NIGERIA (MEDICAL SERVICES) (Hansard, 18 June 1969)

§ Mr. John Tilney (Liverpool, Wavertree)

We in this House have little right to discuss Nigeria except about what we can control. That limits us to arms, aid and trade. We do, however, feel deeply for old friends, of every race or tribe, and a stirring of conscience about a country for which we were responsible for so long.

I have just come back from Nigeria. I was privileged to have an hour and a half discussion with the Head of State and I saw many of his senior advisers. I met the business community in many places. Although I went much by air. I travelled 800 miles by road. I met many people with every kind of interest and experience.

It is not up to me to blame anyone for what has gone by. I do not know 636 how many people were killed in 1966—I suspect many fewer than propaganda makes out, although I believe that here and there there was a local wish for genocide. I am certain that in responsible quarters there is no such wish today. Indeed, I saw several Western Ibos who had returned to their property in Kano, and I was much impressed by what had been done to hand back or safeguard Ibo houses in Benin. One feels that it is odd, however, that hardly anyone has been punished for what happened in those dreadful days in 1966, days from which, as I think the Minister will agree, springs the intransigent obstinacy of the Ibo leadership today.

When I was in Warri, I heard at night the constant drone of aircraft carrying arms to Uli airstrip. No doubt, there were a few relief aircraft mixed up among them. Why Red Cross and other relief aircraft cannot go by day after having been properly cleared is hard to understand, although, as communication has not been of the highest order, the clearance notice may not get to all the places it should.

I am sure that the Federal Government realise that if Nigeria is to be one they must have the Ibos as their friends. They are, therefore, trying to be as humane as possible, but are fighting under considerable difficulty. That difficulty might be eased if there were not so much feeling in many parts of the Federation that the war is a long way away and business and pleasure should go on as usual.

I am aware that no European should ever predict what may happen in Africa, but I suspect that there is a danger that the war may go on for much longer than many people think possible.

Iboland has several hearts. The terrain is such that the frontier or no-man's-land can be up to 100 miles deep, and a whole platoon can disappear by taking a few paces off the road. Despite the wish of most villagers—as in our Wars of the Roses—to get back to the soil and to their crops, even if all the roads and towns were taken, a core of banditry masquerading as freedom fighters could terrorise thousands of square miles for years to come.

My plea to Her Majesty's Government tonight is for medical help to be offered, 637 if need be—to show that we are thinking of the future rather than the present—to both sides. I have seen some of the large number of hospital casualties on the Federal side from Kano and Kaduna to Lagos and Benin. I am told that they are the lucky ones. Most soldiers who have more than superficial wounds die in the bush.

I was told that there was no anaesthetist in Benin, that a brigade might be lucky to have one doctor and that that brigade might be spread over hundreds of miles. It was told that by the end of the war one in four of all Federal troops would probably be casualties. The lack of medical help is appalling, and even in the hospitals in recovered territory such as Enugu some of the equipment needs servicing by competent technicians to make it work.

Some people might say that once Her Majesty's Government had decided to support the Federal Government help should be given wholeheartedly rather than halfheartedly, and that a few ground to air missiles would stop the airlift and finish off the war and its attendant horrors within a few weeks. But Nigeria years ago turned down the projected defence agreement with us, and few of wisdom would wish to escalate the already ghastly conflict.

I do not know how many medical units we could spare. It would certainly be good training for them. I believe that all three Services in this country should be ordered to provide field hospitals and advance dressing stations capable of immediate surgery. They should provide a medical chain of evacuation comparable to our in the last war. The personnel should be in uniform with distinctive armbands, and should probably be unarmed, although self-defence against bandits should be considered. Civilians should not be relied upon for administration. The general near chaos in the freight terminal sheds at Apapa or Ikeja airport is a warning against that.

By immediate accounting this suggestion would appear to be expensive, but in the long term it might well save vast sums of money, for the stakes are high. Nigeria and Britain in partnership have already achieved much, but the potential is much greater. What is more important is that such a gesture would enable thousands of Nigerians who die today to survive. 638 It should be understood that those who by such action are made fit again will not be called back to their regiments, though one hopes that once the war is over they would be available for work of reconstruction.

I happen to believe that sooner or later there will have to be a political settlement and that it is better to accept less than total victory if the alternative is absence of control and anarchy. People seem to think that the solution has got to be African-inspired. I do not understand this. I believe it is a major Nigerian and Western world interest to work for a compromise. I am told that the day for an international force, to which the Ibos who still believe their own genocide propaganda could surrender, is past. Yet without it they are likely to fight on. Cannot the rebels in their turn accept that a Swiss canton has its own independent laws, though no seat at the United Nations?

Whatever the future, a humanitarian gesture—even if not accepted by both or perhaps either side—should, I believe, he made by Her Majesty's Government. And what better one than a recovery operation enabling a future generation of Nigerians to survive.

§ The Under-Secretary of State for Foreign and Commonwealth Affairs (Mr. Maurice Foley)

Hon. Members on both sides of the House, whatever their views on the Nigerian war, will be grateful to the hon. Member for Liverpool, Waver-tree (Mr. Tilney) for giving us the opportunity to devote a short period of time this evening to the question of the medical help which we have given from our resources in this country to the casualties of the Nigerian conflict.

This is a matter on which we are all united in strong feelings of compassion for those who are human victims of a terrible war and in our anxiety to give all possible help to those victims. On these matters, and in our earnest desire for peace and an end to the fighting, I have no doubt we are all at one.

At the same time I should emphasise that it is the possibilities of British help that we are debating tonight, not the internal affairs of Nigeria. As my colleagues and I have often had to remark in the House, it is not for us to debate 639 the internal affairs of a sovereign independent State, be that a State of the Commonwealth or not. Still less is it our business to contemplate active intervention in what is Nigeria's domestic problem.

We have already been helping in two particular ways in which I am sure the hon. Member for Liverpool, Wavertree would approve. I refer to the provision of the British surgical team for maxillary facial work at Kaduna in Northern Nigeria and the children's medical care unit at Enugu, the capital of the old eastern region. A team of doctors, nurses and technicians provided by the Royal Air Force and a civilian consultant from the Queen Victoria Hospital, East Grinstead, went to Kaduna in January of this year. They not only did excellent work in helping to deal with casualties suffering from gunshot wounds in the face, but also in training Nigerians in this work. The team has now been replaced by two doctors from East Grinstead under Ministry of Overseas Development technical assistance arrangements.

It seems likely that this kind of arrangement will continue as long as the need exists. The British doctors and the matron serving at the orthopaedic hospital at Dalla, under O.D.M. auspices help to deal with casualties not only in that hospital but also in the Kano city hospital nearby. As the House is aware, we set up in Enugu a child medical care unit. This unit started to operate early this year in the local hospital where they work in close co-operation with the Nigerian staff.

There are 15 doctors, nurses and technicians in the unit, which not only deals with children but also treats emergency adult cases, some of whom are suffering from gunshot wounds. During our recent visit, my right hon. Friend the Prime Minister and I visited this unit, and we were able to see the good work that it is doing which, in its turn, is financed by Ministry of Overseas Development Aid funds. In all these cases, the presence of British doctors and medical assistance means that this is a real help to the Nigerians on the spot.

In addition to this aid, which I have just mentioned, the O.D.M. has received requests for four artificial limb technicians to go to Nigeria to make and fit 640 limbs and to train local craftsmen in this rather specialised sphere. The Ministry is now beginning to recruit suitably qualified experts, but it is rather difficult because it is a specialised sphere.

Also, under the auspices of the British Council, a consultant from the Moor-fields Eye Hospital recently visited Nigeria and helped with a number of operations in one of the military hospitals over a period of several weeks.

The hon. Member for Liverpool, Wavertree has spoken eloquently and movingly of the terrible circumstances which he witnessed—and which I have seen—in Nigeria surrounding the needs of the casualties of the war and the desperate shortage of medical resources to cope with these casualties. These are the inevitable consequences of a civil war. They are horrifying to anyone who has been close to them and can see vividly what this means and what one's response should be. We are talking about the war wounded, both military and civilian. The problem of war refugees, displaced persons and starvation is something quite separate—and the House knows something of what we are doing in this respect.

As the hon. Gentleman knows, I have recently been in Nigeria with my right hon. Friend the Prime Minister. I know from our visits to the war areas, what we saw, and what was described to us that the needs are indeed great. Moreover, reports from our representatives in Nigeria confirm the kind of evidence which has been given by the hon. Gentleman this evening.

When, therefore, in March of this year, we received an inquiry about possible British medical assistance through a senior officer in one of the armed services in Nigeria, we at once, without waiting for any formal request, initiated urgent inquiries here as to how we could respond, assuming that such a request was made and endorsed by the Nigerian Government. The immediate need at that time, which was described to us, was for two orthopaedic surgeons, one anaesthetist and two theatre sisters.

However, in the meantime, while alerting our own staff and looking around for the right kind of people and awaiting a formal request from the Federal 641 Government the British High Commission in Lagos was informed by the Federal Government that the staff provisionally inquired about were in fact not required.

This is how the position rests at the moment. If we were to receive a formal request from the Federal Government, then we would certainly look with urgency, because I have seen, as the hon. Gentleman has seen, the need on the spot. But the hon. Gentleman will be aware, as I am, that, realities being what they are and recruitment in this country being rather difficult, the Federal Government may well have looked elsewhere for support and assistance in this particular sphere.

I am sure that the hon. Gentleman would not suggest that we ought to recruit British doctors to go, as it were, into the firing line, because this would present a great deal of difficulty for us. Nevertheless, if we received a formal request from the Federal Government along the lines suggested by the hon. Gentleman we would respond as favourably as we could. We know that the Federal Government have looked elsewhere. They have looked to Canada, to Algeria, and to the Philippines, and they have doctors from each of these areas.

I hope it will not be suspected by the hon. Gentleman, or by anyone else, that the efforts which I have described, and the help which we have given, implies a willingness on our part to give humanitarian aid to only one side, whatever the political grounds may be. As hon. Members know, the head of the secessionist party, Colonel Ojukwu, has repeatedly made it clear that he is not prepared to accept any form of British Government assistance, even in the field of humanitarian relief, and this has effectively ruled out any form of aid by Her Majesty's Government in the form of medical personnel for work in the seccessionist area.

Some months ago we received an informal inquiry via the British Red Cross about the possibility of providing hospital beds and treatment for so-called Biafran war casualties who would be brought to this country by the International Red Cross for the purpose. We immediately initiated inquiries about the possibilities of giving this help, and the 642 Department of Health and Social Security was able to inform us that it would be possible in principle to provide facilities within civilian hospitals in this country for a number of casualties from the secessionist side. We had in mind that the cost of this treatment might be shared between the British Red Cross and the Government, subject to the approval of Parliament.

We informed the British Red Cross who, in turn, informed the International Committee of the Red Cross in Geneva, of our willingness in principle to accept a number of these casualties from the Biafran area. Unfortunately, however, when the International Red Cross made inquiries about this it became clear that the secessionist authorities would not permit any of their wounded to come to the United Kingdom for medical treatment. We were therefore precluded, through no fault of our own, from taking part in the scheme organised by the International Red Cross for bringing Biafran casualties to Europe for hospital treatment.

I think that that account will make it clear to the House that in our approach to this strictly humanitarian problem there has been no question of partisanship or political motivation on our part.

It would be wrong to conclude my reply without any reference to the enormously valuable medical work which has been done on both sides by relief workers from this country, and from many other countries, too, mainly under the auspices of the International Red Cross, but also through the various Church organisations collectively described as Joint Church Aid. Much of the British Government's past contribution of just under £1 million to the I.C.R.C. for relief work in Nigeria has been devoted to medical care and resources, and the same is true of the more than £1 million which had been contributed by the end of last month through the British organisations. Oxfam, War on Want, Save the Children Fund, Christian Aid, and the British Red Cross.

In April of this year three British Save the Children Fund teams in Nigeria alone were giving medical care to about 12,000 people. According to the latest International Red Cross bulletins, about 36,000 people each week are receiving medical assistance in Federal territory, and a further 10,000 in the rebel-held 643 areas. The I.C.R.C. expatriate staff alone now engaged on medical work totals about 157. Between September, 1968, and February, 1969, the International Red Cross spent about £820,000 for the purchase of medical supplies for use by both sides. Over two million people were vaccinated against measles and smallpox.

While this type of relief work for civilians is rather different from the type of problem described by the hon. Gentleman 644 tonight, it is directly relevant, particularly in that this vast international effort has freed other medical resources for dealing with the immediate casualties of the war. I hope that hon. Members, whatever their views about the political issues of the war, can take some satisfaction from the knowledge of our substantial share in that great international effort.