“No Signs Of Improvement In Nigeria’s Healthcare System Since 2017,” Says German-born Dr. Ernst Franzek

German-born physician Dr. Ernst Josef FRANZEK (Ph.D.) is a specialist in the fields of psychiatry, neurology, and psychotherapy. He completed his studies in his native Germany and has been employed in the Netherlands for almost 20 years. He currently works at the Yes We Can clinic in the Netherlands.

He has written numerous articles that have appeared in numerous international medical journals. He has spent the last ten years researching prenatal hunger and adult malnutrition, with a focus on the Dutch Hunger Winter during the Second World War.

In this interview with Comrade Sunny Ofehe, Secretary-General of Legionnaires for Mankind’s Health (LMH), he discusses his recently released article, “Sources of Human Aggression, Violence, Antisocial, and Addictive Behaviors,” as well as the results of his research on the African continent, with a particular emphasis on Nigeria.

He is the founder and executive director of the Netherlands-based Legionnaire for Mankind’s Health. His devotion to and love for the African continent know no bounds.

Could you briefly introduce yourself and let us know what you do now?

I was born in Germany, in the year 1953. My father was a laborer who always put in a lot of effort for his family, ensuring that we always had enough to eat and the essentials for a simple, normal life. My parents worked extremely hard to ensure that I received a quality education and could complete a medical degree at the LMU in Munich. I graduated as a general practitioner before specializing in neurology, psychiatry, and psychotherapy. I have two fantastic sons, a fantastic daughter, and three absolutely stunning grandchildren as of right now.              

I completed my PhD at the University of Würzburg in Germany in 1990, and in 1995, I earned my Habilitation in Psychiatry (University Lecturer) with a thesis on Twin Psychoses on the Schizophrenic Spectrum. A discussion of the debate between nature and nurture in the etiology of endogenous psychoses. 

I have been a clinician and researcher in the Netherlands since 2003, specializing in addiction, dual diagnoses, and general mental health care. My recent research interests have been in the long-term effects of prenatal and postnatal malnutrition, including severe starvation, on somatic and psychological health.

I have been employed as a Senior Psychiatrist by Yes We Can Clinics in the Netherlands since 2018. This organization provides clinical treatment for children and adolescents between the ages of 13 and 23 who have complex psychiatric and psychological disorders, including addiction. This is one of the best jobs I ever had in my life.

I established the non-profit organization Legionnaire for Mankind’s Health in 2020, serving as its first Executive Director, an organization that has gained international prominence in a short time. 

Can you tell us if, in your recent visits to Nigeria, you noticed any appreciable advancements, particularly in the field of general healthcare?

I have followed the development of health care in Nigeria very thoroughly since 2017. As a matter of fact, I have not seen any sign of improvement in Nigeria’s health care system since then. Proper healthcare is still only available for the privileged and upper classes. It is obvious that only privileged people in the country have a life expectancy compared to the civilized western countries.

An overwhelming number of people in Nigeria, however, live in poverty or even extreme poverty with less than 1 dollar per day. Many diseases are caused by scarcity, like a lack of healthy food, a lack of clean drinking water, or a lack of proper sanitation. There are more than 40 million people who do not even have functioning toilets and adequate sanitation. The population of Nigeria with now about 200 million people,  is mostly younger than 40 years.

The mean life expectancy is far below 60 years. One out of five children dies before age 5. The reason for this is prenatal and postnatal malnutrition,  lack of adequate midwifery, and a lack of (early) baby care.  Another reason for the high prevalence of deaths before 59 years are diseases which could have been easily treated by a normal functioning health care system. However, the vast majority of Nigeria’s populace could not afford to pay for a hospital, a doctor, nurses, or medication. Almost nobody has and/or can afford health insurance. Falling ill is, in many cases, like a “death sentence.”

The situation in mental health care is even worse. In the big cities, there are psychiatric hospitals. You will be shocked by the fact that in rural areas of Nigeria, mental health care is almost completely missing, and when you count psychiatrists per capita of the whole population, you find 0.1 psychiatrists for about 1 million people. The consequences of these dreadful and inhuman situations are high levels of depressions, suicides, violence, criminality, insurgencies, child soldiers, and addictive behaviors. In particular, violence and addiction are the results of poverty and not the cause of it.  

The problems of Nigeria’s common people, therefore, are poverty, mismanagement of resources, neglect of the youth, and exploitation of natural resources with environmental degradation through western countries. It is a known fact that the “civilized world”  promotes corruption in Nigeria, based on greed for power, resources, and money.

You are the founder and current executive director of a non-profit organization with a Dutch base called Legionnaire for Mankind’s Health (LMH); could you please explain the goals of LMH and how it intends to help the people of Nigeria? 

The primary starting point of the Legionnaire for Mankind’s Health is Africa, with a special focus on Nigeria. I have been to Nigeria several times since 2017, most recently in January or February of 2021. I saw the unbelievable contrast of extreme richness and extreme poverty. I saw a country that could be a paradise for mankind, but which is kept in custody by corruption, disinformation, a lack of normal infrastructure, and a completely insufficient healthcare and education system.

My overall conclusion was that the underlying problems of millions of Nigeria’s common people are lack of enough and healthy food, lack of clean water and adequate housing, lack of midwifery and adequate baby care, lack of adequate sanitation, lack of adequate primary and secondary education, and lack of adequate jobs for youths, and that these issues have to be tackled intensively and as soon as possible. If nothing happens, a great catastrophe is imminent.

The Legionnaire for Mankind’s Health is not a charity organization. The organization stands for encouraging and putting people in a state where they can peacefully gain access to basic needs of life.

Charity is often used to cover up crimes against humanity and the environment. Nigeria needs empowerment among its own population. Magic elements of this approach are quality education for everybody, free university education for skilled young people, keeping well educated people in the country (no brain drain), and making natural resources benefit the whole populace. Not the status of  parents should determine the life and development of Nigeria’s children and youths, but talents, skills, ambition and personal effort.

I’d like to congratulate you on your recently published article, “Sources of Human Aggression, Violence, Antisocial, and Addictive Behaviors.” What inspired this article, and why?

A great body of research points to the fact that preconception, prenatal, and early postnatal hunger, starvation, and malnutrition have lifelong negative consequences for surviving individuals. Via gene-environment interaction, i.e., so-called epigenetic processes, short-term survival benefits are provided, however, in the long run, these processes predispose affected humans to various severe somatic and mental illnesses in adulthood.

Based on scientific research, there is little doubt that these epigenetic processes play a major role in predisposing to excessive aggression and violence and finally contributing to the development of antisocial and addictive behaviors. As long as people are born, they have to grow up and live in life threatening conditions and adverse environments with a lack of proper food, a lack of education, and insufficient health care. High liabilities to aggression, violence, antisocial, and addictive behaviors will persist as important character traits of humans.

Access to and affordability of quality nutrition and education, as well as access to and affordability of adequate health care for every human on this planet from the very first days of life, are claimed to be unconditional premises to transform humanity into a peaceful and eventually sustainable species.  

After reading this article, which clearly illustrates the situation in Africa and among Africans, what, in your opinion, has caused the rise in these behaviors among people, and how can we deal with this situation?

Privileged and upper class people in African countries are a little minority but they are often possessing all resources, money and power. The civilized western world supports this situation through encouraging corrupt behaviors in order to get cheap access to Africa’s rich resources and cheap labor.

The common people suffer from modern slavery, exploitation, and terrible life conditions. People are dying from normally treatable diseases, millions of children are dying before the age of 5 years; pregnant African women have a 300-fold higher risk of dying during pregnancy and giving birth compared to women in Europe and the US.

Undernutrition results in a reduced ability to recover after a crisis, impairs mental and somatic health, and impairs the cognitive functions of a population. As an overall consequence, it causes the dependence of whole populations and nations on ongoing support. The situation will not improve through charity; in fact, charity even stabilizes it. The people have to get empowered, governments have to work hard for adequate infrastructure, industrialization, agriculture, science, education, and healthcare systems. Wars and armed conflicts need to be banned, Multicultural communities should be supported, Tribalism and religious fanaticism must be stopped, Peaceful coexistence must become the norm.

Can you elaborate on the upcoming LMH conference in Munich in 2023 and how Africans might profit from it?

The forthcoming 2023 conference of LMH in Munich on February 5, 2023 will highlight what mankind really needs to deal with the future challenges and dangers of life on planet Earth. The world needs Africa as an equal partner. The world is interconnected, what happens in one part of the planet influences the whole planet, positively as well as negatively. The title of the conference is “Empowering Mankind’s Potential,” and international experts drawn from Germany, The Netherlands, The UAE, Nigeria, and Argentina will address a broad range of sustainable approaches to transform Africa’s future development.

The major goal of our organization is to spread awareness of Africa’s healthcare challenges to the world. Therefore, our conference locations are usually strategically chosen. The inaugural conference was in Rotterdam, The Netherlands in 2020 and titled “Mental Health of Youths and its impacts on Nations Development”. The second conference was organized in Dubai, the Middle East, and titled “Devastating Consequences of Insufficient Health Care on Africa’s Emancipation.” And now the third conference will be in Munich, Germany, in 2023. We intend to produce a policy document from the conference due to the knowledge and professionalism of our speakers.

Your long-standing collaboration with the Federal Neuro-Psychiatric Hospital in Edo State and the University of Benin Teaching Hospital culminated in a request for you to join the faculty as a visiting professor. What benefits can your international experience and knowledge provide the university?

During my visits, I have delivered several lectures at the Teaching Hospital and the Neuro-Psychiatric Hospital in Benin City. I met competent colleagues and enthusiastic young students. My main focus is not only to provide international knowledge to the young students. A great proportion of doctors who have finished their medical studies leave the country and start working abroad because  of much better payment and working conditions. 

The money doctors are getting for their hard work in Nigeria, is not attractive for them. Working in the mental health care sector at all is not attractive, because mental health care has a very low political status in Nigeria. This is why mental health care is completely lacking outside of big cities. Traditional healers and the church are trying to help in the treatment of severely mentally ill people.

As a visiting professor, I would like to encourage young medical students not to put money and wealth at the top of their list of future prospects, but passion, love for disadvantaged people, and an understanding of how the behavior of psychiatrically ill people can be derived from (partially and often temporarily) disabled brain functions.

Isolation and punishment are inhuman and cause long-lasting traumas, even after someone has fully recovered from the psychiatric episode. Knowledge and carefully recognizing the healthy parts of severely disturbed patients help substantially improve their life conditions and even improve disease symptoms. “Love what you are doing, and put money and status in second/third place. “Become an advocate for your patients, treat them always with compassion and human dignity, and never see them as second/third class people, or as mad people suffering from a punishment from God.”

As a visiting professor, I want to contribute to building up a social primary healthcare system with and for local people. The health care system has to be independent from outside the country, independent from NGOs located in other countries, and also independent from religious institutions and charity organizations. The youths of Nigeria have a lot of intellectual power. The youths have to be brought into the condition of using their intellectual power properly in order to develop their own country, based on local tradition and modern scientific knowledge.