Research and Advocacy for Health Equity

A woman in her seventies arrives at a clinic in Delta State with a condition that has been treatable for the past eleven years. Somebody gives her the medicine. She goes home. She comes back.

That is the part of our work you can picture, and it is the part that is easiest to fund. A clinic visit has a price. A term's fees have a price. You give, someone is helped, and the arithmetic is clean.

Here is the harder question. Why was she not treated eleven years ago?

Not "why did she not come". She came. Why was there nobody to see her, in the place she lives, at a cost she could meet? Answer that and you are no longer buying one clinic visit. You are changing the number of clinic visits that are ever needed.

Nobody is paid to ask
Nigeria does not lack doctors because Nigerians are not becoming doctors. It lacks them because of a chain of decisions: where training places sit, what they cost, who can afford to stay, what a newly qualified doctor earns, and what a plane ticket represents against that. Each link is a policy. Each policy was made by someone, on the basis of some evidence, or none.

Changing a policy requires showing the person who can change it what is actually happening, in numbers they cannot argue with, gathered from the communities they govern.

That work is unglamorous, slow, and almost impossible to fundraise for. It has no photograph. It produces a document, not a rescue. And so in most of Nigeria it is simply not done. The evidence about our health system is largely gathered by people who do not live inside it, and often it is not gathered at all.

We think a foundation that supports medical students and treats elderly patients is in an unusual position to do it. We see both ends of the same broken pipe: the student who cannot afford to finish, and the patient who has nobody to see. Most researchers see one or the other. We are standing in the middle of it.

What we are asking you to fund
We are being straight with you. This programme is beginning. We have not yet published a study, and we will not pretend otherwise. What we have is the access, the clinical contact and the students. What we do not have is funding for the part that turns all of that into evidence.

Your gift to Research and Advocacy pays for:

Fieldwork. Getting to communities across Delta State and actually asking, rather than estimating from a desk in a capital city.

Student researchers. Medical students we already support, paid properly to do real research. That is also how a country grows the people who will do this work in twenty years' time.

Publication. Data that sits in a drawer changes nothing. Getting findings into journals, into the hands of state health officials and into public view is a cost in itself.

Advocacy. Turning up, repeatedly, with evidence, in the rooms where these decisions are made.

The honest case
If you want your money to help someone this month, give to Elderly Healthcare or to Medical Student Scholarships. Those are real, they work, and they need you. We would rather say that than talk you out of it.

But if every naira goes to treating people, nobody is ever funded to ask why they got sick, and we will be running the same clinic, for the grandchildren of the same patients, in 2050.

Research is the only part of our work designed to make the rest of it smaller.