Our people send patients abroad for organ harvesting ignorantly — NMA president

 

Mike Ogirima

In this interview with ENIOLA AKINKUOTU, the President of the Nigerian Medical Association, Prof. Mike Ogirima, speaks about the challenges in the health sector

The Federal Government is considering barring doctors in the public sector from having private practice because the 1999 Constitution does not allow anyone to do private practice apart from farming. What is the NMA’s position on this?

The NMA will support every action that will improve the health system. We will go against any doctor that is using the government’s hours to do his business and I am sure that other professions, whether in the health sector or in any other areas, should do the same. You cannot rob Paul to pay Peter. So, give to Caesar what belongs to Caesar and to God what belongs to God.

But the laws, as it is today, we have laws and guidelines guiding doctors working in the public health institutions on running a private medical outfit. The Medical and Dental Council Act has its guidelines for private practice. There are rules and regulations. One of them is that you should not be found working on your private hospital during work hours. You shouldn’t divert patients patronising government health centres to your private hospital. These things are wrong.

So, what we want the government to do is to implement the law. How will they do this? For example, the Medical and Dental Council of Nigeria has remained in limbo, it was dissolved against the wishes of the NMA. We want that council to be in perpetuity just as ASUU (Academic Staff Union of Universities) went ahead to convince the government that the NUC (National Universities Commission) board or council must remain in perpetuity.

We have been shouting for the past two and a half years since the MDCN was dissolved but it seems the government does not want to listen to us. They don’t know the implication. This is one of the implications of having a council in place. With council, you can constitute a tribunal to try any errant member. We have many members with issues of misconduct in the past two and a half years. We have members that are professionally negligent in the last two and a half years but we lack the power to constitute a tribunal without the (medical and dental) council. I hope the government will deem it necessary to constitute that council without delay.

Even if you don’t trust the members, you can dissolve them. But thank God that 80 to 90 per cent of those who constitute the MDCN are statutory officers in various departments. The Director of Hospital Services from each state are members. The NMA President and secretary are members. So, whether you dissolve it or not, there must be an NMA President, there must be a director of hospital services at anytime. So, what is the government playing with? The government is playing with the lives of its citizens.

You said the refusal of the Federal Government to constitute a council is affecting issues of discipline. Does it mean that some errant doctors are still in practice?

Until you catch a thief, you cannot call anyone a thief. Until you have evidence and try a person under the appropriate authority like in our own case, a tribunal, you can’t say that person is negligent and even if you suspect that person of being negligent or having cases of misconduct, it is only the appropriate institution that can take a decision; may be, suspend for the time being until he or she faces the law.

Isn’t this affecting the health sector?

It has affected everything, seriously, including this issue of harvesting of organs in Egypt which the Minister of Health recently spoke about. If we catch anybody, the tribunal will be set up if the medical council has been put in place. The National Health Act, which was passed in 2014 and is not yet fully operational, is there to guide us on all these issues. We are in court with other civil society organisations to challenge the government on enforcing the Act because issues like these that are coming up are contained in those laws.

Since there is no council, what steps will the NMA take to curb the rising cases of organ harvesting which the health minister asked you to look into?

We have started taking steps by sensitising the populace and ourselves and that was why I released that letter to the public. I was of the opinion that the letter should be well circulated and I am glad that journalists have picked an interest in it and I must commend the NUJ for helping us to circulate the letter.

The next step is that we are pursuing our case in court to make sure that the National Health Act is made operational. Thirdly, we are not going to rest until the MDCN is constituted and this must be done urgently because the Nigerian health system is on the verge of collapse. 

Everybody is doing anything they want in the health sector.

Also, the NMA began an initiative known as the doctors’ stamp to identify who a quack is. So, if you see a doctor in a clinic, please demand his stamp. The stamp has a lot of security features. So, that way, we are doing our in-house cleaning exercise. So, let the government help us to do the needful.

Is there reason to believe that Nigerian doctors are conniving with their foreign counterparts to harvest organs of Nigerians?

Have you heard of child trafficking? What is worse than that? Organ harvesting is even a lesser incident because it is the exchange of a human organ for money while human trafficking involves selling a whole human being which is worse. We read in the newspapers and electronic media that these heinous crimes are also being perpetrated in our land. The selling of children is worse than the selling of an organ. So, even if organ harvesting is not taking place in Nigeria, I am sure our people are the ones encouraging these victims to travel abroad including Egypt, for their organs to be harvested unknowingly. But ignorance is no excuse before the law. So, we are investigating on our part. We are investigating ourselves and if we find any of our colleagues wanting in that area, we will bring them to face the full weight of the law.

The minister said one of the reasons government officials travel abroad for treatment is that Nigerian doctors are fond of leaking patient information to the press. Do you share this view?

I don’t think I share this view. He should name the doctors doing such because the physician’s pledge states categorically that the information you get from a patient should be treated confidentially even after the death of that patient. The only way you can divulge information is when a fellow doctor asks for medical opinion. In the court of law, this is the only condition. Let the minister name the doctors leaking patients’ information.

You said the health sector is on the verge of collapse. Do you think the Federal Government should declare an emergency in the health sector?

It should, without delay. We call on the government to declare a state of emergency because if our people are patronising other clients, then that means there is no trust in the system. It is like having a defence system but using foreign soldiers. That means we don’t believe in our defence system. Should we allow that to happen? No!

It has been said that one of the biggest problems in the health sector is the inadequate number of doctors and yet many doctors find it difficult to secure placement for ‘housemanship’. Does this worry the NMA?

Yes, it does. I said recently that in the last one week, I lost nothing less than five colleagues to fatigue. They had stroke, they collapsed after 24 hours of non-stop duty. These were young promising colleague. Nigeria needs nothing less than 280,000 doctors according to the World Health Organisation. The WHO recommends one doctor should see 600 people. That is the ratio. If you compare that to our population of over 180 million, we need nothing less than 280,000. How many doctors do we have that are practising in the private and public health sectors? About 45,000! You see why my colleagues are dying? We also need our health facilities to be upgraded so that medical students can be well-trained. Ironically, the federal, state and local governments say they don’t have the funds to employ doctors and other health workers. What an irony! But they have the funds to sponsor white elephants projects that they cannot complete before the end of their tenure.

But recently the Kebbi State Governor, Atiku Bagudu, said he could not find doctors to employ despite the willingness to pay

Let them train doctors. In those days, there used to be bonds that medical students would sign. Right from day one, you are placed on a salary so that when you graduate, you will work with the government based on the terms of the agreement. Why are they not doing that? That was a system of ensuring that you have enough manpower. What has happened to that system today? Most of them have stopped giving scholarships. Most states don’t do that anymore.

Recently the wife of the President, Aisha Buhari, lamented furiously the abysmal state of the State House clinic, where she said there were no syringes or drugs and a functional X-ray machine. Do you think the clinic should be privatised?

Well, it is left for the government to decide on how best to make the place functional. It is not just that clinic that has that problem. Most of our public hospitals are even worse than that and that is why most people will not patronise government hospitals. There is no trust.

According to a report by the NOI Polls in collaboration with Nigeria Health Watch, about 2,500 Nigerian medical doctors left Nigeria between August and September. What is the NMA doing to curb this trend?

Why should I discourage my members from leaving the country if you cannot employ them? What will they eat? Won’t they feed their families? The government should do the needful. The NMA cannot stop anybody. We can only advocate and remind the government to be alive to its duties.

The doctor that died three days ago, finished as a public physician. He had no job, two years after completing his post-graduate training. That alone is an emotional stress. He collapsed. I don’t want my colleagues to collapse. Anywhere they can get jobs, let them do so. After all, it is a way of getting foreign exchange into the country when we export our products. And they are doing well outside the country where they have well-equipped hospitals and have job satisfaction.

This year has seen an outbreak of Lassa fever, meningitis and monkeypox. What are the causes of these epidemics and what can be done to reduce the frequency of such infectious diseases?

Our environment is the problem. Our environmental conditions are poor. I urge Nigerians, particularly the entrepreneurs, to key into solid waste disposal. Once we do that, we will have a clean environment, our air will be free of germs and such recurring epidemics will be minimised.

Do you think the NGO regulation bill being debated at the House of Representatives will affect the health sector if signed into law, given the fact that NGOs are known for implementing interventionist programmes?

It is not a law that should be allowed to see the light of the day. We don’t want laws that will gag NGOs. The NMA is an NGO but we have enough guidelines that regulate NGOs. Such a dictatorial law should not be allowed. Let them enforce the laws that are already in existence. You can checkmate the activities of NGOs. The government has the organs to do that. Let them strengthen the organs saddled with that responsibility.