By Anselm Okolo
I missed his birthday on April 7, this year for reasons I cannot truly fathom. Actually, I was waiting for the birthday to write an epigraph on the person of His Highness “Eze” Iyeme Efem, Omeroha 1 of Izzi land in Ebonyi state, popularly called “Chief.”
The sobriquet “Chief” is not a city claim or gift as the case may be. It is a title robustly earned by Iyeme for doing meaningful and life-changing work in fistula care, treatment, and post-treatment services to women across Nigeria but especially in Ebonyi state.
For 5 years, Iyeme crisscrossed the hinterlands of Ebonyi, just as in many other communities in Sokoto, Kebbi, Bauchi, Kano, Katsina, Jigawa, and Cross Rivers just to mention a few, finding and bringing succor to the aged, young, and very vulnerable women, all bearing a common condition – obstetric fistula – at the National Obstetric Fistula Hospital in Abakaliki.
For all of this humanistic work to women of the state, sometimes at the risk of his own safety, in the hinterlands of Ebonyi state, the Traditional Rulers of Izzi Nnodo Clan, comprising 10 autonomous communities, I mean real ones, not the city-based questionable self – imposed chiefs in some other parts of Igboland gathered and inducted him into the “Highest Ezeship of Izzi Nnodo Clan, conferring on him the title “Omeroha 1 of Izzi land” meaning a “Charity King” of all the people of Izzi land, hence the appellation – “His Highness.” The conferment ceremony was an elaborate ceremony with all the trappings of the culture of the people and the high and mighty of the state, including the representative of the Governor of the State and his wife.
It also had in attendance representatives of the Non-Governmental Organizations. It was a big very event in honour of Iyeme for service to humanity. This is the origin of the “Chief” everyone called him afterward. Those who understand the weight of the traditional title call him “Igwe”, meaning King.
He is true of the Royal Family and Crown Prince of Itigidi in Cross River State. It is an honour and respects duly deserved. I also came to understand that Iyeme was also conferred the title of “Nana Nkosuohene” (King of Development) of Obrayentobuase Nupe in Wasa Amenfi District of the Western Region in Ghana. So, those who know him well call him “Eze Nana.”
As I came to know, Iyeme had worked in Ghana for five years, managing a Child Survival and Nutrition project in the Western Region of Ghana. During his work, he not only introduced several strategies and partnerships that led to the reduction of malaria in children under 5 by 25% as revealed during the Western Region Health Meeting 2006.
Iyeme also single-handedly built a ward for newborns in the very rural community where is project was working and we realized that there was just one ward that served both males, females, and children.
For Iyeme, bringing to care for these poor and vulnerable women was more than a task, it was a vocation. Denying self of many comforts offered by his position as Project Manager of USAID funded Fistula Care Plus project managed by EngenderHealth, to be in the fields in search of these poor and often tattered women, Iyeme would say his reward is the smile that return to the faces of these women after successful fistula repairs.
For a man his size, a towering 6.7-footer or something around that, when he is around you, you will be lucky not to be dwarfed by him. Not many are lucky not to be. I am a very tall man myself but the humongous presence of this gift to humanity also makes me feel a little inadequate in height when I stand next to him.
Chief is an avid lover of music. His love of music transcends generations and genres. When not at work, you can easily catch him dancing rivetingly to the music of the 60s, 70s, 80s, and contemporary Naija beat with the same fervour and stamina. He does not pass by my reckoning of being a great singer himself, but Chief is always happy to whirr to an Igbo highlife song now and again.
He is a stickler for details in the workplace. A task undone is a telling of an unfulfilled working day for the Chief. He strives not a leave today’s task for tomorrow. Having worked with him on many sensitizations and awareness creation campaigns on fistula in the community and trained several media practitioners on fistula together, I can say on record that Chief never okays a campaign to start unless he is convinced the methodology proposed will deliver the expectations.
I remember having to work over and over again on an activity agenda with the Chief until he was sure the process and transition from one item to another were seamless and explainable. He makes you get ready for assignments.
According to him, if you plan well, then implementation will hardly run into a hitch. I agree.
Chief is a total network and advocacy King. In Nigeria, a country of many culture-mix, getting government officials to buy into programs and activity’s purpose and speed is a herculean task often coloured by the various cultures. Iyeme did not allow that to slow his delivery time on advocacies.
He saw the culture mix from an interesting perspective. “Know the people and their culture and you can easily reach them” and it worked superbly for him in all the focus states of his projects. He simply had a way through all the cultures and barriers inherent in them.
Iyeme is a cool talker in many Nigerian languages. Schooled mostly in the Igbo-speaking states and his native Cross Rivers state, Iyeme speaks eloquent Igbo language and a smattering of most other languages in Nigeria. He shocked me once with his communication in Yoruba. I asked where and how he learned and understood the language, and his response was simply, “I was in Lagos for some time and needed to be able to move around and get things done easily”
Chief is highly respected in the development circle in Nigeria, including at USAID. His understanding and experience of project implementation and how to deal with community and stakeholder orientation and mobilization made him a highly-priced voice on the table during meetings. No wonder in October 2016, he was honoured with the award of “best USAID Chief of party in Nigeria” by the Presidential Malaria Initiative (PMI) Team in USAID.
He inherited a troubled fistula care project in Nigeria and turned it into a highly delivery project two years after and earned a roll over to the Fistula Care Plus Project that ran for another five years. Awareness on fistula today in Nigeria is directly linked to his leadership work under the project. Many milestones were recorded under his watch. Populace awareness of fistula grew exponentially, Three National Fistula Hospitals were established and a fourth one (Ibadab) was in the offing then.
Many Nigerian surgeons and practitioners were trained and retrained and certificated. Several Nigerian journalists were also trained in accurate reporting of fistula and how to make fistula stories compelling and inspirational.
Yes, Chief left more than footprints in fistula and women empowerment in Nigeria. He is also urbane, civil and a gentleman. He is easy to be trusted because his words are not different from his actions. These qualities made him a sure leader among his colleagues and friends.
Well grounded in his work and tasks, Iyeme was on top of all the project issues and factors driving them in the country. You are not likely to catch him searching for answers to questions even at short notice, a reason many media practitioners, particularly health reporters, found him an interviewers’ delight always.
Describing his work in Nigeria in a media interview in 2017, Chief responded thus to a question:
I Kickstarted real Fistula programming in February 2007 and managed it until 2013 October when it ended. During this period, I worked to change the face of Fistula intervention in Nigeria. Working with Senator Iyabo Obasanjo, the then Chair of Senate Committee on Health, the Federal Ministry of health where I worked to move Fistula from Hospital Services to Family Health Department, then established the Fistula desk office, then got the Family Health Department (FHD) to appoint a Fistula desk officer, worked with Senate to ensure budget line for Fistula Desk was established and funded to the tune of N25m in 2008/9, then worked to get Fed Government to take over the Ebonyi Fistula Center as a National Obstetric Fistula Center.
I had worked assiduously to have USAID approve the Fistula project to start in Ebonyi state. And upon approval, become the first health project to come to Ebonyi state (hitherto a non-USAID-focused State) to the appreciation of the state. The state was further happy to see that the local fistula center was now taken over by Federal Government and was exceedingly appreciative because it relieved the state of the high cost of managing such a center to provide free services
Once the center became National, it was now easy to push for the Baba Ruga fistula center in Katsina state to also become a federal center for the Northwest. This also paved the way for the first Fistula center we had established in Ningi, Bauchi state to become a federal Center too for the Northeast.
Then in 2012, with high-level advocacy to the presidency, the then President put in his budget proposal to the National Assembly that two-thirds of the women with Fistula will be repaired in the 2013 fiscal year. This was the height of advocacy.
In October 2013, the Fistula Care project ended but we had already established 9 additional fistula centers to the 5 we met, bringing total centers in Nigeria to 14, with a total combined Fistula repair for Nigeria put at about 4,300 women. These included repairs done by the centers, the pooled effort repairs by the project, and occasionally, camps by UNFPA. So, the project ended on a very high note, leading to the US Government’s decision to refund it as Fistula Care Plus Project.
Because of the delay in getting the new project ready, I moved on to take over management of the USAID Global Supply Chain Project implemented by John Snow Inc.
The project was in the 8th year of its 10-year extended award. So, I inherited a load of expectations. Construction of two pharmaceutical warehouses one in Abuja and the other in Lagos. Both were supposed to have been completed before my arrival but approvals to take possession of the grounds for the construction had not been received.
The question then was how do we accomplish this in two years? Secondly, how was I to ensure states became more involved in managing supply chain activities, so systems had to be created for them to do so, all to be accomplished in the two years.
So, I got to work, with the dedicated staff, I first worked on breaking down the silos within the office, created midlevel managers to empower regional staff to take more controls, closed all the regional offices, and had the state government provide office space for the project to enhance capacity development of state government staff to eventually take over. This birthed the Logistic Management Coordinating Units (LMCU) that are functioning today.
I used my high-level advocacy skills from the Fistula Care project to the Government, MOH Hospital Services, the then Minister of Health, and his FCT counterpart, and that yielded fruits with approval to commence work on the sites. Once work commenced on the building of the Medical Warehouse on the Jabi/airport bypass, just before the Judicial Commission, I proceeded with my team to start a discussion on approvals to build the Lagos warehouse on the premises of the Central Medical Stores, Oshodi.
The extension of the project for another year, gave us breathing room to properly consolidate work on the warehouse. Suffice to say that by February 18, 2017, I completed the assignment, received the certificate of habitation for Lagos warehouse and handed it over to the USAID Activity Manager at the premises of the warehouse, to the Glory of GOD.
I immediately returned to the US on February 19, 2017 and continued working for JSI when a plea from Engenderhealth to return to Nigeria to redeem the image of the Fistula Care Plus project that had challenges meeting its deliverables. I had a hard choice to make but thinking of the women with Fistula and their needs, I could not stay back, I had mixed feelings but had to leave JSI and joined EH on March 16, 2017, returning to Nigeria on April 4th to assume post.
I got to work immediately, creating a strategy of “Unlocking Potentials” that will see the utilization of all Teaching Hospitals and Federal Medical Centers to provide a certain number of repairs. The goal for this was to increase the number of repairs from the teaching hospitals and Federal Medical centers to about 7,900 women a year, while regular repairs by other facilities will yield 5,000 repairs annually. So, this strategy will give us a total of 12,900 repairs annually.
This strategy was born out of my initial approach of “locking the tap and taking time to empty the bucket.” This was because we had 12,000 new cases of fistula every year and a backlog of between 150,000 to 200,000 women with fistula. So, I argued that if we can address the incidence through improved surgical outcomes, increased repairs, and massive prevention approaches, we will be able to begin to ensure no more Fistula by 2030.
We also, within the period expanded Fistula services into Osun state and the facility is managed by the University there, fitting into the unlocking potentials strategy. But the project closed, and it took time for another mechanism to be initiated by USAID. I am happy that this has now been initiated and the project activities have started in 4 states including FCT.
For all of these accomplishments, a rare feat for anyone within the public service space, some staff in FMOH had recommended the Chief for the conferment of a Nigerian National Honours Award. The recommendation was not considered by the approving officers for reasons best known to them, but in the minds of rural and poor Nigerian women who can smile again today because of the humanitarian work Chief did in Nigeria, he is sure wearing that garland of selfless service to them and the country.
So, 62 sure looks good on you Chief. We in the development space and media in Nigeria look forward to another tour of duty for you in the country and envisions that as you age gracefully, your capacities will get better like the wine.
Anselm Okolo is CEO at Journalism Skills Support and Mentoring Initiative, JSSMI, and a journalism trainer based in Abuja and can be reached via email@example.com