Global Health in a "Restricted" Country: Breaking the Barrier of Stereotypes

June 15, 2015
Lagos, Nigeria, a vibrant city

By Dr. Sulzhan Bali, MSc-GH '16

Let’s play a game. Shall we? I give a word and you think of the first word that comes to your mind.


Pat yourself on the back if the word you came up with was NOT "scam," "419," or "Boko Haram." Treat yourself to a chocolate if the word that you came up was a positive word.

You see, stereotyping comes naturally to our species. Often, our outlook is dictated by the media, news, and hearsay—which although important, often gives us an incomplete singular dimension of the holistic picture.  Unfortunately more often than not that singular dimension dictates our biases.

 I must admit, before I arrived to Nigeria for fieldwork, I was afraid. Afraid of what awaited me on the other side. After hearing reactions such as “Stay careful in Nigeria, scamming is so common,” Oh no! Isn’t that where Boko Haram is?” and a few tales of evacuation, kidnappings, and even car jackings, I had started really wondering whether I should be excited at all. It didn’t help that my fieldwork country site was considered entirely restricted by the University for safety purposes. No wonder I was a little nervous as I disembarked the plane.

After I landed, my first experience of Nigeria was a man offering help at the airport for the cart. I didn’t have local currency yet and I needed a cart for my luggage. I remembered of the innumerable warnings by friends and family to keep my wits about me and to trust no one. Did I take his help? Yes. Did he run away with my bags? No. Over the course of next two weeks, I would discover each and every Nigerian whom I met to be warm, friendly, helpful, and yestrustworthy!

The risk of being scammed or cheated exists in every big city, and Lagos is no different. This city of 21 million people is a melting pot of cultures, and like any other metropolitan city in the world is like a coin with two sides. My time in Lagos so far has turned the idea of Nigeria that I had upside down. Yes, there is poverty. Yes, development is an issue. So is corruption, a weak health system, malaria, maternal mortality, and infant mortality.

Yet, there is also will power. There is optimism. There is an incredible spirit of entrepreneurship, which I am yet to see in another part of the world. Every Nigerian is an aspirational entrepreneur, hustling to be a successful one. People have a safe job along with an entrepreneurial venture. It's no wonder that in Nigeria, 41% of women between 18-64 years are entrepreneursthe highest in the world! Unfortunately, Nigeria also ranks among the worst 20 countries in the world for women entrepreneurs. Many of these entrepreneur women are small traders or market women and entrepreneurship is a by-product of necessity due to lack of opportunities in the formal sector.

Yet, despite it all, there is no denying the fact that entrepreneurial energy in Nigeria is on a high. There is an impressive desire in almost all Nigerians that I have interacted with to build something of their own. Optimism and innovation have overshadowed the constraints of red tape and lack of infrastructure. Many entrepreneurs in Nigeria are in it to make an impact and facilitate social change. An apt example is EbolaAlert, an organization that I am collaborating with for my study on "Evaluation of the Role of Private Sector in Ebola Response in Nigeria." EbolaAlert started as a twitter handle at the peak of Ebola outbreak in West Africa. People across the world were getting their accurate information on the Ebola outbreak through it. What started as an information-providing platform turned into a global health influencer that is now launching multiple public health education campaigns across Nigeria in partnership with CDC, Unicef, MSF, and the private sector.

Global health is about collaboration and coordination. It is about dialogue between sectors, organizations, and cultures. To be able to do that successfully, one has to look beyond the biases. Casting away our lens of bias requires looking beyond what we see and hear in media, news, and hearsay which is only possible with a cultural immersion and an open mind. This is why fieldwork is such an important component of global health.  Nigeria is not perfect. No country ever is. As the biggest economy in Africa and a country all set to reap its demographic dividend, Nigeria has the means and the will to become a great nation.

I recently met a few Nigerian young professionals in Lagos. These were Nigerians from across the world visiting for the Young Nigerian Leaders Conference to talk about the future of Nigeria. As it happens, Nigeria's biggest assets are its people, many of whom are using lean entrepreneurship, collaboration and ideation to facilitate change in all spheres. From my vantage point, the whole world is Nigeria's oyster. Restrictions, on the other hand, lie only in our mind set. 

No prize for guessing which is the first word that comes to my mind when someone says Nigeria. It is "entrepreneurship."