Strangely, I have written two pieces surrounding Nigeria’s healthcare system.
I say strangely because even as I hope to write more, I am a little baffled at how satisfying the process of writing those pieces was.
Satisfying to me as a writer, as a person concerned about Nigeria – and its health system - and especially satisfying to me as an artist.
During the process of writing these pieces, I was forced out of my comfort zone in the more abstract world; in fiction and in poetry.
It was my first try at writing in the non-fiction genre. And, of course, I was lucky to have an editor who was willing to be thorough, and nudge the piece towards excellence, as well as listen to what my own vision for the piece was.
Yet, it did not change the fact that it was a stricter discipline of writing. In a way that there were more rules to follow, where I was not the singular authority on what is true on the page. It pushed me into a zone where I had to examine my old notions of truth, expand them too.
I got to examine what the truth looks like outside of my own head.
And it made me ask; can a collective truth exist? One that fits in all the facets of being a person alive in this world.
I was asking if there was a precept or universality that stretches across the internal milieu of the human condition. And how our internal experiences interact with the ‘outside world’. With the wheels that turn economies, societies, cultures and civilizations around.
I wanted to write a simple piece about what medical care in Nigeria looks like presently for health workers, and what the future looks like for this sector.
In the end - rather, along the way – I got to test the idea that no part of the human experience is mutually exclusive of another.
HOW IT ALL FITS
Research was a big part of the process of writing these pieces.
And I think this is one way that creative writing, and journalistic writing differ, and yet are the same.
In the first piece I worked on, I was surprised by the amount of work required to dig up facts, stats and references to build up the idea that I wanted to create. And to weave that idea into a story that showed the human impact beneath all of those figures and pages.
One moment in particular that I remember is having to think through, and find a relevant link between the health disparities seen in Nigeria, and that of another country. An Asian one at that, and explain what these countries have in common. What makes them unique, what makes them worthy of being compared to one another?
I got the answer to the first question early on, before I even started working properly on the piece.
They are similar in their background realities, especially around healthcare.
The thing these two nations have in common is that they are both ‘developing countries’, where governments as well as private establishments are big players in their health system. The unique thing India has is that its own private health care system is stronger than the public one. This is what allows it to attract patients from Nigeria, patients who go there particularly for those private establishments.
It is a real thing that affects peoples’ lives, in some cases it determines if people live or die.
It was why I considered this topic to be something important to write about. It is a thing that shows up in the nitty-gritty, real lives of people. I had to know what the root issue was.
The root in the end, is in the economy. How money moves, or does not move. This is what affects the outcome of the health system, and further; peoples’ lives.
I learnt that how economic resources move is dependent on what is important, what is valuable to a group of people. And to the people chosen to rule over them. Perhaps under the root of the economy, is the ideas that drive that economy, and drive where the resources in that economy are heading to. It is what finally shows up on the surface in the health system, in the country generally.
It was odd to work out the answer to a puzzle directly from beginning to end; why does the health system look this way?
But that was only one angle, I wanted to take a step further with another piece, and look at the whole thing again.
A BETTER EXPLANATION
In the second piece, I wanted to ask the question from a more historical, and sociological angle; how did we get here?
And how does our present situation affect the most vulnerable among us?
Ideas are what civilizations are built on in the end. But what ideas matter? Which ones lead us towards better?
For the second piece, I wanted to exhume the ideologies our health system is built on, shake it up from the dust of the past and look at it directly in the light.
Knowing where we come from, is important in helping us figure out where we are going, and how to get there. The problems we are prone to, the strengths we have shown in the past.
In the second piece, I wrote about how the collective medical institution in Nigeria was founded on a foreign concept of what health care is, and how it should fit into society.
For example, medical education in Nigeria was modelled after the British system. It was easier that way, and it opened up opportunities for new doctors to be licensed in both Britain and Nigeria.
What it did however, was create a medical establishment that was so ideologically different from the beliefs of the people that the establishment wanted to serve. There was of course, a resulting disharmony. One that persists till today, where there is a certain distrust of medical interventions – because they are not fully understood by the people they serve.
This problem, like the one underlying the more economic problem, is something that stems from wrong, or ill-fitting ideas. And I did say in both articles that to move forward, we must be willing to stare this truth in the face. Then move on from there by understanding what this truth says about us.
In truth, just as I mentioned in this post about visual art being a tool to reclaim our identity in a more African, or even a more general perspective, the institutions we create must be in protest against worldviews that do not necessarily fit into our own unique experience of being human.
Western ideologies fail in the area of considering good for a collective of people. They are shaky in considering truth that encompasses the realities of people with different perspectives. And it is unfortunate how these more western ideals filtered into how we run things post-colonization.
But this whole blog is about how we can use hope to find good things, good things that remind us of great possibilities. And use that hope to reshape the future, to frankly consider our present and how to move forwards from it.
Perhaps this is where art of any form is linked to these more ‘real world’ issues. It can be a fire that incites change in how we think about the world we live in. in what ideas we choose to consider, and to build on.
AN IDEA IN PRACTICE
I am a writer. I think things, I write them down, and I share them with the world.
Writing this piece makes me wonder about the practicalities of just, art. And maybe I cannot carry out an experiment on the whole world, but in my own life, in my own experience, how has art pushed me towards change?
I can think of a few definite examples, which is a good thing.
But I am cautious about it. Maybe it is not art itself that does it. Maybe the art just opens us up to look at the ugly truth. And truth, no matter how ugly, is truth. It can be trusted. It can be banked on to plot the next course of action, the newer plan.
And it comforts in a way, even harsh truths; they let us see just how bad things are, and thereafter show us the sun breaking out timidly in the horizon.
These two medical pieces definitely showed the uglier truth about health, and therefore life in Nigeria. But like all of journalism, like all art, it is a straight-faced beauty that we can rebuild, reform, reshape our societies, and therefore our lives, around.
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