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Chimamanda Ngozi Adichie, the world renowned novelist has given us a story to worry about. Her story is not fiction. It is a factual story of the admission of her 21-month old son, Nkana Nnamdi in a Victoria Island hospital, Euracare, in Lagos last month. In a statement in which she made an allegation of criminal negligence she said that the anesthesiologist administered excessive propofol and failed to monitor the sedated toddler but casually switched off the oxygen before carrying him to the intensive care unit without following proper protocol. The child was scheduled to fly to John Hopkins Hospital in the United States the next day. He never made the trip. He died putting the mother and the father Dr Ivara Esege, a Family Medical Doctor, in tears. Both parents were around throughout the ordeal. My condolences to the parents. The Lagos State Government has directed that an investigation be made into the matter. That is fair since it has already become a public issue that has drawn attention to Nigeria in an unpleasant manner. The Healthcare Facilities Monitoring and Accreditation Agency (HEFMAA) has also promised that there will be transparency. We hope so. In Nigeria there are many people who have suffered from medical mistakes, negligence, mismanagement etc and have borne these quietly, noiselessly, either because they do not know how to get redress or they think they cannot get redress or do not want to stay for 10 years in court. Unfortunately, I belong to this group. I have had my bad experiences with several Nigerian doctors and hospitals but I have often refused to take up such cases. I just move on without any noise-making because I know that no hospital or doctor anywhere is perfect and that you can hardly get any redress in Nigeria. Am I right or wrong?
Whether I am right or wrong I have decided to narrate some of my experiences and what I did in each case: There is a big name hospital in Lagos that Newswatch used to patronise. One day I went there for malaria treatment. I told the doctor that I had bitter-leaf taste in my mouth and I wasn’t sure what it was. Before I finished making the statement he had made a prescription. I was surprised because I thought he was going to send me to the lab for a blood test so as to know whether it was malaria or typhoid or both. I took his drugs for three days. I was not healed. I went back and saw another doctor, another grey-haired man. He sent me to do a blood test but made a prescription without waiting for the result of the test which was going to be ready the next day. I took his drugs for three days. I was not healed. I went back to the hospital for the third time. At this time the result of the blood test had come. The doctor, also elderly, told me that I had a new strain of malaria. And he prescribed Fancida. I knew that Fancida had been in use for a long time so how could that be the cure for a new specie of malaria. I did not argue with him. I collected his prescription, took it for three days. I was not healed. I went back to the hospital for the fourth time with anger.
This time I was referred to a pretty, young female doctor and I was saying to myself “if the elderly ones could not help me is it this young one who will do it.” I had my doubt. I decided to ask her a personal question. “Doctor, I am sorry to ask you a personal question. How old are you please?” She said: “I know why you are asking the question. All the three doctors who treated you before now are older than me. But they don’t read anymore. I am 28. If my prescription does not cure you, you can come back and fight me.” She prescribed Halfan. That is what healed me. I went back to thank her but I never patronised that hospital again.
Many years ago, I had a problem with sinusitis. Several drugs were taken, no cure. My doctor said that I needed surgery. I yielded. He did the surgery. I got minimal relief only. I decided to try another hospital. They said I needed another surgery. Out of desperation I agreed to go under the knife again. On the day scheduled for the second operation I changed my mind. I decided to go to the United States to have a second opinion. In a hospital there I was told that I have an allergy. They told me what it was, prescribed a tablet for me. I have been healed. This was an indication that medical knowledge here is poor. For more than 20 years sinusitis has not bothered me again.
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My wife was suffering from insomnia and when she was looking for healing for some other ailment she informed the doctor, a Professor, of her battle with insomnia. For this other ailment the doctor prescribed a drug that she wanted my wife to take four times a day. I told my wife that if she had to forgo her sleep and stay awake to take the last dose of the drug at midnight it might complicate her sleep problem. She agreed but did not want to skip it. When she went to the United Kingdom she sought a second opinion on her ailment. The doctor in London said that it was unwise to prescribe that any drug be taken four times in a day because that can cause insomnia. And if the person already has insomnia that arrangement will complicate it. The London doctor reduced the dosage of the drug to three times a day. Isn’t that a commonsensical approach to the practice of medicine? I had the same experience in an eye hospital in Nigeria a few years ago. After I had surgery in the hospital, the doctor the in charge, a lady, gave me three eye drops one of which I was to use every six hours. I did not argue with her. I simply reduced the dosage to three times a day. And I am not blind today. Even a doctor may lack commonsense. That is it because commonsense is not common.
I have been battling, like all adult men, with the problem of prostate enlargement for years now. Sometime last year a doctor in one of the hospitals I use said I needed to do a test since I had not done it for a year. When I brought the report of the test he said that it was fair but that I still needed to see a Urologist. He invited a Urologist who said that eventhough the report seemed fairly good I still needed to go through a procedure. I wasn’t convinced because of the wishy washy manner the entire procedure was arranged. I thought that big money was the major motive. One of my children decided to accompany me for the procedure. On the scheduled date the Urologist gave us a three-page document to read. After reading the document we asked him questions. Question one: Are there risks in this procedure? Answer: Not really, not really. But all procedures have risks. Question two: If there are risks, are there facilities in this hospital for handling such risks? Answer: Not really, not really. Question three: If there are post procedure complications are there facilities in this hospital for handling such complications? Answer: Not really, not really. Question four: In that case what would we do? Answer: We go to another hospital. With that answer it was clear that they just wanted to make money, big money. We terminated the process and just went away angrily.
In many hospitals in Nigeria money is the main event, not the service, not people’s lives. A security man in an estate where I live had a cut in his finger as he was breaking a coconut. Instead of going to a pharmacy to get the wound bandaged he went to a nearby hospital. They charged him for registration, consultancy fee and treatment. They gave him a bill of 49,000 naira for treatment that wouldn’t cost more than N2000 in a pharmacy. He was dazed. They detained him until the money was paid. That is not medical practice. It is wuru wuru business.
There are many, very many, things wrong with medical practice in Nigeria. No one expects medical practice anywhere to be perfect because doctors are human beings and no human being is perfect. But the appropriate authorities need to do more to curb certain excesses, malpractices and inadequacies. Some of them are low research, thirst for big money, poor infrastructure, absentmindedness (forgetting scissors in patient’s stomachs during operation), poor electricity, admission of patients who do not necessarily need to be on admission, fake medical doctors and nurses, incompetent injection administration, poor diagnosis, low training standards which make many Nigerian doctors unemployable in some countries, poor professional standards and oversight, endless consultancy fees (in Canada elders are not charged consultancy fees). A lot of these lapses arise from the fact that our doctors are poorly paid in many Nigerian hospitals. That is why we lost some 15,000 doctors to other countries between 2020 and 2024, a period of just four years. If we are not to lose more we have to pay more. And if we pay more we have to demand more from them. My two trips to Canada for treatment in the last two years have indicated to me that in the medical field we have a long way, a very long way to go in Nigeria eventhough I also admit that medicine is not perfect anywhere in the world.
