It is my pleasure to address you all at this auspicious occasion 0f International Nurses Week of 2020. It is pertinent to remind us that earlier The World Health Organisation has dedicated this year as the Year of Nurses and Midwives. The theme of the year 2020 International Nurses Week celebration is Nurses: A Voice to Lead-Nursing the World to Health. The celebration is aimed at showcasing the role of Nurses and Midwives, to recognize and celebrate the unique and vital responsibilities of these group of professionals that constituted and has been described as the back bone of the entire skilled and multidisciplinary sector. This unique honour was targeted at raising the profile and status of nursing and midwifery workforce worldwide. It is also the correspond to 120 anniversary of the ICN. Nurses week is celebrated annually from the 6th and culminates on May 12th the birthday of Florence Nightingale and is the observance of International Day of Nurses which is spearheaded by International Council of Nursing (ICN) since 1971.
Florence Nightingale was a Social Reformer, scientist and Theorist. Symbolically she was given the title of “The Lady with Lamp” at the Crimean War that broke out in 1853, among the British Empire and Russian Empire. The war was claiming many soldiers more death caused by infection than from bullets. Though there were enough Surgeons and Physicians that were operating upon wounded soldiers but lack of adequate and professional nursing care led to to the invitation of Florence Nightingale by the Secretary of War Sidney Herbert. Before the arrival of the Nursing team there were about 60% fatalities at the Scutari Hospital in Turkey and from January to September 1855 the fatality of 33% was reduced to 2% through her efficient nursing care services. Just like it id today her success at entrenching good personal hygiene, nutrition and adequate attention to manipulate the environment made The Chief Medical officer at Scutari Hospital Dr, Duncan Menzies, to mobilize to oppose and burry the work of Florence Nightingale. The happenings today perhaps is not strange to Nursing profession with out break of Covid - 19 that welcome year 2020, the dignified year of Nurses and Midwives, coincidentally its aboutb recapiyulating the historical antecedent.
2. Today, Nigeria Nurses and Midwives are joining the rest of the world to commemorate The birth of Florence Nightingale and celebrating The International Nurse’s Week. Our deepest gratitude goes to God almighty for keeping us all alive to celebrate another nurse’s week despite the pandemic of COVID-19, in all sense of reasoning, we have the responsibility to appreciate all our nurses and midwives for all they have been doing worldwide including in our country. According to Dr. Tedro Adhanom pronounced that Nurses Midwives are single vital and unique workforce that constitute about 60% of the professionals in health care services. He recognizes that the Nurses and Midwives performs very important pivotal roles and are often the first professional contact the patient have and perhaps the only one, from the cradle to the grave. It is pertinent to note that Nurses and Midwives is the single parameter to measure the standard and services any health institutions can offer. Dr Margaret Chan the immediate past DG of WHO claimed at the ICN Congress at Seoul, South Korea in 2015, that for any health care services to meet its set target, the quality of the Nurses and Midwives is measure of treatment outcome, in health promotion, illness prevention, diagnoses, treatment and rehabilitation and restoration of patient to pre-morbid state.
3. On the 30th December, 2019, there was an outbreak of coronavirus (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2). The first case of the novel coronavirus was reported in Wuhan City, China on the 17th November, 2019 while in February 27th, 2020, Nigeria recorded the index case of COVID-19 disease as well. The World Health Organization (WHO) declared this novel coronavirus disease (COVID-19) a pandemic on 11 March, 2020. This highly infectious disease raised global health concerns and ravages nation’s operations, making life more difficult for the vulnerable and marginalized communities. As at 12th May 2020, Nigeria had 4,641, 902 cases recovered and discharged while 150 deaths have occurred. Today we have a record of 5162 cases, with 1180 treated and are discharged but the death toll has risen to 167 persons, cutting across 34 states out of 36 States plus FCT with an exemption of Cross Rivers and Kogi State. Lagos State, Kano State and FCT have been the leading states with highest burden of COVID-19 while Anambra state has the least prevalence with one case of COVID-19.
4. The impact of COVID-19 further worsen the tremendous hardship caused by insurgency, civil unrest, poverty, illiteracy, high disease burden, criminal activities, famine, civil disturbance, occasional break down of law and order, burglary and other criminal activities in the communities e.t.c However, the impact of COVID-19 on Nigerian Nurses and Midwives cannot be over emphasized amidst tension, insufficient Personal Protective Equipment (PPE), anxiety, inadequate provision of medical consumables and few life support equipment, absent of life insurance and problem of transportation in some instances.
5. There are also increase assaults on the Nurses and Midwives, hiding of medical/travel history as well as non-disclosure of contact with an infected individual when patient and relative present at the health care facilities. These further exposes frontline health care professionals to infections particularly COVID-19, in our resource constraint society. There are evidences of lack of adequate awareness and knowledge of the nature and transmission of COVID-19 disease, there is equally lack of adequate knowledge on the use of PPE and sometime infectious diseases principle and protocol are been violated by some health care frontline professionals. The hazard been confronted by Nurses and Midwives are enormous and being unduly exposes to this virus with thousand on isolation. The WHO prescription is 40 nurses per 100,000 population but Nigeria is operating 5-6 nurse to 100,000 populations.
6. Over two thousand Nigerian Health care professionals especially Nurses and Doctors have tested positive to COVID-19 while about fifteen health care professionals have lost their lives. Our health care system appears to have been over stretched and on the verge of been overwhelmed. The statistics as received through NANNM Covid – 19 Situation Report Room. Almost one thousand Nurses and Midwives have been exposed to Corona Virus, out which about 200 are currently on isolation and about 70 out of about 600 that have been tested have tested positive. On the whole about five (6) nurses and midwives have lost their lives.
The current situation provides unusual opportunity for commitment and increase investment on nursing and midwifery profession, need for synergy between the Government, Professional Association, Traditional Institutions, Religious Institutions, Civil Society Organizations and Private bodies to galvanize efforts in finding lasting solutions to COVID-19 Pandemic.
The Nurses and Midwives have many roles: they provide and manage personal care and treatment, work with families and communities, and play vital/pivotal roles in the health care system worldwide. Nurses are advocate to the public in matters relating to their health, they are teachers, counsellors, comforter, clinicians and plays the role of a guardian to the downtroddens and the orphans. Nurses are sometimes mothers surrogate, researcher and health administrator and statistician depending on the health care he or she is working with.
As rightly stated by Dr. Gro Harlem Brundtland, Director General, World Health Organization September 2002, “Nursing and Midwifery services are vital resources for attaining health development targets. They form the backbone of health systems around the Globe and provide a platform for efforts to tackle the disease that cause poverty and ill-health. If the world is to succeed in improving health systems performance, urgent action is needed to overcome the problems that seriously undermine the contribution these services can make to the vision of better health for all communities”
7. I have no doubt that everybody is aware of the importance of the role Nurses play in curbing the pandemic we are facing currently however, we are not losing sight of the fact that 2020 has been designated by WHO as the year of the Nurse and Midwives, henceforth, it is a time to celebrate the services they render to keep Nightingale's efforts alive via implementing and taking forth the policies by Nightingale that keep people healthy and care for them while they are ill or even manage to a peaceful death.
8. Nurses are an integral part of health care system who have the potential to shape the image of health care delivery at all level when supported and empowered. The National Association of Nigeria nurses and midwives (NANNM) is a professional - cum trade union organization recognized by the Trade union (Amendment) Act of 2005. It is a non- governmental and non- profit organization authorized to organize all professional nurses and midwives who are trained, registered and licensed to practice nursing profession at all the levels of health care delivery system, namely primary, secondary and tertiary both in public and private sectors in the country.
The NANNM''s role is to: protect the health and wellbeing of the public, to collaborate with Nursing and Midwifery council of Nigeria to set and enforce ethics and standards of education, training, conduct and performance so that nurses and midwives can deliver high quality healthcare consistently throughout their careers, this is our mandate and we shall ensure we realized it.
As we all know nurses are believed and well recognized to be compassionate in all their dealings, having sympathy and concerns about others and the willingness to help and also care for them. Men, women, children, family, community, society and the nation as a sacred trust all the services rendered by all nurses and midwives across the globe ,we are known as harmless people, who only seek for the betterment of others even if we would prefer to hide our own personal pains and ensure we put smiles on people faces. Nurses and midwives are well endowed with skills and special abilities to safe live, promote health, prevent illness and alleviate suffering, also with deep sense of dedication, integrity, empathy and humility we deliver our services. Nursing and midwifery services is unique based of oath commitment that we pledged at induction in to the practices of the profession. The pledge eschew bad conduct and imbue Nurses and Midwives with judicial, ethical, moral, social and spiritual responsibilities and duty of care to be an harbinger of peace and tranquility, comfort, bearer of hope and restorer of happiness and reliever of burden of diseases and infirmity.
1. Invest in Human Resource for health: The government at all level of care need to make an intentional efforts to employ more Nurses and Midwives to particularly at the PHC and secondary health facilities, this is essential in achieving Sustainable Development Goals as well as Universal Health Coverage. Dr, Halfdan Mahler DG WHO from 1973 to 1988 admonished all governments at all levels not to rely only on training and recruitment but make periodic condition of services with the view to improve upon it and to motivate as well as ensure retention of already recruited health care professionals to ensure affordable, accessible and undisrupted and ceaseless health care services to the public.
2. It is on this note that we call on the President and Commander In Chief of Armed of Nigeria President Muhammad Buhari, (GCFR) and Grand Ambassador Of Nursing and Midwifery workforce in Nigeria to use His good office to look into the request of Nigeria Nurses and Midwives
- Direct the FMoH to release without further delay the withheld salary of our members in the Federal Health Institutions.
- To formulate policies that will reduces disharmony within health care professionals by ensuring justice and equity in health sector.
- Provision of the modern equipment, infrastructure, and adopt modern IC in health sector to improve Nigeria health sector performances, and learn from the lesson of Covid 19 that no where is better than our own indigenous health care system.
- Review all salaries and emoluments of our members along with others on COHENSS salary scale for the spirit of fair play and equity.
- Publish and fully implement the Nurses Unified Scheme of service and correct the anomaly on entry point of BNSc degree holders in line with their colleagues with same number of years in the Universities. It is equally pertinent to adjust the entry point of nurse interns
- We have been marginalized for so long by depriving us the department of Nursing with a full fledge Director and enhance nursing services in Nigeria.
- The Federal Ministry of Health, Head of Civil Services of the Federation, Federal and Civil Service Commission to obey the laws and circulars issued and endorsed by them in allowing Nurse specialist tom operate according to their scheme of service. Public Health Nurses, Midwives, Nurse Anesthetist to perform what they are trained and licensed to do as committee of MD and CMD has turn themselves into establishment, and constitute a parallel Council on Establishments and formulating regulations on services matters.
3. State and Local Government to invest in community Nursing and Community Midwifery programs which target to admit and train indigenes of a given community who if successful will stay back in their various communities to provide care at the very basic level, this will combat the high maternal, neonatal and child mortality in the communities. The country Nigeria is aiding and encouraging institutionalized quackery. The international best practices has that Nurses and Midwifery should exercises jurisdiction on every nursing and allied services in matters of training and practices but reverse is the case in Nigeria. Even the universal Task Shifting are turned upside down to mean task deprivation, the reason why Primary health CVare are deserted by Nigerians and Teaching and Tertiary institution are been overwhelmed with patient over flow.
4. Strengthening Infrastructure All tiers of government to invest more in building structure and human capital development, of Colleges and Departments of Nursing in the Universities, this will boost the admission rate by the Nursing and Midwifery.
5. Empower NURSES to carry out research and exchange program to boost quality nursing care
6. Leadership: Government to involve more Nurses and Midwives in both policy and politic position at all level of governance
7. Capacity building: Often time nurses are excepted in training and this have huge effect in the quality of care rendered, hence regular training and retraining of Nurses and Midwives is key to best practices.
8. FMOH should engage Nurses and Midwives in the Masters program in Field Epidemiology scholarship programme which has been ongoing for 11 years in Nigeria without single Nurse. There should be advance nursing program and research with scholarship.
9. Advanced Practice Nursing is not yet recognized in Nigeria, we run a Fellowship Programme at Regional level – the West African College of Nursing made up of five faculties and confers consultancy in those 5 areas of specialization. Nigerian Government are recognizing and motivating the product of the sister college that are now the back bone of Nigeria health sector becoming consultant and over time becoming Professors in the choice of career but their counterpart in Nursing are not even recognized not even to say the certificate be used for career development employers as been vanguard by the FMoH. Other Countries like Ghana, Gambia, Republic of Benin etc are making use of the product of the sub regional college that is situated here in Nigeria.
Nigerian Nurses and Midwives are using this opportunity to praise the effort of President Muhammad Buhari, the SFGN led by Bar. Boss Musthafa led PTF to take into consideration that no country succeed by planning for and not with frontline health care professionals. Therefore the government should involve the professional association leadership in all stages of planning. The government should not lose the sight of the very vital roles of Nurses and Midwives play as soldiers in the frontline of the war against Covid 19, all over the world Nurses are the most valued health care professionals as the person that are more exposed to the victim of this virus, as such Nurses and Midwives should be recognize the gallant warriors need to be appreciated through enhanced hazard allowances, insurances, and improvement in the provision of PPE im all its compliments that it deserved.
We are at this point appreciate those that recognize and appreciate Nigerian Nurses and Midwives, The WHO General Assembly, The DG WHO, World leaders like PM of UK, The Nigeria House of Representatives, and members of Governors Forum and want to call on Others but in public and Private establishment to do the needful.
Let me use this opportunity to call on the Federal Government, NCDC, Nigeria police force and all other security operatives to please accord my members the due regards and cooperation to further motivate them into higher performances.
The Federal Government are to be admonished to increase capacity to test for Covid 19, stop all processes and innovations that are not tested and trusted, be more democratic in evolvement any legislative processes. Our association owes it a duty tom increase our creation of awareness through rigorous health educations, and provide counselling and educations from grass root health care services, to secondary and tom the ivory towers at the infectious diseases hospitals and at critical care services at intensive care rooms.
Let me once again thank our field soldiers and general at the war of combatting Covid 19, that is our Nurses and Midwives not to relent in our battle against this virus. However please insist on been properly kitted before attending to any suspected cases of Covid 19, infact it is safer to treat every case as suspected cases until proved otherwise but ensure you provide care and concern as well as sense of belonging for all your client.
As a Professional Association we have directed our members to contribute to the care and donate generously towards the welfare of all victims of Covid !9 and all our members that are either in isolation or on the treatment wards. He donation ate from our state branches, to specialist associations, unit branches and individual members. Our last count has revealed several hundreds of millions what of support to fortified the course of funding Covid 19. Our prayers is that we shall not incur more deaths among our members.
To the public let us sacrifice for a while as ransom for our freedom and abide by rules of social distancing, hygienic regulations, sneezing and coughing hygiene, adequate nutrition, use of sanitizer, mask and always avoid crowd. Let us also declare our status to your nurses and midwives and other health care professionals.
Finally, healthiness and wealth are mutually exclusive and non can be pushed away, but let our FGN demonstrate courage not to weigh comfort over health security, and remember that health is a precursor of wealth, let pursue our health before our wealth. “The wealth of a country is contingent upon their health, and the health of your nation is a product of how the country treat their Nurses, (Judith Shamah, former ICN, President). Happy celebration.