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EMMF:
Making a Difference in Nigeria
A history of the Eastern Nigeria Medical Centre
Eastern Nigeria Medical Centre from Its
Founding in 1963 until the Civil War in 1967
The Eastern
Nigeria Medical Centre (ENMC) was built and opened to the public in 1963 during
a period of relative calm only three years after Nigeria was granted
self-governance as a member of the British Commonwealth. Funds for the construction and early
management of the hospital were made available in large part by prominent
Americans who befriended the hospital’s Medical Director and Surgeon-in-chief,
Dr. Nlogha E. Okeke, when he was resident in the United States to pursue his
undergraduate education and to receive his medical training. Among them were The Rt. Rev. Norman B. Nash,
D.D., Episcopal Bishop of Massachusetts, John J. Byrne, M.D., Chief of Surgery,
Boston University, and members of the Ella Layman Cabot Trust of Boston. Bishop Nash, Dr. Byrne and Dr. Okeke were
instrumental in the development of the Nigeria-American Hospital Foundation
(N-AHF) that was incorporated in Massachusetts in 1960 to provide for the
construction of a non-profit hospital in Enugu. Upon his return to Nigeria, Dr. Okeke and his wife Ifeoma, a
nurse whom he had meet in Boston, set about to build a 98 bed hospital on 12
acres of leased land and a loan secured by a local bank. Support for the program was given by many
high-ranking officials of the Eastern Region of Nigeria, in particular its
premier Dr. M.I. Okpara who presided over the commissioning of the hospital in
1963. In addition to the support from
the Cabots and Lodges of Boston and from the N-AHF, the ENMC attracted interest
from the West German government, the Canadian government, and the foreign
office of Her Majesty’s Government in Britain--all of which donated various
kinds of medical equipment to start the hospital. In the U.S. seven additional foundations donated equipment, while
the Nigerian Tobacco Company provided anesthesia equipment.
On May 11, 1965,
the Minister of Lagos Affairs for the Federal Republic of Nigeria signed the articles
of incorporation for the Eastern Nigeria Medical Centre and appointed seven
trustees: two were physicians, three were businessmen, one was an educator, and
one was a nurse. The aims and
objectives of the institution were “To provide for all manner of people a
charitable non-profit voluntary Hospital to be established and managed at Enugu
. . .”
From the outset
the hospital was a not-for-profit, charitable institution that it remains. In
addition it served the Eastern Region as a teaching hospital that attracted
many American and European doctors to teach the intern physicians and to donate
their services to heal the poor. Peace
Corps. volunteers from the U.S. were treated there by two U.S. doctors who received
their training in tropical medicine at the hospital. The hospital’s reputation grew, and many Nigerian physicians
joined the staff, most with specialty training in the U.S. or England. At its height the hospital was staffed
equally with expatriate doctors and Nigerians, was approved by the Nigerian
Medical and Dental Council to train interns, and had a favorable ratio of
charity and paying patients that allowed the hospital to be self-sustaining.
All this changed
in 1967 with the coming of what the Nigerians refer to as the civil war or, as
Westerners have called it, the Biafran war.
Major General Yakubu ‘Jack’ Gowon’s federal army ended the secession in
1970, but not until the Eastern Region was decimated. American television showed scenes of mass starvation among the
‘Biafrans.’ Many Nigerians fled the
carnage, including Dr. Okeke and his family who returned to the U.S. where he
practiced surgery in Massachusetts. At
the end of the civil war the military government forcibly occupied the hospital
and left it in a deteriorated condition.
Gowon was overthrown in 1975 by Gen. Murtala Mohammed who was himself
assassinated in 1976 and succeded by Gen. Olusegun Obasanjo. Gen. Obasanjo promised to return the country
to civilian rule and personally saw to it that the hospital in Engugu was returned
to Okeke and the Board of Trustees.
Rehabilitation and Operation of ENMC after
the Civil War
With little in
the way of compensation from the Nigerian government, Dr. Okeke sought to
rehabilitate the hospital. All of the
equipment and supplies had been stolen or destroyed. The cost of rehabilitation was more than the original cost to
construct the facility. Yet with the
help of N-AHF in Boston and the (Episcopal) Bishop’s Fund for World Relief in
New York, individual Nigerians replaced enough of the equipment to allow the
hospital to reopen. Meanwhile Gen.
Obasanjo restored civilian government to Nigeria as he had promised, so that by
1979 there was renewed hope that Nigeria had seen the end of civil discord. Oil prices were high, and revenues were on
the increase. Unfortunately civilian
rule lasted only until 1983 when an unstable coalition government dominated by
the North could not control corruption and answer the charge that the election
of 1983 had been fraudulent. On the
last day of 1983 the military again seized power, as it was clear that there
was no confidence in the civilian regime.
The leader of the coup d’etat was Major General Muhammadu Buhari whose
political leanings favored the North.
His military government sought to control corruption with executions and
long prison sentences and to promote the work ethic. Gen. Buhari was not up to the task of negotiating Nigeria’s
foreign debt, and in 1985 the economy slid into a deep recession with massive
unemployment. At the ENMC Dr. Okeke
found that most patients were unable to pay for their medical care, forcing all
the expatriate members of the medical staff to leave Nigeria. In August, 1985, Buhari was deposed by Major
General Ibrahim Babangida, who like his predecessor promised sweeping changes
in government. He restored the
constitution with himself inexplicably at its head and promised the return to
civilian rule. Babangida faced
dissension in the military but weathered a failed coup. He was less successful with organized labor
which was experiencing a resurgence in political strength or with university
students whose campus demonstrations against the government were struck down
with the deaths of a number of the students.
Babangida also failed to halt Nigeria’s entry into the Organization of
the Islamic Conference, an international coalition of Muslim states. The opposition was led by the Christian
Association of Nigeria which had been formed in 1976 and which proved to be an
embarrassment to the Babangida regime.
Gen. Babangida proved no more adept at controlling Nigeria’s foreign
debt than his predecessor. By 1986, 44%
of export earnings were being used to service the foreign debt. A National Economic Emergency was declared,
and a number of austerity measures, including a 30% surcharge on imports, were
adopted. Hoping to avoid an IMF loan,
the attempt to reschedule its foreign debt failed. The World Bank stepped into the breach with a $4.2 billion loan
over three years. The eligible debt was
finally rescheduled in 1988 but not without penalty to working Nigerians who
suffered from an unemployment rate of almost 12% and from heavy devaluations of
the naira in 1986, 1988 and 1989. In
1994 the naira was worth five cents.
Today the naira is worth less than one cent.
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