Covid-19 and safety of Nigerians

NIGERIA produces some of the finest physicians and nurses in the world. Unfortunately, it is countries like United State, United Kingdom Saudi Arabia and such wealthy countries that are now the beneficiaries of their expertise. They are celebrated in these lands. I have encountered these fine Nigerians. There also remained a vast pool of fine healthcare professionals in our dear country. The heroic sacrifice of Dr. Ameyo Adadevoh in saving Nigeria from the scourge of Ebola is known the world over.  She curbed the spread of the Ebola virus in Nigeria by acting professionally, placing the Ebola patient zero, Patrick Sawyer, in quarantine despite pressures from the Liberian government. It was reported that she had never seen an Ebola patient before, but she was able to diagnose and provided Nigeria with the opportunity to contain Nigeria’s first-ever and only Ebola outbreak in July of 2014. This is the hallmark of professionalism and dedication to service. She acted in public interest, she acted in accordance with the oath she took – The Hippocratic Oath.

The advent of COVID19 has exposed the fragility and utter inadequacy of Nigeria health system. It has also exposed how poorly trained and how lacking in professionalism, that the vast majority of Nigeria’s healthcare workers are. COVID19 has also laid bare, how superstitions, hearsay and rumours has taken hold of those that we entrust our lives to for care. Tales from Nigerians who have had the misfortune of falling sick or in need of medical attention and had to visit our health establishments have been replete with tales of healthcare workers that has become beholden to crass conjectures about the health condition of their distressed patients. Not a few has ended in fatalities.   Daniel J. Boorstin was convinced that the greatest obstacle to discovery is not ignorance—it is the illusion of knowledge. Another version of this saying from the famous British physicist, Stephen Hawking, goes thus; the greatest enemy of knowledge is not ignorance; it is the illusion of knowledge. People who think that they know all are far more dangerous to our collective survival and existence than the illiterates amongst us. The illiterates may be taught to know. Those who are convinced that they know all and therefore do not need to enquire further, become blinded by the illusion that they know it all. They are the ones putting us all in great peril.

Unfortunately, as COVID19 starts to find a foothold in our country, rather than act rationally and professionally, many healthcare professionals, and establishments now act based on fear fuelled by rumours and hearsay. The toxic combination of fear, lack of empathy and poor professionalism is what fuel their actions. They are resulting to turning away patients from their establishments in fear that such patient may be COVID19 infected when in fact they have no basis to believe that such patient posed a threat to themselves or to others, other than their unfounded fear. They are erroneously believing that they are acting based on knowledge. Alas, their action show that they lack valid knowledge and are suffering from their illusion of knowledge. This is dangerous to all of us! These set of healthcare professionals have been killing Nigerians for long. They are, in their conducts, armed with their licenses and certificates, more dangerous than COVID19 and unfortunately, they will kill many more, by their actions, than COVID-19 will ever do during its rampage.

The typical argument for their actions, or inaction, will be that they do not have personal protective equipment to protect themselves while they do their work. But real hospitals and places of care do not just turn their registered patients, or any such patients that present at their doors away. They will, at the very least, perform the least cursory assessment of the patient’s condition, provide them with the emergency care needed to stabilise them before referring them on to establishment with the right expertise. That is the least that is expected of anybody in the caring profession. That is what to expect from doctors and nurses with any vestige of compassion and humanity remaining in them. Real doctors and nurses do not just gape and gawk at distressed patients who are in agony, and their distraught carers who rushed to the hospital door for help. Patients go to hospitals, believing that doctors and nurses there will help them to live. Unprofessional practices, lack of empathy and kindness further deplete the already meagre confidence that the Nigerian public have in our healthcare system. This is not in our collective interest.

On 26 March 2020, Dr. (Hon) Afolabi Atolagbe passed on in Osogbo. He died because he was refused the medical attention he needed at a critical time. He died because all the hospitals that he was rushed to in Osogbo failed to act to preserve his life. He died because the healthcare practitioners in those hospitals were everything but professional and human. In the early evening of March 26, 2020, Dr. Atolagbe called his driver to take him to his doctor because he was experiencing severe headache and feeling tired. He was promptly helped into his car, ice pack placed to his head, and taken to a specialist hospital. At the hospital, the matron and some nurses came out but did not approach their patient. The matron went back inside, ostensibly to consult with the doctor. The matron soon came out, but not to offer help and succour, but to dismiss her patient without any help. All pleas for some sort of emergency care fell on deaf ears. She went back inside with her nurses and slammed the door in the face of her dying patient!

In all of the encounters detailed, it is obvious that all the doctors and nurses encountered have conveniently forgotten or chosen to ignore the Hippocratic Oath which they swore to uphold on their entry into the caring profession: “The health of my patient shall be my first consideration”, and “I will maintain the utmost respect for human life.” By their actions, it was obvious that it is their habit to casually disregard this sacred oath and the basic duty of a physician to the sick and casually brush aside their obligation of preserving human life. I am aware that those concerned will be quick to point out that as doctors, they are at liberty to choose whom they will serve in rendering their professional service to. However, this does not absolve them of their obligation to provide care to a patient to the best of their ability in an emergency situation. Others may wonder what purpose this will serve. The question is should we keep quiet and watch evil pervade our society? Yet, other may say that this is an act of God.

They may argue that it was his day that came. But such people should be reminded that God does not condone acts that are lacking in mercy and kindness, as demonstrated by these so called health professionals, hence, “love your neighbour as thyself”. I am sure such individuals with this notion of “act of God” will not wish this upon themselves or members of their family. Moreover, God does not need mere men to aid His work if He so decided to call any of His creations home. For long enough, the vast majority of our society has kept quiet in the face of such infamous acts that is being highlighted in this piece, including my very self. This is act of complicity that promote the festering of such behaviours that put our continued existence as a sane society in utter peril. Keeping quiet or shying away from discussing this is akin to aiding and abetting acts that are tantamount to manslaughter. The Nigeria Medical and dental Council has a role to play in calling to order their members who hold the sacred oaths that they swore to in absolute contempt. Or how do you describe a doctor who wilfully neglected his patient or refused to attend to his patient, even in emergency. How does the medical community respond to doctors and nurses who flagrantly denied a patient in need of urgent medical attention the care that such patient deserves?

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Under Rules 26 to 70 of the Code of Medical Ethics in Nigeria, the acts that were referenced above amount to Infamous Conduct by these medical professionals. Specifically, The Code of Medical Ethics in Nigeria identified the following, amongst others, as acts constituting Professional Negligence:

• Failure to attend promptly to a patient requiring urgent attention when the practitioner was in a position to do so.
• Manifestation of incompetence in the assessment of a patient.
• Making an incorrect diagnosis particularly when the clinical features were so glaring that no reasonably skillful practitioner could have failed to notice them.
• Failure to refer or transfer a patient in good time when such a referral or transfer was necessary.
• Failure to do anything that ought reasonably to have been done under any circumstance for the good of the patient.

The individuals and institutions identified above, individually and as bodies acted without due regards to their patient’s wellbeing. They failed to provide to the patient requiring urgent medical attention the care that he needed, they have fallen short tin the discharge of their duty of care to patients. They have not acted conscientiously and in manner that is befitting of their callings. They failed to provide medical assessment to a distressed patient which they could have reasonably done as skilful and competent practitioners under the circumstance, for the good of the patient.

It is failings like these in our land that continued to drive some of the best in the land away to sojourn in foreign lands. This deplete our natural God given resources and talents. It stifles our ability to grow and develop as a functional society. It is such desensitisation to the suffering and needs of others that frightens Nigerians from returning to the land of their birth to take part in building it. Is it right that acts like this continue to put the lives of Nigerians in a situation of uncertainty and dangers? This is why Nigerians feel vulnerable in the land of their birth and thus flee to foreign lands for safety.

It is up to those involved to own up to their shortcomings, to start to make right what they have individually done wrong, to make the necessary atonements, such that their acts will stop being a source of sorrow to families and the society. It is up to them if they want to make it right with their God (or gods) and to wash the blood off their hands and heads.It is up to them to decide that, going forward, they will be springs of hope and not a source of sorrow and despair. The excerpts below, from The Yom Kippur Liturgy – ‘’Gates of Repentance’’ aptly captures what needs to be:

‘’Now is the time for turning. The leaves are beginning to turn from green,to red, to orange. The birds are beginning to turn and are heading once more toward the south. The animals are beginning to turn to storing their food for the winter. For leaves, birds and animals, turning comes instinctively. But for us, turning does not come so easily. It takes an act of will for us to make a turn. It means breaking old habits. It means admitting that we have been wrong, and this is never easy. It means losing face. It means starting all over again. And this is always painful. It means saying I am sorry. It means recognizing that we have the ability to change. These things are terribly hard to do. But unless we turn, we will be trapped forever in yesterday’s ways. Lord help us to turn, from callousness to sensitivity, from hostility to love, from pettiness to purpose, from envy to contentment, from carelessness to discipline, from fear to faith. Turn us around, O Lord, and bring us back toward you. Revive our lives as at the beginning, and turn us toward each other, Lord, for in isolation there is no life.’’

We can, if we choose to, start to turn to ways that will heal our land, making it a land of hope and happiness, where all of us can flourish together. On the other hand, we can continue down our present path, where the weak are left to perish, the sick are left to die and hopelessness continue to fester.

Atolagbe writes in from the United Kingdom

NIGERIAN TRIBUNE