaths due to ovarian cancer in 2020 remained at the 2018 level of 2.9% of all cancer-related deaths, the proportion of deaths due to cervical cancer dropped, just as the incidence did, from 14.8% in 2018 to 10.1% in 2020.
However, it is not clear how Nigeria’s health authorities achieved this feat with cervical cancer. The WHO report showed that Nigeria took no serious steps towards eliminating cervical cancer, as seen in the WHO extract below.
The Health System Capacity extract shows that there was no available staff in the Ministry of Health with a proportion of their time dedicated to cancer even when there were up to 10,000 cancer patients. Besides, other capacity issues such as the availability of less than 16 CT scanners per 10,000 cancer patients or the availability of just 6 radiation oncologists per 10,000 cancer patients, prove that the drop in cervical cancer might just be a fluke.
Clearly, between 2018 and 2020, Nigeria’s burden of cancer has increased from a total of 115,950 cases in 2018 to 124,815 in 2020. Also, the 70,327 cancer deaths in 2018 had spiked to 78,899 in 2020.
It certainly takes beyond a fluke to relieve the cancer patients, their caregivers and families of the mortal, mental and economic burden of cancer.
Facing Unhappy Clinicians: Balancing Care for others with a rewarding Career
“Go and use passion to pay your NEPA Bill”
While Nigerians are plagued daily with several malignant moral, monetary, and mistreated cancers, the country also faces an exodus of the needed medics, researchers, academics, as well as young viable families from the country to other countries or from the profession to other rewarding business even while in the country.
Industrial actions by medics and academics is so commonplace that many have lost count of them over the years. The workers union of a health service or educational institution are more likely to be on strike or planning to embark on a strike than they are fully at work.
This is due to the fact that medical professionals are paid meagre salaries and work under very undignifying working conditions.
For instance, a medical doctor by the name Olawale Ogunlana lamented his poor pay as a medic on February 2nd 2022 in a Twitter post. “What I earned as a Medical Doctor in one year, I earned it in under a month as a Content Creator in the Tech space. I want to see what will make me practice medicine in Nigeria again.”
When queried by @ObioraLouiss whether he was driven by passion or money, the frustrated medic simply replied “Go and use passion to pay NEPA Bill.”
Mr Ogunlana’s thoughts reflect the dilemma of Nigerians who had invested a lot of time and money in their training and qualification as health care providers, but who are compelled to balance their passion to care for others with the pressure to cater for their own basic needs too, which their take-home pay hardly covers.
Compared to 190 other countries, Nigeria’s spending on health infrastructure is very low, even when health services appear to receive one of the highest allocations in the countries’ budget.
According to 2012 data analysed by the CIA World Fact Book, Nigeria ranks 109th out of 191 countries in terms of the proportion of GDP spent on health.
Source: NOI polls
A low percentage of the country's Gross Domestic Product spent on health simply means a low amount of people’s aggregate incomes spent on providing health care for the people.
Thus it is not surprising that medical personnel from Nigeria are moving out to those countries that have invested a better part of their GDP on health. A high level of investment in health in a country usually means that clinicians in that country would receive a better pay.
Top destinations for Nigerian medical doctors seeking work opportunities abroad
Source: NOI Polls
The NOI polls show that the United Kingdom, the United States, Canada, Saudi Arabia, and Australia are the top 5 destinations for Nigerian medical professionals.
“You hope the system gets better, but over time it doesn’t and so people check out.”
A NOI poll showed that 88% of medical doctors are considering work opportunities abroad, and 86% of them are doctors who have between 0-10 years of medical practice. That is, Nigeria might be losing the younger and vibrant medics to the diaspora.
Source: NOI Polls
On Friends and colleagues seeking work opportunities abroad
Source: NOI Poll
Further quotes from In-depth Interviews conducted during the NOI Poll
Source: NOI Polls
So, some Japa and some die Trying
Nigeria’s unhappy clinicians are not the only ones exiting the failed Nigerian system, the rich Nigerians facing unsparing cancers are also exiting the country to receive king-size treatment abroad, while the average Nigerians are forced to painfully exit the country to the land of the Dead.
And though Nigeria has been spared any of the unrelenting coups in France’s unweaned colonies neighbouring it in West Africa, the daily terror unleashed on the citizens by Islamic terrorists, bandits, herdsmen, unknown gunmen, kidnappers, repeated ritual and extrajudicial killings that go on unabated daily overthrows the sanity of the remaining normal minds.
Thus, on account of the ever-looming personal, social and economic danger, even non-clinicians and non-cancer patients are forced to exit the country to relive their threatened dreams or repair their broken dreams outside Nigeria.
And for many less fortunate ones, they have been forced to exit Nigeria to retire their dreams in some unknown colonies of Necropolis.