“Ideas Change Nations”

(Leke Alder: A Man of Many Parts)
Ayodeji Jeremiah

He is resourceful and innovative. A man of small stature but big dreams and ambitions. His name naturally evokes thoughts on branding, strategy and creativity. A widely travelled man, his reception is an exhibition gallery of photographs of the many and far flung places he has been to. Leke Alder is a writer, a lawyer, a photographer, a painter, an architect, a brand and business consultant, a designer… “I’m what you can call a polymath: a multi-talented person. I paint, I draw cartoons, I design furniture, cloths and interiors, I write computer programs and I do so many other things.”

“I’m Leke Alder. I read law in school, but now I work as a consultant, a brand and business consultant. I’m a very simple person; I’m fortunate in life; God has been very kind to me and that mercy and grace is what has carried me thus far. I don’t ever want to forget that.” Leke, an only child of his parents studied law at the then University of Ife, now Obafemi Awolowo University graduating in 1985 and was called to the Bar in 1986.

“I served in Bauchi, but I had facial paralysis so I had to come back to Lagos. I stayed six months in Bauchi and then completed my service year in Lagos.” Leke worked briefly in a law firm, Wole Lofun and company, “he was a Christian gentle man. That was during Youth Service and briefly after Youth Service; I worked there for about two years before leaving to start my entrepreneurial pursuit.”

“People often ask me what it feels like to be an only child. Sincerely, I don’t know. I grew up alone so I don’t know what it feels like to have brothers and sisters.” Asked if his being an only child might be a reason for his being so creative, “I’m not sure …because there are many other people that are creative who have brothers and sisters.”

Leke was born in Lagos. His family comes from Lagos and Abeokuta in Ogun State. “I also understand that some Alders come from Warri. There’s an Alder town in Warri, but I’m not from that part of the country.” Before proceeding to the University of Ife, Leke had his secondary school education at Igbobi College. “I schooled in Igbobi College and Kings College. I attended Igbobi College first. Every Alder had to go to Igbobi College. You just had to go there because there are generations of Alders that have schooled there before. Before I was born, my father also decided that I would go there.”

Did he start his entrepreneurial pursuit with the name Adler Consulting? “That’s like ascribing omnipotence to me! A vision is a progressive thing. It is revealed to you from stage to stage, as you display faithfulness. I had registered a company called Leke Alder and company as a young man during Youth Service. Every lawyer registers a company because every lawyer thinks he’s going to own his own law firm. But I never practiced law in my firm. We were doing something I call Visual Identity Design. Then I was advising people on marketing and marketing strategies. It just kept on growing. It wasn’t as if I had an extraordinary vision of what this company is right now. If God had shown it to me then, I probably would have fainted. It’s just progressing as we move along. It had to be from stage to stage because my faith as a young man could not have carried what I’m dealing with right now.”

Law, branding and visual editing are worlds apart, how did he get to put all these together? “There were bridges in-between. As a young man in the University- at about 18 or so, I held an exhibition. It was so large that it turned out to be larger than the Departmental exhibition itself. Over two thousand people came for the exhibition. That’s one of the things I think led me into this creativity field. It just kept progressing from there. Before I left the University, I had a registered a Greeting Cards company. I remember we printed some cards in the UK. After that, I formed another company called Peculiar Cards, and we did a series of religious greeting cards, which turned out to be very successful. But I felt limited so I left that and started literarily on my own. People would come to me for business advice and I would give the advice and they would make huge sums of money out of it. Along the way, people started paying me commensurate out of their profit. That was the progression. I never really had a vision for this company.”

Alder introduced branding to Nigeria because “we were passionate about our country. I remember I took a group of people to Moor House hotel in Ikoyi and I locked all of us in there and said, ‘We’re not going to leave here until we come up with a blueprint to solve Nigeria’s image problem.’ That was what eventually led to the Heart of Africa project. We started this in the year 2000, but in order to get to that stage where the whole nation will buy into the concept of branding, we had to do publications. We started what we call Brand Research in Nigeria. We published the Alder Brand Reporting, in which we rated all the banks according to their brand standards. This was an extremely innovative thing in those days because nobody had even heard the word branding at that time. We decided to lay the foundation and that was how society came to know us as a branding company. From there, we started liaising with external bodies and external institutions in order to elevate the country. For example, we went to Cranfield University in London and asked them to do a case study on Guaranty Trust Bank. It wasn’t on a profit basis. It was just something we felt needed to be done because Cranfield was a centre of dissolution of case studies in Western Europe. I worked together with Ambassador Bolade Osinowo and we did this branding thing in London. We formed an NGO in London to promote Nigeria’s image amongst professionals, and all the while we were spending our own money. We were also taking senior Nigerian Executives, up to CEO level to London. We organised an annual brand seminar called Mind The Gap. It was a program where CEOs, General Managers and Company Executives would be trained by Professors from Western Universities: Cranfield University, London School of Economics and so on. We had speakers from all over the world. Finally, we brought the concept down to Nigeria to train civil servants and those who couldn’t afford to go to London. We were able to train two thousand civil servants free. We also instituted what we call the Alder Prize, which was half a million naira, to anybody who had an idea of how to move the nation forward. Students from the University of Benin won that prize, and the Federal Government gave them the prize. The love of my county and the passion to make a difference in the environment is what has led to all these initiatives, and it has been one door opening to another. It’s not because we were gifted extraordinarily; it has just been one thing leading to another.”

Apart from Alder Consulting, Leke Alder is involved in many other pursuits. “There are so many of them. Don’t forget that I’m also an author. I spent eight months last year writing about fourteen books and they’re all doing well. They are a commercial success. We refused to launch any of the books because that’s not the way we work. And like every other thing we did, we started small, and because we wanted to achieve some level of excellence, we had to print some of those books abroad. We just wanted to access the technology there. The books also kept multiplying so we had to register another company to handle that separately from our consulting business, and it’s been doing well. It is called Leke Alder International. It’s just focuses on the Leke Alder brand and it has nothing to do with Alder Consulting because they are two different things. They have different brand values. We’ve published fourteen books now; we’re due to release another three very soon. We have a notebook line, a greeting card line and we’re also introducing other products. We’ve literarily created the Alder Brand as a separate entity from Alder Consulting. I get emails every day from thousands of people who have read through my books. It took a lot of research to write some of those books and they have helped thousands upon thousands of people, and now when I go out, I think I’ve lost my visual virginity. But they’ve all become so successful.”

How has the reception been to the idea of using branding to help the country? “It’s been fantastic! Look at the changes that have been taking place because of the power of a single idea. First of all, almost all the banks have changed their corporate identities, if not all. Second, branding is now being studied in the universities. Third, we now have Brand Managers in companies, not just Corporate Affairs Manager. Fourth, new magazines have now crept up that are totally focused on branding. Five, every major newspaper has a column dedicated to branding. Six, Nigerian brands are now being exported all over the world. Seven, the standard of our products have significantly risen because of an understanding of what branding is all about. Eight, we are now even able to talk about branding as a national phenomenon. Nine, because of the work on Heart of Africa, Nigeria became an investment proposition in the eyes of the Western World. The bad image that we had during the Abacha years is gone. Because of the enormous work we also did, issues of 419, kidnapping and prostitution have really reduced. So what we have is an extremely silent revolution. Even the advertising agencies now say that they are brand consultants, all because of a simple idea. Ideas change nations.”

Are there other people who are trying to do exactly what he is doing, and is Alder Consulting facing any form of competition in the business? “First of all, the fact that you’re being copied is a good compliment. Our approach was not to become the only masquerade in the market place. Our approach was to stimulate the environment and improve Nigeria’s economy. We started as an economic proposition. In fact, it was incorporated into the NEEDS document, under Dr. Mrs. Ngozi Okonjo Iweala. In terms of competitive scenario, we’ve never seen ourselves as competing with anybody. We just focus on the race. The purpose of our organisation is to use the power of ideas to transform society; we want to raise future generations of Nigerians who will have a passion for excellence. We want to help our clients’ develop their businesses. That’s all we focus on. We never use side mirrors or rear view mirrors. Our organisation is so unique. What we do is completely different. Our approach to work, our recruitment system, our culture; everything is completely different. We receive close to six thousand applications every six months in this company, and we never do any form of advertising or marketing. We don’t even have a signboard outside the office building. The secret of our success: One good job! That will make you recommend us to the next person. We are totally dependent on the quality of the jobs we do, and all the clients we have, whether local or international, have been gotten through the power of one good job. One of the reasons our clients come to us is that we’re not business touts. Our office environment is very quiet and very serene. CEOs and government ministers must feel free to walk in here without being embarrassed. We’re a gentleman company.”

Alder’s concept of leadership is Davidic: heart and skill. “You must develop skills to mange people, but that skill must be motivated by a good heart. We lead by example in this company. We have no titles so you will not see anyone with a title on his or her business card; we just lead by example. For us, there is no separation between work and life. We say that our work is a progression of our life. We don’t have any 9am to 5pm lifestyle; it’s a 24 hour life. We don’t, for example, reward hardwork in this company because we always work hard. I also believe that that term is an oxymoron because there’s no easy work. Work, by its very nature, is supposed to be hard. But there are things we reward: faithfulness and loyalty. Whatever we do must sing excellence. If it’s not excellent, it will never get out, and if it’s not excellent, it’s not us.”

“The greatest challenge in Nigeria is our thought system. Our political system has a particular thought system that discourages excellence. It takes a lot to go against that norm. When you believe in meritocracy; when you believe in values, you won’t subscribe to certain things. There is that spirit that discourages too many good people from being in the position of power, and power flows down. The Charis of leadership always flows down. For example, there was a time in this country when we had a leader who used what could be termed 419 as an instrument of leadership. What happened was that 419 just rose statistically in the country. And when we had a leader who was violent, the rate of violence also rose within the country. So it’s so important that people who are good for the country get to the position of power so that they can positively influence the politic and it will definitely take place in our lifetime!

Why won’t he want to take up any political office himself? “In the previous disposition, my job was to empower Government with ideas that could transform the country. We worked with quite a number of ministers, and you will never believe the extent to which our ideas worked. I cannot begin to enumerate them. Whatever I feel is right for me to do in order to transform this society, I will do. But I’m not going to make the mistake of doing what Shakespeare describes as rotten ambition. It’s not about me; it’s about where I am best equipped to transform the society. Right now, I am transforming society by trying to raise a new generation through my publications and my lectures, both in Nigeria and abroad. You’ll be shocked how effective those speeches have proven to be. That’s the first stage. If I do feel that I need to take a political office, I will take it.”

Has the current global financial crisis affected branding companies also? “Don’t forget that what we do here is based on ideas. So in any clime, we will always be relevant because during financial crisis, the question people ask Alder Consulting is, “How do we drive ourselves forward?” We are not a branding company, we are an Ideas Organisation. Branding is just one of the ideas we throw out there, and because we are very good at what we do, the power of that single idea just took on a life of its own; but a lot of the work that we do here never manifest as branding. People consult us for what we have upstairs. Any time you have to ask yourself “How?” or “What?” you can come to us. We only answer two questions: How? and What?”

On his wife and children, “I don’t like to bring my family into the public arena. I’m a very private person, and already my life is getting too public. I want my children to grow up absolutely normal. I don’t want them to have all these chips on their shoulders. I also don’t want them to carry what I call a name burden, where people begin to have huge expectations from them because they bear the name, Alder. They’re too young to begin to experience all that. I also believe that everybody has a program with God. This is my life; they have their lives and I expect them to find out their own purpose. Nobody chose my path in life for me, and I’ve made up my mind I will not choose for my children. I will only train them properly, and if they make mistakes, I’ll correct them. But my love for them will remain absolutely constant.”

Leke Alder, a Christian is the author of Life as I see it; Conversations of a 21st Century Saint; Grim White Green; Brandit!; 080808; My Boss is Demanding; Pilgrimage and The Great Alchemy.

Healthcare Delivery in Nigeria: Any Hope?

Ayodeji Jeremiah

“We believe good health is a basic human right, especially among poor people afflicted with disease who are isolated, forgotten, ignored, and often without hope." — Former U.S. President Jimmy Carter

“A child falls ill with fever, chills and convulsions in a village over half-a-day’s journey away from the nearest health centre. After three sleepless nights of agonizing helplessness for the family, it succumbs.
A middle aged artisan in a State capital falls from a height at his workplace and sustains a compound fracture of the femur. He is taken to the general hospital where the surgeon, lacking the tools for the most appropriate treatment, undertakes what he euphemistically calls “conservative management” and watches helplessly as the patients deteriorates steadily and dies. A 19-year old Polytechnic female student becomes pregnant following sexual indiscretion with a married schoolteacher. She is petrified of the consequences and seeks the aide of a traditional abortionist in the backwoods of a city centre. A week later she is brought into the hospital with roaring septicaemia from pelvic infection. She rapidly passes from anuria to delirium to convulsions and eventually succumbs. A Government Minister trip sin his bath and injures his ankle. Clinical and radiologic examination in the Teaching Hospital show a soft tissue swelling with no fracture. Yet he is promptly flown out for treatment in a European country – cost to the tax-payer: 20,000 Dollars These four scenarios exemplify the cruel irony of our health care situation in Nigeria. The child with a fever and convulsions, probably malaria, need not die from it. Similarly, with good occupational health education the frequency of industrial accidents should be a great deal lower than it is today, and the mortality from relatively minor accidents should be insignificant. The young lady with the septic abortion, even if reckless, need not succumb had there been adequate measures to confront overwhelming infection and combat acute renal failure in a hospital setting. Her indiscretion may even have been averted with adequate and timely sex education of her “at risk” vintage. The fourth scenario, in which well over two million naira of public money is spent for overseas treatment of a minor ailment in a top government functionary, is clearly indefensible but all-to-familiar even today…”
Emeritus Professor of Medicine, University of Ibadan, Nigeria, Professor O.O. Akinkugbe, in his address entitled, “Nigeria’s Heath Status: Two Steps Forward, and One Back — The Enigma of Success in Retreat” during the 11th Annual Convention & Scientific Assembly of The Association of Nigerian Physicians in the Americas (ANPA) on July 6-10, 2005.

The above scenarios presented in the address of the eminent professor of medicine at the above mentioned conference are all too familiar in Nigeria. 49 years after independence, Nigeria cannot boast of a qualitative healthcare delivery system. Sometimes in late 2008 and again in January 2009, there was a furore in the public over the health status of President Umar Musa Yar’Adua. During his barely two years in office, every vacation taken by the President is now taken to mean he is travelling overseas for medical check-up. The president’s health has become a major source of concern for many Nigerians with some prominent groups even calling for his resignation. Political opponents and critics now use the opportunity to browbeat the government. All of these of course play down the real issue. It has now become the norm more than the exception for our leaders to routinely travel abroad for medical treatment. Most times, we only get to know when things go wrong and the person in question doesn’t make it back alive. 49 years after independence, shouldn’t our president be able to undergo comprehensive medical check-up and even treatment within the borders of our nation? The trips by President Umaru Yar Adua supposedly for routine medical check bring to the fore acute problems of Nigeria’s medical system.
The wealth of a nation, they say is its health. The sustainability and viability of a country’s economic and social growth depend largely on vibrant healthcare sector of that nation. No country can maintain a steady economic growth in the absence of an adequate healthcare system. Given the current state of health care in the country, we can only conclude that Nigeria is a very poor country. The Nigerian healthcare system is composed of decrepit health facilities and comatose medical institutions that have suffered from prolonged neglect and under-funding, leaving everyone open to risk of unwarranted death. Health care facilities in the country are generally in poor condition with chronic shortages of essential equipment, drugs and human resources. The most severe is the lack of adequate skilled attendants, which are the most essential element of quality health care, because they often leave to the private sector, or move to other facilities due to lack of resources or proper remuneration. Access to quality healthcare is either limited in Nigeria or nonexistent with staggering financial burden to families and the nation. While the prevalence of fake drugs and substandard products are compounding the problems, the AIDS epidemic and unhealthy lifestyles of many individuals are making the matter worse. In Nigeria, people die of minor illnesses that could have been prevented with simple medications and healthy lifestyle.
In such circumstances you only pray not to fall sick in Nigeria or develop any serious ailment that requires urgent care, you are more likely to be struck by lightening than to survive an emergency medical condition in Nigeria. The continued stagnating healthcare system in Nigeria is of great social and economic consequence. The health crisis in the country has taken an added significance because of the absence of constructive comprehensive national health policy. The federal government seems to have no meaningful collaborative effort with the state and local governments. The implication of this phenomenon is catastrophic.
Nigeria’s population estimate is 140,000,000 with a growth rate of 2.4%. While Nigeria has a birth rate of 43 births per 1000 (2008 estimates), the infant mortality rate is 74.2 deaths per thousand birth lives with a life expectancy rate of 51.6 years (2008 estimates). Out of the estimated 27 million women of reproductive age, one in thirteen die due to causes related to pregnancy. Recent figures indicate that the maternal mortality ratio (MMR) is 800/ 100,000 live births in Nigeria. Of the annual 3 million pregnancies in Nigeria, approximately 170,000 result in death that is mainly due to complications during pregnancy and childbirth. The main causes of maternal mortality in Nigeria are haemorrhage, which accounts for about a quarter of all maternal deaths, sepsis 15%, complications of unsafe abortion 13%, hypertensive diseases of pregnancy 12% and obstructed labour 8% (UNICEF). Approximately 35% of Nigerian women experience their first pregnancy by the age of 19. The Nigerian Demographic Health Survey further states that only 15.3% of married women are currently using contraception, of which only 8.6% are using modern methods (e.g. condoms and birth control pills). Only 60% of women receive antenatal care and approximately 31% of all deliveries take place in a health care facility. Moreover, only one-third of all deliveries are attended by skilled attendants in Nigeria. A study conducted in the northern part of the country indicates that 25% of all deliveries take place in the home with no assistance or attendance present. (WHO)
The statistics are pathetic and undoubtedly scary. Nigeria spends a total expenditure on health as percentage of gross domestic product of 3.5%. Most of these go into payments of salaries of the few remaining healthcare professionals in the government sector. Nigeria’s teaching hospitals once famous for training some of the best professionals in the world have all been reduced to glorified cottage clinics, as a result of which the best and brightest have left the country in search of better opportunities abroad. Estimate suggests that there are over 5000 doctors of Nigerian descent practicing in the US alone, ironically most were trained at home. Despite the tragedy of unnecessary loss of lives, from an economic standpoint funds channelled in training these professionals, or running the facilities become wasted, just as avoidable death depletes human capital of the country. Analysing the depth despair, the sheer number of such untimely deaths from preventable diseases, accidents and incompetence paints Nigeria as a country “at war”
In 2003, after religious and political leaders in the Kano region banned polio immunisation, contending that it sterilised girls and spread HIV, an outbreak of polio spread through Nigeria and into neighbouring countries the following year. The Kano region lifted its ten-month ban against vaccination in July 2004. On Aug. 24, there were 602 polio cases worldwide, 79% of which were in Nigeria. The WHO overall health system performance score places Nigeria 187 out of 191 countries. This composite measure of overall health system attainment is based on a country’s goals relating to health, responsiveness and fairness in financing. The measure varies widely across countries and is highly correlated with general levels of human development as captured in the human development index.
The above situation in Kano shows how the development of the healthcare sector is intertwined with literacy development and improved living conditions. In a country with a literacy rate of less than 70%, most citizens resort to poor traditional healthcare or self medication with adverse results. It is a common knowledge in the preventive medicine community that an individual who does not smoke nor use any tobacco products, eats good diet, wear car seat belts and exercise regularly is sure of living up to 70 years barring no unforeseen circumstances or "acts of men or God". Improving the healthcare system will involve empowering the average citizen economically and educationally. Improving the healthcare system will involve more than just throwing money at the hospitals, especially the teaching hospitals as most past governments have been doing. Primary Health Care continues to be the cornerstone of health development and the National Health policy in Nigeria. Focus on this sector has to be revitalised as follows:
1. Improving primary and public healthcare education especially with regards to preventive care will ensure that even the least literate of citizens have access to knowledge and information on what to do in every situation. A situation where diseases like tetanus, typhoid fever, cholera, dysentery are still killing many in the country is appalling. Even malaria, which still kills 2 million children every year, can be prevented through the use of treated nets, clearing of the environment and use of anti-malarials. A survey by the World Health Organisation shows that less than 6% of Nigerian children under five years of age sleep under mosquito nets. Even less than 1% sleep under treated mosquito nets. Less than 34% of this same group who have fever receive anti-malaria drugs. This area should also focus on behavioural change enlightenment programs for the people, which should focus on areas of diets, smoking, sanitation, exercise, sexual transmitted diseases and other behaviours that may impact the health of the country. 2. Primary Health Care facilities in Nigeria need to be improved to appreciable standards. 60% of health care facilities in the same survey above did not have any stock of nationally recommended anti malarial drugs. At least one standard primary health care centre built and equipped with required facilities and staff should be the goal for each local government area in the country. How can this be funded? State and local governments can partner with foundations to receive grants that will be used to build and equip such centres. Drugs and equipment can be donated by pharmaceutical companies and manufacturers. Staff can be sourced from agencies and organisations that provide volunteer staff on a revolving basis. 3. Improving sanitation facilities and drinking water sources. Less than 48% of the population have access to improved drinking water sources. 44% use adequate sanitation facilities (UNICEF). Communicable diseases account for more than 60% of diseases in sub-Saharan Africa. Providing drinkable water and improved sanitation facilities will help cut down on transmission of such communicable diseases. Again, state and local governments working in collaboration with international agencies can build safe and improved drinking water and sanitation facilities that communities can share. By providing sanitary environments, such as provision of portable water, sewage, sewage control and refuse management and reduction of overcrowding, most of the causes of infant and maternal deaths, which are infectious can be prevented and reduced.4. Improving nutrition amongst school age children: UNICEF statistics shows that 29% of children under five are underweight. The government in collaboration with aid agencies and NGOs should ensure that every child from age 6 yrs till 13 years eats quality breakfast and lunch (provision of school mid day meal and lunch in government schools). Poor nutrition does not only impair learning but also lowers resistance to diseases.5. Aggressively ensure that vaccination rates, which have improved over the years is not only maintained but improved on. Vaccines have saved thousands of young lives and with proper use they will continue to do so. Diseases such as Polio, Chickenpox, Measles, Mumps, Rubella, Diphtheria, Whooping Cough, and Tetanus are amongst infectious diseases that have been greatly controlled through the use of vaccinations in children, who are most susceptible. 6. Refocus healthcare funding on the primary healthcare sector with public health being treated as a priority issue. The core functions of public health are to prevent epidemics, to protect the environment, the workplace and to ensure safe housing, food and water. To further promote healthy behaviour, to monitor the health of the states and the country, to help mobilise communities for action on health related issues, to respond to disasters, to target outreach communities for health services, to train employees for the investigation and prevention of disease, and to protect policies to protect the health of the environment and the people. By attacking the primary and public health sector, we will be able to effectively deal with over 85% of health problems in the country. Many of the most severe afflictions are entirely preventable. Yet people living in developing nations such as Nigeria die or are disabled because they do not have access to the services they need to treat their illness or avoid infection entirely.7. Partner with international organisations such as the Carter Centre, the Bill and Melinda Gates Foundation, UNICEF, WHO in improving research, attracting funding, training personnel, developing vaccines and delivering health solutions to those that need them most.
The Carter Centre building on village-based drug distribution systems now in place in Nigeria to prevent river blindness, is also reducing incidences of the parasitic disease schistosomiasis, enhancing children's abilities to grow, develop, and learn. The same health care delivery infrastructure in Nigeria also is helping to prevent and treat lymphatic filariasis, a disfiguring and shame-ridden disease afflicting the poorest of the poor.
The Bill & Melinda Gates Foundation works with organisations around the world that are using innovative methods to improve health in developing countries. They focus on discovering new insights to fight serious diseases and other health problems affecting developing countries, developing effective and affordable vaccines, medicines, and other health tools and delivering proven health solutions to those who need them most. They also support advocacy efforts to build awareness of global health challenges, develop new ways to finance health programs, and improve health data. The Gates Foundation targets diseases and health conditions that cause the greatest illness and death in developing countries, yet receive little attention and resources. Their focus includes Diarrhoea, HIV/AIDS, Malaria, Maternal, Newborn, & Child Health, Nutrition, Pneumonia, Polio, Tobacco, Tuberculosis, and Vaccine-Preventable Diseases.
Governments and NGOs can take advantage of the opportunities provided by these organisations by working in close partnerships with them. This will require a strategic change in the way our government works and in the way our leaders think as in Nigeria, it's always a problem if you work through the government. Individuals, corporate bodies and religious organisations must therefore step in even where the government has failed.
One of Bill Gates' top health strategists, Dr. William Foege, thinks Nigeria "provides an important model for the rest of the developing world" and some key lessons the Gates Foundation must take to heart if it wishes to accomplish any lasting change. Those lessons come from the resilience and resourcefulness of Nigeria's people, not its government. And they can be found in the work of Nigerians like Dr. Emmanuel Miri, who was educated in the United States and has devoted his life to improving the health of his homeland. Miri directs Global 2000 in Nigeria, a project sponsored by the Carter Centre in Atlanta. The first waterborne disease Miri targeted was river blindness (onchocerciasis). It's caused by a worm transmitted to humans through biting black flies that live near fast-moving rivers. The worms often migrate to the eyes, damaging tissue and making this disease the leading cause of blindness in West Africa. Another, even more common disease, is snail fever (schistosomiasis). It's caused by a blood fluke transmitted from snails to people when they swim or bathe. It's a debilitating, chronic and occasionally lethal infection characterized by bloody urine that afflicts about 200 million people worldwide. Elephantiasis (lymphatic filariasis) is an infection that causes massive swelling of the leg or, in men, the scrotum. The parasite, a worm that infects and blocks the lymph system, is transmitted by mosquito bites and, occasionally, person-to-person. None of these diseases can be prevented by vaccines: the Gates Foundation's weapon of choice. The common link for all is water, whether directly through drinking or bathing, or indirectly as a breeding ground for the parasites.
"Many people don't think of water as a public health issue," Miri said. But he said it is the biggest public health challenge for Nigeria and for many poor nations. Most rural Nigerians get their drinking water directly from rivers, streams or ponds. But even in urban areas, water safety is an issue. In Lagos, only about 30 percent of the city's 8 million residents have direct access to potable water. And in Jos, one of Nigeria's main cities in the north, the regional hospital draws its water from an open well outside the children's ward. "If you have good water, many of the diseases of Africa would disappear," said Gen. Yakubu Gowon, a former Nigerian head of state who now works with Miri promoting water safety programs throughout the country. "Clean water is the key to health in Africa. It is paramount." Global 2000, a non-governmental organization, has made clean water its top priority. But even with the donations it has received from the Gates Foundation and from drug companies, it lacks the resources for the major, capital-intensive projects that are needed to fix the problem. Those agencies that have the budgets, UNICEF, the World Health Organisation, and the United Nations Development Program acknowledge the need for clean water. But it doesn't really fit their public health agenda. As a result, Miri said, "very little has been done about it." Part of the problem is a lack of coordination among the various international bureaucracies. But another reason is that the big aid agencies, unlike non-governmental organisations, must work in partnership with government.
Nigeria’s current state using the WHO health indicators can only be compared to the health status of the developed countries in the 19th century. The solution to the current health status of the country will require us learning from the experience of the developed countries. That Nigeria’s health care system is in a comatose state is no longer in doubt. What is required is urgent and immediate intervention by all well meaning Nigerians who are in a position to do so.

Africa’s Big Boys

Seun Onanuga

Although in most African countries, what seems to be prevalent within the polity is an endless struggle for power, there are quite a few where everything seems to be just under control. While the government of some leaders are being severely challenged and threatened, some others have been able to cleverly or forcefully retain power and frighten away every form of opposition. There are also some countries in Africa today where issues of inter-party conflicts and manipulation of electoral processes are almost non-existent.It is fascinating to note that Africa has not only experienced some of the longest regimes in the past, but also currently has some of the world’s longest serving leaders. Many of these power-drunk leaders have not only succeeded in taken sole ownership of power in their countries, they have also succeeded in converting the wealth of their countries for their own individual purposes. With the exception of a few notable ones, most African leaders seem to be addicted to power that handing it over often becomes very difficult for them. As soon as they get into power, whether through a military coup or a civilian election, they begin to plot our strategies that will enable them stay in power indefinitely. This phenomenon, which has been described as the primary weakness of African leaders has no doubt proved them to be greedy and inconsiderate.It should be noted that in the history of Africa, Nelson Mandela is the only African ex-president to have willingly stepped down as president after just one term in office. Africa has produced some of the worlds most conceited, insensitive, nasty and autocratic leaders. One of such men was Cote d’Ivoire’s Houphouet-Boigny who ruled his country for a total of 33 years. Although Houphouet-Boigny succeeded in unifying the people of Cote d’Ivoire in his time, he also suppressed every form of opposition that could have served as a threat to his government. In the West, Houphouet-Boigny was commonly known as the “Sage of Africa” or the “Grand Old Man of Africa.” From the 1940s until his death in December 1993, he played a leading role in the decolonisation of Africa and in his country's politics. He moved the country's capital from Abidjan to his hometown, Yamoussoukro and built the world's largest church there, the Basilica of Our Lady of Peace of Yamoussoukro, at a cost of US$300 million. Like many of his predecessors, Houphouet-Boighy did not willingly hand over power, he died while in office. At the time of his death, he was the longest-serving leader in Africa's history and the third longest-serving leader in the world, after Fidel Castro of Cuba and Kim Il-Sung of North Korea.Houphouet-Boigny however is only one of the many sit-tight rulers that Africa has ever produced. There were many others that also succeeded in holding on to power in their own countries. Notable among them are King Hassan II of Morocco, who ruled the country for a total of 31 years and Emperor Halie Salasie of Ethiopia, who ruled for 44 years and is currently the longest so far on the continent. Kenneth Kaunda of Zambia presided over his country for 27 years, Mobutu Sese Seko of Zaire ruled for 32 years, Julius Nyerere ruled Tanzania for 21 years and Kamuzu Banda ruled in Malawi for 28 years. Lasana Conte of Guinea was another man who held so tightly to the helm of power in Guinea until he died in 2008. Conte gained power though a military coup on April 3, 1984, when he ousted the then interim president that took over following the death of President Ahmed Sekou Toure, Guinea’s Head of State since independence. Conte, just like many other political leaders began on a seemingly good note, ordering the release of 250 political leaders and encouraging many citizens to return home, but he too soon began “falling in love” with power and he held on to it for 24 years until death took him away. When Conte assumed power, he suspended the constitution of the country and banned political activities from taking place. After much pressure from international bodies, Conte eventually gave way to a multi-party system in the ‘90s. Political parties became legalised in 1992 in preparation for the elections which were to hold in December the following year. In the first election, Conte won with a landslide victory, claiming 51.7% of the votes, leaving the second runner-up, Alpha Conde with only 19.6%. The second multi-party elections tool place in December 2003 and Conte won again, this time with 56% of the votes. Conte still not satisfied, decided to amend the constitution so that he would be able to run for a third term. Conte did not only succeed in procuring his third term, he also was able to extend the period of the tenure to seven years. But soon, his health began to deteriorate rapidly and efforts to revive him proved abortive. On December 3, 2008, the President of the Guinean National Assembly, Aboubakar Sompaore came up to announce on television that Conte, whose tenure was supposed to end in December 2010, had already died. Barely six hours after his death, the Leader of the Guinean Armed Forces, General Diarra Camara, ordered Captain Moussa David Camara, to announce on the radio that the military had already seized power in the country. Conte’s refusal to hand over power, in spite of his ill health, depicts the character of many African leaders today. Despite the fact that many of them are old, sick and void of ideas, they still choose to cling to power, doing everything possible to suppress the opposition. The attitudes of many African leaders have become a major threat to the rule of law and good governance. Many of these leaders have already become obstacles to progress and development in their respective countries as they consistently refuse to play politics in a fair and even handed manner. They are often tyrannical and intolerant of opposing views.Looking at the length of time over which these men ruled their respective countries, one would wonder whether it was the desire to stabilise their respective countries or the desire to break records that motivated them to stay so long in power. Just in January this year, Omar Bongo, the president of the relatively tiny, oil-rich Gabon marked 40 years as leader in the country. Although his record seems to be impressive enough, the 74-year old Bongo still has five years before the expiration of his tenure (if he does not seek for yet another elongation). The implication of this is that by the end of his tenure in 2014, Omar Bongo would have spent a record-breaking 45 years as the leader of Gabon, making him the longest serving president ever in Africa. There even still appears to be brighter years ahead for Omar Bongo who seems to be enjoying good health as opposed to many of his contemporaries who are battling with one ailment or the other. And who knows? Maybe before the end of his tenure, he may still want to manoeuvre his way to remain in power. President Robert Mugabe of Zimbabwe is another man whose political malice has caused no small stir in his country and the world at large. Mugabe today, is regarded as a dreaded leader, and his refusal to hand over power despite clamours from his own people, has drawn a lot of attention from many international organisations. Although there are actually some other countries where their leaders have even stayed longer in power than Mugabe, his own case seems to be a bit more on the side of turmoil. Under his rule, the health and well-being of the Zimbabwean people has dropped dramatically. According to the World Health Organisation, Zimbabwe has the world’s shortest life expectancy- 37 years for men and 34 for women. According to UNICEF, the country also has the greatest percentage of orphans (about 25%) and the worst annual inflation rate (1,281% as of 2007). Mugabe himself has said, “Zimbabwe is mine” and has rejected calls from some African leaders to step down. He also told delegates of his ruling Zanu-PF party at its annual conference, “I will never, never, never surrender.” Robert Mugabe is not the only president to have ruled a country for 25 years; there are some who have ruled for even longer years. Notable among them are Muammar Gadaffi of Libya, whose rather frightening face has been able to scare off every opposition and has retained power in his country for the past 39 years. Gadaffi was commissioned into the Libyan army in 1965, and soon began laying the groundwork for the overthrow of the Libyan monarch, King Idris I, whom he considered a pawn of the Western European nations. Within four years, Gaddafi took control of the army and on September 1, 1969, he seized power in a carefully planned bloodless coup. He assumed command of the Government as Chairman of the ruling Revolutionary Council and declared himself as Commander-in-chief of Libya's armed forces and its government, although he did not promote himself beyond the rank of colonel. Today, Gadaffi still remains in firm control of his government. He is currently the fourth longest serving Head of State and the longest serving head of Government in Africa. Hosni Mubarak of Egypt is a man who has also successfully held on to power for more than 26 years. The 79 year old leader, who was also a former Air Force chief, believes that the longer a person stays in office, the more efficient he becomes in administering the affairs of his country. This principle is what has made him to retain some of his ministers for as long as 20 years. Murabak however fails to understand that staying too long in one particular office could make a person run out of ideas and also deny others, who have better ideas, the chance of proving their worth. Hosni Mubarak came into power on October 6, 1981, following the assassination of President Anwar al-Sadat. He immediately instituted a vigorous economic recovery program within the country and mended relations with other Arab states, which were damaged after Egypt's peace with Israel. He initiated a policy he called “positive neutrality” toward the great powers. Mubarak was re-elected when his National Democratic Party won the October 1987 elections and was thus able to nominate him as the sole candidate for president. In 1993, he was again re-elected for another six year term. In November 1995, just before parliamentary elections, Mubarak's government accused the Muslim Brotherhood of helping violent Islamic groups. Many of the Muslim Brotherhood's members were arrested, and several who planned to run in the elections were tried and sentenced to prison. Critics accused the government of trying to eliminate even peaceful opponents. In the elections that followed, Mubarak's National Democratic Party won another overwhelming victory and he was elected to a fourth six-year term in 1999. Paul Biya of Cameroon is another man who seems to be playing deadly games with the polity of his country. Having ruled Cameroon for 25 years, President Paul Biya wants to go on ruling until 2018, when he will be 85, whereas the constitution decrees that he cannot stand for a further seven-year term in the 2011 elections. Although there are dissenters in the ruling party, President Biya would not have much trouble persuading his parliament to pass the necessary constitutional amendment, since he controls it through his iron grip on the Cameroon People's Democratic Movement (RDPC).Some observers fear that Cameroon might replicate the troubles of Ivory Coast and Kenya. Mr Biya has held power far longer and has entrenched it far deeper than Kenya's Mwai Kibaki, who was originally democratically elected. The presidential succession is particularly problematic, because Mr Biya is not grooming a successor. Cameroon also has no powerful opposition leader (ethnically based or otherwise) such as Raila Odinga. Yet many of the ingredients for an eventual explosion are in place.Sudan is one of Africa’s countries that has suffered the greatest effects of war in recent years. The ongoing civil war in Sudan is said to have so far displaced more than 4 million southerners. Some have fled into southern cities, such as Juba while some others trekked as far north as Khartoum and to neighbouring countries like Ethiopia, Kenya, Uganda, Egypt, and so on. The crisis has made many unable to grow food or earn money to feed themselves, and malnutrition and starvation has become widespread. However, in spite of all these occurrences, Omar al-Bashir, the leader of Sudan, who has been accused of genocide, is still not ready to leave even after twenty years in power. Sudan is the largest country in Africa, (approximately the size of Western Europe) and since independence in 1956 has been roiled by civil war almost continuously. This war was initially between northern Sudan and the south, which objected to its isolation and lack of development in comparison to the north. President Omar al-Bashir was brought to power following a military coup in 1989. Under al-Bashir's leadership, the new military government suspended political parties and introduced an Islamic legal code on the national level. He then became Chairman of the Revolutionary Command Council for National Salvation (a newly established body with legislative and executive powers for what was described as a transitional period), and assumed the posts of chief of state, prime minister, chief of the armed forces, and minister of defence. On 16 October 1993, al-Bashir's powers increased when he appointed himself President of the country, after which he disbanded the Revolutionary Command Council for National Salvation and all other rival political parties. The executive and legislative powers of the council were later given to al-Bashir completely.On 14 July 2008, the Chief Prosecutor of the International Criminal Court (ICC), Luis Moreno-Ocampo, alleged that al-Bashir bore individual criminal responsibility for genocide, crimes against humanity and war crimes committed since 2003 in Darfur. The prosecutor accused al-Bashir of having “masterminded and implemented” a plan to destroy the three main ethnic groups, the Fur, Masalit and Zaghawa, with a campaign of murder, rape and deportation. The ICC issued an arrest warrant for al-Bashir on 4 March, 2009, indicting him on five counts of crimes against humanity (murder, extermination, forcible transfer, torture and rape) and two counts of war crimes (pillaging and intentionally directing attacks against civilians). The charges against President al-Bashir have been strongly rejected. Chairman Muammar al-Gaddafi of the African Union referred to the indictment as a form of terrorism. He also said that the warrant was only an attempt by the west to re-colonise their former colonies. Al-Bashir himself has rejected the charges, saying "whoever has visited Darfur, met officials and discovered their ethnicities and tribes ... will know that all of these things are lies."Omar al-Bashir is an example of an obstinate leader who, despite his evident failure, still refuses to step down as president. A similar thing happened to Charles Taylor of Liberia. Although Taylor ruled for only six years in Liberia, he also exhibited much of the sit-tight leadership attitude. Taylor, who used to be one of Africa's most prominent warlords, was elected president of the country at the end of the first Liberian Civil War that took place in the early 90s. In mid-1990, Prince Johnson, the former senior commander of Taylor's NPFL broke away and formed the Independent National Patriotic Front of Liberia, INPFL. Johnson's supporters also split from Taylor's group and captured Monrovia for themselves, depriving Taylor of outright victory.The civil war turned into an ethnic conflict, with seven factions fighting for control of Liberia's resources (especially iron ore, diamond, timber, and rubber). At the official end of the civil war in 1996, Taylor became Liberia's president on 2 August 1997, following a landslide victory in July, in which he took 75 percent of the vote. Taylor's toughest competitor, Ellen Johnson Sirleaf, collected only 10 percent of the vote. While in office, he ran down the Armed Forces of Liberia, dismissing between 2,400 to 2,600 former personnel, many of whom were ethnic Krahn brought in by former President Samuel Doe. He then built the Anti-Terrorist Unit, the Special Operations Division of the Liberian National Police, and the Special Security Service, which guards Liberia's presidents. However, peace never returned to Liberia after his election, and during his entire reign, he was forced to fight against pockets of insurgency against his government, with about 60% of the country in the hands of insurgents by 2003.As president, he was known for his flamboyant style and quasi-religious hypocrisy. Upon being charged by the UN of being a gun-runner and diamond smuggler during his presidency, he publicly appeared in all white robes and begged God for forgiveness (while denying the charges). Taylor was paraphrased to have said that “Jesus Christ was accused of being a murderer in his time.” Numerous allegations were levelled at Taylor since he took office in 1997, including continuing to assist rebel forces in Sierra Leone with weapon sales in exchange for diamonds, and helping in acts of atrocities against civilians that have left many thousands dead or mutilated, with unknown numbers of people abducted and tortured. Moreover, he has been criticised for the widespread conscription of children as soldiers in the war in Sierra Leone.In spite of the grievous allegations levelled against him, Taylor was still not willing to relinquish power. It took a public call from the former US president, George W. Bush, for him to willingly resign as president of his country. On 11 August, Taylor resigned, leaving Blah as his successor until a transitional government was established on 14 October.There are also several other countries in Africa where these sit-tight leaders have gone absolute. One is King Mswati II of Swaziland, who is sub-Saharan Africa's last absolute monarch. He was crowned in April 1987 and has been in power for a total of 22 years. Although political parties had been banned in landlocked Swaziland since 1973, the king introduced a new constitution in 2006, but the ban on political parties remained. The king has kept control over the legislature in a country, plagued by food shortages and one of the world's highest HIV/AIDS prevalence rates. Also in Tunisia, President Zine al-Abidine Ben Ali, now 72 has been ruling for the past 22 years as well. Ben Ali has overseen successful economic reforms and crushed an Islamic fundamentalist opposition since he came to power in 1987. Supporters of Ben Ali have predicted he will seek another mandate when his latest term ends this year. Commentators say he can take credit for making Tunisia the healthiest and best educated nation in North Africa.Apart from the fact that these sit-tight leaders are not willing to leave the seat of power, they are also accumulating vast amount of wealth for themselves and also mismanaging the assets of their respective countries. Omar Bongo of Gabon, for example, is said to be one of the richest men in the world today. Bongo and his family are said to own 39 properties including luxury villas, 70 bank accounts and nine cars in France.Some of the most corrupt African leaders include the late Mobutu Sese Seko of Congo, General Sani Abacha of Nigeria, Hosni Mubarak of Egypt, Denis Sassou Nguesso, incumbent president of Congo, Eduardo Dos Santos of Angola, Obiang Nguema of Equatorial Guinea, Lansana Conte of Guinea, Arap Moi of Kenya, Gaddafi of Libya, Blaise Campore, Yoweri Museveni of Uganda, Paul Biya of Cameroon, Jerry Rawlings of Ghana, Charles Taylor of Liberia, Iddriss Deby of Chad Republic, Bakili Muluzi of Malawi, Frederick Chiluba of Zambia and Meles Zenawi of Ethiopia among others. There are others whose corruption status has not yet been determined such as Joseph Kabila, Paul Kagame of Rwanda, Robert Mugabe of Zimbabwe, Kenneth Kaunda of Zambia, Francois Bozize of the Central African Republic and Yahya Jammeh of Gambia. Kenya’s Mwai Kibaki, for example, faced a re-election battle and has been accused of not doing enough to fight corruption which cost Kenya at least $1b a year. Guinea’s Lansana Conte was accused of pocketing 70% of all revenues that came from the sale of bauxite in Guinea. Equatorial Guinea’s Francisco Obiang Nguema presided over a corrupt and despotic regime, curtailed the rights and freedom of his people, silenced opposing views and dealt mercilessly with the media. Many of his country's 600,000 inhabitants live in poverty despite billions of dollars of revenue from oil. He was sued by Transparency International over allegations of corruption and embezzlement. Uganda’s Yoweri Museveni, who has been in power for 23 years, became very popular in promoting nepotism. Museveni is president; his wife Janet First Lady, MP and a Minister; his son Major Muhoozi Kainerugaba an army commander of his elite group and possible successor. Museveni’s younger brother, Caleb Akandwanaho, is senior presidential advisor on defence. His daughter Natasha Karugire is private secretary to the president.Also in Zambia, a High Court in Britain ruled in 2007 that Frederick Chiluba, Kenneth Kaunda’s successor, conspired to rob Zambia of $46 million. The elections that brought Rupiah Banda, the current president into power were decried by the opposition as not being free and fair. In South Africa, Jacob Zuma the new President is embroiled in corruption allegations and although a rape case against him was dismissed by the court, his reputation has been badly damaged. Blaise Campore has ruled Burkina Faso as his personal fiefdom for the 22 years he has been in power. Algeria’s Abdelaziz Bouteflika won his third term after using the rubber stamp parliament to change the constitution of the state. However, Africa has some few shining examples. Botswana, Africa’s most successful economy is also the continent’s only true democratic country where multi-party democracy has been in place since independence in 1966. It is the least corrupt country in Africa and has a good human rights record. It is the only country in the continent where the leaders have used revenue from the natural resources mostly diamond to benefit the people. It is the world's largest producer of diamonds and the trade has transformed it into a middle-income nation. The current president Seretse Khama Ian Khama came to power in 2008. Namibia also joined the community of democratic nations after Sam Nujoma handed over power to his chosen nominee Hifikepunye Pohamba, after three terms as president. Like Botswana, Namibia’s leadership are using revenue from diamond to improve the wellbeing of the people.Judging from the way these sit-tight leaders amass wealth to themselves, we may well assume that many of them do not want to leave the seat of power because they will no longer have access to their countries’ wealth and they will also be liable to face prosecution.Another reason why many African leaders cling to power is because they have what could be called a “messiah mentality” i.e. they often claim that their people love them and that the state of their countries will grow worse if they should resign. In all respects, African leaders have portrayed themselves as bad examples for their people and the world. There is therefore a need for the evolution of a new style of leadership on the continent- a style that encourages mentoring and succession. In the more advanced democracies there is always a succession plan, so that in whatever situation they find themselves, there are always those already groomed to take over. By contrast, succession in Africa is often a gambler's throw so that in most of the continent, including Nigeria, it is not known where the next leader is coming from. There is therefore a need for a re-orientation in Africa. African leaders must learn that a country belongs to its entire people and not just to politicians. Those who succeed others must allow others to succeed them.The president of the Unites States, Barack Obama, in his inaugural speech, on Tuesday, January 20, 2009, sent his warning to some of these sit-tight leaders. He said, “To those who cling to power through corruption and deceit and the silencing of dissent, know that you are on the wrong side of history.” The new President, whose message was directed especially to African leaders who continue to stay in power at the expense of their people, warned that they would be judged by their actions. He also said, “To those leaders around the globe who seek to sow conflict or blame their society's ills on the West - know that your people will judge you on what you can build, not what you destroy.”President Obama's message came as a response to most Africans who expressed the wish to see him address the issue of African leaders who have clung to power for decades. It should be recalled that when Obama was only three years old, Africa's longest serving President, Omar Bongo, was already more than four years in power. Observers believe that such a message could be directed to such presidents, to whom he said "you are on the wrong side of history."Meantime, President Obama promised to work with the leaders who are willing to change. Said he, “We will extend a hand if you are willing to unclench your fist.” He also pledged to help poor nations. He said, “To the people of poor nations, we pledge to work alongside you to make your farms flourish and let clean waters flow; to nourish starved bodies and feed hungry minds. And to those nations like ours that enjoy relative plenty, we say we can no longer afford indifference to suffering outside our borders; nor can we consume the world's resources without regard to effect.”It is therefore expected that the new world Government, headed by the United States president, Barack Obama, will fulfil its pledge in fighting against sit-tightism in Africa. If this is done, then there is a chance that Africa will experience remarkable development at this time.