Doctors in Nigeria: Healers or Killers?

Oluyinka Olutoye

Recently, Nigerians were proud to celebrate Dr Olutoye, who trained at Obafemi Awolowo University (formerly University of Ife), Ile-Ife, Nigeria. He is a specialist with expertise in fetal and neonatal surgery with specific interest in congenital diaphragmatichernia and complex wounds.

A Nigerian trained Dr working in Texas, USA, along with his partner, performed an incredible feat of delivering the same baby twice, thirteen weeks apart. He removed the baby from the mother’s womb at 23 weeks, performed surgery on her to remove a tumour, then replaced her in her mother’s womb and delivered her again, healthy at 36 weeks.

Most foreign countries one goes to, whether, UK, USA, UAE, to name a few, one finds that several top medical consultants in their hospitals are Nigerian. Same with nurses. A lot of them trained here.

The Child

Last week, the tragic death of a six year old child at a Victoria Island hospital, finally necessitated the writing of this piece. I have however, decided to omit the names of the parties involved in this sad case for reasons best known to me.

There have been allegations of medical negligence against the hospital by the Parents of the child, while the hospital maintains that they did all that was required of them in the treatment of the child.

I interviewed both the Parents of the child and doctors from the hospital. The Parents of the child (the Parents, the mother or the father) and the hospital confirmed to me that the child suffered from sickle cell anaemia. The hospital also went further to say that the child also suffered from asthma, as they put it, suffering from ‘two chronic illnesses’.

Here is a brief overview of what happened. I will try to be as accurate as possible. Kindly, forgive me if I have left out any pertinent details.

Day 1

The child did not eat breakfast in the morning. His father offered to feed him, but he refused. The child was obviously having some of his asthma issues. The child was insisting on going to school. The father refused, saying he could not go to school on an empty stomach. He decided there and then that instead of going to school, the child should see the family doctor. The family doctor happened to be away, abroad, but another doctor on duty at the clinic nebulised the child and administered an antibiotic injection, Rocephin. The family doctor’s clinic claims that the father was informed that the child should be put on admission at the hospital.

Nebulisation is the treatment of asthma and other respiratory related diseases by the administration of medication in form of a mist inhaled into the lungs through a machine. The doctor put a call through to the family doctor abroad, informing her that the child should be admitted to hospital, so as to be able to take the antibiotics intravenously.

The child went home, felt better, and even ate a hearty meal of rice and stew.

Day 2

It was not clear what happened to the child that day, but the father took him to the hospital late that night and into the next morning. The child was complaining of stomach ache.

Day 3

The father and child were in the hospital into the very early hours of the morning, say about 1 am. The child still had the stomach ache and the doctor on night duty (Young doctor) asked that the child should be admitted, but gave no viable reason why, according to the father. The father asked Young doctor if there was an immediate treatment plan, necessitating the child’s admission to the hospital at that time. The Young doctor offered him no viable explanation or treatment plan, so he left with his son, saying that they would return later that morning (I guess when the Consultants would have resumed duty).

Later that morning, as early as 7am, the father and child were back at the hospital, with the child still complaining of a stomach ache. On their return they still met Young Dr, who was getting ready to go off duty. Not too long after, two Consultants of the hospital, resumed. They took charge of the child’s case (Consultants 1 & 2). The child was placed on admission that morning.

In the meantime, the mother’s sister, a paediatrician practising in USA (Aunty Dr), had been contacted by the mother. The chats that were made available to me, that is, between Aunty Dr and the mother, were from very early in the morning of Day 3. Aunty Dr suspected that the child may have pneumonia, and acute chest syndrome, which was not unusual in a child with sickle cell. Aunty Dr felt that the pneumonia should have been evident from a physical examination. She also recommended that an ultrasound of the child and respiratory etiology should be carried out.

The Parents claimed that Aunty Dr’s suggestions did not go down well with Consultant 2, who seemed to feel offended about being told what to do by another doctor. The father informed me that it was several hours after Aunty Dr’s suggestion, which in tears, he passed on to Consultant 1, that the child was finally given a chest x-ray which confirmed Aunty Dr’s fears, that indeed, he had pneumonia, with the left lung being in a worse condition than the other.

Consultant 1 directed that the child should be nebulised every four hours. Aunty Dr told the mother that she was unclear as to the reason for nebulisation. She was more concerned about the pneumonia being treated.The child was still having terrible stomach pains. Another antibiotic, crystalline penicillin was added to the Rocephin.

The father said that he noted that the medication being given to the child may have been inadequate as his weight was 24kg and not 12kg, as noted in his chart. For children, medication is usually prescribed according to weight.

Day 4: The Final Day

Just before 3am, the mother told Aunty Dr that the child’s breathing was laboured, 95bpm with 150 heart rate and he was sweaty. Aunty Dr thought he had a fever, the mother said that he didn’t. She was asking the mother a lot of questions, was there a Consultant present, the antibiotics etc. She was still insisting on an ultrasound to check if the child had fluid in his lungs, how bad it was and so on, and that the antibiotic should be changed to levofloxacin. She was however, not sure whether that particular medication is even available in Nigeria (Apparently, levofloxacin is not generally used for children, because it can affect their growth).

At 4am Aunty Dr told the mother that fluids, antibiotics, pain control and possibly a blood transfusion were necessary, depending on the child’s haemoglobin level. Two minutes later, the mother told Aunty Dr that the hospital was about to give the child a blood transfusion. The child’s breathing dropped to 85bpm. This worried Aunty Dr who said it was crucial for a Consultant to be in the hospital to attend to the child. There was none. She told the mother that she wanted the child transferred to the ICU of another hospital, because she felt that the child’s care needed to be escalated. The transfusion started and breathing was still laboured at 92bpm/142 heart rate.

Based on Aunty Dr’s recommendation, the mother wanted the antibiotic changed. The hospital said the antibiotic needed at least 48 hours for it to kick-in, after which it would be changed if there was no improvement. The mother contacted the family dr on this issue, for her to convince the hospital to change the antibiotics. The family dr told the mother that the 48-hour time frame was not unusual, as no antibiotic was so good that it worked instantly, it needed time to take effect.

By 9.35am, Consultant 2 told the mother that there was no improvement from the day before, and the child could get worse before getting better. The family Dr confirmed to the mother that this sometimes happened. The family Dr had also recommended another antibiotic if the present one failed, vancomycin.

A few hours later, the child was rushed to the ICU of the hospital.

The child died at about 5.30pm on Day 4. May his sweet, little, gentle soul rest in peace with the Lord. Amen.

What the Hospital Said

For the Hospital, Day 3 was their Day 1.

Day 3, Hospital Day 1

The child was brought to the hospital late in the night, into Hospital Day 1. The child had been given a Recophin antibiotic injection at the family dr’s clinic on Day 1. Recophin injection was not administered the next day (Day 2, before the child was brought to the hospital). Ideally, the injection should have been given daily during the sickness. The Young Dr nebulised the child and requested that the child be placed on admission. The Young Dr said that the father refused the admission, saying that the child was feeling better after the nebulisation. The Young Dr then advised the father to come back to the hospital if any problem arose later in the night.

The father arrived with the child at about 7.50am. The child was in extremis, that is, in some sort of breathing distress. The normal process before consultation/admission, taking of vitals and so on was by-passed. The child was nebulised, the intravenous line was set and the child was stabilised. The hospital said that stabilisation of the child was priority and it took some time to achieve this. The child was given another dose of Rocephin and the chest x- ray was done and reported on, before 11.30am. The child had lobal pneumonia. Crystalline Penicillin, the drug of choice for the ailment, was added to the Rocephin. The child was also put on oxygen. The child improved a bit.

However, by 5.30pm, the child was more breathless, wheezing. Consultant 1 therefore instructed that the child should be nebulised four-hourly.

During the night, there were three medical officers on duty (Young Drs). The hospital says that in most parts of the world, it is normal that Consultants do not do night duty. Medical

Officers, also called Registrars in the UK, do the night duty, and may contact the Consultant in charge of a case, in cases of emergency, during the night.

The hospital ‘s position is also that it is not normal procedure to take instructions from an unknown third party (Aunty Dr in this case), on how to treat your patient. The only other doctor that could have issued instructions on the treatment of the child would be the family dr, who was the child’s doctor.

Hospital Day 2: The Final Day

Consultant 2 had been contacted twice during the night, so he came back to the hospital about 5am.The child was given a blood transfusion in the early hours of the morning. The blood transfusion did not achieve the desired results.

Another antibiotic, Meropenem was added to the other medication that the child was on.

Consultant 3 resumed duty for her normal 10am-2pm shift. She had not been involved in the case. She however, coordinated the transfer of the child to the Intensive Care Unit (ICU) around 11am, when the child still showed no improvement.

The hospital states that the Intensivist, and not Consultant 3, intubated the child and put the child on a ventilator. Consultant 1 says that at a point, there were about eight doctors attending to the child, trying to save his life, 3 Intensivists, 2 Consultants and 3 other doctors.

The child went into cardiac arrest at 3.30pm and was resuscitated. He then had a second cardiac arrest from which he could not be resuscitated, and he died.

The child is presumed to have had Fulminant Pneumococcal Septicaemia, which can kill in 24 hours. That the rapidity of decline in the patient conditions is inherent in a sickle cell patient with acute chest syndrome. The hospital said that the child had previously been on admission in the hospital for a pneumococcal infection in 2012, an ailment which sickle cell patients are particularly susceptible to (as well as children under the age of five years). The hospital stated that abroad, some children with sickle cell take Penicillin V for life, apart from the vaccine which does not cover all the strains of pneumococcal infection, to protect themselves.

The hospital referred me to the book, “Sickle Cell Disease” by Graham R. Serjeant, for more information on the condition.

Unanswered Questions

What does one say in such a painful situation? The Parents felt that the hospital did not handle the treatment of the child properly, resulting in the death of the child. The hospital feels that the child should have been on admission earlier and insists that the antibiotics may have failed, which unfortunately is possible, but, they did all that they could to save the life of the child. The hospital believes that it treated the child with the proper standard of care.

The child’s situation, is too unfortunate for words. More investigation or an inquiry into the matter is certainly required to shed more light on the incident. Though I am a lawyer, and not a doctor, several questions come to my mind:

1) If the child was admitted to the hospital on Day 1 instead of Day 3, would it have made a difference

2) Why didn’t Young Dr contact a more senior doctor or Consultant to handle the case that night and ensure that the child was admitted immediately

3) Were the Parents made aware by the doctor at the family dr’s clinic or by the Young Dr that the condition of the child may be serious. Did the doctor at the family dr’s clinic recommend to the father directly that the child be admitted

4) If the hospital had carried out Aunty Dr’s instructions as to the tests and changing the antibiotic to levofloxacin, what would have been the result

5) Is there no quicker way to test and ascertain the efficacy of a medication that has been administered on a patient, like a blood test or something else, than just to sit and wait for say 48 hours to see the physical manifestations

6) Was the treatment plan that the hospital used the right one

Some Other Cases of Medical Negligence

Broken Arm

Some years ago, maybe about 2009 or so, my little son broke his arm. We rushed him to a well-known Orthopaedic Hospital in Victoria Island. He was given some pain relief and I had to hold his hand up all night. The Consultant (a senior one I might add), said that he could not set the hand on the day he broke it, because my son had already eaten that day, and he needed to give him an anaesthetic before setting the arm. I was beside myself.

First thing the next morning the arm was set, and put in a plaster cast. We were asked to come back to the hospital a week later for an x-ray, to see how the bone was healing. To our shock, the x-ray revealed that the hand was healing in an opposite direction, sort of back to front. The Consultant had failed to insert pins into the arm to hold the bone together, when he was setting it! Sort of like tearing a piece of paper in several places, and placing it back together without gluing it!

We travelled abroad a few days later and saw the doctor. It was in London that I learnt that the Consultant for the arm is different from the one for the leg! To cut a long story short, the window of opportunity had passed, and nothing could be done to repair my son’s arm immediately.

We had to wait another year. When the arm was fully and badly healed, my little son had to undergo another operation in London. The arm was broken again, pins and plate inserted, and put back in a plaster cast. He then had to do some sessions of physiotherapy and the doctors were surprised that he more or less regained full use of the arm. Another year later, he underwent another operation to remove the plate in his arm.

How could a so-called Senior Consultant be so careless and negligent?

Brain Aneurysm

A friend of ours went to a well-known hospital, again in Victoria Island, suffering from an excruciating headache, a type she had never experienced before. After the hospital ran some tests, she was told that she had an aneurysm and that she had to be operated upon immediately or she could die. She was so afraid. Luckily, she had BUPA Insurance and called them immediately. It was an emergency. She was evacuated to Lebanon for treatment.

On getting to Lebanon, after an extensive series of tests were conducted, it was discovered that all she had was high blood pressure! She was given medication and sent on her merry way.

Cancer

A friend of mine went for a mammogram. The report of the mammogram, prepared by a radiologist (qualified doctor that interpretes x-rays), gave her a clean bill of health. However, in doing her monthly self-examination, she had discovered a lump in her breast and gone to see a Dr who removed a specimen and sent it to South Africa for testing. She had Stage 3 Cancer!

After removing the lump and having her chemotherapy in Nigeria, my friend proceeded to the UK for radiation therapy, the next stage of her treatment. On her first visit to the Consultant, she went armed with her mammogram. Immediately the Consultant put the x- ray on the screen, he told her that the x-ray was blank! The very same x-ray that the Nigerian radiologist had prepared a report on. That is to say, if my friend had relied on the mammogram and its report, and had not sought a second opinion because of the suspicion raised from her monthly self-examination, she would have been dead and buried by now.

Most people have one horror story or the other about mis-diagnosis and wrong/bad treatment resulting in death, even in things that may be considered to be common place, like child birth.

Youth Corper, Ifedolapo Oladepo

Recently, there was the case of Ifedolapo Oladepo, a pretty first class graduate of Transport from Ladoke Akintola University of Technology, Ogbomosho, Oyo State. She was a youth corper at the Kano NYSC Orientation Camp.

Ife was brought to the camp clinic on November 27 at about 5pm. Apparently, she had been experiencing a headache and fever for about two days, before she was brought to the clinic. At this point, the versions of Ife’s story differ. Some say that she was ignored and not given timely treatment because the camp clinic felt that she was not really sick, but simply trying to avoid camp activities. Ife’s family claims that she was given an injection by one of the camp doctors, which she reacted to, which led to her breaking out in a rash, and her condition worsening. The camp doctors claim that she had the rash when she was first examined. Ife was brought back to the clinic at about 3am November 28, from where she was transferred to Gwarzo General Hospital.

Again her family claims that she was supposed to have been taken to Aminu Kano General Hospital, not Gwarzo General. Gwarzo General claimed that they had to stabilise her for the two hour journey to Amin Kano General.

Ife died on November 29, before she could be moved to Aminu Kano General, ostensibly from a kidney-related ailment, which they said arose from a urinary tract infection.

Her family is claiming that medical negligence on the part of the NYSC doctors and the delay in effecting Ife’s transfer to Aminu Kano General Hospital, caused her death.

Code of Ethics in Nigeria, 2008

Even though the medical and dental professions in Nigeria are governed by the Code of Ethics in Nigeria 2008, their code of ethics seems to be highly ineffectual.

Things like:

1) failing to attend to a patient promptly when a patient requires urgent medical attention and there’s a doctor present in the medical establishment to do so, 2) incompetence in the assessment of a patient,

3) making a wrong diagnosis especially in the face of clinical features that are so obvious that no reasonable dr could have failed to notice them

4) making mistakes in treatment,

5) administering wrong medication,

6) delay in transferring a patient to another medical facility when a particular facility

cannot cater for the patient

7) taking on patients that you cannot handle are considered to be against the code of medical ethics.

Section 25 of the Code provides for a medical and dental practitioners investigating panel and a disciplinary tribunal. The panel investigates any allegations of negligence and misconduct. If there is any substance to the allegation, the matter is forwarded to the tribunal for trial. The Tribunal has the status of a High Court, but the punishment it can mete out in the case of a finding of guilt are, as far as I am concerned, rather lenient. The punishments provided for by the Code should be reviewed.

Depending on the gravity of the offence, a guilty practitioner may be struck off the register, suspended from practice for a period not exceeding six months, or simply admonished.

Section 30 of the Code of Ethics only provides six months suspension or being struck off the register, even in the case where negligence results in permanent disability or death (gross negligence).

Steps that can be taken in Cases of Medical Negligence

People, apart from filing a complaint against an erring medical practitioner to Medical and Dental Council to forward to their investigating panel, you can report such a person to the Health Facility Monitoring and Accreditation Agency at the Federal Ministry of Health. You can also pursue a civil claim in tort against such an offender.

Report can also be made to the Police who would conduct a criminal investigation, which if there is a finding of gross negligence or recklessness or wanton disregard for the life of the victim, the Police can prosecute or forward the case to the State Attorney-General for action.

After all, Section 317 of the Criminal Code Act, 2004 provides that “A person who unlawfully kills another in such circumstances as not to constitute murder is guilty of manslaughter”.

Section 325 of the same law provides a maximum punishment of life imprisonment for a person who commits manslaughter.

Where a few medically negligent doctors are made examples of, and prosecuted to the fullest extent of the law, spending the rest of their lives behind bars, it will certainly make others more careful in the handling of patients. Doctors, who for example, are general practitioners, not oncologists, and do not have the training, expertise or know how to treat cancer patients, will stop doing so. Or Orthopadic Surgeons who acts as Gynaecologists and deliver babies regularly, just to make money, will also stop.

Reasons for Medical Negligence

Lack of Will to Take Action Against Erring Medical Practitioners

I believe that one of the major reasons why medical negligence is very much on the rise in our society, is that those affected do not take affirmative action against medical offenders. Maybe its an African thing. You hear people saying “Amuwa Olorun ni” (“it is brought by

God, the will of God”). Where in USA, a victim or their family sues regularly in the cases of medical negligence, it seems quite rare in Nigeria.

Greed

I once knew a doctor, here in Nigeria, I don’t know what exactly his field of specialisation in medicine is, but I know that apart from general practice, he treated a patient that I know for cancer, performing the actual surgery to remove the cancer and also handling the chemotherapy aspect. That process went well.

A young lady, who had been married for a few years without a child, was not so lucky. She was told by the doctor that she had to have a laparoscopy (a minor surgery that uses a thin, lighted tube passed via an incision in the stomach, to look at abdominal organs or the female pelvic organs to find problems such as cysts, fibroids, infections, and adhesions) to determine what could be the cause of her inability to have a child. She died in the process.

Someone else told me that he performed an orthopaedic hip replacement surgery on her mother, which went bad. The poor woman was in excruciating pain for months and eventually had to be taken to India for another surgery. He performed another type of minor surgery on another friend, who had to go to USA to correct the surgery that he performed on her.

He would probably still be in University now, if he had actually studied and specialised in all the different types of medicine that he practices here in Nigeria!

You find doctors handling patients that they are not trained to handle, telling patients that they need to go on admission or worse still, have operations, when it is not necessary, simply to make money.

This brings me to the next reason for medical negligence in Nigeria.

Lack of Adequate Monitoring by Government and the Medical Council

It seems that the Health Facility Monitoring and Accreditation Agency of the Ministry of Health needs to up its game. If this agency was actually doing any monitoring, how would one doctor be able to practice 100 different types of medicine, and badly too, and get away with it?

When I raised the issue with the friend that introduced me to the Dr Of All Fields (who had an excellent bed-side manner, I might add), World War 3 almost broke out. Dr Of All Fields even had the audacity to write to me and insult me, warning me never to visit his clinic again! He had once treated me when I was bitten by a dog. He gave me all the nine injections, one tetanus and eight rabies, and in my case he did well.

The Monitoring Agency should have branches all over Nigeria, and all hospitals and clinics should be visited from time to time, to ensure that standards are being maintained, check their records of death and so on.

Working Conditions

We all know that Drs in government hospitals are so poorly paid, it is laughable. They are forever going on strikes because even though their salaries are a pittance, government still doesn’t pay them timeously. What is the rationale behind, or the justification for paying a legislator who may not even have tertiary education, works only a few days a week, such an immorally high salary, while those who go to school for many years (probably the longest), save lives on a daily basis, work extremely long and tedious hours in very harsh conditions, are not only paid a pittance, but owed that same pittance? It hardens them. It makes them do their jobs half-heartedly, while the other half of the heart is thinking of how to make ends meet, instead of concentrating on the job. After all they too have families to cater for. As for those working in private hospitals that are better paid than the government ones, I’m not sure what their own excuse may be. Could be because of the fallen standard of education in Nigeria. Lack of adequate knowledge.

Shortage of Manpower

Also, there are not enough doctors to go round. Apparently in a population of about 160 million people in Nigeria, we have only about 40,000 doctors. Where the ratio is about 1 dr to about 242 patients in the UK for example, in Nigeria it’s about 1 dr to 5,000. This certainly affects the quality of services rendered. They make many mistakes in assessments and diagnosis and administration of medication, especially injections. Just as the ratio of cases to a judge are too high, it is the same with that of patients to a doctor. Poor remuneration, lack of equipment, harsh working conditions and so on, have made so many Nigerian medical personnel to check out to greener pastures, where they are better appreciated.

Carelessness

My cousin told me that she was scheduled to have an operation in a private hospital in Lekki. She was told that her iron level was low and it needed to be boosted before the operation could be performed. She said that the most senior matron in the hospital was the one that gave her the injection. On her way out, the matron chased after her to tell her that she had administered the wrong dose of injection. Luckily, she had given her too little. Needless to say, my cousin decided to go and have the operation done in South Africa. That if such a mistake could have been made by a senior matron, she had no business having an operation in such an establishment.

Cover Up

There is no well established type of procedure and investigation when a death occurs in a hospital. Hardly, is there any investigation into the causes of the death and there are no measures subsequently implemented, to avoid the reoccurrences of such deaths.

Standard of Education

Is it just that the standard of education has dropped? In the old days, a certificate from UCH, Ibadan, was the equivalent of that of University College Hospital, London. Now, there is no longer any confidence in Nigerian medical training, so much so that doctors that are seeking opportunities abroad, now have to pass a series of exams in order to qualify for a job.

With all the sex for marks offences by lecturers, incessant strike actions, broken down/non- existent facilities in the medical schools, to name but a few, its no surprise that we are churning out doctors that are not up to the task.

Impunity

We live in a society where people are not held accountable for their actions, doctors are no different. Lately there has been an outcry against the Judiciary and the Legal Profession, but the truth of the matter is that the medical profession too, may be no different.

Some Reasons for Negligence Cited By Doctors Lack of Equipment

I interviewed one or two doctors who have worked abroad. One of the reasons that they cited for medical negligence is lack of equipment in Nigeria. Medicine has moved away from the guess work type thing of the 1800’s. Its no longer about you have a temperature, you may have malaria or fever, or typhoid. There is a simple blood test that will tell you whether you have malaria or not in five minutes.

There are diagnostic equipment like CAT Scan, MRI, and so on, but they are not so readily available here, and even when available, to do the tests can be very costly. Also the diagnostic machines that are available in Nigeria are often outdated and antiquated.

NEPA

Lack of electricity is a big problem. People have died on the operating table, when electricity supply is cut during a procedure. Storage of medication and specimens which have to be preserved at certain temperatures is impossible. This same medication that has not been properly stored due to lack of electricity supply loses its efficacy and is now prescribed to unsuspecting patients. Private Hospitals have to spend so much on investing in alternative means of power supply like generators, inverters, solar etc. This is then reflected in the prices of treatment being offered to patients, as costs have to be covered. Why then, won’t they tell you that you need an operation, when you don’t?

Integrity of Medical Personnel

The doctors also cited the man power and ethics that goes through the medical value chain. One doctor said that where in USA, you would have no reason to question the result of for example, a laboratory test, here in Nigeria, you worry about the integrity of the people, to the point that you ask for a re-test, because you doubt the veracity of the test or whether the laboratory assistant actually carried out the test or took a bribe to change the result!

NAFDAC

The Doctors said that NAFDAC was also a big problem because they are not on top of their game in certifying medications. The doctors stated that where the more common medications like ampliclox and so on are easy to find in the market, less common, new and more efficacious drugs, are not available in the market, because they have not received NAFDAC certification. NAFDAC staff need to go on proper world approved courses on medication regularly, to know what is extinct and what is current.

Sometimes, the drugs to treat patients for particular ailments are not available on the Nigerian market.

Patients

The doctors also said the patients themselves sometimes constituted an obstacle to their own treatment. They cited a lack of transparency as a big problem. Patients when asked whether they have any conditions they are being treated for, would sometimes answer in the negative, even when they do. Patients were fond of visiting several doctors on the same medical issue, taking different medication prescribed by the different doctors, and not revealing anything about their previous treatment and medication history to the new doctor. They also said that, on the average, most Nigerians do not embrace western medicine, they also do traditional and Church, sometimes coming to the hospital as a last resort, when the ailment which could have been treatable, may have become too advanced to be treated. Some like the Jehovah’s Witnesses, refuse blood transfusions, even when it is life saving.

The doctors suggested that there should be healthcare financing, just like government is doing agriculture financing for farmers. Also aggressive training in human resources and ethics.

It is obvious that the problems in the Nigerian Health Care Sector are complex and numerous. They are also very connected with the negative trends that have pervaded our society, like corruption, drastic fall in the standard of education, lack of vision, bad prioritisation, mismanagement and so on. Our healthcare sector is in dire need of revamping. To this end, Government and all the stakeholders in the health sector, will need to get together to forge a way forward, to improve medical care in Nigeria. It is imperative that this is done as a matter of urgency.