Medical Accidents: Are doctors still burying their mistakes?

Our recent blog on the words of the Minister of Health regarding the attitudes of doctors and nurses to work in public hospitals has inspired this piece by our guest contributor Kingsley Obom-Egbulam.

Its a must read!

Like most people, we all went into 2009 with so much expectation. If you are a Christian in a country like Nigeria, in line with the usual “prophetic declaration”, your pastor must have given the year his or her name, thus changing the year 2009 to “ year of endless harvest”, “year of sweat- less success”, “year of soaring on eagles wings”, and this popular one, “year of laughter”.

I am not too sure what the year was called in my place of worship. But whatever name we called the year, was almost eroded by a terrible news we got less than one week into 2009.

“Have you heard the sad news?”,that seems like my happy New Year greeting that morning. I had just settled down to business that day which incidentally was my first day at work in 2009 and my colleague, who must have suspected my need for some updates sauntered in and announced the unexpected news. “Sister Nwugo died last night”.

You can imagine the reaction that followed the bombshell.

Nwugo Okoye was until her death, the Head of Corporate Communications at Etisalat-one of Nigeria’s mobile telecommunication companies. Before moving to Estisalt, Nwogu had worked as Manager in charge of Internal Communications at MTN, this was after over a decade of robust practice in the advertising industry.

She was good!

Nwogu’s fruitful and vibrant life was cut short after a failed Myomectomy ( an operation done to remove fibroids while leaving the uterus intact).

She went into the theatre certain she would make it. She could afford to have the surgery done anywhere in the world. But she chose to have it here. Was it a gamble? Did Nwugo commit suicide by opting to remove a disturbing fibroid here in Nigeria –a simple surgery many other women have had and came out successfully in Nigeria? Was she just another addition to the growing list of medical accidents we all have to put up with in Nigeria?

Less than ninety days before Nwogu’s death, somewhere in London, Ada Effiong had gone for an even more complicated surgery. Considering the nature of the surgery, she didn’t want to gamble, or so it seems. Unlike Nwugo, Ada never thought she would make it. “I had to settle all outstanding issues, my will, and other issues that needs to be resolved, something just kept telling me I wouldn’t make it; so I didn’t want to leave any problems when Im gone”.

Ada made it. She is still alive , hale and kicking.

A public health physician recently said that in resource-challenged settings like Africa, more patients are likely going to die in hospitals due to medical accidents occasioned by negligence than the impact of the illnesses they are suffering from. This, according to the doctor, is a global fact, even if it appears questionable and only applicable to developing countries. But is this a rule in Nigeria or an exception? Can this pass for a rule that must be obeyed by hospital users and people who will have cause to see any doctor and be eventually admitted or it is an exception we should not bother about?

In the wake of the June 12 Celebration last year, a few Nigerians in Lagos were mourning and preparing to bury one of the best female voices on radio -at least in the last decade. Adetutu Badmus, former Radio Nigeria Network news caster, fantastic compere’ and gifted voice-over artiste had her voice on over half of all the radio commercials produced in Nigeria. She had just moved from Radio Nigeria to LTV 8 as Head of Programmes and Content Management. Many of us were already looking forward to a revival in that stations programming policy and consequently its quality of programmes. All of our dreams suddenly turned into nightmares.

Tutu died in the labour room of a tertiary health institution in Lagos, less than a year after her wedding.

Again, did she commit suicide by opting to have her baby in Nigeria since she could afford to have the baby abroad?

Incidentally, Tutu’s service of songs was officiated by Gbenga Adeoye ,a Pastor with the Seventh Day Adventist Church, who lost his wife a year ago in circumstances similar to that of Tutu. Adeoye said the doctors who attended to his wife had a case to answer. Though they’ve buried their mistake, Adeoye believe “God will judge them for their negligence”.

Dr. Badmus, Tutu’s elder brother said he is not just sad that he lost his kid sister , but that he is sad that his sister died a needless albeit avoidable death. And being a doctor himself, he certainly knew the undercurrent of Tutu’s death.

Without casting aspersions on our health system or passing a vote of no confidence on our medical personnel, truth is: we are fast building a health system that swallows its patients.

It is becoming dangerous not to have some working understanding of basic diseases and possible therapies and (depending on your faith),a team of prayer warriors or Alfas interceding on your behalf before seeing any doctor these days. You may end up being a cadaver( a corpse good only for teaching medical students in teaching hospitals) if God doesn’t show up on your behalf and avert an accident or negligence.

Three of my friends lost their dads to this chain of medical accidents and it continues to form their attitude towards medical care in Nigeria. The first one, her dad suddenly started convulsing(or so it seems)and was about to kick the bucket. He was taken to the hospital and they found out after some tests that his blood sugar level had risen far beyond normal. He was immediately given some medication to bring down the sugar level at last close to normal. But the drug had an adverse effect on the man .He was given more than he required. He lost his mind and was like that until he passed on less than two weeks after.

The other two are similar even though they were in separate hospitals that were hundreds of kilometers apart. They both had hypertensive dads who were also diabetic .And in both cases, their dads had malaria and were rushed to the hospital after some days of trying to find out what exactly was wrong. They were admitted immediately they got to the hospital and were infused with dext
rose because they hadn’t much energy, food and water in them due to severe loss of appetite. Nobody bothered to know their medical history or find out whether they were diabetic or not. Can you believe that?

Of course, they both passed on ,one of them died less than 48 hours after being admitted.

Another pathetic case was that of a patient-an old man ,who was diagnosed of hernia. He needed to be operated upon. The surgeon wanted to make it snappy and get it done with in no time so he could attend to other personal perhaps more important matters. To achieve this, the patient was generally anaesthetized-this was to put him to sleep and save him from experiencing the pain of the surgery while it lasted.

But it back fired.

The patient responded badly and the complication that arose was not bargained for. Considering the age of the patient, and the fact that he was also diabetic, some medical experts believe that he should have been locally anaesthetised. By this, the pain would only been relieved around the part or region of the body where the surgery would be carried out while the patient remains awake to see what was going on. That would have reduced the amount of anaesthetics in the old man’s system and consequently the length of time he would have spent out of this world.

The good news is that this patient is alive today and kicking-thanks to the hospitals massive investment in ultramodern medical facilities.

It is still too early to forget that renown Attorney and human rights activist, Chief Gani Fewinhimi also had a taste of these of these medical accidents. Our beloved Senior Advocate of the Masses and of Nigeria, still flies in and out of London for treatment.

Fawehinmi is scared…yes scared for you and I who may not be able to fly abroad like him and the president when we are about to join the growing list of victims of medical accidents in Nigeria.

Gani, a living legend and a firm believer in the future of Nigeria and its potentials, had to escape for his dear life to London contrary to his patriotic principle. Gani had been on treatment for pneumonia in a highbrow hospital on Victoria Island.

Gani’s treatment was informed by a misdiagnosis. He go to know this when he arrived London mid last. After several checks in London, he was confirmed to be down with cancer and had to be placed on cancer treatment. It is not clear how much damage the initial misdiagnosis had done on his health, but the truth is: if Gani had died in Nigeria before he was flown abroad chances are that doctors in that Victoria Island hospital would have told Nigerians that he died of pneumonia. And we may never get to know the truth. Never!

If this could happen to the likes of Gani and even the president(before he had to run to Germany)what then is the fate of other Nigerians?

Millions of medical mistakes are mostly premised on wrong diagnoses. Leading most times to unnecessary surgery and sometimes failed surgery which may lead to death.

In cases where the diagnoses are right, negligence and lack of respect for the patient is said to be the main enemy and when this enemy shows up in the course of treatment someone has to pay the price most times it is the ultimate price.

How do we stem the tide of medical accidents in Nigeria? How do we ensure that doctors are held responsible for negligence when a life is lost needlessly in their hospitals or clinics? How can we even prove these cases in the first place? How alive is the Nigerian Medical Association(NMA)and indeed other bodies regulating medical practice in Nigeria to the responsibilities of ensuring patients protection and standard of practice?

The Lagos State government stirred the hornets’ nest last year when it passed the Corona’s bill into law .The law ,among other things was supposed to (at least, on paper) keep doctors in check and put an end to questionable deaths of patients in hospitals. Of course the law also contained aspects considered injurious to medical care-aspects which well meaning doctors say can prevent them sticking their necks to saves lives already at the brink of death.

For now, one reality we cannot run away from is the fact that many Nigerians have died (and would still die)simply because their cases were poorly handled in hospitals. Some have gone unnoticed and in the case where the victim is a prominent person, some questions may be asked. But like all cases, no one will be held responsible or brought to book. How can we end this unusual epidemic confronting ignorant Nigerians and their families lost to medical accidents? How long will doctors continue to bury their mistakes while pilots die with theirs?

Too many questions. When would the answers come?

Kingsley Obom-Egbulem, a social entrepreneur and communication specialist is Chief Creative Officer, Health Communication and Development Initiative(HCDI),Lagos and Editor-In-Chief, MANHOOD Magazine.

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.

Discussion3 Comments

  1. Dr. Sampson Ezikeanyi: MD, MPH, MBA/MPA

    Dear Kingsly,
    You vivid evaluation of the attitudes of Nigerian doctors and the healthcare process and outcome has assured me that some persons are around to join my “voice” that i have been raising that was never heard.
    I also happened to be a Nigerian doctor but after my Specialist Training in Public Health in Hebrew university, Israel (where am also working now), i realised the issue on ground and decided to be a “positive deviant” to bring information close to the consumers of healthcare. The problem is enormous but it has to be placed on the front burner of government issues. I am here to provide suggested ways forward. Health is a political idealogy of the government in power at any point in time. Our advocacy must be directed to the government for needed policy issues. The doctors have a lot of incentives to do whatever they like at least for now: for example, the information asymetry between the patient and the doctor, agency relationship between the same patient and the doctor and failure in the healthcare market due partly to externalities because the free-market system does not work in the healthcare market. It is worse with the Health Maitenance Organisations(HMOs) operating in the country now where doctors are placed on Fee For Service (FFS). This has the incetive of the doctor over supplying unnecessary care to increase his/her income. Regulation is needed and this is where government comes in. On the part of government, the strategies have been targeted on the hospital and curative medicine while in the continum of health planning and management, there are other policy options e.g health promotion to change lifestyles, environmestal and Occupational health, Health Education and Hygiene, Human resources for health (paramedical and real Managers) Some of the patients you mentioned died of some diseases that are avoidable by change in life styles (Hypertension, Diabetics & obesity, smoking e.t.c).This is where the developed and other developing countries are. It is cheaper, effective and the cost benefit is high. The recent globalisation wave and its consequencies of demographic and epidemiologic transition will still have severe effects on our failed health system. Government has not realised these issues until their “own” is involved. This is why a Minister of a country could get up to reject the report of a well done research from UNICEF on infant and child mortality. It is painful where truth and our healththcare is killed at the expense of imaging making of a country that is nonresponsive to the healthcare needs of the governed. Even my grandmother in the village knows that infant and maternal mortality are big issues of urgent concern in Nigeria. Do we have to wait for UNICEF report to see it ourselves?
    Please, how do we channel this advocacy?. It is not a faceless fight. I am ready anytime to provide needed policy advice on the way forward. The new Health Minister is the listening type and our President is interested if these data is transformed into information he can understand and use. Lets rise now and leverage these opportunities.

    Dr. Sampson Ezikeanyi: MD, MBA/MPA, MPH
    Epidemilogy, Health Services Policy and Mangament, Hadassah, Jerusalem.

  2. I am a law student in a Nigerian University , i concur with both Mr. Kingsley and Mr. Stanley, i’ve noticed the rising spate of Medical Negligence among Nigerian Medical Practitioners, which inspired my choice of Project topic as i am currently writing my project on a critical appraisal of the tort of Medical Negligence in Nigeria. This is not to say that there aren’t competent practitioners, for i know a few myself, but the rate of negligence seems so startling that there’s hardly any room for the astounding successes to be talked about, much less heard of. This article has been quite useful to me, and i would be looking forward to being able to assist in putting a halt, if not an end to this Negligent craze. keep up the good work!!

  3. I am a Nigerian Lawyer about to run a PHD program on medical negligence. Having practiced as a nurse for 18 years before going into the legal practice it bothers me that there are no led down rules on patient management in Nigeria, the patients are not informed as to their rights, this is further compounded by our labeling every death as the will of God and corruption in our system. There is a way forward: each professional body should be promote accountability and willing to give up erring members. If a body like NAFDAC can trail and influence drug issues in Nigeria to some extent such body is required to help with medical negligence. How about lawyers taking up such cases before the cameras? This will create sensitization

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