Bright Ekweremadu is the Country Director of CBM in Nigeria, an organisation working to improve the lives of people with disabilities in the poorest countries worldwide. He was previously the Managing Director at Society for Family Health (SFH), where he served for 14 years.
How have you enjoyed the first months with CBM? What has surprised you about your new role?
I have been here for about three months, and it has been really exciting. I have wonderful colleagues in the country, regional, and international offices as well as the member associates — who are all very helpful, experienced and passionate about their work. It is very motivating and reassuring that I am in the right place.
One major surprise that struck me a few days after I joined is that CBM’s is not as widely known in Nigeria. Even though CBM started here in 1968, it is more known through the work done by its programme implementation partners than by itself. I think we all have to work on making CBM’s name known a lot more — not to take the glory, but for people to know that there is an organisation supporting these partners and their great work.
If you reflect on your transition from Society for Family Health to CBM, how do the two organisations compare in terms of organisational culture and challenges?
Although SFH and CBM both work in health, the two organisations have very different focus areas. At SFH, the focus is on HIV prevention, malaria, and neonatal, maternal and child health. At CBM, the overarching focus is on disability inclusiveness, which is something that is completely new to me. In Nigeria, there are a large number of people living with disabilities and nobody is listening to them or taking care of them.
Both organisations face the challenge that the Nigerian government is still not contributing as it should to public health. It is really unfortunate that the international donor agencies are the ones funding health improvement projects, and the Nigerian government is riding in the backseat. That is gradually changing, but it is going to take some more time before we get to a comfortable level.
What challenges do you see for people with disabilities in Nigeria?
I am very concerned about how persons with disability are surviving in internally displaced people’s camps. If people who are not physically challenged are finding life difficult in such situations, I can only imagine what the disabled are going through. This is one area where CBM has carved a strong niche for itself, although working in conflict areas is a major challenge for us. On a daily basis, I worry about the safety of the staff and partners. They get up in the morning and go into what I would call a battlefield to make sure that they are reaching people. The Government forces are there to help as well as the International NGO Safety Organisation (INSO). INSO gathers information about safety issues in the Northeast and we get online immediate alerts once there is an issue at any place and we circulate the information to our staff members. This has been very helpful.
What projects are you currently excited about?
The Seeing is Believing project really excites me. It is a comprehensive eye health programme targeting children under five and it has made a lot of impact with regards to preventable eye problems because children are screened at a young age. For example, recently the Albino Foundation in Nigeria had a national awareness conference where a large number of albinos gathered. We used that opportunity to conduct free screenings for all participants and treating eye problems that would have gone unaddressed otherwise.
Mental health is a major problem in Nigeria and many people are walking around with stigma and are not being helped, so I am excited about the Comprehensive Mental Health Project that is being implemented by the Methodist Church in Nigeria through its NGO subsidiary called Comprehensive Community Mental Health Programme (CCMPH) based in Oturkpo in Benue state. We are currently expanding the project to Borno, which is one of the states where the insurgents have been wreaking havoc since 2009. There are a lot of psychosocial issues associated with people who leave their homes and stay in these camps, so this project could help a lot of people recovering from this trauma.
As a senior leader in Nigeria, what do you consider the key skills a good Country Director needs to bring to the health sector to make an impact?
First and foremost, you need strong advocacy skills in order to see that the relevant policies are promoted and implemented. You also need a strong network and networking skills to partner with government and other organisations. Also, you must have team building and people skills to be able to build a trusting team, socialise and get involved.
What impact did the recent elections in Nigeria have on topics like disability-inclusive development and inclusion as a whole? What challenges or changes do you expect?
An estimated 25% of people have some form of disability, yet at the most basic level, disabled people were hardly considered during the planning stages of the election. Something has to be done so that they are able to exercise their right to vote. The Government of Nigeria should strategically consider the inclusion of disabled people in governance — as is the case in most African countries. But until disabled people are included in government, they cannot be represented adequately, they need to be on the table when decisions are being made so that they are able to speak on behalf of their membership.
Unfortunately, the umbrella organisation of persons with disability in Nigeria seems to have been embroiled in a leadership crisis. This is one area where I want to get involved, to ensure that the trouble gets resolved amicably so that this group can present a common front. This would help them to confront the challenges facing them as a team so that they can speak for themselves and fight for their place at the decision-making table at both the state and federal levels.
If you look at the public health situation in West Africa as a whole, what progress do you see and what gives you hope?
The health indices in almost every country in West Africa are poor. Over 80% of people in West Africa pay for their health out of pocket despite a large number of people living below the poverty line. Recently Ghana has made progress because of its ability to embrace a health insurance scheme. Nigeria has a national health insurance scheme, but it is not working as effectively as it should. Although some state governments in Nigeria have started their own insurance schemes, it will be difficult for them to be effective if the national health insurance scheme is not working well. Both need to be rejuvenated.
Another priority is that healthcare centres need to be strengthened in terms of structure and equipment-- and more importantly in terms of human resources. Our tertiary institutions are supposed to handle only referral cases, but they have become places where people go to for primary ailments. However, there is renewed interest at the federal and state level to rebuild the primary healthcare system. The states of Lagos and Delta are piloting arrangements where private institutions run the primary healthcare centres on behalf of the government. This is an innovative and wonderful approach and I see it as the future of primary healthcare centres and the health system in Nigeria.