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A Right to Healthcare

A grad fights for law reform in her homeland of Nigeria

donalee Moulton
from Hearsay Magazine
Volume 35, Winter 2013/14

Cheluchi Onyemelukwe Onuobia prefers the road less well taken. It was that fondness for the unconventional that led her to the Schulich School of Law.

The Nigerian native received her law degree in her home country in 2000 and three years later was looking to step beyond those borders to complete a master of laws degree. The traditional route would have been to apply to a school in England. “Someone suggested Canada. They said it was a ‘nice’ country,” says Cheluchi.

She acted on their advice and applied to five schools, and approached five professors she’d like to work with. One of those professors left an indelible impression—Dr. Jocelyn Downie. “She always replied to my emails with warm and friendly notes, and lots of helpful information,” says Cheluchi, who graduated in 2004 with her LL.M.... and in 2010 with her JSD.

The study of health law is not common in Nigeria, but its practical implications appealed to Cheluchi. “My bosses recommended corporate law, but I thought health law was a way to impact life directly,” she says.

The next thing she knew she was walking the “lovely streets of Halifax,” and adjusting to a new country, a new culture, and a new academic environment. The city, Cheluchi remembers, “was completely different from what I expected. I came mid-summer and it was cold. People would walk by and say, ‘Gorgeous day,’ and I would yes, ‘Yes, it looks lovely,’ but there was no heat coming from the sun.”

The lovely day was mirrored in lovely—and heated—conversations in the classroom. “The graduate seminar class was very small, and we got to know each other very well,” says Cheluchi. “The seminar introduced us to different legal areas. It was very inspiring.”

It was health law that most inspired Cheluchi, and she studied under Dr. Downie. For her LL.M., she asked herself what health law meant in the context of her homeland. “At the time, access to HIV and AIDS drugs was a very topical issue. I looked at it from a human rights perspective.”

Cheluchi’s JSD thesis focused on the regulations surrounding research involving humans in developing countries.

“The challenge then and now is that there is not much money in most developing countries. We don’t do much indigenous research. Companies from developed countries were moving to less developed jurisdictions to do clinical trials in ways they would not do elsewhere,” notes Cheluchi.

Her thesis explored what was being done to hold governments and countries accountable and to protect people. “You need to focus on what you do locally and what needs to be done internationally. That is what makes a difference,” says Cheluchi, whose studies at Dalhousie were funded by a Killam Scholarship and the Canadian Institutes of Health Research Training Program in Health Law, Ethics and Policy.

She points to testing of a meningitis drug that was conducted about 15 years ago in a northern Nigerian community experiencing a meningitis epidemic at the time. “People saw white coats and assumed they were there to help the children,” says Cheluchi. “I thought, ‘They would not do that in the U.S.’ There were no protocols in place.”

Cheluchi’s research also further opened her eyes to the differences between her country and Canada. “I’d listen to some of the things Canadians would talk about and think that our issues were so fundamental. I thought they must wonder why we don’t do something,” she says. “I vowed to do something.”

Cheluchi has practised law in a top law firm in Nigeria, developed policy and regulation within government, and consulted for different international development organisations. While at Dalhousie her career path changed. Cheluchi, who is the lead consultant at Health Ethics and Law Consulting, an organization that provides legal, policy and research services, established the Centre for Health Ethics, Law and Development, or CHELD as it is commonly called, in 2010. Initially, she says, the idea was to focus on law reform, which it does. But today the organization also does much more.

“Practically speaking, people don’t have the information they need. Before you can reform laws, you need to ensure people understand the issues,” says Cheluchi, who serves as executive director of the non-profit organization.

Today the Lagos-based think tank relies on law, policy, ethics promotion and research to improve public health in Nigeria and other African countries.   Its broad mission is to provide information, analyse current policy responses to health issues, and advocate for health law reform, health system reforms, and health policy implementation. 

CHELD also addresses health concerns and promotes good health by engaging in development projects. These include the provision of health literacy and education to the general public about health issues, preventive measures, latest developments in health research from around the world, and the promotion of consumer awareness.  It also includes educating health professionals about their legal and ethical obligations.

“The ultimate goal is to promote better health outcomes in Nigeria and other African countries,” says Cheluchi, who is also a senior lecturer at Babcock University’s School of Law in Nigeria.

The CHELD team comprises lawyers, doctors, health professionals, social scientists, economists, public health specialists, gender specialists, and statisticians. Each professional brings their expertise to different aspects of the organization’s work, providing a holistic approach to health law and policy development, and to the projects that CHELD undertakes.

One recent initiative is focused on mental health legislation in Nigeria. CHELD is working to engage the minister of health about the development of new law in this critical area. “But we don’t talk about mental health as human beings. It’s shrouded in secrecy,” says Cheluchi. “We need to get to the point where people are open about this.

“In Nigeria,” she adds, “there are still institutions where people are kept outside because they have mental health issues. Education is required. It needs to go hand in hand with legislation. There is still a lot of awareness that needs to be done.”

Cheluchi, who has taught courses in health law at Dalhousie, is helping to create that awareness on this and a myriad of other health-related issues. She writes a regular column for Nigeria’s Daily Times that is reprinted as a blog on CHELD’s website, www.cheld.org. One recent entry discussed Cheluchi’s invited participation in a Consultative Meeting of Experts on the Right to Health in Africa that was held in Nairobi.

“One of the things that we talked about was the need to ensure that people began to understand that there is such a thing as the ‘right to health’…. [W]e talked about the need to educate people on the normative contents of the right to health and what this means for them—accessibility of health facilities, availability of essential medicines in health facilities, availability of skilled personnel (the doctor’s strikes in Lagos State) comes to mind, the quality of treatment, and preventive education, and ethical and cultural acceptability,” she wrote.

“There may be scepticism about what difference we can make as individuals, even as non-governmental organisations,” she added. “But standing still will not take us to our destination. One day, the right to health will be a reality not merely a rhetorical question.”

Writing is not just a central part of Cheluchi’s vocation, it is also her avocation. She has just completed her first novel and is currently looking for an agent. Also in her spare time, Cheluchi likes to sing. However, she says with a laugh, “there isn’t a lot of leisure time. I have three children, and they keep me busy.”

They are also part of the inspiration that keeps her on the road less travelled. •