A Medical Talk, by Professor Nimi Dimkpa Briggs

Delivered as part of the 2015 Conference on Peace and Development, held by the Akuku Toru Local Government Area Council of Traditional Rulers and Chiefs, Abonnema on Saturday 19th December 2015.

Gathered in this town square today is an epic assemblage of the people of Abonnema (Nyemoni), Obonnoma, Abissa, Soku, Sangama, Kula, Idama, Belema and Offionama. They are here as constituent parts of the Akuku Toru Local Government Area created in 1991 by the Federal Government of Nigeria to foster and fast-track grassroots development. All extractions of the Kalabari nation, the people of AKULGA have lived their lives in brotherhood and harmony for decades on the shores and tributaries of the Sombriero River, which they affectionately call Akuku Toru and as expected, they are all led to this venue by their most revered traditional rulers with the Amayanabo of Abonnema, HRM king Gbobo Disreal Bobmanuel II, Owukori IX as Chairman in Council. My first assignment therefore is to thank the Chairman in Council, our highly respected traditional rulers, our mothers and fathers, very distinguished ladies and gentlemen, youths and even the children who are congregated here for giving me the opportunity to speak at such an outstanding occasion. For me the recognition is momentous as it situates me squarely where I truly belong – a true breed of Nyemoni, the York City of Nigeria.

My understanding of the request by the AKULGA Council of Traditional Rulers to me to give A Medical Talk at this event is that I should examine some health issues concerning our people. And here I will commence by drawing attention to the fact that health, in its widest sense, is beyond the mere absence of disease as, in reality, it connotes complete physical and mental wellbeing. Thus, being healthy is fundamental for our happiness, and a prerequisite for our ability to pursue our individual and collective aspirations as well as being able to meaningfully contribute to our personal, family, community and national progress and development. Therefore, as health is of such prime significance in all that we do, it is not surprising that it is not only hospitals, clinics, pills or even the much vaunted injections and drips – some of our cherished traditional portals of health, that, as important as they are, keep us healthy. Indeed, a whole gamut of many other things do: the environment in which we live, the life styles we pass, the food we eat, the quality of the air we breathe, what we drink and much more. So, just as doctors, nurses and other health workers are trained to look after our health, we as individuals, families and communities also have some responsibility to ensure we stay healthy. In the same vein, it is not only activities in the health sector – hospitals, clinics, surgeries – that determine our state of health; those in many other sectors such as water resources, nutrition, sanitation, transportation, trade, and others also exert substantial influence. Thus, effective contribution to health is derived from many sectors from which knowledge, skills, competences, and resources are harnessed and deployed. It is such sectoral collaboration that best assures the health of a people.

This fact of collective responsibility for health and wellbeing is not lost on good leaders – such leaders play their part and encourage others to do theirs also, their actions being at all times underpinned by a desire to achieve this goal. Let us by way of illustration examine what our forebears did when they founded this island in 1882 which became the great city of Abonnema, the capital of our Local Government Area.

Realising that nothing good, including health, thrives in the presence of chaos and disorder, their initial actions on arrival here, were to establish order and precept through functional spatial organisation. The entire island was divided into compounds called polo, where the paramount chief of each war canoe house from the old shipment as it was then known, his other chiefs and their entire households lived. A Street constructed from one end of the island to the other connected all polos while some parcels of the land were set aside for merchandising, communal meetings and recreational activities. Furthermore, each polo had at least one properly dug, deep well to provide potable water to which everyone had free access. Polos were subdivided into ogigos which were constructed in modular fashions for the accommodation of individual families. There were also subsidiary open fields in each polo which served as additional playgrounds and places for meetings. Besides, most ogigos also had their own wells.

To have succeeded in putting such a virgin land, as it then was, into a distinctive functional order which, till this day, is of prime importance to the operations of society without a formal knowledge of geography and urban planning is an outstanding feat of statesmanship and an immense contribution to the development priorities of a people. For health, it meant that water was available to support life: for drinking, domestic functions and personal hygiene. Modular replication of residential accommodation as well as open fields for recreational activities made environmental sanitation easy, enhanced communal interactions and offered children the opportunity to engage in outdoor plays and recreation even at night – an important component needed for their healthy growth. The ogigo arrangement made supervision of the health of individual family members by respective ogigo heads possible. It also served as a precursor to some form of family specialisation in different aspects of health care – notable ones being in the areas of trauma especially sores and other exposed injuries, supervision of pregnancies and deliveries and the care of mentally ill patients. Thus, family heads were obligated to seek help from experts and persons in neighbouring ogigos when necessary. Furthermore, food items including much needed fruits and vegetables could be purchased from a central market which held at designated times while subsistence farming in the backyards of various ogigos boosted the available fresh fruits and vegetables for family consumption. It is conceivable that the other towns and villages in the LGA were developed in similar manner.

It is tempting to downplay or take for granted the impact of such effective social order on health. However, the point has to be made that a foundation that defines hierarchy as well as levels of responsibility and encourages peaceful coexistence of people in communes, is imperative for the establishment of an integrated care system that would cover all aspects of health including those that would address matters relating to specific disease conditions as we know them today.

This structured arrangement – a masterly display of native intelligence, on which the health system was based, met the needs of our forebears at the time. It was foundational and so needed to be improved upon with time. However, it is difficult to argue that much has changed over these 100 years and beyond. Most of us still defecate directly and throw our refuge into the same river and swamps in which we bathe, catch fish and harvest other aquatic food items – isam, mgbe, ngolo, oporo – which constitute our major sources of protein as did our forebears. Often, we kill fish with dynamites and disperse dangerous chemicals which poison marine life and by extension, ours. Wells, from which many of us still obtain our drinking water are often left uncovered and exposed to the elements and so, they become homes for cockroaches and rodents. Children occasionally fall into them. Some of us abandon the designated burial ground and even bury our dead ones close to these sources of drinking water. Furthermore, drainages that are designed to channel effluents from our various polos and homes into the river are never cleaned but left to be permanently blocked with all manner of filth including faeces from humans and domestic animals. A visit to the big drainage at the back of BOP between Oruwari and Iju polo will drive home this point. So also will a walk along the sea shore from Owusara to Nyemoni Mission reveal the extent to which our river has been polluted by plastics and other waste materials with poor biodegradable properties. We have desecrated the land with huge fires set up for cooking petroleum products, euphemistically called kpofire with all its attendant negative health consequences. Your Majesty and our respected Traditional Rulers, so strong has the degradation of the environment been that on the whole, what comes through is that in the past 100 years or so, we, Akulgans, have conducted our affairs and deployed the land in such a manner that it is now less able to support our health and well-being as it did in its pristine form with our forbearers.

Herein then lies our path of action and the three things we as a people, especially our younger ones need to do – more as a way of keeping healthy than as one for treating diseases. First; we are to take some responsibility for our own good health in the way we live and the things we do. Second; we should take steps to protect the environment so as to make it a healthy environment and one that will better support a healthy way of life and our happiness. Third; we have to establish and create better access to functional, quality, scientific modern health care for all our people that would address the preventive, curative and promotive aspects of health and well-being to ensure freedom from disease and longevity. These issues do not operate in isolation but I will speak to them in my concluding comments as if they do.

Life style patterns are key determinants to health outcomes. A balanced and nutritious diet, with emphasis on fresh fruits and vegetables and fish as the main source of protein as well as a number of other personal life choices are usually advocated. Of these, heavy alcohol intake and lack of physical exercises would appear most germane to this great assembly. While available information confirms that alcohol in moderation is of some benefit to health, taken in excess, the drink could cause a number of deadly diseases let alone the dehumanization and stupor it causes its addicts. In this respect, we all have to reconsider the large volumes of alcohol and spirits that are consumed in this town of Abonnema and probably other parts of the LGA especially at various functions or as part of the weekly process of socializing. The massive presence of Okada and other motorized vehicles in town have lured many away from the traditional long walks our people took, with all their health benefits, to market places, schools, entertainment sites, compounds other than theirs for visits and socializing. I drew attention to this possibility when I addressed the chiefs and peoples of Abonnema at the turn of the millennium on the consequences of the Degema – Abonnema Bridge which was then under construction. The result is that many people you see in our various compounds and ogigos do not look well. They can hardly walk a couple of yards without being short of breath and are often unable to do simple things for themselves. But we can help ourselves even in a little way. Cut down on the amount of alcohol we consume, make walking part of our life style and try to eat as healthily as we possibly can.

The deterioration in the environment is of serious concern. While it may be true that our current level of national development precludes us from suitably tackling some of the issues I raised, such as providing a central sewage system where all our body effluents would be properly treated before discharging into the sea, we can at least do something. Reactivating the Scan Water System of Abonnema that has remained moribund for decades will ensure the availability of pipe borne water that is of better quality than the well water which most of us still use. Communal cleaning of the environment, as used to be ordered by paramount chiefs, when I was a kid in Abonnema, could be resuscitated. And efforts could be made to discourage everyone from engaging in illicit refining of petroleum products in our backyards and farmlands.

On the third and last matter of modern health services, many would agree that the services, as they currently are, are flimsy and rudimentary despite the large number of highly trained health professionals that Abonnema alone has produced – some with global acclaim. The services constitute a very far cry from what obtained in the 50s and 60s when the General Hospital, Degema, alone offered highly professional and efficient services to patients in the whole of Kalabari land and beyond. Indeed, those were the good old days. For now, the General Hospital Abonnema functions in fits and starts, the Primary Health Care centres in Abonnema and Obonoma are hardly patronised; many say they have not earned their trust as sanitation is poor, drugs, out of stock and attitude of some medical staff, repulsive. But we cannot accept this as a people. We must assist government to make these health institutions function properly and use them for the care of all but especially for maternal and child health services for our women and children.

Before I take my seat, let me be the first to accept that poverty is a major factor behind a number of the obnoxious actions to which I have drawn attention which compromise the health of our people. For several reasons, the poor fall ill more often than those who can adequately take care of their daily needs and when they do, their path to rectitude is arduous and less assured. Per capita income here must be among the least anywhere despite our rich resources. Many ogigos of 40 -50 persons have just one revenue earner; a good number, none. The palm produce and timber trade which buoyed our forebears have all but disappeared while the hydrocarbon in the belly of our land is beyond our reach. Hunger is real in this land. The drift to Port Harcourt and other places occasioned by this lack of gainful employment in our land is bad for our health, social formation and way of life and has to be addressed. Your Majesty; this should preoccupy all of us. Form a Think Tank of men and women with business acumen and charge its members with the responsibility of exploring viable options for bringing employment opportunities into AKULGA. Here, dare I ask, is it not time we as a people matched once again to the State and Federal Authorities, this time demanding that the seaport at Abonnema, now capital of Akuku Toru Local Government Area, be reopened?

Long Live AKULGA.

Long Live Rivers State.

Long Live the Federal Republic of Nigeria.

Nimi D. Briggs

Emeritus Professor.


Delivered as part of the 2015 Conference on Peace and Development, held by the Akuku Toru Local Government Area Council of Traditional Rulers and Chiefs, Abonnema on Saturday 19th December 2015.