Episcopal Medical Missions Foundation
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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