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When impostors manage hospitals or prescribe medicines

The decision by the Lagos State Government to close down a dodgy medical centre in the state must be commended. Operating a medical facility with unqualified or dubious workers who pose as professional doctors is a sure way to endanger public health. It is as dangerous as marketing fake and adulterated drugs to the public.

The need to control, standardise, and clean up medical practice and the pharmaceutical industry that dispenses medicines is long overdue not only in Lagos State but also across the country. A national campaign with a nationwide strategy is required. If we don’t do anything now, anyone could become a victim tomorrow. Human lives are too precious to be wasted through patronising medical facilities operated by quacks, pretenders or charlatans.

The Lagos State government’s decision should send a distress signal to all citizens. We must look after our health but we must not allow impostors to mess with our lives. Surely, no one should attribute this incident in Lagos to the current economic crisis. In good times and bad times, some criminals always look for hidden but fast ways to make money off other people’s misfortunes. Why would people who are oriented to crime, who are fully aware that they have no qualifications to engage in medical practice, pose as doctors and administer medicines to patients? It is a sickening behaviour.

A spokesperson for the Lagos State government said the quack arrested for illegal practice had performed surgical operations on three of the seven patients whom he had admitted into the medical facility. These patients must consider themselves lucky. Anything could have happened to them during their stay in the medical centre. They could have lost their lives. The fake doctor may have used insanitary or contaminated surgical equipment to operate on the patients. They could have been infected because of the unhygienic environment in which the surgical operations took place. 

People who engage in this kind of criminal conduct must be prosecuted and, if found guilty, must serve long jail terms that will convey the message that unlawful behaviour is unacceptable in our society. For every crime against humanity, there must be serious consequences. The state government must ensure that the arrested operator of the fake medical centre is put on trial. There is no place for impostors or con artists or pretenders to manage medical facilities in Nigeria. Qualified medical doctors are trained to save lives. Impostors and pretenders live on their creepy philosophy that human lives are not to be saved but to be destroyed or impaired. 

In Nigeria, patients with emergency medical conditions who are taken to second-rate hospitals, private or public, find out that rather than assist to prolong their lives, those substandard medical centres with unqualified doctors and paramedical staff who possess fake qualifications could speed up their death. This is the nasty situation that confronts many people who fall sick or need urgent medical treatment in the country. The worry is that the situation did not start last week or last month or last year.

Quacks who pretend to be qualified medical personnel working in sham hospitals contribute to what I call the death of medical practice in the country. These dubious people have demonstrated that, while no one is allowed to practice medicine without professional qualification and registration by the appropriate organisations, they are emboldened to perform some delicate practices such as prescribing medicines, administering injections, giving blood transfusions, and even operating on some patients.

I have heard of many instances in which quacks performed surgical operations on people that resulted in the death of the patients. In a country in which human lives have no value, a society in which too many people engage in illegal and fraudulent activities, where people order the assassination of their perceived enemies with less than N5,000, a society in which you can buy academic qualifications without attending a university or polytechnic or higher education institution, a lot of people have since realised they could make money through contract killing or through illegal practice that results in the untimely death of human beings. In our society, fake doctors and pharmacists put the lives of many people at great risk. Those who are lucky to be alive have the opportunity to narrate their experiences.

Medical practice in Nigeria has failed already, as some professional doctors have also admitted. Government and stakeholders in the private sector must collaborate to map out strategies to resurrect a dying profession and a shattered healthcare system. Healthcare must be accorded the prior attention it deserves in order to save the lives of citizens.

Over the past four decades, public hospitals and even private medical facilities have failed to respond positively to the healthcare needs of citizens. It is an open secret that public hospitals are poorly administered. Hospitals lack critical life-saving equipment. In terms of hygiene, hospital premises are unappealing because they are filthy. Hospital facilities are unsatisfactory and not good enough. Paradoxically, hospital property and equipment used to diagnose and treat patients are stolen by hospital staff who are expected to look after the equipment. This common practice is consistent with the view that public property in Nigeria is nobody’s property.

Apart from lack of qualified staff, lack of equipment and rampant pilfering of hospital medicines and equipment by staff, proper healthcare management in the country has been undermined by unethical practices of medical doctors and paramedical staff. When senior hospital administrators deliberately or unintentionally engage the services of unethical doctors, nurses, midwives and paramedical personnel, no one should expect hospitals so badly managed to deliver the best healthcare to the people.

Everyone believes the best place to undertake medical check-up or seek medical care and treatment is a well-equipped hospital. Unfortunately, for many people, finding a fully equipped and professionally staffed hospital is as rare as finding a hen’s tooth. It is a desire that only a few in our population can fulfil but it is a realisation that costs money. The medical situation in regional and rural communities is dreadfully poor. Well-resourced public hospitals are virtually non-existent in rural and regional centres.

The situation in developed Western countries is much better and without comparison. The hospitals are competently managed, and many of the doctors, nurses, and other personnel are qualified. This is not say, however, that there are no issues. Of course, there are problems that affect public hospitals in developed countries. Emergency departments are often congested in the same way the out-patient clinics are overcrowded. This is why governments are overwhelmed with the difficult challenge of finding an appropriate funding mechanism to manage public hospitals effectively.

In a country such as Australia that has a large aging population, catering to the public healthcare needs of elderly and frail people requires vast financial and technological resources. Owing to this, some elective surgeries often require patients to wait for up to six months or longer just to see a consultant. Although Australia has one of the best medicare systems in the world that is heavily discounted, and although some people feel the public hospital system in the country is free, which is mostly true, there are problems associated with funding. Discounting bills charged by general practitioners for some types of consultation has left the government confronted with the challenge of finding the best mix of strategies to solve the spiralling cost of free or discounted medical services. There is a limit to which the government can provide free or discounted medical services to all citizens.

A key difference between the medical system in Nigeria and the system in overseas countries is that while private sector participation is virtually nil in Nigeria, in overseas countries there are charities, foundations, individuals and organisations that donate regularly to keep the public hospital system going. Still, donations are not enough. The government has been campaigning to get many people to take out private healthcare insurance cover. That is one way to reduce the burden on government to continue funding the medical system.

Everyone knows the hospital system in Nigeria is in a difficult and confused state. That is why we have numerous second-rate private health clinics littered in our urban and rural areas. These fake hospitals are managed by uneducated and unqualified people who pose as doctors. Additionally, you will find sitting behind the counter at major chemists and pharmacies apprentices who possess primary or secondary school qualifications. These are people who have no basic training or skills in medical practice. Because medical practice and the pharmaceutical industry are unregulated in Nigeria, you will find in the public space many illegal and uneducated medicine vendors who market expired medicines or fake and adulterated drugs in the streets and in bus stations.

Owing to the mess that is called healthcare in the country, a jungle in which everyone claims to be a doctor or pharmacist or nurse, the best gift you could give to your loved ones is to pray that they should continue to enjoy excellent health for the rest of their lives. Experience, they say, is the best teacher, pardon this cliché. I have lost relatives, including an elder sister, because our public and private hospitals, including a so-called university teaching hospital, failed to demonstrate basic knowledge of how to diagnose illness and care for patients.

I must conclude on a sad note. We are walking dead in Nigeria but many people feel they are having the best of times. This might seem so until illness sets in one day and they realise there is no good hospital around to look after their health. That is when they will realise how obsolete and derelict the medical system in the country has been for decades.

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