Growing up here, I was always fed the idea that the United States was the greatest. The United States of America had been able to survive many wars and hard times to get to where it is now. I was taught to believe that America was the greatest place in the world. This country had all the technology, money, and resources. Why else would my family have come here from our small village in Isiala-Umuozu, Nigeria? It had to be because the United States had better resources than not only Nigeria, but many other countries in the world. That was the only reason. That was something I had been taught to believe growing up.
In college, I learned that the United States is actually not the best country in the world. I learned of the USA's rank in healthcare, education, and happiness among others. I searched those same rankings to see where my home country might have placed, only to learn that Nigeria was failing as a state. After that, I became curious to know where other countries ranked and continued to look up various other countries I had traveled to. But, I started to realize something as I looked through the comparisons of all of these countries. I wondered how they were being compared. I wondered whether things like the history of the country or its current status was taken into account upon assigning those rankings.
As we learned about healthcare in the US and various other countries in this class, I wondered how long it took some of these countries to create the kind of healthcare system they had. We learned about the advantages and disadvantages of the healthcare in each of those different countries but I wondered if it was really fair to compare them to one another. While it is true that we can compare the advantages and disadvantages, I don't think we are able to truly say that one healthcare system is better than another, as I have heard people say generally about healthcare in the United States. When it comes to having the resources and funding to create a perfect healthcare system, each country is not at a level playing field. We have to take into account the history in some of these countries and the current situations whether they are political or social that may affect how healthcare is implemented in those countries.
I think that it would also be good to think about how long each of these countries have had to create a healthcare system. How many times were they able to go back to the drawing board and start over, building a new healthcare system using the successes and failures of the old as their template. It takes time to create a healthcare system that's effective for its people. That is why I believe that ranking countries by their healthcare systems is not equal because those rankings don't take into account that all of the countries didn't start at the same level. Not only that, but all of the countries in the world didn't start at the same time. Some countries are almost 400-500 years old, while others are 2-50 years old. I believe that factors like that are important to think about when making and interpreting information from those general rankings. Thinking about those factors won't necessarily change the rankings, but knowing the current state of the ranked countries can give insight into why their ranking is where it is.
For example, Nigeria has a very poor healthcare system, according to world healthcare indices. In the World Health Report 2000, Nigeria's healthcare system was ranked 187/191. In fact, a majority of countries within the continent of Africa make up the lowest 40 rankings of healthcare systems, with Sierra Leone being ranked last at 191. A majority of these African countries are between 50 and 60 years old. After their liberation from their various colonizers and formation of a country ruled by the people who inhabited it, these countries have not had long to create a healthcare system that works for them. They were left with a healthcare system designed by their colonizers, systems that they did not understand. Their current systems were thrust upon them and they were forced to continue with them upon liberation. Despite the changes that have been made to their healthcare systems, the base template is the same as the one created by the colonizers.
I think that having a healthcare system that uses the model of another as the base means that healthcare system will not be very successful. A healthcare system has to take the people it serves into account and the unique differences that exist within that country compared to another. Of course, this doesn't mean that inspiration cannot be drawn from the systems of other countries. When trying to be successful, it is only right to emulate those who are successful in some way. However, the base model for the healthcare system should not be based on that of another country because that same model that works for that country may not work for another country.
There are other things that also contribute to the lack of success with a healthcare system in an African country like Nigeria, for example. There is the 'brain drain', a phenomena that occurs when healthcare workers and many other intellectuals from a country choose to leave the country for success in other places. This takes away major resources for a country attempting to create a successful healthcare system. With the best doctor's leaving the country, citizens are left being treated by only a handful of specialists spaced two or three hours apart. Specialized healthcare and medicine would be impossible for a patient to receive if they had to travel two or three hours to reach a doctor.
There is also a large poverty rate in Nigeria. There is no middle class, one is either of high or low socioeconomic standing. This disparity in socioeconomic status plays a large role in the healthcare system. Those who can afford care are able to receive it, but those who have to pay out-of-pocket with little money are unable to be treated. This leads to the statistics we see for Nigeria for things like maternal health, neonatal mortality rate, death from easily treated diseases, and overall life expectancy among others. People cannot be adequately treated if there are only 30 doctors available for every 100,000 individuals in an area. People cannot be treated if they have to walk days to get to the nearest hospital because they are unable to drive over the damaged roads in their villages. People cannot be treated if there is a civil war and terrorism taking place where they live. Most importantly, people cannot be treated if the country is unable to obtain the technology and resources for its most skilled healthcare workers to use.
In summary, there are many factors that affect the African countries and many other poorly performing countries that we need to think about when looking at these rankings. We have to think about what goes on in those countries, and what barriers prevent them from being able to provide adequate healthcare services to their citizens. Once we begin to think about those things, we can begin to fix them. For me, healthcare is not just about health. It is about everything that encompasses a person's life. To improve those healthcare systems, instead of shaming them, we need to reach out and determine what resources they lack that would help improve their systems. As we talked about in class, some countries believe that healthcare is a basic human right for their citizens. Well, I think that if healthcare is a basic human right, then we should all be helping one another to provide exceptional healthcare across the world because as we saw with the Ebola virus and how it spread, countries are no longer as isolated as they had thought they were from healthcare issues in other countries. So, to prevent future pandemics across the world, I think it makes sense to help one another so that everyone across the world has access to a great healthcare system.
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