Once upon a time, members of the public suspected to have been exposed to the novel Coronavirus received close monitoring from the Nigeria Centre for Disease Control (NCDC), state COVID-19 task forces and other healthcare workers. These days, test results take forever to manifest, bed space is extremely hard to secure at isolation centres, contact tracing is often happening only on paper and healthcare workers are themselves tired. All these are signs the country’s battle against the pandemic is approaching crunch time, reports IBRAHIM ADEYEMI.
“If you really want to die quickly in this season, please go to a Nigerian hospital.”
That statement was from Mobolaji, a resident of Abeokuta, Ogun State, who almost died prematurely while seeking medical attention after exhibiting symptoms he feared were Coronavirus-related.
“I now understand why people travel abroad for medical treatment. If only I had the opportunity to travel at that time, I would have. Our health system in Nigeria is rubbish; I can confirm that,” he says. “I saw a lot of things this season. I swear, most of our doctors don’t know anything. I’m still alive now because of God.”
DEATH ON THE PROWL
Many Nigerians have died of COVID-19 complications because they could not get adequate healthcare. The presence of the virus in Nigeria has exposed the deficiencies of the country’s healthcare system.
Since recording its index case on February 25, Nigeria has witnessed a steady rise in the number of COVID-19 cases. As of July 21, the country had recorded 37,225 cases, with 810 dying across 35 states. This is proof we are already approaching crunch time.
Addressing Nigerians on the 100th day of COVID-19 briefing, Minister of Health, Osagie Ehanire, warned that even the three percent fatality rate was high enough for anyone to be worried.
“In some countries that have been taken by surprise, the health system has been overwhelmed and they have lost hundreds and thousands of citizens to COVID-19,” he said. “We in Nigeria are striving to make sure that our health system does not get overwhelmed by the number of cases.”
SENT TO DIE…
It was a rainy and cozy day in April when Mobolaji suffered a common cold that, before this season, would have been easily treated. But when this “common cold” got complicated by shortness of breath, chest tightness and stuffy nose, he dashed to Mercy Group Hospital in Abeokuta, Ogun State, where the doctors were negatively disposed to admitting him.
“A doctor just gave me some medication and went outside; he told those nurses to let me out immediately and that was done,” Mobolaji recalls.
Another form of ill-treatment, he says, was meted out to him at the Federal Medical Centre, Idi-Aba, Abeokuta, where he protested that he needed urgent medical attention but he wasn’t allowed in. “They didn’t even let me into the hospital.,” he says. “They said I should stay outside.”
And once he disclosed his travel history, “they didn’t want to hear anything else”. He was asked to seek treatment elsewhere.
“You know what these doctors did?” he asks, without waiting for an answer. “They referred me to the Olabisi Onabanjo University Teaching Hospital (OOUTH). They knew I was not going to be admitted at OOUTH, but they felt I would die before I got there.
“The doctors were quite careless. I saw the way they were attending to people there. They brought this other man in a taxi in pain and the doctor was asking, ‘How much do you have?’”
“I told my mom I wish I was not in this country. If I was in a foreign land, they would try their hardest and even if I died there, I would be happy. The healthcare system here is killing people.”
When Mobolaji finally arrived at OOUTH seeking medical aid for this yet undiagnosed ailment, it was to another unpleasant verdict. “We can’t admit you unless the Nigeria Centre for Disease Control (NCDC) brings you here in their ambulance,” he was told.
…BUT SAVED BY SOCIAL MEDIA
In the dead of the night, Mobolaji’s condition worsened; he thought he was going to die. He rang the NCDC emergency line but, much to his shock, he was shunned by the official who answered the call.
That snub alone, he says, could kill. “I couldn’t breathe that midnight and I was already dying,” he tells BusinessDay. “I had no choice but to start sending out messages that I needed to get tested.”
Someone on social media connected him to a contact in Abuja, who in turn connected him to the Ogun State emergency centre. They said they would come test him the next day, but they did not show up.
When Mobolaji saw that he might just be waiting fruitlessly, he made more noise on social media, threatening to go out to seek medication, which meant he could infect more people if he indeed had the virus. The social media uproar that followed his post, especially on Twitter, finally got the attention of the authorities in Abeokuta who would later attend to him.
“I would have died without help if I didn’t raise the alarm on the social media,” he laments. “And if it had happened, they would say I died of COVID-19 complications, meanwhile the killer would have been a poor health system that kills faster that the virus.”
NO BED-SPACE AT IDH… DYING BUT ASKED TO GO HOME
For more than four hours one day in April, Oyinkan watched as her brother Kehinde gasped for breath. He was feverish and his temperature was reading 39.5°C, his body buried in a stream of steaming sweat as he shivered endlessly. Filled with fear, Oyinkan rushed her brother to a general hospital in the Ikorodu area of Lagos for treatment. But there was no improvement.
The critically ill young man was referred to the Infectious Disease Hospital (IDH) at Yaba, Lagos, after exhibiting some symptoms that sparked fears of Coronavirus. Still, there was a problem.
“There is no bed space,” doctors at IDH announced as Oyinkan and her brother arrived at the hospital. They ran tests on him and told him to return home.
By the time he returned to the IDH a few days later, his health had deteriorated. He could hardly breathe and was coughing out blood. But again, the hospital said bed space was inadequate.
“He was given oxygen on the chair for several hours and in the evening they removed it and asked us to take him back home.” Oyinkan recalls. “I became really mad at the doctors. My brother was dying, and they were asking us take him back home.”
COVID-19: POSTIVE… NEGATIVE… NEGATIVE
Oyinkan wore a sunken face while discussing her grievances about the handling of her brother’s health. With all their efforts to secure bed space at IDH proving abortive, his brother was referred to the Lagos University Teaching Hospital (LUTH).
“He was subsequently moved to LUTH from IDH on the suspicion of being a COVID-19 case. He was inside LUTH’s isolation centre for five days; no treatment, no result of the test conducted on him,” she recalls. “LUTH later conducted another test on him and on May 4, his result came out. He was positive for tuberculosis and negative for COVID-19.”
However, when the result of the test conducted on him at IDH finally came out on May 10, after a two-week delay, he was reportedly positive for COVID-19. Due to that result, LUTH had to conduct another test on him before finally confirming he was indeed negative.
Meanwhile, at IDH, Oyinkan’s 76-year-old father and a friend were advised to take the COVID-19 test, having had direct contact with the sick Kehinde. They did and the results all came out positive.
“When we demanded for the results sheets for the tests, they asked us to go to the Ministry of Health,” Oyinkan says. “And later when we pressed further, they called to say the results were negative. They apologized profusely.”
Mobolaji also had a similar experience when he took the COVID-19 test in Abeokuta. His samples were taken to laboratories in Ogun and Oyo States for proper scrutiny. But when the test results came out, he tested positive for the virus in Ogun but negative in Oyo. The test had to be repeated until he was confirmed negative for the virus.
WELL-FED AT ISOLATION CENTRE — BUT NO TREATMENT
Kehinde spoke about how he was abandoned at LUTH for days without medical attention. He could have died. For five straight days, he was writhing in pains in a small room with leaky roof where he was isolated as a suspected COVID-19 patient—without any treatment.
“But we were given good food,” he smiles. “I mean good stuff… morning, afternoon and night. But they didn’t even give me any drug. I was only using those drugs I brought from the Ikorodu hospital.”
Multiple sources familiar with the mode of operation at COVID-19 isolation centres in Lagos, Abuja, Abeokuta, and Sokoto lamented that many victims of the dangerous virus died because of the weaknesses in the system.
A Covid-19 patient admitted at LUTH isolation centre revealed that timely food was prioritised over treatment at the isolation centre. The patient, who asked not to be named, sought external medication because “they were not giving us adequate treatment.”
BEFORE THINGS FELL APART
Unlike Mobolaji, Kehinde and others, some people have good stories to tell of their time as potential COVID-19 patients.
On a Wednesday morning in the early days of the virus, Lanre, a pedagogue in Ogun State, exhibited some symptoms of Coronavirus. His doctor-friend urged him to check his status for the virus, which he did “without any delay.”
“When I called the NCDC emergency number, they didn’t delay. They got me tested almost immediately. When the result came out and I tested positive, they needed to move me to the isolation centre and I obliged.
“I told them that because of stigmatisation, they shouldn’t come to my street. I requested to meet somewhere else, which they obliged me. I was then moved to the centre.”
What Lanre witnessed at the isolation centre in Ikenne, Ogun State, was beyond imagination. “It was home away from home, honestly,” he says.
“And on the performance of the medical personnel, I give it to those guys because even when those who were traumatised started their trouble, the doctors were always calm. I loved their maturity, even though we know that with the nature of our environment, they may be working under enormous pressure. Still, those guys never got angry. At least not when I was there.”
According to Lanre, everything was in place at the isolation centre; meals were served at appropriate times and patients were treated with dignity.
“On the average, we were given seven-two-seven drugs daily, that is 16 tablets, and the number of days one stays there depends on your immune system.”
14 DAYS OF CLOSE MONITORING
Just like Lanre, a United States returnee living in Lagos, a UK returnee who simply identified herself as Kofo commended the efforts of the NCDC agents in ensuring she stayed safe when she returned home sometime in March. Immediately they landed at the Murtala Muhammed International Airport in Lagos, Kofo and other returnees were asked to document their details. But she was not scrupulous enough about it.
“I didn’t even put my number on the form I filled; I only put my dad’s number,” she says.
But, surprisingly, few days after, Kofo received a call from the NCDC. The caller, a lady, said she was reaching out to know if Kofo was fine.
“I decided on my own to self-isolate,” Kofo recalls. “But she kept calling and telling me that if I experienced any symptoms, I should let her know.”
The NCDC agent continually reached out to know the health status of the returnee. Two weeks later, she called to congratulate Kofo and declare her COVID-19 free.
But make no mistake: the duo of Lanre and Kofo had their COVID-19 experiences before Nigeria’s war against the pandemic started to approach crunch time.
‘NURSES AND DOCTORS ARE SUFFERING… AND THEY’RE NOT SUPPOSED TO’
Recent developments show that front-line health workers attending to COVID-19 patients “are now tired of working because they’re not being paid.”
“This really contributes to how COVID-19 patients are dying,” a female health worker at Lagos University Teaching Hospital (LUTH) tells BusinessDay. “In fact, I’m crying for them and I pity them because they are putting their lives at risk yet they’re not being paid.”
She insists the rot in many hospitals alone can kill even COVID-19 patients who do not have underlying health issues.
She explains: “The supply of face masks and Personal Protective Equipment (PPE) is inadequate; and when there is no adequate supply of equipment, the job is not worth it. The summary is that our COVID-19 isolation centre is not what it is supposed to be. I think our CMD is just doing some things because he knows that people would donate, and he’ll surely get money.”
She lamented that nurses and doctors working in that unit were suffering, undeservedly so.
“They’re supposed to get N30,000 per day but they’re not getting that money. I feel like crying for them because it is risky, and they are endangering themselves. When they started working in the COVID-19 unit they couldn’t go home; they were put in a visitors’ lodge and given food.
“But now, even other healthcare workers in the wards are not given face masks. I soak my mask in a detergent and iron it and then reuse it because it is too expensive for me to buy daily. I use mine for three to four days even though it’s supposed to be changed daily. And they’ve not paid us allowances; they’ve not even paid the salary much less the allowance.”
Another health worker at LUTH who begged for anonymity for fear of victimisation added that some casual staff such as the hospital drivers and cleaners who work at COVID-19 units had also not been paid. He noted that many of them were lamenting silently because “they don’t want to lose their jobs.”
“That is why many of them are not putting efforts in the work they’re doing. So, tell me why their patients won’t be dying needlessly?” she asks.
‘CMD CHEATS DOCTORS AND GIVES EXCUSES’
Meanwhile, some health workers at LUTH also made a grave allegation against the Chief Medical Director, Professor Chris Bode. According to them, the CMD is dubious in handling matters of paying COVID-19 front-line workers at the hospital.
In April, the CMD claimed that the new isolation centres in the tertiary hospital were ready to receive COVID-19 patients. He had said that since early February, LUTH had been planning for its COVID-19 operations with a volunteer group of staff comprising nurses, pharmacists, doctors, lab scientists, hygienists, porters and drivers. However, the health workers are now groaning due to the non-payment of their salaries.
“The CMD cheats doctors and give excuses. When government says bring the list of workers in the COVID-19 unit, the CMD will refuse and say they should pay into the hospital account and that is a way of cheating them. They are just using this COVID-19 to make money,” a health worker told BusinessDay.
‘WE’VE GIVEN THEM SOMETHING…’
Professor Wasiu Adeyemo, Chairman, Media Advisory Committee, was quite evasive when asked to comment on repeated complaints by the health workers over their unpaid allowances and salaries.
“I’m telling you they have been paid,” he says. “We’ve made some internal arrangement to make them happy. Anybody who said they had not been paid is not a front-line worker. We’ve given them something and they’re happy. If the Federal Government wanted to pay N100,000 and we were able to pay let’s say N20,000 or N30,000, they should relax. We did that without making any noise about it and they are fine.”
A TIME FOR PERSONAL RESPONSIBILITY
Many of the problems that have surfaced in recent times are evidence of the severity of the challenge that the government is dealing with.
“Everyone is overwhelmed already,” says an NCDC official who offered to speak only on the condition of anonymity.
“NCDC is stressed, state task forces have reached their limits, hospitals have already exceeded their capacities and isolation centres are filled to the brim. The lesson from all this is that if anyone had any doubts, we are now in the season of strict personal responsibility. Prevention has always been better than cure, but never has this cliché been more golden!”
This investigation was commissioned by the African Centre for Media Information Literacy (AFRICMIL) as part of its whistleblowing initiative under its Corruption Anonymous project supported by MacArthur Foundation. Published materials do not reflect the views of MacArthur Foundation.
