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Page added on July 7, 2012
As I was glued to my laptop listening to Star Radio as it aired the now famous Maada Bio’s welcome jamboree in Freetown, I jumped for joy in my sitting room in London when Bio said he would extend the free health care for children from 6 to 18 years. As Bio said those words, he reminded me of President Atta Mills of Ghana at the UN General Assembly in 2009 who committed himself to providing free health care for all children under 18 years in Ghana. And after three years on, even President Obama is a great admirer of President Mills with Ghana having one of the lowest infant mortality rates in Africa because over six million of its children under 18 enjoy free health care in their National Health Insurance Scheme. Therefore, in this article, I will attempt to discuss why such ambitious free health care for children matters and consider possible ways it can be funded.
According to recent report published in April 2012 by Street Children International, it describes Sierra Leone as a young population with 52% of the nationals below 19 years. Therefore, this free health care ambition by Maada Bio will benefit at least 2 million children, yet the plight of children remains dire. Health reports after health reports have shown us that children – whether they are orphans, those living with single parents, the thousands out of school, the 50,000 street children and even the hundreds of thousands who attend schools – are always very vulnerable to diseases like malaria, measles, chicken pox, typhoid, anemia, worm infections, meningitis etc. Worst still in a country where even the former APC Minister of Energy and Power Professor Ogunade Davidson admitted just last year that 3.4 million Sierra Leoneans do not have adequate sanitation, the lives of thousands of children every year are threatened by Cholera, Diarrhea, and Dysentery.
Since 2008, a survey by Ministry of Health, WHO and Helen Keller International in which stool samples of about 5,651 school going children aged 5-16 were examined it had shown the prevalence among children of two of the most important neglected tropical diseases like Schistosomiasis and soil-transmitted helminthiasis. Yet still, other neglected tropical diseases like onchocerciasis and lymphatic filariasis continue to pose threat to the wellbeing of children thereby causing growth retardation, impaired cognition and micronutrient deficiencies. Yes, how many times you haven’t heard parents taking their children aged 6 years and above to government hospitals and clinics, suffering from life threatening infections/diseases and doctors/nurses refuse to treat them because their parents don’t have registration fees or if they have the fees they do not have enough money to buy the drugs on the prescription list. If we provide a free health care for a child up to five years, what happens to that child if he/she suffers from a life threatening disease at age 6, 10, 12 or 16? Do we allow that child to die just because his/her parents do not have money to see a doctor/nurse or to buy prescribed drugs to cure the child? Would the Government allow that child to die just because he is no longer eligible for the free health care which is for under fives?
This Free Health Care has been a programme spearheaded by former British Prime Minister Gordon Brown back in September 2009 to help millions of people in developing countries to access free health care. And there were seven countries to pilot this free health care Initiative – Nepal, Malawi, Ghana, Liberia, Burundi and Sierra Leone. The free health care plan was unveiled at the UN in September 2009 and backed by $5 billion pledges by various states of which the UK’s contribution was worth about $410m. For the past years since the free health care plan started in those seven pilot countries Sierra Leone still maintains the highest infant mortality rate among them as even our neighbour Liberia has a lower infant mortality rate than Sierra Leone according to the recent World Motherhood Index 2012 Report. Ghana has not only record one of the lowest infant mortality rate in Africa, President Atta Mills has been internationally accredited for also implementing a successful free health care for over six million children under 18 years.
In an interview with Erwin van der Borght, Amnesty International African Programme Director, for a piece posted on Amnesty International website in September 2011, Erwin said this about President Koroma’s free health care “Government figures show that since the introduction of the Initiative, more women are accessing antenatal care and delivering their babies in health facilities. However, many women continue to pay for essential drugs, despite the free health care policy, and women and girls living in poverty continue to have limited access to essential care in pregnancy and childbirth.” In fact, now we have heard that Saudi Arabia has given us a large batch of drugs, are pregnant women and lactating mothers going to pay for these new drugs?
Also, in an article published in February 2012 on Pres. Koroma’s free health care by the internationally respected magazine “The Economist” titled “Health Care in Sierra Leone: It’s up to you” the reporter writes “British doctors who worked in the country say the Sierra Leone Government lacks the wherewithal to organise something as complex as the provision of free health care”. The writer adds “Natasha Sauven, a paediatrician, described an official document outlining drug procurement as quite frankly fantasy”. Of course, we all support a free health care initiative but ordinary people will share the views of those British doctors that the APC government lacks the wherewithal to organise such a complex free health care programme because how can we boast of a free health care when drugs and medical supplies go missing without no account leaving government clinics and hospitals empty or in some hospitals/clinics where there are few drugs government officials charge the very pregnant women and lactating mothers as high as Le35,000 for the very drugs and care which are meant to be free?
To start with, as a man who has always said the day he will be sworn in as president he will start work the next day, when he came to London in May he has already started preliminary discussions with the British Government through DFID to extend the free health care to children under 18 years. The reason being is that, DFID is supporting the international efforts to achieve the Universal Coverage of Basic Health Services and they are largely supporting our free health care initiative with an estimated $40 million for the reproductive and child health care programme. No doubts, the Rt. Brigadier Julius Maada Bio shares the British Government’s view on Access to Healthcare that “Nobody should die or suffer ill health because they are too poor to afford treatment when they need it at the point of use”. Hence by extending such a health care for children under 18 the Rt. Brigadier Julius Maada Bio is taking practical steps to promote access to health care for the poor.
Equally, a very crucial area which should also be considered to support the free heath care for children under 18 is the revenue collection from the mining industry. In 2009, the iron ore deposits discovered in Tonkolili Fields estimate to be 4.7 billion tons, which are among the largest in the world. Yet, the APC government signed a 65 year mining agreement with African Minerals in 2010 including generous tax holidays whilst the agreement with London Mining included significant royalty concessions. And most of the mining companies are charged by APC less than the 37.5% rate which by law they are meant to be charged.
Despite all these concessions by the APC government, IMF (2010) estimates that iron ore revenues from royalties alone could increase to $116 million annually by 2015. At the same time diamond smuggling through our porous borders due to poor APC government monitoring and supervision in the mining sector is costing us millions of dollars in revenue collection and the International Crisis Group once estimates a revenue loss as high as $100million. According to the international think tank, Adam Smith International, in their work titled “The Economic and Fiscal Potential of Mining Sector in Sierra Leone” (October 2007), it estimates that with significant institutional and capacity reform in the mining sector Sierra Leone could export $1.2 billion a year in mineral export by 2020. This is why the Rt. Brigadier Julius Maada Bio has always stressed that he will renegotiate some of the mining contracts with the mining companies to get a better deal for the people. Hence, to put all these figures in context to know what impact they will make in the free health care for children, according to the most recent report by Nina Devries of the Voice of America posted on its website on July 4 2012 the present free health care initiative in Sierra Leone so far has cost about $40 million. This means, if we reform our revenue collection in the mining sector by renegotiating all those APC generous tax concessions to mining companies as according to the DanWatch Report “Not Sharing the Loot”, in 2010 the mining industry accounted for almost 60% of exports ($200million) but only a shocking 8% ($24million) of government revenue came from the mining sector as a result of APC’s tax concessions to mining companies; introducing an effective border control to clamp down on diamond smuggling (securing an estimated $100 million over time) and maintaining the revenue from the iron ore which is set to increase to $116 million annually by 2015, even as a nation we should be able to support a free health care for our children under 18
And just by the way, in 2009 and 2010, a consortium led by Anadarko Petroleum, a US based petroleum exploration company, discovered oil reserves off the coast of Sierra Leone estimated at 450 million barrels. Preliminary estimates by the Association of Journalists on Mining Extractives, a civil society organization, suggest that oil revenues could be as much as $100 million (equivalent to projected iron ore revenues) if and when exports commence.
Therefore, we only need a President like Rt. Brigadier Julius Maada Bio who loves his country, his people and ready to make Sierra Leoneans benefit from our GOD GIVEN mineral resources. Like he normally says, our country is resource rich but policy poor, but our children from 6 years to 18 cannot afford to wait for another five years of Pres. Koroma to enjoy a free health care. Yes, we can all make it happen on November 17 by electing Rt. Brigadier Julius Maada Bio and Dr. Kadie Sesay for the sake of the FREE HEALTH CARE FOR ALL CHILDREN UNDER 18.
By: Yusuf Keketoma Sandi BA (Hons) LLB (Hons), London, UK
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