Remembering Olikoye Ransome-Kuti

culled from GUARDIAN, May 29, 2006

Professor Olikoye Ransome-Kuti, a Nigerian nationalist, social reformer and international reproductive health advocate died on June 1, 2003. At the time of his death, he was by common consensus the longest serving Minister of Health of Nigeria, a celebrated upright leader and the principal architect of the major achievements recorded by Nigeria in the field of health in the 1990s. He was the originator and apostle of the doctrine of primary health care in Nigeria, the prime mover behind the highly successful breastfeeding campaign in Nigeria by UNICEF and a prominent spokesperson for equity, human rights and social justice in the implementation of Nigeria's health care delivery system. He was a man who led by example and who believed in the principle of a leader serving his/her people rather than being served, and a man of impeccable character and integrity.

Two incidents in particular demonstrate the resolve and veracity with which Professor Ransome-Kuti conducted his life. As a young House Physician in Lagos in 1955, he visited the morgue of the General Hospital where his father died. There, he encountered the bodies of infants who had died from preventable and treatable diseases such as malaria and meningitis. That very day, he resolved to devote his professional life to paediatrics. In 1957 he joined the Department of Paediatrics of the University College Hospital in pursuance of this goal.

The second incident came over 40 years later, when Professor Ransome-Kuti revealed that his brother, legendary Afro beat musician Fela, died of AIDS-related illnesses. The year was 1997, when many in sub-Saharan Africa - Fela included - continued to deny the very existence of the rapidly-spreading virus. Professor Ransome-Kuti had acknowledged the presence of HIV and AIDS in Nigeria since 1986, but his openness regarding his own brother's death brought many in Nigeria to wider realisation of the true impact of the disease. Professor Olikoye Ransome-Kuti was born into the Jibolu-Taiwo family of Egbaland, Ogun State of Nigeria on September 30, 1927. He attended the University College Ibadan as one of the first set of medical students in the indigenous University. He completed his medical education and training in Ireland and the United Kingdom before taking up his position as a House Physician at the General Hospital, Lagos in late 1954.

After his formative visit to the General Hospital morgue, he received further education and training in paediatrics in Nigeria and the United Kingdom. Early in his career as a paediatrician and professor, he held posts as Senior Registrar in Paediatrics at the University College Hospital, Ibadan and in the Department of Paediatrics of the College of Medicine, University of Lagos. His work in Nigeria made him keenly aware of the inadequacies of a health care system focused on curative care, rather than preventative medicine.

Between 1968 and 1976, Professor Ransome-Kuti directed the Institute of Child Health of the College of Medicine, University of Lagos. It was in this post that he received the opportunities to put to action his beliefs in prevention and community health. His development of successful community-based child health and family planning programs proved to be a turning point in his career. He was appointed the first Director of the Nigerian National Services Scheme Implementation Agency, a post in which he coordinated the deployment of young Corps Doctors to remote rural areas throughout Nigeria.

Professor Ransome-Kuti was appointed Minister of Health in 1985. As Minister, he provided a foothold for the institutionalization of primary health care in Nigeria, acting as an advocate, implementer and a key policy proponent on all aspects of primary health care. He built several primary health care centres across the country and mobilized resources both internally and externally for the development of primary health care in Nigeria. He served longer than any other Minister of Health, and distinguished himself by his humility, transparency, honesty, patriotism, dedication to duty and punctuality.

After his tenure in the Ministry, Professor Ransome-Kuti's work reached the international stage. In 1994, he went to Washington DC to work for the World Bank, where he chaired the Better Health for Africa Panel, a position where he was able to expand the concept of primary health care to other parts of Africa. Indeed, he produced a blueprint for adopting primary health for all of Africa, and for sustaining health care in Africa for years to come. At the onset of the new democratic governance in the country in 1999, President Obasanjo was desirous of resuscitating the concept of primary health care as the bedrock of Nigeria's health care delivery system. He could think of no one else to do this other than Professor Olikoye-Ransome-Kuti. Consequently, he was appointed the Chairman of the National Primary Health Care Development Agency (NPHCDA) a post he held until he died.

The scope of Professor Ransome-Kuti's actions signifies his deep commitment to primary care in areas of health most critical to Sub-Saharan Africa: He ensured exclusive use of breastfeeding in Nigerian hospitals, made compulsory the recording of maternal deaths, fought for the interests of pregnant women, and pioneered effective HIV and AIDS campaign in the early years of the disease. He received numerous awards and accolades, published widely, consulted on health issues internationally, and sat on the boards of many non-profit organizations tackling difficult and neglected issues. His commitment to his work and his country cannot be understated. He was married to the gentle and amiable Miss Sonia Adetoro Doherty, with whom he travelled widely. They had three children, Dotun (1961), Gboyega (1962), and Bisoye (1964). He was a lovely and doting father, husband and family man.

In sum, Professor Ransome-Kuti was a genius at his time, a man with a tall vision who lived ahead of his time, a veritable role model and an example in self-discipline, honesty and transparency. He did more than any of his kind to promote the principles of primary health care and disease prevention in his life time, and he was a strong advocate for sexual and reproductive health and rights, gender equality and social justice. To remember and sustain the legacies of Professor Olikoye Ransome-Kuti in health care delivery, the Women's Health and Action Research Centre (WHARC), a Nigerian NGO has created the Professor Olikoye Ransome-Kuti Policy and Leadership Development Programme (RPLD), with funding from the Ford Foundation. The RPLD Programme was created to honour Professor Ransome-Kuti by focusing on policy and leadership development in sub-Saharan African health care. Specifically, the RPLD Programme's interests lie in facilitating progress in areas of primary health care, safe motherhood, child survival and HIV and AIDS. While it is true that no one will fill Professor Ransome-Kuti's shoes, we hope to continue along the path he pioneered by promoting responsible policy and encouraging passionate leadership in Nigeria.

The objectives of the RPLD Programme are as follows:

To create public awareness and understanding about public health issues relating to primary health care, safe motherhood, child survival and HIV and AIDS throughout sub-Saharan Africa

To stimulate public health thinking and policy development in Africa around issues relating to the aforementioned areas of interest in accordance with the policy framework developed by Professor Olikoye Ransome-Kuti in his lifetime

To build and sustain the right kinds of leadership for implementing these programmes in Africa, similar to those exemplified in the life and times of Professor Olikoye Ransome-Kuti

To celebrate the life of Professor Ransome-Kuti and present it as a model for policy development and capacity building on sexual and reproductive health in Africa

Professor Okonofua is Executive Director, Women's Health and Action Research Centre and Provost, College of Medical Sciences, University of Benin, Benin City