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COVID-19 and the inherent health dangers

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What I heard a couple of days ago from my personal physician has increased my indignation for the present government of General Muhammadu Buhari and added a new dimension to my fears on its ability to contain the raging Coronavirus in the event of an outbreak in the country Except an urgent solution is found, we are in for it. And when I say solution, I am not, in my wildest dreams, looking in the direction of this government, going by its pronouncements and other available, compelling evidences. The doctor, who would not want to be named, for obvious reasons, is a distinguished medical consultant recently inducted Fellow of the Nigerian Medical Association (NMA). He told me two very recent cases that happened within a week in his hospitals and that changed the original subject of our meeting.

He said he got two calls from two of his private hospitals. Both had sought to know what to do about patients who received treatments but had no money to offset their bills. He simply told both callers, who were medical doctors heading the hospitals, to discharge the patients. Barely one hour earlier had a 16 year old girl, who was rushed into his Lagos hospital, where he was attending to me, been released. The young girl was said to have been unconscious after a bout of acute diarrhoea and vomiting. Curiously, she was brought in by neighbours. The mother refused to show up despite being at home. Reason, she had no money to pay the hospital bill.

As usual in this doctor’s hospital, rather than turn a patient in critical condition away, the girl was given attention and stabilized. As soon as she was strong enough to go home, the mother sauntered in. Face-to-face with the doctor, she painted the picture of her predicament. She was married to a traditional ruler who kicked her out with her children, more than 10 years ago. She and her children have over the years shared a joint household with poverty which has stalked them diligently every inch of their way. Recently, it directed them to the garbage where, according to the doctor, they have been feeding daily since the compulsory Covid-19 home stay started. He went further to tell me the story of another woman in his Ikorodu hospital that had a baby through a caesarean session and could not pay. The husband, he said, ran away, leaving the mother and child in the hospital. In fact, the woman had to put her story on Facebook, seeking for help. “I actually saw it on Facebook but I never knew it was my hospital. What would I do? Detain her in the hospital? That would be tantamount to detention or infringement on her fundamental human right, for which the patient could report to the police and have the doctor charged to court. The court can then give judgement against the doctor and fine him say N100 million or whatever amount it deems fit. So, I simply asked my doctor to let her go. All I did was to ask the doctor to tell her to write an undertaken to come and pay whenever she has the money and if she doesn’t come back, so be it”

Another one happened at his Ajuwon, Ogun state hospital where he performed yet another caesarean session on a woman whose husband had no money to pay. The man, he said managed to deposit N20,000 before the operation. Thereafter, he started telling stories. “Again, what do I do? I just asked the woman to take her baby and go. I told her when you have the money come back and pay. The woman danced and danced and left” The doctor cited instances where doctors had been taken to court and fined heavily for not releasing patients who got treated and refused to pay their medical bills. He specifically mentioned one Dr. Afolabi in Ekiti and another Dr. Shobande in Akute, Ogun state to buttress his story. What efforts has the medical association made to get the government’s support to help indigent patients offset their medical bills? Are there such provisions by the government, I inquired. According to him, the association had approached the government on several occasions without any meaningful result. At one of their recent meetings with the minister of health, Dr. Osagie Ehanire the association was told that the Central Bank had earmarked N50billion to assist the private hospitals across the country. “But how to access such funds, nobody knows” he said, adding that the only people who are said to have benefitted from those funds are doctors whose hospitals are already flourishing, apparently those who are well connected to the government at the highest level.

The Nigerian government he said emphatically has no value for private medical practitioners. Ironically, the private hospitals in Nigeria cater for over 75 per cent of the populace.

This, according to him, is further exemplified by the government’s insistence on importing into the country a team of 18 Chinese medical doctors whose designations and professional qualifications are unknown to the Nigerian Medical and Dental Council and other medical regulatory bodies in the country. A press release signed by the President of the NMA, Dr. Francis Faduyile which has been in circulation describes the government move as an embarrassment to the membership of the Association and other health workers who are giving their best in the fight against Covid-19 pandemic under deplorable working conditions, and a fragile health system to be subjected to the ignominy of not being carried along in arriving at such a decision. According to Faduyile, the “invitation is ill-timed and of no overbearing significance considering that whatever experiences the Chinese have can be shared by digital technology through conferencing.

Perhaps more worrisome is the fact that “the Government did not take into consideration the extant laws regulating the practice of medicine in Nigeria as enshrined in the Medical and Dental Council Act. This is one such circumstance where the Medical and Dental Council of Nigerian should be consulted to grant necessary approvals to foreigners to interact with Nigerian patients” But this may not come as a surprise to many Nigerians who have over the years got used to the government’s little or no regard for established rules, despite efforts by its large cache of publicists to paint a different picture.Jolayemi is former Editorial Board member, THISDAY newspapers and former foreign affairs correspondent at The Guardian.

Both private and publicly owned hospitals in the country, the NMA said currently lack Personal Protective Equipment (PPE), test kits and test centres across the country in addition to “lack of any form of insurance for the workforce” These according to the association, “are primordial issues begging for attention at this time” In one of their recent encounters, my doctor said the health minister told the NMA that there were too many medical doctors in the country. At another instance, the minister for Labour and Employment Dr. Chris Ngige, also a medical doctor by profession, was happy to advise his colleagues in the industry to seriously consider seeking greener pastures abroad. Both ministers were of the opinion that Nigeria has too many doctors! With this as the official position of this government, it is now clear why the few government hospitals in the country are mere consulting rooms. The rumour that the Chief of Staff to the President, Abba Kyari was recently ferried to Lagos for treatment after contracting the dreaded COVID-19 is yet to be debunked, thereby exposing what the government has been covering up.

No wonder our so-called leaders and corruption warriors fly abroad at the sight of every minor ailment, including cough and catarrh, frittering away tens of millions of tax payers’ money. On the government’s handling of the monstrous Coronavirus, he said the government is not serious about fighting the scourge. According to him, the government had told the private medical practitioners that they should not handle the Coronavirus cases. Rather, those with the disease should contact the Nigerian Centre for Disease Control (NCDC) for treatment. The question is how do you get tested to determine that you have the infection? The fact is that it is possible to have one or more of the listed symptoms of the virus when in actual fact, what you have is not Coronavirus.

Where does the government expect people to establish that they have the virus before being referred to the Covid-19 centres? In case of outright outbreak, what capacity do the government centres have to deal with the likely upsurge? That aside, what is the government doing to assist the private hospitals that currently handle the 75 per cent of the population mentioned earlier? How many hospitals in Nigeria have been assisted with the necessary PPE like mouth guards, gloves and hand sanitizers among others. “This is what we are dealing with here, and in our two other facilities, on a daily basis” he told me looking fully forlorn and befuddled. The luck we have in this country, according to him is that the Coronavirus cannot take us down the way it is with other nationals because of the peculiarity of our own situation. Otherwise, the magnitude is not what anyone can accurately predict. This is a pandemic that is capable of wiping more than 80 per cent of the country especially among the poor and the vulnerable who live in clusters. Hear him:

“But we are so fortunate in this country that the effect of the Coronavirus which is a protein molecule that is surrounded by fats, fatty layers, is not very effective when the temperature is high. That is why the temperature destroys or inactivates it. The soap, common soap, you know, soap emulsifies fats, destroys it. So, in this country, the virus does not go too far in its level of destruction because the heat here is much. Even though the World Health Organisation tries to say there is no relationship between temperature and the viral infection. The question is why are Donald Trump and other notable medical doctors in the United States struggling for summer to come to see if this virus will follow a natural course? So, in this country, apart from those people who have come from abroad with the terrible disease, very little is known about the destructive effectiveness of this particular virus so it runs a milder case and a lot of the people DO NOT require ventilation. Even though they claim they have imported ventilators into this country but abroad where there is meter, the problem is the destruction of the lungs by the virus because of the cold.

The pathogenicity of respiratory viruses is more during the cold than during the warm weathers, remember its Flu. So, the luck we have is that our temperature makes it to run a milder course. Whether they like it or not, that is the truth. But even at that, we have now recorded what is described as community spread. You know it was the United States that was talking about community spread before now. We didn’t know what community spread was. We were looking at person to person contact but now we are looking at community spread, spreading within the community to those people who have absolutely no relationship with those people who have the virus. And how does the community spread come in? Contact. Contact!
Children can carry the virus asymptomatically. They won’t have symptoms but they can transmit the virus to adults particularly those between the age of 40 and above and particularly among those who have underlining illnesses like hypertension, diabetes, cancer or any other immuno-suppressive illness like organ transplant, tuberculosis and all that. So you will see people who have no relationship with the people yet they come down with the disease. That’s why they say wherever you go please observe social distancing; no touching, no hugging and use hand sanitizer if you have no access to soap and water.

If you have soap and water go and wash your hands as many times as possible. You have touched anything; you have touched even your dress, go and wash your hands. I just came from my house now I washed my hands and sanitized it; when I got here, I sanitized it. When I leave, I sanitize it; when I get home I sanitize it. What does it take to get myself protected? When you come down with the disease, is it the N5000 I used to buy sanitizer that matters to me? No, because the cost is in hundreds of thousands when the problem comes in. These are the problems that we are experiencing. In this country, the government, I repeat, the government does not have any value for private medical doctors. Yet we take care of over 75 per cent of the population. Look at the people that came here today, they didn’t have money. What do you expect me to do? Drive them away? No. I can’t do that. I have to first save the patient’s life. In closing he asked me: “how long can I continue to do that? How many private practitioners can afford to cater for poor people who are incapable of paying their hospital bills? I was unable to provide him and answer.
Jolayemi is former MD/Editor-in-Chief, Newswatch newspapers,
Former Editorial Board member, THISDAY newspapers and Former Foreign Affairs Correspondent at The Guardian.


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