An old man shuffles across the crowded clinic, leaning heavily on his walking stick. He sits on a chair next to the resident doctor and begins to unwrap the bandage around his foot. It is stained dark brown, bent and marked by multiple discharging sinuses. He has a mycetoma, a chronic infection, and has journeyed from Gbajimba, nearly 60km away to the city, where he can receive effective treatment for his condition.
From longer waiting periods to higher mortality rates compared with their urban counterparts, rural areas struggle with shortage of medical personnel on a day-to-day basis. Precious lives are lost to easily treatable diseases. With no ambulances to transport people to hospitals. Emergencies that would be survivable in urban areas are often fatal in rural areas. Communicable diseases, maternal health and immediate care of newborn are also of great concern.
The Benue State Government under the administration of Gabriel Suswam has consolidated on its achievement on infrastructure by constructing over ten health centres across the state to cater for the health needs of communities, but human resources remain a vital determinant of quality of health service. The greater the number of doctors, the greater the outcomes of health delivery. Profit-driven private sector healthcare is not appropriate for the modest incomes of the farmers, fishermen and traders that make up such communities. Against this backdrop, the state government has developed a strategic approach to conserving doctor count known as the Bond scheme.
The Bond scheme is an incentive-based payment scheme that rewards clinical students of Benue origin who agree to work in hard-to-staff communities after their university studies. It is a practical initiative designed to move medical graduates into communities and perhaps specialties that need them most, and retain essential health workforces in the state. Upon successful application, students are eligible for incentive payments up to three years, after which are required to work as doctors in the state for a minimum of two years. This contractual agreement is entirely voluntary. Combined with helping to alleviate poverty, it gives the students a significant psychological boost. As much as patient care is an humanitarian imperative, the decision of where to practise after completion of training is economically driven. Therefore, in a quest for sustainable, effective solution to the problem of understaffed health centres in isolated rural areas, this bill has been passed into law.
Medical students of the Benue State University, Makurdi, have commended the governor on his efforts. However, the scheme has been met with a few complaints. Ferdinand Msughter, a 400L clinical student, lamented on the delay in approval of applications. ‘‘It’s been over 18 months’’, he says. ‘‘We are yet to receive any feedback. I’d like to benefit just like the pioneer sets, but my class fears Bond scheme may have been scrapped’’. A visit to the state Commissioner for Health, Dr. Orduen Abunku in Makurdi, revealed that the Bond scheme has not been discontinued.
‘‘The governor is well engaged in national assignments at the moment’’, he explained. ‘‘Following his approval, names will be sent to the Civil Service Commission for issuance of letters.’’
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