Something to Digest

Posted: March 28, 2014 in General
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I understand that not many are huge fans of the biology class yet I’d like to crave your indulgence and send you back to that dreaded class on the digestive system sans all the enzymes; amylase, lipase, maltase, you know, all those ‘-ases’ that they say help us digest food but we never gave a hoot about, not then and most definitely not now because, well, how many of us now make a living out of those boringly long classes on enzymes anyway? Who needs a class to tell you that there’s a causal relationship between what enters into the mouth and what comes out of the anus even though the two have nothing as far as the eye (and nose) can tell in common?
So I’ll take you on a trip through the alimentary canal which, if you were wondering, is what some biology geeks woke up one morning precisely 250 years ago and decided to call that long tube that extends from the mouth to the anus. The alimentary canal is a long and convoluted tube measuring averagely about 9m or 30ft in length (That’s longer than the entire FC Barcelona outfielders; Xavi, Iniesta, Messi, Alexis and Neymar stacked on one another!). You need to bear with my twisted mind as it digresses now and then; in fact this talk of digestive systems as you are inevitably meant to find out is a digression but still bear with me as my thoughts are as twisted as my cerebrum is and… Aaaaargggghhhh!
Okay, back to digestion. Food is placed in the mouth, chewed until it’s pulp and swallowed. Mind you, from the outset it’s already been mixed with saliva which contain enzymes (oops! My bad! I promised not to talk about enzymes so hence we call them juices which kinda sounds nice) that kick-start the digestive process meaning there’s no going back. With the aid of the tongue, the food is sent rolling into the oesophagus which connects the mouth to the stomach where the food is assaulted with acid and juices. Now, this acid is so concentrated that it can corrode a razor, yikes! From there it moves on to the intestines; small and large, with sections given fancy names like duoden-um, jejun-um, ile-um, caec-um, colon (not so fancy,  sounds more like a punctuation mark) and rect-um. The food is crushed and pushed along the intestinal ‘ums’ with more juices mixed with the food until the body can start absorbing what it needs from the food. By the time it gets to the rectum, it’s no longer recognisable… it’s now shit. Good ole smelly shit that could be yellow, brown, black, fluid or solid but still same old shit and when the bowels get filled, everything is sent packing via the anus.
So what’s all these digestive systems talk all about? Thing is, like I said, my mind is as twisted as the sulci and gyri (just another bunch of Latin words bastardised by English biologists) of my brain if not more. Every day in the media, it seems there’s a conspiracy to malign the Nigerian youth nay, the Nigerian graduate. Everyone keeps saying save for being politically correct and avoiding censors bleeping when they talk that the Nigerian graduate is shit. The mantra is: our graduates are unemployable; they are nothing short of educated illiterates; they lack confidence; they are lazy; they seem out of place in the workplace; they… and the bashing and lashing never stops. These lines are repeated like a broken record and all I hear is shit, shit, shit and more shit. So it hit me, for something to become shit, it must have passed through a system, a digestive system of some sorts, an alimentary canal that converts it from food to shit. If the Nigerian graduate after spending at least sixteen years in the education system, 16 good years! 6 years of which were spent picking beans and melons for “mummies” and “daddies” (you dare not call your teacher “aunty” in a public school); another 6 years of bush cutting and sitting on floors hoping to at least get to learn something, then a hiatus where you hope if you are lucky within four years you’d get admission into the university to study “any-course” for 4 years plus x (where x is a positive integer dependent on the variables ASUU, FG, SUG and their complicit agreement to always disagree). If after these sixteen years, plus a year of mandatory youth slavery, the system produces shit as all these people are wont to make us believe, then this alimentary canal analogy of the system is not just apt but a stroke of genius from moi (thanks for the applause).
However, like the alimentary canal, the system is not perfect. Some food are just stubborn, these roughages as the name imply manage to rough it out of the system undigested. They, by an unfathomable willpower, manage to be the diamond in the rough only to be told “well, yes we know you are smart, brilliant, creative and all but as you can see there are so many of you and so few jobs why not be an entrepreneur, you know, be a job creator rather than a job seeker…”. Bullshit! [please bleep that] The education system as devolved to us by whoever decided people ought to go to school is meant to manufacture job seekers, machines that ensure the capitalist or the dying socialist systems function optimally. Recently, I saw an ad by a school that promised prospective students of getting gainful employment immediately after graduation or else they can call for their money back. Of course, that school is nowhere near these shores however, that’s some real and sincere advertising for the education system which I believe all our schools or at least those schools where you spend a fortune getting an education or some sham close to that (*coughs* LASU) should try.
The bitter truth is that this education system, a part of a faltering organism called Nigeria, has failed and it’s time for anyone who thinks he has a stake in this to, unlike the Morro-nic Minister of Interior, grow some balls and accept their failure rather than throwing spurious blames unconfirmed by data around.  In fact, they should be busy apologising for either their acts of commission or omission that has resulted in the digestion rather than education of almost half of the Nigerian population.
PS: For those wondering whether this writer is also a product of the Nigerian digestive system education system, the amount of shit I just spewed without regard for propriety or civility should clear your doubts.


just me being mischievous with some videos. definitely going to make you laugh. follow the text

Video  —  Posted: May 5, 2013 in Uncategorized
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Religious violence, championed by some Islamic sects, has been a major threat to national security in Nigeria since the 1999 transition from military to civil rule. The problem occurs most of the time in the heartland of northern Nigeria – most especially in Kano, Borno, and Bauchi States. These reasons for the Islamists in engaging in extreme violence include the opposition of some Christians to the introduction of sharia legal system in some parts of northern Nigeria in 1999 and 2000, the decision of the US to invade Afghanistan in 2001, the effrontery of a Danish newspaper, Jyllands-Posten, to publish some cartoons on Prophet Mohammed in 2005. Their dissatisfaction with the quality of governance in Nigeria have been referred to in local communities by a myriad of names but many Nigerians call them “Nigerian Talibans” on the account of their uncompromising rejection of western civilization and fondness for brutal violence.

Attempts to explain the origin and insurgent activities of these militant groups disproportionately reflect what the Nigerian ruling elite would want Nigerians and the rest of the world to know: that the religious “fundamentalists” are a blood-thirsty religious group with no sane social or political claims. Hence, attempts are always made to wipe them out from the society and this manifested during many of the counter-insurgency operations launched against them by the Nigerian army and the Police. The worst case was the 2009 Boko Haram crisis in Borno State during which many of the “fundamentalists”1 were tracked down and openly executed by the Nigerian army and police.

With a view to guiding appropriate interventions, this paper tries to provide an alternative explanation of the situation. It is that the so called “fundamentalists” are one of the grassroots responses to bad governance in Nigeria. Most of the sects were particularly produced by the abandoned sharia1 project of some northern Nigerian Governors. It would be recalled that following the transfer of power to civilians by the military in 1999, some northern Governors introduced the sharia legal systems in their states. Thinking that the “sharia governors” were truly interested in the practice of sharia, the Islamists started all manners of projects considered best for deepening Islamic traditions in northern Nigeria. They became frustrated when the sharia project was abandoned after its political dividends had been reaped by the Governors. The sharia Governors, some of whom have now left power, actually conduct themselves contrary to the sharia project they pretended to introduce. In fact, they are now claiming that the Islamists are not Muslims. Northern Nigerian leaders often maintain this position to protect the integrity of Islam given the senselessness of the violence often caused by the sect members. They maintain the position not necessarily because they do not recognize the Islamists as Muslims. Some of these northern elite in fact have relationships with the sects.

All those now referred to as “Islamic fundamentalists” genuinely responded to the calls of the sharia Governors as the faithfuls did when Uthman Dan Fodio declared his Sokoto Jihad in 1804. The problem that we have now is that whereas Uthman Dan Fodio demonstrated exemplary leadership by firmly establishing the religion of Islam in what is now known as Northern Nigeria (Sokoto Caliphate) and far beyond, the authors of the 1999-2000 sharia policy in northern Nigeria have since abandoned the project and turned to other self-seeking projects. The problem now faced is that the people they motivated into religious extremism still live in their state of utter confusion and find it difficult to retrace their steps back to the “secular” Nigerian state. This category of Nigerians includes those that the police and army are now chasing all over the place largely for preaching an extreme version of Islam. There are thousands of such groups in northern Nigeria today.

There are several dimensions of the problem but the bloodiest encounter between the “religious fundamentalists” and the Nigerian state was probably the Boko Harram (“Nigeria‟s Taliban”) sectarian violence which took place in July and August 2009 most especially in Maiduguri, capital of Borno State. The official explanation is that Ustaz Mohammed Yusuf, the leader of the Boko Haram sect and his followers were kidnapping people and forcibly getting them converted into the Boko Haram movement. The sect was accused of killing police men and seizing landed property which they later converted to training or preaching grounds. With a view to dragging other Nigerians into the (official) demonization project, the sect was also accused of planning to take its jihad to Abuja, Lagos and other parts of Nigeria3. With all these, members of the international community are bound to start perceiving these Islamists from the perspectives of the terrorist groups in the Middle East.

Another official position is that the Boko Haram group has a pathological hatred for western education and civilization. Of course, this is suggested by the name of the group. “Boko haram” means “western education is evil”. The interviews that we conducted in Maduiguri in February and March 2010 suggest that the number one enemy of the sect is not western education per se, but northern Nigerian leaders who have by their governance styles rendered western education not too useful to those outside the ruling elite. These political leaders fail to conduct themselves according to the tenets of Islam as promised during their political campaigns during the 1999, 2003 and 2007 elections. The fundamentalists are worried by the bad governance that makes the majority of those with western education to be jobless for many years while the few that have captured political powers use same western education to protect their misuse of state power and ill-gotten wealth. As far as these people are concerned, it was Nigerian leaders rather than the Islamists that gave western education and civilization a bad name. Hence, our informants are of the opinion that Ustaz Mohammed Yusuf who headed the Boko Haram group was particularly hated by state officials not for campaigning against western education as the public was told but for devoting the best of his daily sermons to reminding these state officials of their contributions to the failure of the Nigerian state. He and his preachers curse Nigerian political office holders on daily basis and the size of loudspeakers they have at their mosques betrays the seriousness they attach to this issue. Yusuf seemed to have ignited the wrath of some political leaders by naming them directly during his sermons and calling attention to specific things they do against the people. Many other Islamic preachers in northern Nigeria do the same thing. This is why the average politician in northern Nigeria perceives the Islamic scholars around them as “the main opposition”. To prevent clashing with them, the Governor of Kano State, Mallam Ibrahim Shekarau (fspsp) had to device an inclusive governance system, known as “A daidaita sau” (meaning it is good to do the right thing) which makes it possible for the leading Islamic scholars in Kano State to be consulted on state matters on monthly basis. He factors their interests and demands into governance4. This is one of the secrets for the peace in Kano State today.

The Boko Haram members were said to be fond of attacking police stations. This was confirmed during our fieldwork. We sought to know why they focus on this particular state institution instead of the ordinary people that the government claims they forced to become members of their section. The explanation we got for the attacks was new. The police forces are said to be fond of arresting and subjecting members of the sect to a long period of extra judicial detention as done to other helpless Nigerians. Such detainees are neither taken to court nor released and are often tortured if not killed. The sect members often attack the police stations “to release their detained members” when all lawful avenues to get them released are frustrated by the police. In some instances, they returned to their camps with arms and ammunition captured from the police. One of such encounters actually gave rise to the 2009 violence in Borno, Yobe, Kano and Bauchi states in July and August 2009 during which an estimated 1,000 civilians were killed by the police and the army. Most of the killings took place after the fighting had stopped and were done in the most bizarre manner.

The worst case scenarios were in Maiduguri, the capital of Borno State where the leader of the sect lived and was killed on July 30, 2009. He was captured by the army and interviewed on video. Later in the day, the police announced that he was killed while trying to escape. A video clip of the killings later shown by Al Jazz era featured how the police after the cessation of hostilities started a house-to-house search for the militants. Many of them, including children, were brought out of their homes, asked to lie on the street and then shot from the back. Two of those shot point-blank were in crutches. They were asked to lie down and were shot. Following a general public outcry, the Attorney General of the Federation and the Minister for Justice, Michael Kaase Aondoakaa on August 13, 2009 confirmed that Yusuf was “killed in police custody” and that Nigeria “condemns in its entirety, the unfortunate circumstances that led to the death of Mohammed Yusuf in Police custody”. A committee has been set up by the government to investigate the matter. That is probably the last that anybody would hear about the matter as it is not in the character of Nigerian leaders to reveal the outcomes of such investigations. A careful analysis of news reports on the Boko Haram crisis point towards three reasons for Yusuf‟s summary execution. The killing constitutes state terrorism to make his followers flee Borno state. The second is that the former Commissioner of Police for Borno State allowed such killing to take place under his command thinking that it would earn him commendation as experienced by some of his peers in the past. The third is that Yusuf and members of his sect were speedily executed to prevent them talking about their grievances and the role they played in past elections in Nigeria. The popular belief of Nigerians is that the governors in various parts of northern Nigeria were familiar with Yusuf‟s “nuisance value” but could not call him to order largely because of the roles he and his followers played in their coming into office. The speedy execution was therefore explained to be a way of ensuring that the insurgents do not live to mention the names of their supporters in government in various parts of northern Nigeria. The truth that is known to many is that several politicians in the region were given spiritual assistance by the likes of Yusuf for winning elections. However, this was in the expectation that the political leaders would provide enabling environment for the practice of Islam in the manner convenient for the “fundamentalists”. Within this framework, the present problem could be said to have resulted from a frustrated expectation. However, it has been revealed that the opposition of the government of Borno State to the Boko Haram sect was not basically because the group opposes western education as its name and activities suggest. The government is opposed to the group largely because of Yusuf‟s penchants for abusing state officials in his sermons. He accuses them of not truly representing the people. This is a popular allegation against the political class in Nigeria. Yusuf probably lacked the peaceful methods for making his points. The role of “preaching” in the Boko Haram incident was further highlighted by a post-conflict situation. In Borno State, the government insisted that all Islamic preachers during the 2010 Ramadan month must obtain license from the government before preaching. Cowed by the state violence suffered by Yusuf, the Muslim scholars in the State had to comply by presenting themselves for screening at the end of which only 150 of them were granted licenses. The explanation provided to the Shehu of Borno by the Borno State Commissioner for Religious Affairs, Alhaji Abdulranman Terab, was that this step was taken “to prevent the recurrence of the Boko Haram crisis”. He observed that what was granted to the preachers were temporary certificates “that could be withdrawn if they failed to abide by the laid down regulations”. He also said that the Borno State government was planning to set up a preaching censorship board for screening preachers on permanent basis. If this project works, then it might be difficult to get any group that could formidably challenge bad governance in Borno State as the Islamic preachers were doing, even if wrongly in some cases.

The Boko Haram incident notwithstanding, many see the Islamic clerics in Northern Nigeria as the only group that can challenge the leaders in the region. In the south, there are many human rights and pro-democracy groups that could do this. Such groups hardly exist in the North but they are easily replaceable by Islamic preachers who do not mince words in calling attention to the inadequacies of the political leaders in the region. Trying to blame the Nigerian judicial system for the continued existence of the Boko Haram group in Borno state, the State government complained that “the leader of Boko Haram was arrested and arraigned before Federal High Court Abuja by security agencies at six different times and on each occasion, he was granted bail”. Why? It was difficult to pin the sect members to any clear act of criminality. There is nothing wrong in a preacher criticizing the present crop of leaders in Nigeria. Everybody dooes the same thing: human rights groups, labor leaders and in fact this was the main issue addressed by Mrs. Hillary Clinton when she visited Nigeria in August 2009. President Obama indirectly said something similar about Nigeria during his visit to Ghana. Yusuf must have started to acquire arms when he got wind of how the government was trying to dislodge his group using coercive instruments of the state. This has to be factored into the explanation of the Boko Haram crisis in northern Nigeria. The Nigerian Inter-Religious Council (NIREC) took the foregoing into consideration in its response to the issue in an advert entitled “Human life is sacred” placed in some newspapers co-signed by the Sultan of Sokoto, Muhammed Habeeb Sa‟ad Abubakar and Archbishop John Onayekan the co-chairperson of NIREC as well as the National Coordinator/Executive Secretary of the organization, Professor Is-haq Oloyede. They condemned Yusuf and his followers for not representing Islam “or any genuine religion worthy of the name” but equally condemned the way the sectarian leaders were summarily executed. They observed that “even at war, prisoners of war have rights not to be executed after surrendering. What has happened has thrown up all sorts of unhealthy speculations as regards the motives for silencing the key actors in the tragedy. It has also tended to confuse the real issues that we should all be dealing with, in a cool-minded, united effort to restore sanity and peace to our nation”. The main point made in this paper is that whereas the “fundamentalist” Islamic sects in contemporary northern Nigeria demonize themselves by perpetrating violence against the people, the fact remains that many of them are merely responding to the failure of the sharia experiment as well as lack of political leadership in contemporary northern Nigeria. The “Islamic fundamentalists” often devote their sermons to the sharp practices of some of these political leaders. In the process they became demonized by the “Nigerian state”. Dealing with this kind of problem would require first and foremost that the political leaders in Nigeria become more altruistic and accountable to the people. The current tradition of killing, maiming and jailing the militants would not solve the problem. The fact remains that the Islamists constitute the leading group trying to force northern Nigerian leaders to become more responsible and accountable to the people. They constitute the only tangible opposition in northern Nigeria and are in fact the equivalents of the human rights and pro-democracy groups that fight bad governance in southern Nigeria. Northern Nigerian political leaders fear and hate them and would not mind a situation where members of the international community provide the support for fighting these militants as part of the global war against terrorism. This requires that members of the international community assesses the situation more carefully otherwise they would be engaging in activities that would on the other hand neutralize their efforts at expanding democratic space in Nigeria.

Professor Isaac Olawale Albert

Peace and Conflict Studies Programme Institute of African Studies University of Ibadan


About Isaac Olawale Albert Isaac

Olawale Albert is a Professor of Peace Studies at the University of Ibadan, Nigeria. He established and up to February 2007 coordinated the Peace and Conflict Studies Programme of the Institute of African Studies of the University of Ibadan. He was contracted by the UNDP in 2006 and 2007 to facilitate the establishment of the Peace and Development Studies Programme of the University of Cape Coast, Ghana. He also established the Peace and Strategic Studies Programme of the University of Ilorin, Nigeria in 2008. He served as the (Nigeria) Country Director of the Institute of Democracy in South Africa in 2006/2007. He is a resource person to several international organizations: Council for the Development of Social Science Research in Africa (CODESRIA, Dakar, Senegal); the Institute for Peace and Conflict Resolution The Presidency, Abuja, Nigeria; the National Defence College, Abuja; a Research Associate of the Centre for Research on Inequality and Ethnicity (CRISE), University of Oxford (UK) from 2003-2007; and, the 2006 winner of the Africa Peace Education Award of the California State University, Sacramento, USA. He was the Foundation Board Chairman of the West African Network for Peacebuilding (WANEP) in Nigeria and currently a regional board member of the organization. He has been teaching on the West African Peacebuilding Institute (WAPI) currently located at the Kofi Annan International Centre for Peacekeeping since 2001. He is an Associate Member of the Finnish Folklore Fellows [Helsinki] and the current Board Chairman of the Society for Peace Studies and Practice [SPSP]. His latest book (2009) is entitled Praxis of Political Concepts and Cliches in Nigeria‟s fourth Republic.

5 Al Jazeera, “Nigeria killings caught on video”, Feb. 10, 2009,; Sham O. Muyiwa, “Nigeria security forces kills unarmed civilians”, February 11, 2010 at 11:24pm,

As The Church Slept

A Treatise on the Boko Haram Phenomenon

Link  —  Posted: June 25, 2012 in Not mine but Sane all the Same

social dementators

Nigeria presently is teetering near the precipice with corruption at a record high and national security at its lowest ebb ever. The Boko Haram menace has been the subject of several heated discourses and the problem seems to have no sign of any meaningful resolution at sight. However, that is not what got me thinking to the point of putting my thoughts on this blog neither is it the crass ineptitude which our government continues to flaunt. What has really gotten me tearing my hairs out has been the rise of the social dementators and those who glorify them on the public sphere. I know you’ll be wondering where I got the word “dementator” from, Harry Potter fans may have an inkling of what it means from the  dementors that guard the prisons at Azkaban. But my use of dementators goes a bit deeper than that, dementator is a latin word meaning to delude or make mad and that exactly is what the people I’m about to describe do.

The current state of the nation has resulted in the emergence of an elite group; they come in different names, social critic, social analyst, social commentator and the most ridiculous of them all, social expert. Many of these people, mostly men dressed in suits, are hitherto unknown and whatever contributions they have made or are presently making to the society are probably still in the pipeline. There is no evidence for their integrity much less their expertise to comment on the issues on hand. You see them flock tv studios, radio newsrooms and more recently social media with their “expert” opinions when what makes them more qualified than the average John Doe is the media platform they are currently on. Many of these guys (they are predominantly men, I can’t remember the last time I saw a lady posing as one on tv) are illogical, prejudiced and sensational. They are rarely factual and the few of them that are distort the facts to fit their obtuse views. They bask in the 30-minute limelight given to them by the talk shows and they speak as if their view is the gospel and anything outside that is shish kebab. What is however more worrisome is the media houses that give these guys the platform to cause social dementation by spreading their demented views of the polity. I wonder whether these institutions have ulterior motives or just like every other sector of the Nigerian state they lack the aptitude for global standard practices.

I wouldn’t have been bothered about these social dementators if not for the turn that the discourse of the Nigerian polity has been taking because of their influence and indeed with the power of the media backing them, there has been an increased dementing of an otherwise demented majority of the Nigerian populace (pun intended). Since dotsencrosses is meant to cross the i’s and dot the t’s, I’ll be X-raying some of their views and the fault in their reasoning. Feel free to drop a comment after reading through.

  • Terrorism is synonymous with Islam/Only muslims are capable of violence

Do I need to talk about this? A so-called social commentator while commenting on the reprisal attacks in Kaduna said that he does not believe Christians are behind the attack because ab initio, a Christian is incapable of violent acts. And that got me wondering, are Niger Delta militants atheists? If you have also been infected with this reasoning, then go and get yourself de-demented period. I rest my case.

  • Northern Traditional/Muslim Leaders have the Magic wand to resolve the Boko Haraam Menace.

While I don’t deny the fact that these people have a role to play, proffering this as a cure-all one-size-fits-all solution to a hydra-headed problem is irresponsible. This is a statement that should only be expected to be uttered by apologists of the emasculated government we have in power. Here is the catch; In a country where community policing is non-existent and people have no iota of trust in the police and state security operatives because of their record of inefficiencies and corruption, it will take the height of self-sacrifice for anyone who has information about these people to report them knowing that their lives and that of their families are at stake. Here’s a group that operates like the Mafia, they are hard to track and when you do work against them, they come to haunt you ruthlessly. So, if the claim that community/religious leaders in the north know who these people are is true, unless the police can guarantee the safety of anyone who wants to help bring them to justice, it will be of no help. And I won’t be doing justice to the religious leaders if I also don’t state the fact which the dementators willfully ignore; those that have come out to speak against BH have been killed violently.

  • Unless Nigeria is Balkanized, there will be no peace

I heard a pastor say this on TV this morning and I was totally disappointed. Here’s a group that is clamoring for breaking the country apart and how do you respond, let’s break-up. This is a view that many dementators hold and it saddens my heart. The question I’d like to ask is this, if we accede to the BH’s demands for secession, what will be the fate of the Northern Christian who by default because of his/her ethnicity will not be a citizen of the southern “countries” and because of his/her religion will be an alien in his hometown if the Boko Haram get their wish? What of those families who though are of southern descent have been living in the North for over 50 years, are they to move back home? which home? When there was unrest in the Niger Delta (and I believe there still is, we are only paying to have peaceful oil exploitation), nobody who’s not of Niger Delta origin called for secession because we all enjoy the oil. We found ingenious ways (paid amnesty) to resolve the crisis. The North on the other hand, are an unwanted appendage, a leech that has to be gotten rid of abi? The truth is we have been together for so long, our centenary is just two years away, that we are now so interdependent that we all need each other.

  • BH was created to make Jonathan look bad

This is a very popular statement and while I can’t state how true or false it is, the question that came to my mind is unless our president is utterly useless, the easiest thing to do would have been to crucify his enemies with their own plot. so why does he seem so clueless? His actions/inactions if for all they’ve been worth do not paint a picture of a victim but that of an accomplice as I can still remember him saying that he has BH financiers in his cabinet. If you know them, why can’t you prosecute them? Or are their strategic value as stepping stones of his political career more important than the lives of innocent Nigerians?

There are more things about the Social Dementators that irk me but I think these are enough to think about for now. So with these few words of mine, I hope I have been able to conjure a Patronus Charm, that will dot the i’s cross the t’s and chase the social dementators back to Azkaban.

In Defense of Polymaths – Kyle Wiens – Harvard Business Review.

Who Pays?

Posted: May 14, 2012 in Healthcare
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out of belly payment

Have you ever slept in a hotel without paying?
Have you ever bought a drug from a pharmacy on credit?
Have you ever collected the results from a lab test without paying your bills?
How many times have you eaten at a restaurant without paying (minus those times when you had to do the dishes)?

These and many more are questions that race through my head when people castigate private hospitals for asking patients to make a deposit before being attended to. First and foremost, we have to realise that no matter what the adjectives used to qualify a (private)hospital are, it is still a business whose sole aim is to make profit just like a school, pharmacy, diagnostic centre, hotel or restaurant. Irrespective of whether a service is essential or not, once it is in private hands, the reason for setting up shop is to make profit, period. These hospitals pay taxes (they can’t evade taxes like other businesses because they renew their licenses periodically and they document all their transactions religiously), fuel their generators, pay their medical and non-medical staff (cleaners, technicians, security etc.) and in summary incur all running costs every business incurs or even more. In the healthcare industry, the private institution that goes into bankruptcy the most are the hospitals simply because they have the highest running cost, the highest default in payment from clients and the lowest profit margin (because most patients can’t afford the cost of standard healthcare). Little wonder doctors are acclaimed to be the worst business managers because they are just too nice. 

When a patient walks into a clinic, his bills start reading from the moment the nurse checks his vital signs (the lady will be paid for her services and same goes for the doctor in the consulting room). The hospital usually is affiliated to a diagnostics lab to which it has to pay for every test carried out from the most routine to the most advanced (emergencies are not an exception), drugs dispensed are bought from pharmacies and paid for in cash not on credit and if a consult is to be made to a specialist, the hospital pays also. The burden for all these costs can only be borne by one person and that is the client (patient or his family, employee or the good Samaritan who brought him to the clinic) and in a situation where this is impossible, the hospital runs into debts and will be unable to offer its services. The saying business thrives best when friends and family pay promptly for services rendered also applies to a hospital. However, the hospital is in a peculiar position when a patient is rushed in during an emergency with no one to foot the aforementioned bills.

For how long can a private institution survive being the good Samaritan and still function normally when a client cannot afford its services? If the available disposable resources were to be utilised on a client what happens to the next client and the one after? School fees are to be paid whether a student passes or not so why shouldn’t payment be made even if a client did not survive an illness due to no fault of the hospital that had offered its services and utilised its consumables in the treatment process? The big question therefore shouldn’t be whether or not a hospital should ask for payment before giving its services but why must payment for healthcare services be out of pocket and at place of need. If a hospital can be assured that payment will be made for its services irrespective of the outcome of the case, they will gladly accept anyone who walks into their lobby without blinking an eye and will utilise every resource available to them to deliver the required service. 

Whether the solution lies in healthcare insurance, community financing or a social welfare scheme, is a discussion for another post but until a solution is found to eradicate the barbaric out-of-pocket payment for healthcare, everyone should keep mum about the decisions made by a private hospital to ensure its survival.

I’s dotted en T’s crossed