UNIVERSITY OF LAGOS
FIRST ABIMBOLA AINA OMOLOLU-MULELE LECTURE IN OBSTETRICS AND GYNAECOLOGY
PRIVATE WEALTH FOR PUBLIC GOOD – HOW DOES IT BENEFIT CHILDBEARING?
BY NIMI BRIGGS
Distinguished alumnus university of Lagos
EMERITUS PROFESSOR, UNIVERSITY OF PORT HARCOURT
PRO-CHANCELLOR AND CHAIRMAN OF COUNCIL FEDERAL UNIVERSITY LOKOJA.
web site: nimibriggs.org
TUESDAY 10 OCTOBER 2017 email: firstname.lastname@example.org
Health financing is a difficult area of health management as many persons are either unable or unwilling to pay for health care especially when illness strikes.1 However, building and appropriately equipping health infrastructure, employing skilled health professionals, providing the daily commodities and even the ordinary routine chores that are needed to run quality health care services are all expensive. Understandably, someone must assume monetary responsibility even where these services are established for the indigent and the poor with no resources to pay for the services and care they receive.
In Nigeria, Africa and beyond, many governments, to varying degrees, are unable to provide funding that would allow them to satisfactorily address the health needs of their citizens even though they tout such responsibility as one of their cardinal objectives. This inability leaves a yawning gap in funding health care, which is met, again, often incompletely, through other sources – recourse to expensive private health care, waiver of user fees, health insurance, philanthropy and many others. It is partly for these reasons of stemming unbearable financial burdens for health care that the newly elected Director General of the World Health Organization (WHO), Dr. Tedros Adhanom Gbebreyesus, an Ethiopian and the first African to be elevated to that exalted position in May 2017, took on the issue of the attainment of Universal Health Coverage (UHC) by all countries as a priority of his administration.2 His wish is to prevent people everywhere, from dying from ill health because they are poor and unable to pay for the cost of what is needed to restore them to good health. And to make the policy endure, the Director General advocates the inclusion of UHC into the Sustainable Development Goals (SDGs) as financial risk protection against devastating out-of-pocket expenditure for health services.2
Today’s lecture discusses philanthropy and examines why people give, especially to education and health care. It reviews child bearing and the factors that influence its outcome globally and in Nigeria. The generous donation by the late Abimbola Aina Omololu-Mulele to the department of obstetrics and gynaecology of the University of Lagos is spotlighted and its objectives x-rayed with commendation and plea for the department to expend the funds in accordance with the expressed wishes of the benefactor. The lecture concludes by calling on all to emulate this worthy example of donating to university academic and professional departments to enable them to fulfill their mandates.
WHAT IS PHILANTHROPY AND WHY DO PEOPLE GIVE?
The classic biblical parable of the Good Samaritan3 who spent his private resources and time to cater for a stranger he did not know who had been stripped of his property, beaten and left half dead by robbers on his way from Jerusalem to Jericho typifies man’s concern for the welfare of his fellow man because of man’s shared humanity. For indeed as Nelson Mandela, even with all his travails, stated in his book, Long Walk to Freedom, “…deep in every human heart there is mercy and generosity”. This altruistic concern for human welfare reechoes in all the major religions of the world and probably serves as the basis of the Greek teaching that the love of what it is to be human is the essential nature and purpose of humanity, culture and civilization.4 Furthermore, it is the plank on which philanthropy, well-intentioned habits that seek the common good and stem from love of humanity, is built.
Globalization and advances in scientific innovation – industrial revolution, mechanized agriculture, technology as well as other human activities, including politics in some countries, have enhanced human prosperity leading to wealth buildup by some individuals, families and corporate organisations which they can expend as they deem fit within the provisions of the law. Whereas some may wish to keep all such acquired wealth to themselves, others, driven by the love of mankind, may choose to deploy at least part thereof, to improve the circumstances of others, even unknown to them. It is this craving to promote the welfare of others through the voluntary donation of privately acquired wealth and other valuable items to worthy causes that constitutes the fundamental of philanthropy. However, such desire and willingness to share or to donate is not necessarily confined to the rich, wealthy and influential people in society as well as persons of ordinary means everywhere also give.
Those who do so – individuals and organisations – adduce several reasons for their actions. To many, it is a religious obligation as the love for mankind, the basis of philanthropy is espoused by all religions as is indicated in the various holy books. For instance, the Holy Bible states: he that giveth to the poor shall not lack; blessed is he that considereth the poor.5a,b and for the Muslims, seeking after the welfare of the poor is an important injunction that is often preached by Imams to all faithfuls. While for some, it is an opportunity to redress injustice and to contribute to the amelioration of global inequalities which create tension, resentment, frustration, anger and associated underdevelopment leading to the friction and dreadful actions that some people take against others and society – terrorism, arson, kidnapping, armed robbery, assassinations and murder. In this way, people feel they are giving back to society from which they have received so much. The rationale here is that beyond a certain point, money has little or no further value. It cannot bring happiness but can be used to save or transform lives.6 Such actions make donors feel good, happy, satisfied, fulfilled and contented. They acquire a sense of doing well by doing good.7 In the same vein, multinational corporations have recognised that the natural and social systems that are in peril – the environment, human security, livelihood – are important to the survival and wellbeing of their businesses, the communities in which they operate and people around the world. So, in the long run, it is in their own overall interest to provide support and incur expenses on behalf of individuals, communities and establishments that do not necessarily provide immediate material benefits to the company, but rather promote positive social and environmental changes in individuals, communities and the world at large – a practice generally known as corporate social responsibility.
Individuals and corporate organisations involved in philanthropy either do so directly or through foundations established by them for the purpose. Furthermore, money and financial instruments are not the only vehicles for philanthropy. Land, property, gift items, personal effects, time, skill and voluntary work are all used to improve the plight of others. Philanthropy is strong in North America and Europe; it is reckoned that about 70% of American households – rich as well as not so rich – give some money away every year.6 But the practice is spreading and increasing number of people around the world are doing so.
Donors’ areas of interest differ widely but helping the poor, as well as supporting religious, health and educational concerns top the list. Others include the environment, climate change and democracy. Many give to religious organisations partly as an obligation (tithes in the Christian faith) and to support their activities in caring for the poor as well as offering sustenance to health and educational institutions. When health organisations receive donations directly, most often, they are to be used to break new grounds in disease diagnosis and patient care as well as supporting critical infrastructure. Giving to higher education, especially universities has been an area of preference for many philanthropists for a long time. The bequeathing, in 1639, of his library of 400 books and one half of his estate – £780.00, by John Harvard to the institution that was eventually named after him: Harvard University, the oldest institution of higher learning in the USA, as its first benefactor, is probably the first recorded act of philanthropy of that magnitude to a higher educational institution. It is difficult to argue that this generous head start did not contribute to the distinction and accomplishment of Harvard University, which is regarded as one of the most prestigious higher educational institutions in the world. Several examples followed by Rockefeller, Ford, Carnegie, MacArthur to various other institutions of higher learning.
The attraction in giving to higher educational institutions is majorly, the students – making a difference in the lives of young ones, the leaders of tomorrow. Therefore, assisting universities to offer equal opportunities to all students, irrespective of gender, colour and disability is an ardent desire of many philanthropic organisations. Furthermore, the ability of universities to generate new knowledge which translates into discoveries that benefit society is attractive to donors who are thus willing to lend support to such virtuous ventures. And this is especially so in health-related educational matters.
OVERVIEW OF CHILD BEARING
By current global estimates, over 210 million women get pregnant each year and give birth to over 140 million children.8 The circumstances in which these pregnancies occur, the venues of confinement and events at parturition as well as the outcome of the pregnancy and delivery processes differ remarkably across the globe. On the average, women in the developed and industrialized world commence child bearing later in life, with some education, and have their pregnancies and deliveries supervised by skilled professionals while mothers in developing countries tend to be younger, with less formal education and often deliver without supervision by skilled personnel. For these and many other reasons, labour outcomes for mother and baby are also widely different, resulting in higher death rates, greater complications and increased residual damages associated with pregnancies in the developing world. For instance, India and Nigeria, just two countries in the developing world, produce one third of global maternal deaths and Sierra Leone, a country with one of the highest maternal mortality ratios (MMR – maternal deaths per 100,000 live births) in the world is in West Africa.9 Sadly, two recent national tragedies – the Ebola virus disease of 2014 and the collapse of the sugar loaf mountain from three days of torrential rain and the massive mudslide it generated in August 2017, all of which claimed thousands of lives in that country of very friendly people – will only worsen this awful ranking as maternal health suffers immensely in times of crisis.
The death of a woman from pregnancy and its related issues is the most devastating outcome of the child bearing process – a physiological activity that exists to keep the human race alive and from which many women, families and communities gain tremendous joy and contentment when all goes well. Therefore, maternal death, along with the near misses of pregnancy – instances in which mothers survived death but ended up with serious debilitating conditions that afflict them beyond pregnancy, like vesico vaginal fistula, damaged genitalia, necrosed pituitary gland – makes maternal health issues those of great concern because of their sheer scale and consequences, especially in areas where pregnancy outcomes are poor.
However, until recently, maternal health did not receive attention commensurate to its significance probably because poor maternal health together with its associated maternal death is principally a problem of women in the underdeveloped world; the industrialized world having scaled this hurdle, to a considerable extent, in the late 19th and early 20th centuries. However, by the late 20th century, there had been a ground swell of alarm that derived from many research activities and publications including those by two eminent obstetricians10 – Allan Rosenfield, an American and Kelsey Harrison, a Nigerian. In separate publications in the Lancet11 and the British Journal of Obstetrics and Gynaecology12 they drew attention to the neglect that women suffered in developing countries and how this resulted in large scale mortality and morbidity during pregnancy and child birth. Thus, the conscience of the global community was aroused to doing something to alleviate the hardship and death associated with child bearing in many countries.
Accordingly, there followed a myriad of actions commencing with a Safe Motherhood Conference in Nairobi, Kenya in 1987, February 10-13. Countries, foundations, families and individuals pledged finances to support actions designed to bring succor to mothers and to fund research that would lead to a better understanding of why women died. Hundreds of Non-Governmental Agencies (NGOs) sprang up the world over to be involved in the process and countless number of conferences and meetings were held to find solutions to the problem of poor maternal health.13,14 Furthermore, most of the organs and agencies that have interest in global health care – World Health Organisation, World Bank, United Nations Children Fund, United Nations Population Fund as well as some leading medical journals like the Lancet, all keyed into this concerted global effort to reduce the death and destruction associated with childbirth.
Of these many activities, let us expatiate on just two, not least, for their tremendous impact on the maternal death imbroglio: the inclusion of maternal death reduction in the Millennium Development Goals (MDGs) and the remarkable visibility that the Lancet has given to issues on maternal health, especially maternal death.
The MDGs and maternal death.
Goal 5 of the eight development goals that were set up as investment in human development by global partners and world leaders in 2000 to address issues of extreme poverty, hunger, disease and avoidable deaths (known as the Millennium Development Goals, MDGs), aimed to Improve Maternal Health through a reduction in maternal mortality ratio by three-quarters over a fifteen-year period. By 2015 when the United Nations analysed information from the terminal reports of the 189 countries that participated in the investment process, it was found that global maternal mortality ratio had declined by 44% from 385 deaths to 216 per 100,000 live births.15 Although this reduction was unequally distributed and short of the anticipated 75%, it was sufficiently enamoring to encourage further global efforts at tackling this dragon of our time.10 Thus, in the new global post 2015 agenda, known as the Sustainable Development Goals (SDGs), Goal 3, Health and Well-Being, aims, “by 2030, (to) reduce the global maternal mortality ratio to less than 70 per 100,000 live births”. This would require a 68% reduction in MMR at an annual reduction rate of 7.5% which is more than double the annual rate of progress that was recorded under the MDGs, 2000-2015.16 Were this to be achieved, it will be good news that could not have come a moment earlier especially for countries in the developing world.
The Lancet and maternal death.
Since it published the “Where is the M in MCH” paper by Alan Rosenfield11, the Lancet, a highly reputable medical journal with extensive global reach has kept up its interest on issues relating to maternal deaths. It has published many original research and commissioned articles that have led to a better appreciation of the various aspects of the problem:
prevention, causes of death and the management of desperately ill pregnant women who constitute the bulk of those that die. From its maternal survival series of 2006 to its maternal health ones of 2016, the journal has made available an accumulation of facts on the factors that cause death of pregnant women and options for substantially reducing maternal mortality and morbidity worldwide.
From these publications and many others, we now know that some of the major direct causes of maternal deaths everywhere are:
Complications of unsafe abortion
Bleeding associated with pregnancy and delivery
Hypertensive disorders in pregnancy
Obstructed labour and its consequences
We also know that effective antidotes are now available for many of these conditions and that where appropriate actions are taken early enough and in good measure, it is possible to prevent most of these deaths and the devastations that child bearing causes in some women that manage to escape death when things go wrong in pregnancy and labour.
CHILD BEARING IN NIGERIA
Reference was made earlier to the publication in 1985 of the outcome of 22,774 consecutives deliveries that took place at the Ahmadu Bello University Teaching Hospital in Zaria, Nigeria between January 1976 and June 1979 by Kelsey Harrison and members of his team of which today’s lecturer was one. So comprehensive and groundbreaking was that account that despite its antiquity, some of its findings and lessons are still relevant in Nigeria apart from the global impact they made.
With a maternal mortality of 1,050 per 100,000 deliveries then, in that hospital, death rates were high; at MMR of 1,257 now (2016) at the University College Hospital, Ibadan17, one of Nigeria’s flagship health institutions, it can be surmised that they still are in many parts of the country. In fact, it is estimated that the country loses about 145 such women every day, a staggering 6 every hour!18a,b Mothers who had not had antenatal care and came into hospital as emergencies when things had gone wrong were the largest group that died. That situation is still true today. Women who skip antenatal care for one reason or the other – cultural barriers, insecurity, lack of services – and only seek help late when serious complications have arisen, are the ones that mostly die or end up with horrendous morbidity. Pregnancy outcome in girls who had commenced child bearing early in life as teenagers for assorted reasons and with little or no education, is still poor as it then was. Complicated cases of abortion which were rare in the studies by Harrison and his team are now major contributors to maternal deaths especially in some cities of southern Nigeria. Haemorrhage and obstructed labour retain their prime positions. Unlike the substantial number of mothers that delivered in the teaching hospital during the Zaria studies (22,774 in 3.5 years, i.e.,> 6,500 per annum), most women for several reasons, now shun the nation’s major teaching hospitals, especially those in the south of the country, for their confinement. In 2016, barely 1,000 mothers delivered at the Lagos University Teaching Hospital or the University of Port Harcourt Teaching Hospital.19,20
The most important message that emerged from the Zaria studies was the revelation of the huge contributions that social and other non-medical factors made to poor child bearing outcomes. In many instances, these factors acted in combination with existing medical disorders to produce devastating effects. Thus, the processes that led to the death of many women commenced outside the hospitals, where they finally died. The factors included poverty, lack of formal education, harmful cultural practices, ethnicity, religious influences as well as deficits in the health care delivery system.21 Sadly, several years away from the 1976-1979 studies, these factors are still operational in the child bearing firmament of the country and are partly responsible for the different outcomes of pregnancy and child bearing in the country’s diverse geo-political zones. For instance, the MMR for north-east Nigeria, where girls tend to commence child bearing early and often without formal education, is stated to be 1,549 in comparison to 165 in the south-west where women tend to commence child bearing later after obtaining some formal education.18
Because of the importance of these contributory and synergistic effects of social and non-medical factors on the eventual outcome of pregnancies, they are now being incorporated as vital elements in the efforts to improve maternal health and to reduce the carnage of death and destruction. A few examples of such actions will suffice: Poverty reduction was a cardinal goal of the MDGs and so was female education. Under the Subsidy Reinvestment and Empowering Program (SURE-P) which was established in 2012, Nigeria reinvested savings from fuel subsidy removal on some critical infrastructure and social safety net programmes including the provision of a Midwifery Service Scheme to ensure professional midwifery services in health institutions. Nigeria’s National Health Act 2014 provides for the creation of a Basic Health Care Fund (BHCF) for the provision of basic minimum package of health services to all citizens through the National Health Insurance Scheme as a means of alleviating the inability of the poor to pay for health services. So also, is the use of Universal Health Coverage (UHC) as a government policy to prevent death from ill health because of poverty, Conditional Cash Transfer to support women who have antenatal care and deliver in recognised health institutions as well as the various empowering (N-power) schemes being currently set up by government to enhance skills acquisition by unemployed university graduates. Furthermore, government is reviewing its sexual and reproductive health policy to make effective family planning options more readily available to men and women to reduce fertility and unwanted pregnancies.
Despite all these efforts, Nigeria’s health care delivery system is still fragile.18b Not surprisingly, child bearing in the country is not structured to produce the happy outcome that is expected of it. The official MMR of the country at 57618a is still too high even though many believe that the figure is an underestimation. In the absence of a compulsory registration of births and deaths it is difficult to contest the view of the sceptics. The fact that the picture of child bearing that emerged from the Zaria studies has hardly changed shows that we have worked and published on the subject for (over) 30 years yet there is little on ground in Nigeria to show for it…21 Unfortunately, this situation, in a way, is reflective of the lack luster performance of the country in its polity, social fabric and infrastructural as well as human development. Nigeria must get its act together and satisfactorily exploit the abundant human and natural resources that it has, to evolve a society where things work for everyone. The best outcomes of child bearing are obtained from such organised and caring societies.
ABIMBOLA AINA OMOLOLU-MULELE
Willingness to give something back to society does not appear to be as common a practice in Africa, Nigeria inclusive, as it is in Europe and north America, where some of the rich regard themselves as trustees of their wealth who should live without extravagance, provide moderately for their families, and use their riches to promote the welfare and happiness of others. Andrew Carnegie, one of the richest men in history is said to have pledged to spend the first half of his life making money and accumulating wealth and the second, giving it all away, as a moral obligation.22 It is said that he did just that through the vast empire of corporations and companies that he established, many of which are functional till this day and from which many Nigerians and institutions have benefited. Similarly, Bill and Belinda Gates, Warren Buffet, well-known philanthropists from north America, have pledged to give away most of their wealth before they die, giving just enough to their children to make them comfortable. As an illustration of the willingness to give by Americans of all stations in life, J. J. Watt an American football star hoped to raise a relief fund of $200,000 to assist victims of hurricane Harvey in August 2017 in the south-east Texas area of the United States of America by committing a personal donation of $100, 000. By the 5th day, he had raised $10,000,000!23
But in Africa, again, Nigeria inclusive, it seems charity is home based. So, the rich garner wealth and money which they tend to spend and leave behind for their children as well as immediate and extended family members, hardly sparing a thought for the needs of others. Sadly, in some instances, such inherited wealth creates serious disagreement and rancour between siblings and families which end up in messy and protracted court cases where last Wills and Testaments are disputed and discarded and unpleasant family secrets made public. In such situations, the accumulated wealth is left to rot and lose its value and paradoxically, become a curse rather than a blessing. Partly cultural and as an apprehension against going back to poverty and hardship, rich Africans tend to accumulate wealth as insurance for themselves and families.
Gladly, the situation is changing and many individuals and families who have made money through transparent and honest means are becoming desirous of giving back to society. Thus, they are setting up foundations and outreaches which encourage good governance, fund education, cater for the needs of the poor, stimulate and inspire talents in youths, help the sick and needy and contribute to other worthy causes that benefit mankind. Mo Ibrahim, Aliko Dangote, OB Lulu Briggs, Tony Elumelu and TY Danjuma are just a few names of such persons that come readily to mind.
It is this group of public-spirited individuals which is growing rapidly in Nigeria, that the late Abimbola Aina Omololu-Mulele has joined through the generous cash donation, in her last Will and Testament to the department of obstetrics and gynaecology of the University of Lagos. So, who was she? I did not know her, but I know one of her younger brothers, John da Rocha Afodu, emeritus professor of Surgery at the University of Lagos, who was my teacher at the College of Medicine in the late 1960s. A little story of our encounter one day will probably help to put his sister in perspective.
I was assisting Mr. da Rocha Afodu as he was then known, in a day case herniorrhaphy. After I had infiltrated the left inguinal region where the hernia was with lignocaine solution, a skin incision was made. Where upon the patient jumped up from the operating table, grabbed the gown of the surgeon and screamed: do you want to kill me? Mr. Afodu, the surgeon, cool as a cucumber, apologized to the patient and very politely requested him to lie back on the table. Obviously, I had not infiltrated the field of operation satisfactorily with the local anaesthetic, which he then did and the rest of the operation went on uneventfully. The calmness, humility, politeness and consideration for the patient which Mr. Afodu demonstrated on that occasion, let alone his forgiveness of my shortcoming, were characteristic of him and were some of the very qualities which we, as students, strongly admired in him. A less student-friendly teacher would have thrown me out of the operating theatre for the huge embarrassment that I caused him.
My feeling was that those qualities of concern for the welfare of others, serenity, modesty and civility were familial and so, not confined to Mr. Afodu. They would have been shared with his siblings of which Abimbola Aina was one as they were all grandchildren of the formidable Chief Candido Joa da Rocha Afodu of Brazil and Lagos, who was a contemporary of the legendary Herbert Macauley, arguably one of Nigeria’s founding fathers. Having lost their dad, Pharm. Mobolaji Abisogun Afodu (formerly Benson) who died, again fighting for the freedom and welfare of others during the second world war, the lot fell on their grandfather to bring them up. And so, I was not surprised when researching for today’s lecture, I got to know, that Abimbola Aina was a civilized and urbane woman whose life had depth, content and meaning. Consideration for others was always paramount in her actions and in order to consummate this passion, as one of her many actions, she established the ADRAO international nursery, primary and secondary schools (Abimbola da Rocha Afodu Omololu) with the secondary school section having provisions for anglophone and francophone speaking students, as far back as the early 1960s. Little wonder it took the personality of the then prime minister of Nigeria, the late Alhaji Tafawa Balewa to perform the official opening ceremony of the school in April 1964.
As for her cash donation to the obstetrics and gynaecology department of the University of Lagos, the late Abimbola Aina spelt out the objectives in her characteristic way, as she had done in other cases, with distinctive candor as follows:
1.organizing and funding public lectures annually in the field of obstetrics and gynaecology for the purposes of stimulating and advancing the frontiers of knowledge in obstetrics and gynaecology as well as teaching through research findings in the field of obstetrics and gynaecology.
2.to fund research from time to time in obstetrics and gynaecology and to stimulate and enhance industry-university cooperation through the use of research findings in obstetrics and gynaecology.
These objectives clearly indicate how Abimbola’s private wealth should be used to benefit public good which in this instance is represented by the activities of the department of obstetrics and gynaecology of the University of Lagos, a professional and academic unit with the remit, among others, to rigorously teach and proficiently supervise child bearing in all its ramifications to ensure the health of mothers and their newborns. In response to these directives, today’s lecture, the first in the series, states that
child bearing remains a dangerous gamble12 for many women in Nigeria despite several years and efforts to make it safer.
far too many women still die and far too many who survive, still end up with serious debilitating diseases that compromise their well-being for the balance of their lives.23
to stem this large-scale death and destruction, we all, as Nigerians, must act differently.
while the professional and academic community should continue to research on how to prevent or manage patients with the specific and direct causes of death and disability – torrential haemorrhage, fulminating eclampsia, generalized infection, extensive organ damage and others,
we all must also pay better attention to evolving a nation where things work for everyone.
For better child bearing outcomes, we must all collectively address the less appreciated wider web of issues of bad governance, poverty, ignorance and general underdevelopment that underpin the dismal picture that we currently have. We should install governments that are more responsive to the yearnings of the poor and evolve reforms that reduce social unrests and conflicts, encourage female literacy and advance the quality of life for all to lift most of our people out of poverty, deprivation and ignorance. For, as a core issue, high maternal mortality depicts underdevelopment.24 It is therefore not surprising that using such social reforms involving a broad spectrum and continuum of care25 of which maternal health is part, such as safety of life and property, food supply to meet daily needs at affordable costs, clean environment that promotes healthy living, potable piped water in sufficient quantity, basic health care that is predicated mostly on preventive as well as promotive actions, many countries and states, some not as endowed but better organised than Nigeria, like England,26 Cuba,23 and the state of Kerala in India13 were able to effect drastic reductions in their MMRs. They succeeded because such reforms affected the downtrodden masses rather than the individual, benefited the poor than they did the rich and promoted the community in preference to the house hold.
As for philanthropy, outside the support it extends to teaching and research, its role in providing succor to the poor in whatever form is important. Such roles could include running free maternity hospitals, paying for the ante natal and delivery charges of the poor to prevent them from patronizing religious homes and other places that are not equipped for such specialised services10 and taking up the hospital charges of indigent patients before discharge from hospitals.
Let me commence my concluding remarks by thanking the department of obstetrics and gynaecology for nominating me and the authorities of the University of Lagos for approving my nomination to deliver this lecture. Your kind gesture has enabled me to be at this happy occasion and to share ideas and pleasantries with colleagues and friends at this great citadel of learning, the University of Lagos, of which I am a proud Distinguished Alumnus.
When I received the letter of invitation to deliver this lecture from the advancement office of the vice-chancellor, I immediately recalled that I had had the privilege of delivering the 13th Biennial Abimbola Awoliyi Memorial Guest Lecture of the Medical Women Association of Nigeria at Port Harcourt on 20th September 2007.27 In that lecture, which was titled Change in Lifestyle as Antidote to Emerging Diseases, I eulogized the virtues of Dr. Abimbola Awoliyi, the first Nigerian female doctor and first Nigerian female obstetrician and gynaecologist. She was a lady whose child contracted measles after playing with other children who also had the disease in the city of Aba in the then Eastern Nigeria. She toiled hard to save these children, including hers. The others survived but hers died of respiratory complications. So, on seeing that today’s lecture had to do with the benevolence of another Abimbola, I decided to check the meaning of that name. The correct meaning, I am told, is born into wealth and that immediately explained why these two women did something so special. Names, my people say, mold characters.
Abimbola Awoliyi and Abimbola Aina Omololu-Mulele, who seemed to have had a lot in common – both were professionals who achieved important firsts in their gender category, gave from their hearts – in one, her unstinting services; in the other, her accumulated wealth. The life experience arising from their shared name, Abimbola, had taught them that shared wealth is greater wealth and in this respect, let us recall that Andrew Carnegie, that very rich American once said of riches and wealth: the man who dies thus rich dies disgraced.28 My first call therefore at this important lecture, is for all namesakes of these two humanists to emulate them and give today, in cash or kind, to a noble course. Furthermore, other than complying with the stated objectives of the benefactor, the purpose of my speedy acceptance to speak at this forum would have been defeated if today’s discourse does not encourage each one of us, starting with myself, to give something to a worthy course. I am referring to our money, time, skills or any such tangible or intangible items that can help to uplift the lives of others, make them healthy and happy and to be in better control of the affairs of their lives. Above all, something that could possibly prevent a would-be-pregnant woman from dying.
Universities everywhere are complex organisations with equally intricate mandates.29 Established as institutions in perpetuity, universities generate, propagate and exploit knowledge leading to inventions and discoveries that enhance mankind’s progress, preserve the environment and foster national development and global competitiveness. Thus, their actions result in a better understanding of the world which benefits society and promotes the common good. Additionally, they positively impact their community in the areas of education, health, agriculture, commerce, employment and serve as conscience of society.30
Such complex functions and far reaching commitments require understanding and support from the universities’ audiences as well as adequate finances for their effective execution, often more than what university proprietors can provide – a deficit which many universities remedy through several avenues, including philanthropy. It is within this context of giving to universities that Abimbola Aina Omololu-Mulele example commands our collective applause. May her kind soul rest in peace.
Ohaegbulam, Samuel, C. Sustainable Financing of the Health Sector. Chapter 4. Towards a new dawn for the Health Sector in Nigeria post 2015. Olusegun Obasanjo Presidential Library.2016. pp 125-146
Universal Health Coverage: a political choice. WHO DG, Dr. Tedros Adhanom Ghebreyesus’ speech at a side event during the high-level political forum meeting, New York, July 18, 2017.
The Holy Bible. Luke Chapter 10, verses 25-37.
a The Holy Bible. Book of Proverbs Chapter 28 verse 27. 5.b. The Holy Bible. Psalm 41 verse 1
Bill Clinton. Giving. How each of us can change the world? www.randomhouse.co.uk
Dunn, Elizabeth W., Lara B. Aknin, and Michael I. Norton. “Spending Money on Others Promotes Happiness.” Science 319, no. 5870 (March 21, 2008): 1687–1688
Trends in Maternal Mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, WORLD BANK GROUP and the United Nations Population Division.
Etuk, Saturday J. Maternal Mortality: The Dragon of our Time. 75th Inaugural Lecture. University of Calabar.26th July 2017.
Rosenfield A, Maine D. 1985 Maternal Mortality – a neglected tragedy. Where is the M in MCH? Lancet July 13; 2 (8446): 83-5.
Harrison KA. Child-bearing, health and social priorities: a survey of 22 774 consecutive hospital births in Zaria, Northern Nigeria. British Journal of Obstetrics and Gynaecology. 1985; 92 Suppl. 5:1-119.
Briggs ND. Why do many women still die in child-bearing in Nigeria? 2008 Annual Okoronkwo Ogan Memorial Lecture of the Department of Obstetrics and Gynaecology, University of Nigeria, Nsukka. Tuesday, 14 October 2008.
Briggs ND. Women’s Health: A Nation’s Wealth. University of Port Harcourt. Valedictory Lecture Series. No.2. February 23, 2009
Lancet Maternal Health Series. September 2016.
Omigbodun, Akinyinka. 2017.Consultant Obstetrician and Gynaecologist, University College Hospital, Ibadan. Nigeria. Personal Communication
a-Nigeria Health Watch. August 16, 2017; b-http://healthnewsng.com/ones-open-letter-to-president-buhari-appeals-for-more-investment-in-health/
Anorlu, Rose. 2017. Consultant Obstetrician and Gynaecologist. Lagos University Teaching Hospital, Lagos, Nigeria. Personal Communication.
2016 Annual Report. Department of Obstetrics and Gynaecology. University of Port Harcourt Teaching Hospital, Port Harcourt. Nigeria.
Harrison, Kelsey A, 2016. We reap what we sow. 1st Distinguished Guest Lecture. University of Medical Sciences. Ondo city. Wednesday June 15, 2016.
Briggs, Nimi. Why do many women still die in child bearing in Nigeria? 2008 Annual O.K. Ogan Memmorial Lecture of the department of obstetrics and gynaecology, University of Nigeria, October 10, 2008.
Progress for Children: A Report Card on Maternal Mortality. No.7. September 2008.Foreword. UNICEF.
Cuba. Wikipedia. The Free Dictionary.
Briggs, Nimi. Change in Lifestyle as antidote to emerging diseases. 13 Abimbola Awoliyi Guest Lecture.2007 Biennial Conference of Medical Women Association. September 20, 2007.
Briggs, Nimi. Fulfilling the mandate. Rivers State University of Science and Technology. 24th Convocation Lecture. 3 May 2012.