Call 999 – ABUJA


Once again, as Nigerians, we bow our heads in shame.

On the 1st of October 2010,  there was a bomb blast right next to Eagle Square, at the heart of the Nigerian Government, then there was another one, inside Moghadishu Barracks, Abuja at the heart of the Nigerian military, shortly after another inside the headquarters of the Nigerian Police in Abuja and finally, when it appeared that Nigerian State institutions were no longer able to arouse the desired attention, they struck the UN in the heart of Nigeria’s capital. The consequences of this for Nigerians is being well and extensively analysed in various media, much more competent to do so than we are. But the one conclusion we can draw from this is that security cannot be bought with big contracts, cannot be provided by soldiers on road blocks, not by CCTVs all over the city, nor by armoured tanks and assault rifles. Relative security can only be achieved by firstly targeting the root causes, and secondly by diligent, well managed, proactive, intelligence co-ordinated with an effective response force. Sadly, you can buy this off the shelf.

Another thing you cannot buy off the shelf is an emergency medical response service! 

If we showed our gross incompetence in the area of security in preventing the blasts, our incompetence in the emergency health response was even more glaring. Look at the images below from the Nigerian press, taken following the UN blasts, and kindly note the complete absence of anyone resembling medical personnel, look at the the chaos around the ambulance, the state of the patients being carried away….and remember this is not Aba, Jalingo or Ogbomosho (nothing against these beautiful cities), this is Abuja, the capital of Nigeria, 8th largest producer of oil in the world, self acclaimed Giant of Africa, recently re-branded as a great country, with great people.

A lot has been made of the fact that Nigerians responded in masses to calls on radio and social media to go out and donate blood for the healthcare provided by hospitals in Abuja. The question that has not been asked is why this was necessary in the first place. We have a National Blood Transfusion Service, funded by our taxes.Their HQ is on 39 Abidjan Street, Wuse 2, a few minutes from most hospitals in Abuja. Is it really not rocket science to have blood reserves to manage emergencies. And what if there was a really large incident, with more than the 100 people affected here? What would we do?  Blood did not run out after a day, or two, it ran out after an hour! Compare this to the South African Blood Service. Right on their front page they tell you the blood supplies they have available for the entire country, at any point in time. At the time of writing this – it was for 5.2 days!

A lot of kudos has to go to the Minister of Health, and the Minister of State for Health for trying to lead the health response themselves after the incident. While Prof Chukwu tried to co-ordinate the health sector response, Dr Ali-Pate was one of the first at the National Hospital in Abuja. Yet, all they had to work with were their mobile phones, as there is no “Operations centre”, anywhere in the Nigerian health sector to manage medical emergencies. There is in fact NO MEDICAL EMERGENCY SERVICE in the nation’s capital, Abuja. As the incident unfolded, hospitals that did have ambulances sent them to the scene, the Nigerian Red Cross rallied its troops,  The Federal Road Safety Commission deployed its ambulances (you will find them, manned by drivers, at different corners of Abuja), to the scene. But the lapses were there for all to see. Patients were carried in ways that can cause more harm than good, no competent personnel was available to provide appropriate emergency care before evacuation, chaos reigned. Nigerians will know that our ambulances are better designed to transport the dead than the living. And as if the tragedy of the acute response was not enough, the UN decided that it was unsafe to continue managing the sick at our premier medical facility and had most of the severely ill evacuated to South Africa.

And to the final point – communication. A day after the incident, probably in recognition of the failure in communication of the health response, we noticed the Federal Minister of Health was on Twitter! he had just joined on the 8th of August. There is no way to confirm if he personally was tweeting, or if the Twitter account is also managed by colleagues from PATHS2 currently managing the Ministry’s website. But at least he recognised the importance of communication at this time. When we @Nighealthwatch asked him who was leading the health response, @FMOHNigeria obliged us with this response ….”Overall control for health response by me. Incident site control by HMSH/Corp marshall FRSC. Nat Hosp response by CMAC“. Since then …he has been off Twitter….until yesterday’s tweet – Latest on UN bldg: 22 dead – 11 UN staff – 10 Nigns, 1 Norwegian(f); 117 injured-27 on admission, 1 of these in Nat hosp & various other hosps. But for now, he appears busy leading all the very important people on tours to visit the injured at our National Hospital.

We must as a priority for our country, set up emergency medical services in at least all the state capitals in Nigeria. And yes, there is the money to do this. If we can build an 8-lane
express way from Abuja Airport to the city and buy 3 new presidential jets, we must have the money to do this – its all about priorities. No, it is not good enough to buy ambulances, or even to put a few telephones together in a call centre as done by FRSC. It must be a MEDICAL service, managed by a multi-disciplinary medical team that can provide emergency medical services from the point of incidence to the intensive care unit. It must be integrated into existing trauma services in the country. We must have a simple, nationally recognisable number to call… 999! We must train the colleagues, exercise and test the system, and make it work. The good news is that none of this is rocket science! They already exist in most other African countries from Accra to Johannesburg to Cairo! The bad news is that this is Nigeria, and despite all our outcries – we can almost bet, that there will be another major incident or accident, and the medical response will be exactly the same…or worse.

Professor Chukwu – prove us wrong. Take it to the next Federal Executive Council meeting, next Tuesday. They will listen!

….Nigerians follow OUR Minister on Twitter @FMOHNigeria

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (, which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

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