COVID-19: Consultant Doctors Lament Abysmal State of Nigeria Health Sector

By Seriki Adinoyi

Consultant doctors under the aegies of Medical and Dental Consultants Association of Nigeria (MDCAN) have lamented the abysmally poor state of Nigerian health system, adding that the outbreak of COVID-19 has exposed the rot in the sector.

Addressing the press in Jos Tuesday, the President of MDCAN, Prof. Ken Ozoilo, also feared that by mathematical projections, there is a likelihood of a spiking of both infection and mortality given the experience of other more endowed countries so far.

Ozoilo said: “This pandemic has exposed the abysmally poor state of the Nigerian health system. This has arisen from chronic neglect and under-funding of the sector by successive governments and refusal to look into concerns and advice of the health care practitioners over the years. We have repeatedly lamented the poor conditions of service, poor infrastructure, lukewarm attitude to effecting reforms that will make the sector accessible to a greater majority of Nigerians and the ravages of brain drain in the sector, but all these have fallen on deaf ears over the years.

“It must be abundantly clear that the sorry state of the health sector in Nigeria today is not necessarily a reflection of lack of funds, but rather the choices that we have made, and the things we have prioritised over health. The current pandemic must however be seen not as a time for lamentations, but another opportunity to make the right decisions about what truly matters to us as a people, and how to begin to correct the ills suffered by this sector in the past.”

The association said that the information reaching it from different chapters of institutions across the country do not portray a positive picture as front line personnel in most of the institutions do not have enough supplies of personal protective equipment (PPE) such as gowns, gloves and masks among others, thereby putting their lives in great danger, adding that the little that is available is rationed and deployed in an ad hoc manner that makes nonsense of the concept of universal precaution.

It said: “These items are meant to be available for use as a matter of routine, and not only after a diagnosis has been established. Furthermore, going by the natural history of the disease, transmission occurs prior to onset of symptoms, meaning that protection is required from healthy looking carriers and not just those who are already down with the full blown disease.”

“We are in receipt of reports from across the country to the effect that only few states and institutions have taken the pains to establish functional isolation centres. We want to reiterate that the opportunity to act is now. Waiting till an index case occurs, or for an escalation in the numbers so far diagnosed, is a grave error. We strongly advise that while this situation subsists, Accident and Emergency (A&E) departments in all hospitals should put in place a system for screening and triage of all patients before access to the A&E floor and contact with large numbers of health personnel and other patients.

“As can be gleaned from the experience in the Lagos University Teaching Hospital (LUTH), the University of Ilorin Teaching Hospital (UITH) and the University of Benin Teaching Hospital (UBTH), contact with even one COVID-19 patient will result in the quarantine of large numbers of doctors and other scarce health personnel desperately needed in the response effort for a period not less than 2 weeks. Some of these may come down with the disease and some may well lose their lives. Their protection with appropriate gear is therefore of utmost priority.”

The association also raised a concern over the number of testing centres available in the country, saying: “While we commend the effort of the NCDC in expanding the capacity of the country to test by increasing the number of centres that can carry out the test, we believe that more needs to be done in this regard. Given the population of Nigeria, it is very important that greater efforts be made to expand and further decentralize testing. Testing is not only critical to identifying and containing threats for further infection, it is also necessary for freeing up resources from cases that are suspected but negative, in favour of those who do actually need them.

“We urge all state governments to urgently set up isolation centres and take meaningful steps to ensure that such centres are made habitable and sanitary. A situation where inmates of such centres escape because of discomfort from such facilities as has already been witnessed does incalculable damage to the whole effort. We very strongly recommend the makeshift tents being erected by the Lagos State government as a model to be emulated.

“We strongly commend those Nigerians and corporate bodies that have made donations to the response effort. We wish to however strongly advocate that these donations be channelled into the four thematic areas of provision of PPEs, establishment of isolation centres, testing and treatment. We caution that care must be taken to prevent dissipation of these scare and valuable donations on wasteful logistics and the like.”

On invitation of foreign medical professionals, Ozoilo said: “We wish to caution government on the use of foreign medical professionals in the current effort. It is not always that a copy and paste solution works. Nigeria has quite a large pool of capable hands that can and should be harnessed in this effort. Our membership comprises the highest echelons of medical specialists of national and international repute, and we hereby place their collective expertise and experience at the disposal of the government across the country. While it is prudent to learn from successes stories of others, it is also prudent to be mindful of the fact that the disease appears to be clearly manifesting local epidemiological characteristics that must be studied carefully and taken into account, in developing an effective and efficient local response.”