Covid-19 Reflections Part 1: Scarry Statistics by Mandy Asagba
In a country of over 206 Million people ranking 7th largest in the world, (1) coupled with its poverty status in the midst of affluence evidenced in a survey by The World Poverty Clock, an organisation that tracks world poverty in 2018 declared Nigeria the poverty capital of the world. (2)It reported ;1. That 87 million Nigerians, live in extreme poverty. 2. Defined extreme poverty as a situation when someone’s daily income is below $2 a day.3. That Nigeria is one of the countries with the least access to quality healthcare.
The Lancet, a medical journal, also in it’s 2018 survey reviewing access and quality of healthcare in 195 countries from 1990 to 2015, ranked Nigeria 140th position. Do we then in the light of the above have what it takes to battle COVID-19?
Please answer after reading through this article and tell us if we can afford to take chances and risk the lives of millions of Nigerians in the face of COVID-19 Remember life has no duplicate. JUST STAY HOME! Anything short of total lock down It’s better not imagined with the statistics herein.
How many practicing Doctors do we have? About 72,000 registered with over half the number practicing outside Nigeria. An outcry by the National Universities Commission in 2019 on the dangers of the shortage and need for minimum of 300,000 Medical Doctors to meet the WHO standard was met with deaf ears or heard but yet to take concrete step.
(3) How many Hospital beds do we have for inpatients? Five hospital beds per 10,000 population
What is the ratio to patients? One doctor per 5,00~0 people in Nigeria , compared with the World Health Organization (WHO) recommendation of one per 600 people.
(4) How many Nurses do we have?
About 240,000 nurses and midwives and by WHO standard the country will need 471,353 nurses and midwives. (5)
Nigeria ranked 7th among 57 countries classified as facing shortage of health workers in the world and 2nd in Africa.
How many General Hospitals and Health Centers?
The Federal Ministry of Health’s (FMOH) Health Facilities (HFs) 2005 census revealed a total of 23,640 public and private hospitals in Nigeria
How many Intensive Care Units (ICU) do we have?
No accurate data. The dearth of ICUs, had resulted in the death of many Nigerians. Lagos state alone needs over 100 intensive care bed spaces but the present number is still a far cry from the standard. According to Dr. Sylvia Cole, Consultant, Intensive Care Unit, Paelon Memorial Clinic, Lagos,“No matter how rich a trauma patient is, he/she may die if there are no emergency services like an ICU to stabilise their condition. He/she may lose functions of vital organs like the kidney, liver and become brain dead within this period”.
How many Ventilators do we have ?
Nigeria has less than 500 ventilators for coronavirus patientsWith the surge in the number of reported coronavirus cases there is dire need for more ventilators to save the lives of Nigerians. Nigerians have questioned the rationale for lawmakers embarking on purchases and distribution of exotic vehicles at this critical time instead of addressing the global crisis . 400 luxury Toyota Camry 2020 Edition vehicles which cost about $30,000 X 400 = $12,000,000$30,000 can buy 6 Ventilators thus 6 X 400 ventilators can buy a total of 2,400 Ventilators. This will sure save many lives.
How many Respiratory Therapists do we have and Patients ratio?
Estimated proportion of registered respiratory physicians to the national population at 1 per 2.3 million individuals.
(5) How conducive are the ICUs, The General Hospitals and Health Centres? Far cry from World Health Organization standard with lots of mosquitoes. You must have your personal disinfectant to have a sound sleep.
How many Laboratories and Research Centers do we have ?
Less than 50 officially registered on line.
What are the sanitary conditions at the General Hospitals / Health Centres ?
Below average
How accessible are the General Hospitals/ Health Centres?
Not easily accessible.
How available are the drugs required for treatment of their ailments?
30% availability
How affordable are the drugs?
Not affordable for the MassesMany patients turned beggars for funds to purchase drugs for their treatment.
How well do the Medical/ Health Personnel treat the Patients?
Shabby treatment, disrespectful and nonchalant behavior except you apply the Nigerian oil ( grease some palms with cash) Though there are some good health personnel with integrity and character.
How long do Patients have to wait to be attended to?Average of 2-6 hours. Below that you must have applied the Nigerian oil and or gotten there at 6 am.
Do Patients get treated before payment or upfront payment before treatment even if dying?
Upfront Payment except with intervention of some NGO’s with MOU to treat accident emergency victims at no cost ( e.g The HEI’s accident emergency project, #ThatNoneShouldDie Initiative) and some special ICU cases.
How many have died in cases such as this?
Thousands – no accurate data
In 2018, Health Maintenance Organisations (HMOs) industry report that only 5 per cent of Nigerians have health insurance, which means most Nigerian pay for medical care out of pocket. This portends serious danger in the face of Covid -19 Though the Government has promised free treatment, however this is not 100% guaranteed if the situation get overwhelming.
A combination of widespread poverty, poor access to healthcare and low health insurance cover is a fertile ground for disaster in the face of Covid -19.
Right outside the Lagos State University Teaching Hospital (LASUTH) at Ikeja, all the way to Ikeja bus stop indigent patients regularly beg for alms from passers-by and motorists to carry out medical tests or to pay for drugs and other medical bills. This is replete in other major hospitals across the country.
Thousands of patients die or are held hostage in hospitals because they could not afford hospital bills as little as N5,000 or less due to extreme poverty in the country.
The inability of indigent patients to pay their medical bills before treatment has caused many untimely deaths and for the few lucky to be treated, inability to pay after treatment has led to surging cases of false imprisonments ( now referred to as medical detention).
Medical detention is where patients who are unable to pay their medical bills are held hostage by private and public hospitals until they pay. A 2017 Chatham House report stated that victims of medical detentions, most prevalent in sub-Saharan Africa are mostly “women requiring life-saving emergency caesarean sections, and their babies.”The report stated that people most vulnerable to medical detention are the poorest of the poor requiring emergency treatments. Subjecting them to double jeopardy – physical and verbal abuses by medical officials, further impoverishing them as they’re made to pay even for the days of forced illegal detention and causing them emotional trauma most likely to complicate their health. This is illegal and actionable. It deters healthcare use, increases medical impoverishment, and an abuse of fundamental human rights ( Right to human dignity and Right to Liberty) and the right to access to medical care.
How well remunerated are the Medical /health personnel compared to their counterparts in other climes?
House Officers/ Interns are paid between N140, 000 – N200, 000 Medical officers: N180, 000 – N200,000Resident Doctors: N190, 000 – N280, 000Consultants: N700, 000 – N800, 000
Compared to their counterparts earning well over $10,000 (equivalent of N3,600,000) a month in other climes, little wonder the mass exodus of health workers.
What is their monthly/ hazard allowance ?
N5000 This is dicey in the face of Covid -19
How many have left the country for greener pastures,
About 60% have left for greener pastures with 9 in every 10 doctors considering work opportunities outside Nigeria.
It’s time we get our priorities right: who deserves better welfare package? A doctor or a law maker? Arising from the above statistics and state of affairs, can 50% of the citizenry afford the basic sanitary products to prevent COVID 19? Can they afford running portable water to observe the regular hand washing? Can they even afford to call the toll free numbers? Do they even have phones or access to phone? If yes are their phones charged or with credit? Do they even have access to these information? Can they afford to observe social distancing considering their peculiar accommodation ? If they stay home are they guaranteed 3 square meals.
This portends serious danger.Now the crux, if civilized climes like Britain, America, Italy and Spain with better health care, facilities and good sanitary conditions, information system and better per capita income are dying in their hundreds for Covid -19 infections, WHAT WILL BE THE FATE OF NIGERIANS? Better not imagined! O GOD ARISE for your people! Any attempt at failure to take urgent, deliberate and sincere action would be tantamount to subjecting Nigerians to mass death sentence. THIS CAN BE PREVENTED!
COVID 19 FATALITIES
Italy went from 2 cases to 400 in 26 days South Africa from 1 case to 557 in 19 days, Nigeria from 1 case to 131 in 10 days
WORRISOME.
- Over 311,988 people have tested positive for the virus worldwide as at Sunday 22/3/2020
- Data from Johns Hopkins University reports that the virus has killed at least 35,000 people around the world.
- The number of cases in the U.S. has surged to 183,875 making it one of the worst hit countries in the world and has recorded 3,711 death
- China, Italy and Spain are harder hit than the U.S.
- Italy has 105,792 cases with 12,428 confirmed deaths
- Spain lost 8,269 people to the virus with 94, 412 confirmed cases.
- Though China earlier had the largest number of confirmed cases with 81,304 people testing positive and at least 3,259 deaths as at today China has 82,278 with 3,309 deaths the pandemic has largely moved to Europe and the U.S.
- WHO said more cases are being reported in Europe every day than were reported in China at the height of its epidemic. (8)
- Most U.S. confirmed cases are in New York State, which has reported major surges in infections
- Forty-five states have shut down all schools, and bars and restaurants have also closed in many areas as governments ban group gatherings and instruct people to stay indoors. California and New York, among the largest economies in the U.S., have shut down all nonessential businesses indefinitely in an effort to contain the spread of the virus.
STAY HOME! STOP THE SPREAD
The best and most experienced Doctors in the world have warned that the only way to stop the spread and save lives is to Stay at Home.
We therefore implore our leaders to take more drastic measures to stop the spread as well as cushion the effect of Covid-19 by making our stay at home bearable.
Provide uninterrupted power supply, no power disconnection for any reason whatsoever not even for non payment of power bill, supply sanitary products, food and water to Nigerians while at home.This is much cheaper than getting overwhelmed with treatment.
THE TIME TO ACT IS NOW! SAVE OUR LIVES! NO EXCUSES!!!
References
1. The Nigeria National Bureau of Statistics
2. Premium Times Monday March 23,2020
3.This Day Newspaper January 22, 2020 Article Emmanuel Addeh in Yenagoa
4.Isaac Folorunso Adewole, the then health minister
5. http://www.nursingworldnigeria.com/2017/05/
6. Gaps in Capacity for Respiratory Care in Developing Countries. Nigeria as a Case Study by Daniel Obaseki et al. Ann Am Thorac Soc. Apr 2015NIH US national library of medicine
7. Fine lib.com
8. CNBC Health and science
9. Statistics.com
Mandy Asagba is the President African Women Lawyers Association President @awla.africa
