Since January 28, 2020 when I wrote an article titled “Fanatical Witnesses” some members of the Jehovah Witness Sect have been pouring venom on me. Their caustic and acidic articles are the equivalent of leaving the ball and kicking the leg, to use the lingo of football. They say that I am ignorant because I do not know that there are alternatives to blood transfusion. But I did not set out to write about blood transfusion and or its alternatives. My concern was on the right to life as the supreme right in the hierarchy of rights. Here are the facts: Mr & Mrs Emmanuel Onokpise are Jehovah Witnesses. Mrs Onokpise was delivered of an anaemic baby girl that weighed 2.2 kilogrammes. The doctor said since the baby was anaemic she needed blood transfusion. The couple said blood transfusion was against the tenets of their religion. They wanted an alternative option to blood transfusion. Apparently the hospital thought blood transfusion was the best option for the baby. The parents refused and took the baby to another hospital where the same argument ensued. Someone hinted the Lagos State Government that a child’s life was being put at risk due to the intransigence of the parents.
The State Government through the office of the Public Defender got a court order which authorised it to rescue the baby and do whatever was necessary to save her life. The State Government took the baby to Massey’s Children’s Hospital where she was given blood transfusion. The Director of the Office of the Public Defender (OPD) Ms Olayinka Adeyemi said that “when a child faces the threat of harm the State Government has the authority to wade into the matter ….. No parent of a child can infringe on the rights of the child.” I commended the Government for its responsible and compassionate approach to the matter without which the child’s life would have been put at grave risk by her irrational parents whose stance in the matter is a poke in the eye of reason. I spoke to three doctors about the alternatives to blood transfusion, their availability in Nigeria, their affordability and their suitability for the situation of the anaemic baby in question. Here is their summary of the various options
(a) Autologous transfusion – the collection and re-infusion of one’s own blood into the owner. This is said to be used for people who bleed internally as a result of certain trauma e.g a motor accident, a fall from a height resulting in rupture of internal organs with life-threatening bleeding internally. This blood is clean and can be reinfused during surgical operation to save the patient (b) Intraoperative cell salvage (ICS). In this case blood is collected during an operation, washed and filtered. The blood cells are packed and reinfused into the patient.
(c) Post-operative cell salvage (PCS). This is the same as the procedure under b but the blood is collected after the operation.
(d) Erythropoiesis Stimulating Agent – This procedure is meant to stimulate blood production urgently but may cause serious problems like severe high blood pressure and blood clotting life threatening problems like thromboembolism. This is said to be usually deployed in chronic disorders such as cancer
(e) Iron preparations administered by drip. This is said to be suitable for a specific type of anaemia (eg iron deficiency anaemia). The doctors I spoke to said that the baby in question did not qualify for any of the above alternatives. They also said that many health facilities in Nigeria do not have these capabilities even if the patient was fit enough to benefit from any or a combination of the above procedures. They also said that if any of the hospitals that the baby was taken to had these alternatives the cost might be prohibitive. They all commended the State Government for its decision on the baby. One of them said: “while the freely expressed and signed wish of a competent adult must be respected, the rights of a minor, disabled, mentally handicapped, unconscious or drug compromised adult must be protected by the State.” Several western countries have provided an ethical and legal framework for Jehovah Witness parents’ refusal of blood transfusion. In Italy, the courts have adopted measures that prevent parents from exercising their parental responsibility when that exercise is not in the best interest of their children. If the parents withhold consent for blood transfusion, the Probate Registry is empowered to grant consent. Some legal authorities in Europe underline the fact that “it is morally required, not merely morally permitted, to overrule parental refusal of treatment because the refusal constitutes a form of child abuse, child endangerment, child neglect or inattention to the rights of the child.” Infact, if treatment refusal results in a child suffering parents may be criminally liable.
Medical technology is very far advanced in Europe and America but you cannot say the same thing of Nigeria. Those who find these advances in the internet may think, falsely, that they are also available in Nigeria. Most of the equipments used in our hospitals are grossly outdated. I have had encounters with a few high-brow hospitals including some of our university teaching hospitals and the report card is very poor. Even basic equipment are lacking in most of them. A few months ago a relation of mine who had stroke was rushed to a university teaching hospital. In the emergency ward I saw patients sleeping on the bare floor. The lucky ones were sitting on wheel chairs because there were no beds. I had to go and sit on my relation’s bed each time she went to the washroom so that no one comes and takes the bed away in her absence. Someone I know was diagnosed of cancer here. When he went abroad the doctors told him he did not have cancer, but a tumour which they cleaned out of his system within a week. I have written several articles on medical misdiagnosis in Nigeria. This misdiagnosis is caused largely by the outdated equipment used by these hospitals and also because some of the medical personnel do not have the opportunity to update their knowledge in a field that has been seriously transformed by the rapidity of technological change. Let us admit that we are very far behind the rest of the world in medicine just as we are in many other sectors. What sort of doctors do we expect our universities to produce for the country’s hospitals when the universities are often on strike? When many students who only score 100 or 150 over 400 are admitted into our universities every year.
Those fellows who thought I am ignorant did not find out whether or not any of the three hospitals that Mr. Onokpise’s child was taken to had the alternatives to blood transfusion. Did they find out whether or not those alternatives if available suited the condition of the baby? If they knew the hospitals where the alternative treatment procedure existed why didn’t they take the baby there instead of dictating a procedure they wanted to hospitals that didn’t have those facilities? The truth is that many medical procedures that are available to people abroad are not yet available in this country. That you find these new equipments and drugs on the internet does not mean that they are available in Nigerian hospitals. The reasons they may not be available are that (a) they are capital intensive and (b) they may not be easily affordable by the generality of Nigerians. For example, no sensible doctor will prescribe expensive drugs for patients who live in rural areas because those drugs may not be available in rural area pharmacies. If they are available the cost would be too prohibitive for the rural dwellers to purchase. In Nigeria children are badly treated even by their parents. Some of them are subjected to very inhuman treatment because they cannot complain. But it is worse if the baby is too young, as Mr. Onokpise’s baby, to know that her right to life is being trampled upon by people who should stand guard over that right. The Lagos State Government played its part excellently as a surrogate parent when the biological parents failed woefully in their duty. I know that as a human being I am ignorant about many things. However, the one thing I am most ignorant about is why any responsible parent would put the life of his child at grave risk because of his incomprehensible religiosity.
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