How do you do your work of monitoring the various entrance and exit points into the country?
My staff send reports to me every minute. This is 3.16 pm the next flight will depart from Umaru Yar’Adua Airport. The report is from Katsina. Every one hour, I can tell you what is happening across the country. I get reports with the pictures.
How are you able to do this?
You see, I told all my staff that they have to be IT compliant. For example, when my staff told me that Abuja is going to start airlifting pilgrims, I told them that this year; no pilgrim shall leave Nigeria sick. So, before they open the camp, my staff will go and inspect the camp, certify it to make sure that it is swept, cleaned and from there, they will show me the picture of the toilet, I will see it here.( Holding up his phone) I will tell them that “your toilet is not clean. Go and make sure that the toilet is cleaned, open the taps, let me see the water rushing”. They will open it, I will see it. I will ask them to show me the water tank. ‘Show me the food that they are eating’ because we certify food also. Port Health staff educate the food handlers- check their finger nails, check the water those going on Hajj drink, the environment they sleep in, the toilets they sleep in, where there are mosquitoes, snakes, scorpions, we fumigate and kill them. The camp has been closed for one year, so, by the time we go and check and fumigate it, the rats, scorpions will die and by the time we go and wash the place, we will see all of them and it is then that the pilgrims can enter. As they are going on hajj, we take their blood pressure, check them for diabetes and as they arrive at their destination, their diabetes and hypertension will be treated. If they are pregnant, we ground them because they cannot travel to Hajj with pregnancy. We have tests for pregnancy. They give lectures through which they train pilgrims on what sicknesses to expect, what to avoid, take their blood pressure and advise them. Our pilgrims have never been better educated than what we did this year because we are afraid that there is a new epidemic in the Middle East and if it comes into Nigeria, we would be in trouble- that’s the Middle East Respiratory Virus, MERS. So, all our staff have it on their finger tips, including even a youth corps member. If he comes here, he must learn how to train travelers. If you wake them up from their sleep, they must know how to train travelers. We check the planes before they enter, check the cleanliness. We check the contraband items seized from travelers too. Port Health Service staff are struggling to send me reports all over every minute. They will show me the water facilities, what type of emergency toilet arrangements are there when the figure is high, I have more than 2000 pictures from around the country here (inside the phone) because they come in from around the country every hour. When aircrafts come, they have to go and fumigate it to make sure there is no mosquito inside the aircraft. We also check ships, land border, airport, border, sea ships when they arrive we check how they cook food inside. My staff take speed boats, go to the high seas to check the ships. As you sit here, I have received reports from airports, ground crossings and I couldn’t have arranged it. Let me see if I can see any report from ground crossing (checks the phone). Yes, this is from Kaduna State, from Maiko border( ask journalist to read report) “Vehicles no, 12, passengers, 222, temperature above 37 degree, 0, good morning sir.” If there is anybody with temperature above 37, I will be informed immediately and we have a signal code- red code, yellow code, green code- you can see that we have the green code in most of these places, but by the time we have a temperature alert of over 37 degree, we switch to red alert, all of us are on alert, and they know I will not sleep until the alert is over. The Perm Sec himself does not sleep, even if it is 2 am, I wake him up that ‘Sir, there is a problem, we have so, so case.” Like last week, we had a case of somebody who came from Sierra Leone with high temperature, my coordinator in Lagos spent the night with her. She was a director, but she was reporting by the minute to me and I in turn was waking the Permanent Secretary. I said there is a problem and I am going to be waking you up to give you update. He said go ahead. When the day broke, I sent him a text to inform him that the result was out and informed him the person had no Ebola and had been discharged.
When did you begin to have these comprehensive operations?
This year, the Ebola issue has woken us all up. Things that we were a bit relaxed about before, we are now doing better. And one thing that this Permanent Secretary did which I always applaud is that in the midst of fighting Ebola, all of us were on what we called ’emergency mode’ but he was insisting that we must leave residual institution benefits after the emergency, and that is what has helped Port Health Service. Most of the investments made were not just transient investments, they are investments that we could fall back upon even when the epidemic is gone. And the staff morale is phenomenal. Whenever we have a threat, we have an emergency team made of well trained epidemiologists- there are three categories of them- many of them are doctors, veterinary doctors and the third group are laboratory staff who have excelled, and working in the field. They have come back for their Masters degree. They are the foot soldiers that handle this data for us, they are very good at statistics. Some of them are doing their residency programmes while some are already consultants in other fields. If there is an emergency that will last 24 hours, I will activate another emergency mode. I will give you the example of the emergency group that I did when some Nigerians went to Liberia and came back, so we had to monitor them-before they left and after their return, for 21 days. We created what we called an EVD response group and everybody that is concerned is added to the group. So, if I send a message, everybody concerned will react immediately and send their report and everybody is carried along until the matter is closed. We have successfully concluded the monitoring of the people from Liberia. They are all healthy and this emergency group is closed, so everybody is disbanded. As soon as another threat arises, if it is solvable within 24 hours, we deal directly with the field office, if it is not, we reactivate an emergency team for it.
What is your staff strength?
Our staff strength is 607, but to cover our 180 posts, we need 1, 725 staff immediately. That is the ideal, it is well calculated and nothing is left to chance here. We know the locations, we have done the distributions and we know where the staff need is high and we know how many shifts they run. And we know what an ideal shift should be like. So, we calculate that and know that we are short staffed by 1, 122 workers. It will even be better for us to have 2000, because of redundancies, you want to move people around or allow them to go on vacations.
Are you making efforts to employ more people then?
We have a presidential waiver to employ and the process is going on. What the former President approved then was 660- 330 for another department and 330 for us. But that is not enough.
What are the categories of staff you want to employ?
We employ several cadre- doctors in small number, nurses in larger number, but the bulk of staff that we need are environmental officers because they are the foot soldiers on the frontlines and they are the people officially certified by WHO to do certain functions- like certifying an aircraft, a ship. The environmental health officers can go into the ship, certify the ship, the crew, the environment, their food, everything and issue a valid document that can be used anywhere in the world. And that is why the most important staff we have in Port Health are the environmental health officers. Every other person follows. We are not presently in about 200 posts.
But are all our borders covered?
Now, when I hear people talking about the porosity of our borders, I understand their anxiety and I tell you, when you work in an environment, you get more intelligent and wiser by the day. And I will give you an example- when you come in through Kwara State which is one of our most important and difficult borders, people can come in through different routes, but ultimately, all the routes lead to a main road. They must merge from the different tributaries and pass through that main road. But when you look at all the tributaries, you will think our borders are porous, but they are not. We have mobile teams that attend to them. Then, we have field teams that also block these major tributaries; we also have another large team that monitors the smaller routes. So, if they escape from one, they cannot escape from the other, and ultimately, we will pick them. That is what is happening in Chikanda. But the public will say Nigerian borders are porous, but we know what we are doing. That’s why we called them expansive borders.
You said all these began this year?
No, we have been doing it. But because the staff have been in the field, they’ve lost their sense of touch with headquarters because government is not providing them with what to work with, so many of them were relaxed. And that is one thing that has changed in the past one year- there is now improvement in logistics, up till late last year; the entire Nigeria Port Health Service had only three vehicles- one in Abuja which is not serviceable, one in Lagos which is about seven years old. What we did during this Ebola thing fetched us 18 vehicles. Though, it is still a far cry from what we need, it is totally different from what we had before.
How many of those cameras do you have?
We have 12- two are in Abuja, two in Port Harcourt, two in Kano and six in Lagos. But Lagos requires minimum of 12, because I can put 24 in Lagos. But we have statistics to show that those six have made a difference in Lagos. We have reduced the volume of our volunteers gradually from about 500 to about 300 and by the end of last month, to zero because of the cameras. You can calculate the payments the volunteers would have received, you can imagine the speed of passenger flow when they are being manually checked and the speed when they are going through a camera which they don’t even see- we only sit behind the camera and monitor and if we want, we can rewind it to see who has high temperature and if a staff is not doing well, we can detect it because we can see if a person with a very high temperature has passed through the system. But they are very vigilant because the records are kept. So, the cameras have helped to reduce cost, personnel. They have brought orderliness, and help to keep records which we can retrieve anytime making our accuracy to be improved. We are very careful with three words in Port Health- healthier, safer and easier. We combined the three words in our work. Whatever will be healthier, safer and safer for the travelers we take it. So, the Dangote cameras have really made the job easier for us, safer for us, safer for the traveler, healthier for the traveler and healthier for the country.
How much does the camera cost?
I don’t have an idea, but I know that even installing it, training, printing of the manuals, training on servicing, cost him a lot of money because he brought experts from Dubai to go round and train 20 people per camera. So, he trained 240 people and in our bid to create redundancies, we now make sure that virtually every staff that is in any airport has had an opportunity to train with the cameras. So, every staff of the Nigeria Port Health Service in the airport can handle those cameras.
How do you monitor these things?
It is very easy- the first thing you do is to automate your system to make sure that there is delegation. I can also let you know that we are monitoring every corpse that comes into the country. People don’t just wake up and bring corpses. No airline can bring a corpse here until we certify it and there are corpses we have denied, including those of VIPs. There was a VIP that died somewhere and we said I cannot sign that death certificate, the Perm Sec kept receiving calls and I went to him and said, ‘sir, this is what is happening,’ he said ‘Dr. Gwarzo, go and do what is right’. That man was not buried in the country. He was buried where he died because bringing him in would have opened us up to further challenges. He didn’t have Ebola, he didn’t have a health problem, but bringing that corpse back would have broken our fundamental policy and I told the Perm Sec that ‘if we do this, we are going to derail our policy that has saved us. You can give an administrative approval, but it is not good’. He said we don’t need to do that. Let’s do the right thing. He has empowered us, so we did the right thing. And I can tell you, any corpse that gets our certificates is genuine based on scientific evidence because there are documents we look for before we give it. Also, to reduce our workload, I have automated that system. I sat down with the staff and drafted a policy- who handles this level of approval? If it is this, this, don’t look for me, go and type the certificate, I will sign it. My staff who is a level 7 officer can call you and say, if you apply, this thing is going to be denied because he has not seen one, two, three documents and when they call me, I will say he is right, listen to him. And we have support from various agencies- ICPC has done us tremendous help. My own signature and that of my key staff are all over the world and instead of doing the right thing, some people will go and fake it. Somebody came in here with a fake certificate, he wanted me to endorse further. I called ICPC, they came here and picked him up. He is in jail now because if we don’t do that, we are going to open up this country to danger. Every death certificate that we signed is genuine, it is not hazardous to Nigeria. We handled about 35 different certificates on different issues- food handling, fitness to travel etc.
How are you handling all these, especially in the past three months when there is no budget?
Some of the activities we do are funded by government directly, for example, yellow card. Government produced the first batch, but now, the programme is funding itself because we charge money for the yellow card which goes back to the central account. Then, as we issue certificates, we also issue receipts from government treasury and the money paid go directly into the Ministry of Finance, but we keep the records and now go and tally at the end of the quarter or at the end of the year as the IGR collected by the ministry. But one unfortunate thing is that none of our airports, seaports or land crossings has been gazzeted as internationally accepted POE- Point of Entry or Point of Exit because there is an accreditation that takes place and you are now certified as designation. Then you can issue certificates that are even more recognized and can charge money. So, we are losing that money because we are not certified.
What does it take to get that certification?
A lot- some structural changes in the airports- how people come in, where they sit, where they are screened and the services you provide and also, the way you work with the other agencies, ICAO and all the agencies even the one dealing with shipping lines. So, when you have everything in place, you invite the WHO to come and certify you, but we are not qualified and we are losing a lot of revenue.
Is there any move to do that?
Yes! We have gone through almost stage two now because it is lengthy process. We have started and that is what is contained in the document of our reform process.
What are the major challenges that you are facing?
First of all, most of our policies are old. The Port Health Service was established in 1925, but the latest review of our laws was in 1968, then Nigeria is behind schedule in implementing the WHO/AITA 2005 regulations and that is why we cannot charge money. Nigeria is yet to designate point of entry in line with IATA. We’ve been given seven years now to do it. It involves a lot of changes- you have to work with FAAN, the Nigeria Port Authority, shipping lines to change certain structural issues.
