Nigeria Medical Association

By Aliyu Musa Dada

Today, I want to bring our attention to a heartbreaking incident that highlights the shortcomings in our government’s support system. Dr. Tijjani Ibrahim, a young and dedicated medical doctor, fought bravely against decompensated chronic liver disease caused by Hepatitis B infection.

Despite the efforts of his friends to raise funds for his treatment, Dr Ibrahim tragically passed away before realising the required amount. This unfortunate event raises serious concerns about lacking a robust system to assist individuals, even those tirelessly dedicated to serving others, like Dr. Ibrahim.

We, as citizens, deserve a government that prioritises the well-being of its people, especially those in critical need of medical support. It is disheartening to witness the struggles faced by individuals who have dedicated their lives to saving others, only to be let down by a system that fails to provide adequate assistance.

Dr. Ibrahim’s passing is a stark reminder of the urgent need for reforms and investment in healthcare infrastructure. It should not rely solely on the goodwill and generosity of friends and well-wishers to fund essential medical treatments. Our government should be responsible for ensuring accessible and affordable healthcare for all citizens, especially those in dire situations.

In this moment of grief, let us remember Dr. Ibrahim as a compassionate and dedicated doctor who selflessly served his patients until the end. Our thoughts and prayers go out to his family and friends during this difficult time.

May Dr. Tijjani Ibrahim’s soul rest in peace, and may his legacy inspire us to advocate for change. Let us raise our voices and demand better support systems for individuals facing medical challenges.

We must unite as a community to address these issues and hold our government accountable. We can start by engaging in constructive conversations, raising awareness about the gaps in healthcare support, and urging policymakers to prioritise the well-being of their citizens.

Remember, change begins with us. Let us honour Dr. Ibrahim’s memory by actively working towards a healthcare system that provides timely and accessible support for all those in need.

By Fadhila Nuruddeen Muhammad

The journey towards becoming a doctor often begins in childhood, driven by a deep desire to help others and positively impact people’s lives. For many, like myself, the path may take unexpected turns, leading to different callings. I recall my childhood fascination with medicine, even playfully emulating the role of a doctor in my school days, using improvised tools such as cloth face masks and hand gloves to “perform surgery” on classmates’ pens. I’d then transfer the ink from one tube to another, all to save my classmates from running out of ink. Life has a way of guiding us, and for me, that path led to journalism.

Tijjani Ibrahim, however, followed his childhood passion to become a committed and dedicated young medical doctor. His journey was filled with promise, but it took an unfortunate turn when he was diagnosed with advanced Chronic Liver Disease, Liver Cirrhosis, a consequence of Hepatitis B Viral Infection in June 2023.

Dr Aisha Danbatta, a medical consultant at Murtala Muhammad Specialist Hospital, explained Hepatitis B as a global health challenge that targets the liver, causing both acute and chronic illnesses. “This virus can be transmitted through various means, such as from mother to child, unscreened blood transfusions, exposure to contaminated materials, sexual contact with an infected partner, and even through saliva. Unlike HIV, Hepatitis B has a longer lifespan, making it easier to transmit.”

Dr Danbatta emphasised the prevalence of undiagnosed cases due to a lack of immunisation, leaving many unaware of their condition. Those diagnosed often struggle to afford vital tests like viral load measurements, which determine the quantity of the virus in the blood and assess the extent of liver damage. Physical examinations, ultrasounds, and fibroscans are also crucial in evaluating liver fibrosis and scarring monitoring the progression of the disease.

Dr Tijjani was first at the National Hospital, Abuja, where he was doing his house job and diagnosed with Liver Cirrhosis at the same hospital in June this year. The cost of his treatment was quite high, and he could not afford it. The National Hospital Abuja could only support his medical bills by creating an official memo. He was later transferred to Aminu Kano Teaching Hospital in Kano.

Hamza Danyaro, a friend of the late Dr Tijjani Ibrahim, explained that “his return to Kano was motivated by the hope that the National Medical Association (NMA) Kano State chapter could provide support. However, it was revealed that to benefit from their assistance, he needed to complete his National Youth Service Corps (NYSC), pay his dues, and work for at least a month or two before becoming eligible.”

“Tijjanii was not strong enough to go through these. Instead, we rallied to seek help from dignitaries such as politicians, the House of Representatives members of his local government in Kumbotso, and organisations. Unfortunately, the lengthy protocols inherent in today’s politics prevented direct outreach,” Danyaro added.

Tijjani was left with no other option than to seek funds. His friends organised the fundraising. The campaign was expected to raise a sense of urgency and necessity to help support a young medical doctor with funds to support his medical bills. This kind of transparency can prompt people to contribute to the cause. But only a tiny amount was raised after several days of campaigns.

Fauziyya D. Sulaiman, a philanthropist with a heart of gold, shared her disappointment on social media, writing, “It’s unfortunate that despite our community boasting politicians and business leaders among us, we couldn’t muster N25,000,000 to support Tijjani. If this were about some trivial matter, you would have seen some of us at the forefront. This is undeniably a disgrace.”

Dr Khalid Sunusi Kani, a medical doctor and health advocate, penned an open letter addressed to President Bola Ahmad Tinubu through Solacebase online newspaper. In this heartfelt letter, he expressed the critical need for Dr Tijjani Ibrahim’s services in Nigeria, emphasising the pressing issues within the country’s healthcare sector and the alarming rate of “brain drain syndrome.”

He wrote, “Your Excellency, Nigerians too are in desperate need of his services, looking at the manpower deficit in the health sector and the rate at which we suffer from ‘brain drain syndrome.’ I strongly believe Nigeria and Nigerians are unprepared and cannot afford to lose someone like Dr. Tijjani Ibrahim.”

Chronic Hepatitis B places individuals at a high risk of cirrhosis and liver cancer, leading to severe health consequences. In July 2023, the World Health Organization revealed that 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new conditions occurring yearly. While there is no specific treatment for acute hepatitis B, medicines can effectively slow the progression of cirrhosis, reduce the incidence of liver cancer, and improve long-term survival.

Dr Tijjani Ibrahim died on September 6, 2023. His dedication to the medical field and his efforts to make a difference in the lives of others will be remembered and cherished.

Witnessing a doctor who devoted his life to saving countless others facing such challenging circumstances is genuinely disheartening. He dedicated his life to the mantra of ‘One Life, One Liver,’ yet our society struggled to come together to save his life. In a world where trivial issues on social media can garner an astonishing number of likes, it’s heartbreaking that Tijjani needed just 25,000 people to contribute a mere dollar each or someone who can just pay the total amount.

Tijjani’s story serves as a poignant reminder of the power of collective action and the importance of rallying together to support those in need, especially those who have dedicated their lives to serving others. Let us reflect on this unfortunate situation and take it as a call to action. Together, we can make a difference and ensure that the heroes who dedicate their lives to saving others do not suffer in silence.

“One Life, One Liver”: A heartfelt tribute to a fallen hero leaving an indelible mark on the world. May Allah rest his soul, amin.

Fadhila Nuruddeen Muhammad is a social media influencer based in Kano and can be reached via fadhilamuhd@gmail.com.

By Bello Hussein Adoto

Medicine is a sacred profession where trust is vital. Yet, fakes and their accomplices undermine this trust and put everyone at risk. Medical doctors must stand up and sanitise the system first by not promoting quackery.

Meet Abawulor Omenka, a 35-year-old Nigerian who made headlines after presenting a second-class upper degree in Medicine and Surgery to Covenant University Medical Centre, Ota, Ogun state, for employment.

For those who don’t know, medical degrees are not classified. It is either you pass or you don’t. There is no first-, second-, or third-class, as you have in education, law, engineering, and pharmacy programmes.

So, for Mr. Omenka to present a second-class upper degree shows something was wrong. True to suspicion, he was found to be a fake doctor and handed over to the police. Omenka’s case is symptomatic of how doctors contribute to quackery, deliberate or not.

The role of doctors in quackery is subtle yet significant. For instance, Omenka, in his interview, talked about the different hospitals he has worked for. One of his interviewers told The Punch, “…he (Omenka) had worked at the hospital owned by some of our colleagues that we know. We put a call across to them, and two of them actually confirmed that they knew him very well. I told them he was trying to apply as a medical officer, and they told me he worked with them as an auxiliary nurse or, better put, as a hospital assistant.”

Imagine if he had earlier been reported to the police or the Nigerian Medical Association and removed from circulation. He wouldn’t have had the guts to apply to be a medical officer at a hospital.

Beyond that, doctors should not allow their hard-earned certificates and licenses to be used to register clinics run by unqualified individuals. Many quacks wouldn’t have had clinics to experiment on patients without doctors registering the clinics for them.

The practice of quacks using a doctor’s license to operate their clinics is well established. As Professor Shima Gyoh, a former provost of Benue State University College of Health Sciences, told the International Centre for Investigative Reporting, “A lot of these illegal clinics are run by cleaners in the hospitals; I knew some who started clinics without approval. What they do is you start a clinic, you ask a doctor to stand behind you and register the clinic in his name, then you pay the doctor something. Instead of the doctor inspecting what you are doing, he does not do that, and then you continue to run your clinic independently. Yet, you are not a doctor.”

Moreover, doctors are honourable people who should not be found near quacks and quackery. Yet, some doctors help quacks run their clinics. The quack will open a clinic and handle common illnesses while the trained doctor comes in for the severe ones. This partnership gives the quack a veneer of legitimacy, which allows him to attract more patients and handle even bigger cases.

Another factor is economical. I know things can be challenging for doctors, especially those in private practice. They must establish standard hospitals, hire competent staff, meet regulatory standards, and offer quality services. All these cost money.

Nevertheless, the need to balance the chequebook does not excuse hiring untrained hands as cheap labour or training them to become health workers themselves. The male trainees graduate to become ‘doctors,’ while the female ones are called ‘auxiliary nurses.’ Whatever that means.

Let’s be clear. I don’t have a beef with medical doctors. If anything, I am grateful for their remarkable job in the face of limited resources and an overwhelming workload. My aim is to call on them to sit up and excise this cancer eating into their noble profession.

Of course, fakes are not exclusive to the medical profession. Bogus certificates and fake professionals are around us in the form of fake doctors, fake lawyers, fake soldiers, fake engineers.

Nevertheless, patients place enormous trust on their caregivers and doctors should know better than to endorse quackery. They are trained, more than most, to know the value of health and wellness and respect the sanctity of their patients.

They have read tonnes of materials, done lots of practicals, and spent years doing exams upon exams to show they have studied human functionality and diseases and can apply the training to treat people. They shouldn’t be found contributing to quackery in any form.

Medicine should have no room for quackery. Human life is too sacred, and the burden of care is too great for those not qualified by training, experience, and certification to play poker.

One could say that doctors and non-clinical health workers can work together in a task-shifting, task-sharing arrangement. This way, routine, low-skill tasks can be shifted to health workers like community health extension workers (CHEWs) and health technicians so that we can have better use of our depleted workforce and ensure that everyone gets quality healthcare. I agree with this arrangement.

In a task-shifting, task-sharing arrangement, everyone knows their job. However, what some doctors do currently is not task-shifting or task-sharing. What they do instead is aiding and abetting an aberration fast becoming a norm. This needs to stop.

Bello Hussein writes from Ilorin via bellohussein210@gmail.com

By Bello Hussein Adoto

A few days after someone glibly told me that the grass was greener in Nigeria, a young medical doctor Dr Diaso Vwaere was crushed to death in an elevator accident at the General Hospital in Odan, Lagos State.

Netizens and other persons who have worked at the hospital said they complained about the malfunctioning elevator for years, but the management did nothing tangible to address it. So the young female doctor, with two weeks to complete her housemanship, took the elevator to retrieve a dispatch—a food package—on the ground floor. She never made it.

I imagine her in the elevator anticipating the food she ordered, salivating, getting ready to devour her food, and returning to her busy schedule as a house officer. I imagine her standing on the elevator, weightless, as it moves.

Then it snapped. Suddenly, the metal box is crashing down from the 10th floor all the way to the ground. Imagine her now in the elevator, weightless, as it falls freely. Imagine her grasp at everything and anything, something to break her fall. Then, bam, it crashed. Imagine her now.

What do you think she would have felt? She was trapped in the rubble. The package she was going to retrieve was less of a worry. Her call can wait. The world can wait. Now, she needed freedom, a way out of the rubble. She needed air. The wreckage is choking.

While in the rubble, time trickled. Seconds must have felt like a decade, minutes like forever. Time trickled. One, two, three… 40 minutes. She was there for 40 minutes before help came. She was out, finally. Ahhh, some relief.

Anyone could have been in that elevator. It could have been a patient, doctor, nurse, relative, or even you, my reader. It could have been a visitor, like the state governor or the CMD. Would this incident have made any difference? I wonder.

A consultant once said it’s better to have a heart attack on the streets of London than in the corridors of a teaching hospital in Nigeria, and I thought that was ridiculous. From what I have seen in recent times, he was not wrong. It is not impossible. We are all at our own’s risk.

Those who should provide the basic oversight at the hospital, from government officials to the hospital management and staff, seem to have other businesses than their jobs. That’s why the elevator could be so bad as to take a life before they consider fixing it. Do we need the president, governor, or minister of health to come and fix it too? What happened to the hospital management?

The elevator accident happened at a hospital big enough to have house officers, ten floors, and elevators. It is a big hospital, indeed, by every standard. Yet there was no blood to rescue Dr Diaso. Some said there was no morphine, emergency supplies, or cotton wool. The last part could have been a stretch, but I have seen resident doctors protest that there was no normal saline, which should be as common as sachet water. Yet…

When patients come to hospitals, and these supplies are not available, and they cannot afford them, they turn on the doctors and nurses that are equally helpless. A soldier beat my friend’s wife, a nurse at Sobi Specialist Hospital, some time ago because she asked him to get delivery packs for his wife’s delivery. Last December, patient relatives at the University of Ilorin Teaching Hospital pinned a doctor to the wall. They beat him because they thought their father was dying and he wasn’t helping. Meanwhile, they were asked to do a test they had yet to do.

These incidents happened in tertiary hospitals where we should expect—sorry, hope—that things are better, where supplies were available for patients to use and pay later. But they aren’t. What is the hope of someone in a rural area?

I wonder what would happen if someone fell off a storey building in Obehira, where I grew up, or Ikuehi, my hometown. What would be their fates? They may have to be referred to the recently built Reference Hospital in Okene. Will they fare any better there?

Back to Dr Diaso, the doctor in the elevator accident. She survived the crash but not the injuries she sustained. She was severely injured and needed blood. “There was no blood available for resuscitation,” wrote the Lagos branch of the Nigerian Medical Association. There she was in the hospital. She had spent 11 months and two weeks on calls, attending to patients, saving lives, unable to be resuscitated because there was no blood. She died. She died in the institution where she served.

They say the grass is greener here. Who is watering the grass?

Bello Hussein sent this piece via bellohussein210@gmail.com.

By Hussaina Sufyan Ahmad

The Government of Kano State ordered the closure of no fewer than 1,581 premises used as hospitals, clinics, pharmacies, and patent medicine shops in 20 Local Government Areas of the state.

The government embarked on these measures following the growing menace of quack doctors, inexperienced pharmacists, and other health officials that use unlicensed premises for rendering health services across the state.

In this regard, the government’s action was said to have been prompted by reports that many unsuspecting residents had continued to fall victim to the nefarious activities of quack doctors and illegal clinic operators in the state.

The state, working in collaboration with the Pharmacists Council of Nigeria (PCN), has since swung into action, shutting the fake centres and moving ahead with more measures to sanitize the state and save the lives of the citizens.

The Registrar of the PCN, Pharmacist Elijah Mohammed, represented by his Director of Enforcement, Stephen Esumobi, told the media that efforts to sanitize the state would continue until the place is safe and secure from unqualified persons to practice and render services.

Mohammed said: “A total of 1,581 premises comprising 657 pharmacies and 924 patent medicine shops were visited across 20 local government areas of the state. A total of 537 premises made up of 138 pharmacies, and 399 patent medicine shops were sealed for offences which include: operating without registration with the PCN, selling ethical medicines without the supervision of a pharmacist, poor documentation, poor storage conditions, unauthorized sale of substances of abuse, amongst others.

While 25 were issued with compliance directives. Many patent medicine shops and medicine dealers in Kano still operate without adequate storage facilities, while others have illegal warehouses scattered around the state, some of these warehouses have a large stock of ethical products and substances of abuse which could find their ways into the camps of criminal elements in the society thus contributing to the adverse security situation.”

Similarly, the Private Health Institutions Management Agency, PHIMA, has also closed down many illegal clinics actively rendering services as hospitals to unsuspecting persons in the state. The Agency’s Executive Secretary, Usman Tijjani Aliyu, said the agency shut a chemist operated by a low-level secondary school exciter as a ‘hospital,’ describing it as a case of ‘quackery’.

The Chairman of the Kano State Chapter of Nigeria Medical Association (NMA), Dr Usman Ali, said that efforts were in been taken to checkmate activities of quack doctors in the state; “We are fighting this quackery, and it is because of this that a committee, Medical and Dental Council of Nigeria, (MDCN) monitoring team was set up in the 36 states including Federal Capital Territory.

“The committee comprises director of medical services of the Ministries of Health as chairman and the NMA chairman of each state as the secretary. About two years back, with the collaboration of the Kano Police Command, we have arrested two to three quack doctors in the state. Similarly, for all doctors in the state, we must make sure a doctor is qualified and certified to practice in Nigeria. That is why the same monitoring team is going round to help check these in hospitals.”