Health and Development: Universities and Fire Engines

The keynote speech of Tulane University Professor William Ellis Bertrand, Deputy Chairman, Board of Trustees, American University of Nigeria, Yola, at the 9th Founder’s Day and 10th Anniversary Celebrations held on 15 November 2014

 

Recent events have put health and West Africa at the forefront of world news. Unfortunately, the media scare tactics have reinforced mis-perceptions of Africa as the home of downtrodden and poverty-stricken people who offer only problems to the rest of the world. To those of us who know and love this continent and its people these pre-judgments are unacceptable and ludicrous. Events such as the Ebola epidemic reinforce those negative images. There is little coverage, for example, of how well Nigeria knew what to do and did it quickly, as the result of a strong and vibrant public health tradition.   Currently there are no known active cases in this large complex and beautiful country.


As I reflect on the issues of a health and development University, I am reminded of an incident early in my career. As a young professor of public health, the Pan American health organization assigned me to work in the country of Bolivia, South America.  At the time, Bolivia had a serious outbreak of cholera, which made headlines in all media outlets in the United States. It provided the same kind of scare messages that we see with the Ebola outbreak today. Cholera is a disease similar to Ebola in many of the treatment and prevention protocols.  Of course, after reading the headlines, I was panic-stricken at the thought of going into a cholera endemic area and along with my mother was convinced that this was indeed to be my last trip.


At the time my senior director was the esteemed chairman of Tulane’s tropical medicine department, Dr. Paul Beaver.   I managed to get up the courage to get an appointment with him so that I could discuss my impending demise from cholera in the jungles of South America. He invited me to lunch at a local hotel and at the end of the lunch; I asked Dr. Beaver how I should protect myself against cholera in these terrible conditions? Dr. Beaver smiled and said, Bill, just make sure you wear a tie.   I sat for a few moments puzzled at what a tie would have to do with cholera; however, not wanting to appear stupid I did not say anything. At the end of our coffee Dr. Beaver turned to me and said are you wondering why it is that I told you to wear a tie to prevent yourself from getting cholera. I responded: Yes sir!  He said:  if you are wealthy enough to be accustomed to wearing a tie, you are probably going to be healthy enough to withstand cholera should you get it and to get good care if you have it.  As a result your risk is relatively low of anything serious happening with cholera, considerably lower than riding your bicycle to work this morning if you do the right thing.

In short, if a society is well-educated, has good preventive and curative primary health care, and is prepared to move quickly - as Nigeria has done - to contain a deadly virus in general the risk is relatively low.


What are the core elements that go into creating an environment that will fight off epidemic threats and encourage better health for the people?


The World Health Organization defines health as- “… a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”  

I will touch on several areas which I believe to be the most important in fighting   disease and in promoting good health. To my mind, these areas of action are the core requirements of the development university.


The first of these is a broad area of individual human security.  It has two parts.    The first and most tangible aspect of human security which we face every day is access to adequate food and clean water. Without sufficient nourishment and adequate water, humans cannot survive. With the scientific and technological innovations largely primarily brought to us by the hard work of universities, the earth now supports the creation of enough calories for the entire population. This is a remarkable feat since starvation was a normal occurrence in all parts of the world a hundred years ago – even during the Great Depression in the United States in the early 1900s. Now with almost six times the total number or persons in the world as in 1914 there are adequate calories produced to feed the world population of 7.2 billion.  This is roughly six times the world population of 1.4 billion people in 1914. This increased productivity is a direct result of the green revolution primarily driven by American Research Universities. It is a strong argument for developing a university in Nigeria based on the American model.


There is still a world and a Nigerian problem and that is food distribution, again leading us to issues of equity and development.  According to Professor Onimawo, (of the Nigerian Nutrition Association), malnutrition contributes to 60 percent of underlying causes of avoidable deaths, in Nigeria. This results in giving the country one of the world’s worst maternal and infant morbidity and mortality rates. There is no unresolvable reason for starvation in Nigeria today. Food security is at the core of the solvable health problems. It is the single most important intervention in public health that can be achieved with political will and focus. Sustainable agricultural, social and economic development is the known response, prescription for improving nutritional outcomes.


The second component of the security epidemic is one Yola faces today with massive forced internal migration.  This migration creates multiple human problems including malnutrition and resultant poor health caused by physical insecurity within Nigeria.    People have to be and feel secure in order to carry out the normal functions of their daily lives. The issue of physical security is inadequately researched outside the area of war fighting.   AUN has begun to focus on human security as an important element of a development university with the adoption of the Chibok girls as part of their educational program they are improving lives through improving education.


The core value in improving Basic Human Rights to security is a stable and enforced rule of law based on the human rights paradigm.

The rule of law and the protection of the rights for all are the basic tenets of the human rights movement which is closely linked to achieving the equal treatment of all citizens. This is a core value of all American universities and that AUN strongly supports.

AUN embraces and reinforces those values that foster security. It provides a model security force for the region, equipping them to  embrace human security as a concept.   The University is moving towards developing a law program to reinforce the importance of the rule of law in development. This will assist work in all aspects of peace and security by promoting sustainable development which is the mandate of the University.  


If we look at how we have conquered the great diseases of the world such as smallpox, polio, and measles it is almost always through research breakthroughs which have sprung from the world’s great research Universities.   These technological and scientific breakthroughs are what have been responsible for expanding the life expectancy of the average human.  AUN is increasing its emphasis on applied development related research. Shining examples of this are the posters reporting the research from Prof Mathias Fonkam’s seniors in the School of Information Technology and computing.…

In the single area that is driving all of science and technology, computing sciences, AUN is a Nigerian institution that we hope will soon be a world leader in undertaking important applied research oriented towards the community.

The most important single proven and researched intervention to promote health and development is through universal education of young people.  To move even faster along the path of development, a focus on the education of young women has been proven successful.     Educated women tend to have fewer children and take better care of the children that they have. As a result, society has a higher quality of human capital at every level and the quality of life improves for all. The single most important intervention for health is therefore early childhood female education – this should, this must be the priority for Nigerians to improve health. AUN has a strong contribution to the role of good management to solving the problems of public health.

I quote a Nigerian professor (Prof Dike Kalu) to summarize how a development University can impact the health of all Nigerians: “the increase in life expectancy in the western nations (80 plus years in several European countries) as opposed to 52 years in Nigeria) resulted from executing well the simple measures such as improved standards of hygiene, sanitary engineering, better nutrition, safe drinking water, and steps to prevent infectious diseases.
 
The science and the technologies involved (in these improvements) have been public knowledge for decades and are not beyond the capability of Nigeria. Witness the control of Ebola.

Effective implementation of these preventive public health measures in Nigeria are obligatory for the elimination of the needless premature deaths … The only barriers to implementing the required public health measures are those erected by us.

AUN through its School of Business & Entrepreneurship and more recently the creation of the Atiku Center for Leadership, Entrepreneurship and Development is focusing on those management and implementation issues that will bring health to Nigeria.  We have the solutions to add 30 years to Nigerian life span (imagine the human capital represented by increasing the productive years of life by over 40% for the largest nation in Africa). We simply need the leadership and entrepreneurship required to implement solutions. The Atiku Center is a giant step in making this happen.      

As I reviewed the accomplishments of the last five years of my involvement at the American University of Nigeria, I was impressed at how elements of the University had expanded into the community recognizing the importance of early childhood education and involving students, faculty, and administrators in the crucial task of understanding and changing primary education.   As a development University, AUN strives to educate from the cradle up. It provides an example of total community involvement.  A partial list of those accomplishments includes:

1.   Community education in information technology and entrepreneurship to over 4,000 vulnerable youth.

2.   AUN students serving as teacher’s aides to under-served primary school populations.

3.   AUN campus used for community functions and activities particularly in the Peace through Sports programs.

4.   AUN serving as the hub for the grand alliance of local entrepreneurs with a focus on starting new business and other activities.

5.     AUN taking a major role in aiding with the internally displaced persons and refugees.

6.   The AUN faculty and staff focusing on real Nigerian problems and coming up with innovative solutions as demonstrated by Prof Mathias Fonkam’s senior research projects from the School of Information Technology and Computing.

7.    There are many other activities but perhaps the most important contribution to human security at this time is the formation by former Chairman [Ahmed] Joda of the AUN board and President Ensign of the Adamawa Peace Initiative over two years ago as a forum for resolving differences and preventing conflict.

I had the honor and pleasure of assisting in the production of a monograph which documented the participation of the students many from privileged backgrounds helping to educate the poorest and least resourced children and around the University. It was wondrous to see the impact of the community involvement on the children and equally impressive was the impact of the children on our AUN students.

So in summary let me focus on how AUN has helped us all to define the role of a development university by doing it rather than thinking about it and thus becoming a center for leading Nigeria towards the path to better health through development.


AUN has focused on training and educating the young with a particular emphasis on young women, the fastest route to development. They have done this by committing the services of faculty and students to all levels of education and by standing behind the community in stressful times. AUN is attacking the core causes of poor health and trying to enable the population to take care of themselves. They are looking into expansion into public health and medicine to augment their role in improving the security of the people they serve.  AUN is moving quickly into a position of importance in all aspects of development in Yola and Adamawa. This reminds me of a story I recently heard about a fire engine crew in Port Harcourt. There was a terrible oil fire and the local fire crew was called to help put it out. The truck with its crew of men came speeding up to the raging and dangerous fire and did not slow down at all but went rushing towards the dangerous flames. The men jumped out and sprayed each other with water and the truck with water and still it sped towards the flames. Ultimately, it reached the flames and put out the fire. The manager of the Shell Company who owned the rig wanted to give them an award for their brave actions and held a big dinner to present that award. He gave a $10,000 check to the Fire Chief.  The Chief said you are most welcome and thank you – the first thing I am going to do with this money is buy a new set of brakes for my truck. I could not have stopped it if I wanted to.

In some ways AUN reminds me of that fire truck rushing to help solve community problems without brakes that work  - - perhaps a good thing when you see the problems have to be attacked in an emergency mode.

I feel honored to have had the opportunity to learn from AUN what a Development University is not by reading learned academic texts in the Oxford tradition but by action for the community in the Nigerian context. I only hope that we can continue to grow that vision to give access to more students who seek a first-rate educational experience.


In the context of Yola I believe that AUN stands up to what might be considered an emerging view of health which encompasses a new vision for human security.

In a recent newspaper interview, our Founder was asked what was needed to solve the serious problem of insecurity in Nigeria.  He responded that “… A lack of political will to tackle insecurity issues holistically” was at the root of many current problems.

I present to you that through his stewardship and unselfish giving to the American University of Nigeria, he is defining that holistic view of human security and health for Nigeria.  On this the 10th birthday of  AUN’s founding with current inspired leadership  of a  short lady from the United States,  there is a  collective force of nature that focuses on education for AUN students, staff and faculty; Education for all the members of the community and ultimately education and resultant better health for Nigeria and Africa.  We are all honored to be part of this magnificent effort so crucial in this vital time for this important country.   Let us not put brakes on this fire engine of change.


W. Bertrand    

11/15/2014

Yola, Nigeria

American University of Nigeria
98 Lamido Zubairu Way
Yola Township bypass
PMB 2250, Yola
Adamawa State, Nigeria

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