Nigeria's Medical Negligence Nightmare

Acclaimed Nigerian author, Chimamanda Ngozi Adichie recently accused Euracare, a private hospital in Lagos, of negligence following the death of one of her twin sons. The 21-month-old was sedated to allow doctors insert a central line and perform an MRI scan in preparation for his imminent evacuation from Nigeria to the United States, where a medical team was on standby.

Adichie alleged in a leaked message shared with friends and family that the anaesthesiologist broke several medical protocols, including administering an overdose of propofol and denying her child oxygen. She also claimed the same anaesthesiologist had been involved in two other deaths, wondering why he was still allowed to practice.

For its part, Euracare has denied any wrongdoing; an investigation is ongoing.

Tales of gross medical negligence and incompetence abound in Nigeria. Hospitals are notorious for denying care to patients with gunshot wounds without a police report absolving them of wrongdoing. It’s also not uncommon to find doctors, especially those working in public hospitals, displaying crude bedside manners or little concern for patients’ wellbeing. Consultations are treated like nuisances, with doctors responding dismissively to patients, as though afraid their inquiries would expose their lack of knowledge.

“Their attitude is so hostile to patients and relatives, yet we provide everything right down to gloves,” said Timi*, whose parent was admitted a few years ago at a government-owned hospital, where medication and medical accoutrements are often provided by patients and caregivers. “All that is asked of them is their humanity and expertise.”

The nonchalance and disdain extends beyond the consultation room into hospital wards and theatres, where it sometimes mixes with a heavy dose of misogyny. It’s no secret that pregnant women face abuse and neglect from doctors and nurses while giving birth. Some female patients have been sexually assaulted or asked intrusive, medically-irrelevant questions during their gynaecological exam.

As a caregiver, Edet*, recalled how a male doctor had approached her mother’s bedside and without a word to either of them started lifting her dress. She stopped him immediately.

“He didn’t say, ‘Excuse me,” Edet said of the ill-mannered physician. “[He] just came and started pulling it up.”

Eventually, she allowed the doctor to palpitate her mother’s stomach. But even he didn’t communicate his findings until she asked.

Many have also criticised the general apathy and lack of professionalism among medical staff in Nigeria. During their stint as a caregiver, Timi said they witnessed a doctor respond to a late-night emergency without any sense of urgency.

“He strolled out with red eyes and his boxers peeking out of his scrubs, looking like a motor park tout,” they said, adding that the same doctor had spoken rudely to a patient calling for help on a different night.

“He turned around and said to the patient, ‘Even the security man is sleeping at this time, let alone me.’ But if someone is calling your attention, then it means there’s something wrong.”

With little to no fear of censure from their indulgent employers, the frazzled public, or the somnolent Medical and Dental Council of Nigeria that regulates medical practioners, doctors in Nigeria can and do operate with impunity. For one, the public’s too meek, impoverished, ignorant or demoralised to file lawsuits or lodge formal complaints against medical malpractice.

Also, hospitals seem more eager to protect their reputation than patient welfare, so much so that some allow their staff work without name tags to prevent disgruntled patients from publicly naming and shaming unscrupulous doctors or nurses. Worse still, given the fact high-ranking government officials—including the president—travel abroad for medical care, there’s little incentive to address poor working conditions that force thousands of medical practitioners to migrate to western countries every year. Currently, there are 55,000 doctors in Nigeria catering to a population of 220 million, far less than the World Health Organisation’s recommended ratio of one to 600 patients.

Treating Nigeria's hazardous healthcare system will require more than sacking one, two or three inept doctors, or as the current trend predicates, setting up another "state-of-the-art” for-profit hospitals in the city. The cure rather resides in enforcing patient safety protocols, insisting on professionalism among doctors and holding accountable hospitals that flout medical care. More importantly, if health services are to meaningfully improve, the government has to increase the meagre four percent it allocates to healthcare in the annual budget.

*Not their real names.