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Tessy Igomu
For Precious Owolabi, the tears have been ceaseless across the country. Like a candle in the wind, his flame was abruptly blown out at midday.
Owolabi was killed by gunshot injuries he sustained on Monday 22, 2019, while covering the clash between the Nigeria Police and members of the Islamic Movement in Nigeria (IMN). The National Youth Service Corps (NYSC) member who was serving with Channels Television, Abuja office, died after several hospitals had allegedly refused to treat him without a police report.
On July 25, while thousands of his counterparts enthusiastically embarked on their last parade across the country, the budding journalist embarked on the final leg of his journey on earth, as his remains were interred.
Bayo Ohu, a journalist with the Guardian Newspaper in Lagos, was gruesomely shot in his home on September 20, 2009 by assassins. Left seriously wounded and bleeding profusely, he was rushed by neighbours to a nearby hospital but was bluntly refused treatment for lack of a police report.
In 2008, Saka Saula, the then chairman of the Lagos State Chapter of the National Union of Road Transport Workers (NURTW) was gunned down in his house. He also died en route a public hospital after being refused treatment for the same reason.
Adebayo Akinwunmi, a senior engineer with a telecommunication company was shot in the ribs by robbers that invaded his home in Ogun State. He was likewise denied treatment by two hospitals after his distraught family couldn’t produce a police report. At the Lagos State University Teaching Hospital (LASUTH), where he was rushed to, there was no surgeon on ground to attend to him due to an ongoing doctors’ strike. Akinwunmi died under the watch of his helpless family members.
These are sad recaps out of the many needless deaths that have occurred after gunshot victims were rejected by medical facilities which insist that family members of such victims must produce a police report.
The sad demise of Owolabi has established the painful fact that such practice is still firmly entrenched in the country. The incident also reopened a national debate on the existence of a law that mandates the treatment of victims with gunshot wounds by medical practitioners without an accompanying police report.
To many people angered by this practice, the sanctity of human life stands supreme and must be held sacrosanct above every other interest.
In 2015, going by the many deaths reportedly attributed to such refusals, a former Inspector-General of Police, Solomon Arase, issued a statement, charging police officers to desist from harassing good-hearted Nigerians that help convey gunshot victims to medical facilities. He also reminded medical practitioners that that they were duty-bound to treat first before taking any other action.
In 2017, President Muhammadu Buhari’s assented to a bill earlier passed by the National Assembly tagged, ‘The Compulsory Treatment and Care for Victims of Gunshots Act, 2017’. The act, which came into effect on the eve of 2018, among other things, made it an offence for hospitals to deny gunshot victims treatment based on the absence of a police report. It also made it obligatory for immediate and adequate treatment to commence with or without monetary deposit.
It however, mandated that a formal report must be made within two hours of commencement of treatment and frowned at any inhuman treatment, attempt to degrade or torture gunshot patients by the authorities.
To many that hailed the bill, it simply gave legal backing to persistent calls for higher premium to be placed on life.
The National Health Act 2014, in Section 20, states partly that: “A health care provider, health worker, or health establishment shall not refuse a person emergency medical treatment for any reason.” As punishment, an offender is liable to a fine of N100,000, a jail term of six months or both, upon conviction.
Despite these, the propriety of treating gunshot victims still appears to be a debacle for medical practitioners. This has left many to wonder why the directives are being flagrantly disobeyed and why the Hippocratic Oath that binds all healthcare providers is also disregarded with impunity.
Most concerned Nigerians maintain that the idea of waiting for police reports before treating a dying individual is archaic and inhuman, and is repugnant to the right to life as enshrined in Section 33 (1) of the 1999 constitution.
According to security experts, the erroneous assumption by some police officers that every gunshot victim might be an armed robber that escaped with bullet wounds during a foiled operation has also helped to fuel this action.
Reports have revealed that over the years, health workers routinely reject gunshot patients due to the tendency by police operatives to harass and incriminate them for treating such victims without obtaining police clearance. Also bystanders that could be potential good Samaritans have been known to watch people die needlessly for fear of being arrested or harassed by the police for trying to help.
Corroborating these allegations, Alozie Okorie, owner of a private security firm, explained that most overzealous enforcement officers often hide under the Robbery and Firearms (Special Provisions) Decree No 47 of 1979, to harass ignorant healthcare providers for offering their services to distressed individuals. He described the behaviour as quite unprofessional.
Okorie explained that the decree was promulgated when armed robbery became high, shortly after the Nigerian Civil War in 1970. He explained that it was a drastic step taken by the military government after it noticed that robbers, who escaped with gunshot wounds, were being treated at hospitals.
A 1986 amendment to the decree later requested that hospitals notify the police as soon as they treat any gunshot victim.
“It was based on this that the police banned emergency medical treatment for gunshot victims. The Act provided in Section 4, ‘that it shall be the duty of any person, hospital or clinic that admits, treats or administers any drug to any person suspected of having bullet wounds to immediately report the matter to the police; and any person, hospital, clinic which fails to report this shall be guilty of an offence’. It also emphasized the need to report and not to demand police report from already distraught family members or kind-hearted individuals that chose to help. This country needs to move beyond just making laws to its full implementation”, he said.
To Thomas Akinlade, a banker, whose friend bled to death after being shot by robbers in Oshodi, the decision by medical practitioners not to treat such emergency is usually driven by the need to make profit, and not the fear of being harassed by the police. He said most gunshot victims rushed to the hospital by good Samaritans are always rejected for lack of financial commitment.
“By the time a doctor or nurse realises there might be little or no financial commitment made on behalf of such victim, they will immediately write a referral, citing lack of police report for taking such action. In all, both medical practitioners and law enforcement agents help to fuel these needless deaths recorded. But then, no one can blame them because the country lacks a functional healthcare system that takes care of its citizen and ensure their healthcare needs are met,” he said.
Akinlade posited that a society is defined by the value it attaches to lives, adding that it was not enough for a bill to be passed or an act documented.
He stressed that the death of Owolabi has made it urgent that the issue be holistically reviewed and measures taken to investigate why it is not being followed to the letter. He called for measures to be taken to accommodate gunshot emergencies and defaulters dealt with to serve as deterrents.
Citing bankruptcy as a good reason why most medical practitioners do not voluntarily treat gunshot victims, a doctor with one of the apex hospitals said aside police highhandedness, most hospitals refuse both accident and gunshot victims because of the cost that will be incurred. He argued that any private hospital that embarks on such philanthropic gesture will close down in no time.
Highlighting how the ‘Gunshot Wounds 2017 Act, might not protect the interest of medical practitioners, the National Secretary, Nigeria Medical Association (NMA), Dr Olumuyiwa Odusote, was quoted to have said that the NMA had in the past voiced its reservations on the Gunshot Wounds 2017 Act.
His words: “NMA believes that even though the law seeks to protect patients with gunshot injury, it is deficient. This is because sometimes, to intervene and save the lives of patients with gunshot wounds, it takes far more than four hours to achieve but that law restricts the period within which you are to report to the police to two hours.
“If, for example, the patient was shot on the chest and you have to take him to the theatre immediately in order to stabilise him and stop him from bleeding, that procedure takes more than two hours to carry out. It means that I am liable. By the time I come out to say I want to make a report to the police, they can arrest me for concealing a gunshot wound patient.
“If a law penalises my intention to save a life, what should I do naturally? To avoid anything that will put me in that circumstance, the easiest way is to refer such patients to centres where they have enough professionals. While the doctors are working, some administrative officers somewhere are contacting the police. But most of the private hospitals we have in the country are usually run by the doctor himself who also administers treatment. By the time he tries to save that life, he will not have time to make that report.
“Again, the police we have in the country will take advantage of that and God help that doctor if he does not have money to give, he is going to be thrown behind bars for doing his legitimate duties. It is difficult for me to say that any doctor who does not take such a patient should be blamed,” Odusote said.
Explaining the consequence of inability to pay for treatment offered to such victims, Odusote said:
“The second problem is that the law does not make provision as for who pays. The law says you must treat, yes. But even if you treat, who pays? One of the major problems we have in this country is that we don’t have a good healthcare financing system. Most patients pay out of pocket. And most of these patients cannot afford out of pocket payment for healthcare.
If you say you want to force a facility to treat patients and by the time he finishes and the patient cannot pay, who pays? It will take a few months for such facility to shut down naturally, and then deny care for thousands of others.”
Odusote also argued that a doctor can only accept a condition that he or she is competent and equipped to manage.
“If you say I must treat a gunshot wound and I don’t have the facilities to do so, the moment I take that patient and he or she dies, I become liable. The law allows us to refer a patient that we cannot manage.”
Despite the stance of medical practitioners on this contending issue, many Nigerians have maintained that the right to life by every individual must be upheld not minding the interests at stake.
