In every part of Benue State, there is an epidemic of quackery in the medical and healthcare sector, slaying and maiming lives of mainly the indigent. With shortage of qualified medical doctors, particularly in most rural communities in the state, absolutely unqualified medical personnel such as auxiliary nurses and laboratory scientists reign supreme.
Ameh Ejekwonyilo weaves through the fatal tales of the acts of violence by these quacks who, posing as medical doctors, are dispatching hapless patients with harmless ailments to their early graves.
AGBO John, a university undergraduate, was lucky to have cheated death, but his younger sister, Stella, who was a high school student, died at the hands of a laboratory scientist who posed as a medical doctor.
Stella John was a senior secondary school student at the Gateway Excel College at Ogeneago in Ogbadibo Local Government Area of Benue State.
“Stella was a highly intelligent student, who looked out for other people,” Mary Ochoche described her teenage niece whose life came to a tragic end in February 2018.
Narrating the late Stella’s ordeal, Ochoche said the deceased’s dream of becoming a medical doctor in order to cater for the health needs of her family and community was cut short by Friday Onuh, a laboratory scientist at the Federal Medical Centre, Efekwo, Otukpa.
“In the first week of February 2018, I took Stella, my niece, to Able Hands Diagnostic Laboratory and Maternity Clinic here at Old Otupka Branch, Ogbadibo LGA of Benue State. She was operated upon by Mr. Friday Onuh, the ‘doctor’ in charge of the hospital. The surgery that was performed on Stella was to correct an inflammation which the ‘doctor’ said was appendicitis.
“But a few weeks after the surgery, Stella’s health kept deteriorating as her eyes turned greenish and she became pale, because she neither ate nor drank water.
“Eventually, we discovered to our greatest surprise that ‘Doctor’ Onuh is not a medical doctor but a laboratory scientist. In the course of our investigation, we found out too that he acquired his hospital’s license in a medical doctor’s name; and that it was Mr. Onuh and a trained doctor that treated Stella’s older brother (Agbo) when he was ill in 2017. But this time, Mr. Onuh posed as a medical doctor and performed the surgery on Stella alone, thereby leading to her tragic death,” Ochoche narrated.
“When we asked ‘Dr. Onuh’ why Stella’s health was getting worse by the day, he responded: “I’m on top of the situation.” So, I discussed with other family members and we forcibly took Stella away from ‘Dr. Onuh’s hospital to the Benue State University Teaching Hospital (BSUTH), where they demanded to see ‘Dr. Friday Onuh’ who carried out the surgery on Stella.
“Curiously, ‘Dr. Onuh’ refused to honour the invitation by the BSUTH authorities.
“Thereafter, we were referred to the Federal Medical Centre in Makurdi, where they equally requested for ‘Dr. Onuh’s presence, but, again, he declined to turn up.
“It was at this point that we knew that something was fishy about ‘Dr. Onuh’s competence as a medical doctor.”
At the FMC, it was discovered that Stella was in septic shock because she suffered sepsis (an infection) during the surgery; her intestine was badly cut. It was also discovered during the referral that Stella’s kidneys were infected.
While at the hospital, four consultants battled to save her life as they performed many surgeries to correct the damage that was done by ‘Dr. Onuh’. They put her on oxygen but to no avail.
Relating Stella’s last moments, her grieving aunt said: “Stella said she didn’t want to die, but she was writhing on the bed in agony until she drew her last breath.
“Up till this moment, I still cry each time I see her former colleagues and students of Gateway Excel College in their uniforms. They remind me painfully of Stella’s dreams and aspirations as an obedient and intelligent child,” Ochoche said as tears rolled down her cheeks.
“Stella’s parents are still heartbroken even after two years since the horrible death of their daughter. That is why they have refused to talk to you (the journalist).
“Eventually, we discovered to our greatest surprise that ‘Doctor’ Onuh is not a medical doctor but a laboratory scientist. In the course of our investigation, we found out too that he acquired his hospital’s license in a medical doctor’s name; and that it was Mr. Onuh and a trained doctor that treated Stella’s older brother (Agbo) when he was ill in 2017. But this time, Mr. Onuh posed as a medical doctor and performed the surgery on Stella alone, thereby leading to her tragic death,” Ochoche narrated.
When our correspondent visited Gateway Excel College, where the deceased 18-year-old girl was a student, one of her tutors, Anthony Samuel Itodo, described Stella as one of the shining stars that the school ever had.
“Stella (John) was one of Gateway Excel College’s shining stars who carried her family and community’s dreams of a better life on her shoulders. She was our Games Prefect, where she demonstrated excellent leadership qualities. She was full of life and participated in several extra-curricular activities. Stella wanted to be a medical doctor so that she could contribute her quota to addressing the teething healthcare problems in this area and surrounding communities. Sadly, that is never to be, as her life was cut short by the same problem of inadequate healthcare system that she had hoped to tackle,” Itodo, who emerged as one of the best 50 teachers in the 2018 Global Teachers Prize Awards, said.
Quackery epidemic
Stella’s heartrending story is similar to that of a 12-year-old boy, Gabriel Oche, of Ijege-Amejo in Okpokwu LGA of Benue State. Gabriel died in January 2019 after he was operated upon by an “auxiliary nurse” in the community.
“The New Year day of 2019 is a moment I will never forget in a hurry,” Joseph Oche said as he narrates the horrible circumstances that surrounded his first son’s death.
“In December of 2018, my son kept complaining of stomach-ache. So, I took him to a neighbouring community where a nurse was operating. The nurse had been treating sick people within the adjoining communities. But when my son got there, he examined him for two days and said Gabriel needed an operation to correct the health problem.
“I agreed because the nurse said it was a minor exercise to remove the appendix. But after the operation, my son was not allowed to eat or drink water for two weeks. Thereafter, we began to see pus coming out of the operated region of Gabriel’s stomach. So, my wife rushed home to inform me.
“My father is suffering what doctors at the Federal Medical Centre, Makurdi, said is “Ototoxicity”, that is, hearing loss. After checking my father’s medical history and the latest treatment he received in October last year at a dispensary in Gboko for bacterial infection, which was a gentamicin injection, they revealed that his predicament was caused by the medicine overdosed,” Jande’s teenage son, Aondona, who accompanied his father to the hospital, said.
“By the time I got to the clinic, which was in the nurse’s bedroom, my son was gasping for breath. He was so thirsty that he pleaded for a drop of water on his tongue, but the nurse refused; arguing that water intake was not good for my son as the surgery had not healed completely.
“The next day, which was 1st January 2019, my son died in my hands,” the 35-year-old farmer said as he wept uncontrollably.
When asked if he reported the incident to the police, Oche said: “Community leaders prevailed on me not to do so as it would spark a war between my community and that of the nurse, who had since fled the area.”
At Ugbokpo and Obagaji, headquarters of Apa and Agatu LGAs respectively of Benue State, two families are grieving over the tragic demise of their loved ones.
Two little kids and husband of a 25-year-old housewife, Alice Ohepo, are still dazed by their mother’s death in January 2020. The husband, Jonathan Ohepo, spoke with sadness of the agony that his wife’s death had wrought on the family.
“My wife was pregnant and went into labour at about 9 am in early January this year. I was on my farm when my older son ran to me that her mother was not feeling too well. So, I rushed home and found her shaking. I took her to a clinic in Ugbokpo, where a caesarean operation was carried out on her after several hours of labour. Unfortunately, my wife and the baby died during the operation,” Ohepo lamented.
In a similar situation, the family of an 8-year-old girl, Onyikwu Inalegwu, in Obagaji, the headquarters of Agatu LGA, is still asking for justice even after two years of their daughter’s painful death.
Little Onyikwu passed on in May 2018 after she received a month-long treatment for an ailment that affected her stomach, Ogbole Inalegwu said of his late daughter.
“I took my daughter to a private clinic here in Obagaji for treatment for an ailment we could not diagnose. The owner of the clinic is Mr. Ochoyoda Anebi, whom we later learnt had operated in Ugbokpo, headquarters of Apa LGA, but ran to our community after he had carried out some surgeries on people which turned fatal.
“It was at that point that we knew that Mr. Anebi is a quack. He had been lying to us that he trained as a medical doctor in the United States of America,” Mr. Inalegwu explained.
The situation is not different in the Tiv-speaking areas of Benue State. At Gboko South LGA of the state, a 52-year-old blacksmith, Matthew Jande, is suffering a hearing loss on account of gentamicin injection overdose he received at a dispensary.
“My father is suffering what doctors at the Federal Medical Centre, Makurdi, said is “Ototoxicity”, that is, hearing loss. After checking my father’s medical history and the latest treatment he received in October last year at a dispensary in Gboko for bacterial infection, which was a gentamicin injection, they revealed that his predicament was caused by the medicine overdosed,” Jande’s teenage son, Aondona, who accompanied his father to the hospital, said.
For Ukande Terna, he might never be able to father a child anymore as his testicles had been tampered with in the course of carrying out surgery to remove a hernia of the scrotum in Katsina-Ala LGA of the state in 2018.
Dr Otene blamed the problem primarily on the twin issues of the Benue State government’s abdication of its responsibility in combating the “monster” of quacks and creating access to healthcare services, as well as widespread poverty and ignorance among the populace in identifying who a quack is in the health sector.
“I was operated upon for hernia of the scrotum at Akure Clinic, a private clinic here in Katsina-Ala in April 2018. Several weeks after the surgery, the operated area was still producing pus. So, I was advised to seek further medical treatment in Makurdi. As a result, I went to the FMC, Makurdi, where I was diagnosed. It was discovered that a vein around my testicles had been badly affected in the course of carrying out the surgery I had. Consequently, the hospital people requested to see the doctor that treated me earlier, but he was nowhere to be found as he ran away. That was when it dawned on me that he had been operating as a quack,” the 42-old father of two lamented.
Terna, father of two girls, said he had lost self-esteem as a result of his medical condition. He noted: “In a typical African society like Tiv land where high premium is placed on the male-child, what will become of my bloodline when I pass on because I can no longer impregnate my wife so that I can have a male child to carry on my family name.”
In Obi LGA, the family of one Mrs Helen Raphael is cursing an auxiliary nurse whose poor midwifery skills allegedly led to the tragic passing of the 36-year-old housewife in February last year.
According to Enyi Raphael, a resident of Itogo Ward in Obi, his late wife was rushed to a maternity home in the area but died after two days in agonising labour.
“My wife was pregnant. So, when she went into labour in February 2019, I took her to a private maternity home that was being run by a nurse. She kept my wife for two days in labour until she died.
“As soon as my wife died, the nurse ran away. So, I took my wife’s corpse to the General Hospital at Obarike-Ito, headquarters of our council area, but the doctors declined to attend to her dead body, which I had wanted them to remove the dead baby before her burial. At the hospital, the doctors spoke to me angrily for contributing to my wife’s death by subjecting her to someone who was unlicensed to deliver a pregnancy,” Raphael lamented.
When this reporter visited the General Hospital on August 10, 2020, a doctor who was privy to the incident explained that quacks were having a field day in the community, which is leading to needless deaths and other life-threatening health complications.
Drivers of medical quackery in Benue
The umbrella body of medical doctors, the Nigerian Medical Association (NMA), Benue State chapter, described the crisis of medical quackery in the state as an “epidemic” that is in dire need of a multi-pronged approach to deal with.
“Medical quackery is a monster we all have to fight to a standstill. It is a major problem in the Benue State health sector. But it is not just the state; it cuts across Nigeria,” Dr Samuel Otene, the NMA chairman in the state said.
Dr Otene blamed the problem primarily on the twin issues of the Benue State government’s abdication of its responsibility in combating the “monster” of quacks and creating access to healthcare services, as well as widespread poverty and ignorance among the populace in identifying who a quack is in the health sector.
He enumerated other factors that are largely responsible for the problem to include lack of access to affordable medical care, police indifference, dilapidated health facilities, inadequate medical personnel, among others.
“Basically, the doctor-patient ratio in Nigeria is terribly low. Apart from this problem, we are now faced with an additional situation where over 80% of the doctors are gravitating towards the urban areas. So, even when the doctors are few, 80% of the doctors are in the towns and cities. If you go to most of the states in Nigeria, most of the doctors are in the state capitals; nobody stays in the villages. With such a situation, the distribution is so skewed towards the towns and those who live in the villages (rural areas) do not have access to doctors at all.
“There is also another dimension of quackery. It is quackery in itself but most of us do not acknowledge it as quackery. Even if somebody is a certified medical doctor and he is not trained in a particular field, and he goes ahead and carries out a treatment on a patient beyond his actual level of training or expertise, such a person is actually a medical doctor but at that instance such as a person is acting as a quack.
According to the NMA chairman, an alleged quack, Oche Isaiah, carried out myomectomy on one Olekwu Ochijele who was suffering from uterine fibroid in March 2017 at Apa LGA of the state. Similarly, he said, Isaiah operated on another pregnant lady, Deborah Aniheli, who was in labour.
“These two people died right on the theatre bed in Inminyi village of Egba Ward,” Dr Otene said.
Proliferation of schools of health technology
Dr Hameed Mohammed, chairman of the Benue State NMA Anti-Quackery Committee, agreed with his colleagues that the “endemic” nature of quackery in the state must be tackled in a deliberately systemic manner.
Dr Mohammed said his committee had worked for over four years in trying to rid the state of quacks but met brick walls as stakeholders were not willing to discharge their responsibilities in halting the unwholesome practice. He fingered the unregulated proliferation of colleges of health technology in the state as a major driver of medical quackery. In his argument, graduates of these institutions go on to set up clinics without approval from the relevant agencies of government in the state.
The lack of data in documenting incidents of medical quackery in the state is attributed to the general problem of poor management of public institutions in Nigeria. “Data are difficult to come by,” Mohammed said.
“Regularly, we see cases of people who carry out surgeries, but they are not qualified to do so. Even if you are a medical doctor, there is a level of training that you need to do certain surgeries.
“Now, we do not keep records but regularly we see cases of quackery. At the level of the Teaching Hospital and the Federal Medical Centre, we see a lot of cases; and these are the ones that come to the hospitals, we are not talking about the ones who died in the villages or who refused to come out and complain.
“So, it’s really difficult to keep statistics, due to the poor management of data in most public institutions in Nigeria, but we see cases regularly. And if you go round the state, you will see these schools of health technology; in some local governments, you would see up to five of such schools. In fact, if you go to Vandeikya LGA three years ago, they had about four of such schools and they are not accredited.
“In most states in Nigeria, they would have only three or four schools of health technology, but Benue State has over 45 schools of health technology, and over 90% of them are not accredited. These schools are supposed to train primary healthcare centres’ workers like community healthcare and extension workers.
“You know they have a standing guideline where if someone complains of headache, for instance, they would administer a simple treatment and then refer such a patient to the hospital if the ailment persists. But you see the graduates of these illegal schools going beyond their capacity and competencies; performing the duties of doctors and doing surgeries. So, these are extreme cases. Then you have other cases within the professionals too. There is lack of standardization among practitioners,” Dr Mohammed said.
Expert views
In detailing the endemic danger quacks pose to human lives in the state, Shima Gyoh, a retired Professor of Surgery and former Provost of the Benue State University College of Health Sciences, Makurdi, said qualified medical doctors collude with auxiliary nurses and even cleaners at hospitals to run unregistered clinics where patients are being sent to their early graves.
“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.
“At the (teaching) hospital, we were receiving patients with complications; some of them died on the spot. A lot of people were severely injured during operations in unregistered clinics; I mean operations done by unqualified people.
Gyoh, who once chaired the Medical and Dental Council of Nigeria (MDCN) further noted: “There is a regulation which demands that a clinic should be set up by a qualified doctor. It follows that, if there is any malpractice in that clinic, the doctor will be liable and be subjected to discipline by the DMCN. Therefore, clinics are registered by nurses and ward attendants who persuade the doctors to agree that the clinic belongs to them (the doctors) so that the clinic can be registered.”
“I, as a consultant in the hospital, I tried to do investigations on this issue, but I was blocked by my junior doctors because some of them own these illegal clinics and they will not tell you. Sadly, they would treat people there beyond their competences. What happens is that when the patient is about to die, these unregistered healthcare providers would hurriedly send them to a hospital without proper reference note,” Gyoh narrated his experience in tackling the menace.
Gyoh, who once chaired the Medical and Dental Council of Nigeria (MDCN) further noted: “There is a regulation which demands that a clinic should be set up by a qualified doctor. It follows that, if there is any malpractice in that clinic, the doctor will be liable and be subjected to discipline by the DMCN. Therefore, clinics are registered by nurses and ward attendants who persuade the doctors to agree that the clinic belongs to them (the doctors) so that the clinic can be registered.”
The retired surgeon said the problem with the registration authorities is that “they don’t check the background; they don’t inspect, they don’t demand to know what is happening in that clinic.
“So, what happens is that once a doctor has put his signature and collects some money from whoever (nurse or ward attendant) that is registering the clinic, that is the end; he (the doctor) never remembers that a clinic was registered in his name. The practitioner who may be a nurse, a laboratory attendant or even somebody who is just blatantly fearless carries on the activity. He doesn’t receive a visit from the doctor under whose signature that clinic was opened. And the authorities don’t bother to inspect or find out what is happening in various clinics in the state.”
Gyoh also blames the regulatory authorities who are lax with registration of medical facilities in the state.
“When you register a clinic, you are supposed to inspect their equipment, building, staff, and their qualifications and experience. And it is from these that you can determine what can be done at the clinic. You can’t register a clinic that has registered as midwifery for delivering babies, and then the clinic goes on to see people with cardiac conditions and hypertension.
“If you inspect, you will find out that this is what they are doing! And you tell them, no, you have to do this, you have to stop this or we will withdraw your license. No, that does not happen. Once the original money is cleared from various hands, then the person who registered the clinic can do anything. So, the big fault is from the registration authorities. You must never register without specification.
He shared a personal experience to buttress his point about the complicity of regulatory authorities.
“When I retired, I came back to Gboko town in Benue State. I applied to the Benue State Ministry of Health to setup a clinic at the back of my residence. They told me, ‘Yes, setup the clinic and start operating it and we will come and inspect it.’ But I said surely you must inspect it before you agree to what can be done there, but they (Health Ministry officials) said, ‘No, no, no. That is not how we do it. What we practice is you set up and start operating it, we will fix a date to come and inspect it.’ Sadly, they never did.
“That was between 2003 and 2004. I closed the clinic because in 2004, I got a job with a mission organisation, a hospital at Mkar; I got appointed as the medical superintendent of that hospital. So, I closed my clinic. I operated the clinic for a few months, but when I got a job; my principle is if you have a full-time job, you have no right to open a clinic. So, I closed the clinic on my own.
“The State Ministry of Health or the Benue State Government should have a committee to register, accredit and inspect all private and even public health institutions. In fact, as far as I am concerned, all health institutions; if the government health facilities don’t meet up with the requisite standards, they should be shut down at once!”
Magnitude of the problem
While assessing the magnitude of the problem of quackery Gyoh said: “Medical quackery in Benue State is an epidemic. It’s very rampant. You as a citizen, if you go to a government health institution, you will be frustrated. If you are not frustrated, frequently, the doctor there would tell you, ‘Well, look, I can see you here but you won’t get good attention, why don’t you come to this clinic,’ and it happens to be his own private clinic. And because there is no control, it is going on; the public doesn’t have a choice but to use it. It is not only in Benue State, it is all over the federation.
“In 2018, I made a publication on the epidemic of Fecal Fistula. Fecal Fistula is when patients after an operation start discharging stool from the abdominal wound because the diagnosis is made that they (patients) have appendicitis; they (quacks) take out appendicitis and they don’t know how to do it properly due to lack of training or carelessness. After four or five days, stool begins to come out of the abdomen, and when that happens, the way of handling it is very special; you don’t just go back blindly, look at the place where the stool is coming from and you stitch it; if you do that it will worsen the matter, and that is what they (quacks) always do.
“They don’t understand and as a result, many patients lost their lives. Because, if you do that more stool would come out; the short-socketing of the intestine is now more severe; the infective stool excoriates the abdomen, thereby depriving the patient of nutrient; the patient loses weight and becomes anaemic and if you do the third operation, the patient is dead. It is at this point that many of the quacks would refer the patient to the hospital.
“As a consultant surgeon, I dealt with this problem so much. I was so fed up when I came to Benue State that I said there is an epidemic of Fecal Fistula. It was published in the international journal of surgery. It was reported to all the authorities, but they never acted on it. So, I left it!”
Needless deaths and agony
Ms Betty Abah, an award-winning journalist and human rights activist, noted that medical quackery had led to needless deaths and agony in Benue State.
Ms Abah said: “These deaths were as a result of the unethical practices of quacks in the state, and are largely due to the decrepit state of healthcare in Benue State. These deaths are as a result of a comatose healthcare system. A system run shamelessly by quacks at every street corner and completely unregulated. Some state-run hospitals are even worse off. The consequences are avoidable deaths every day.
“In most communities and towns of Benue, auxiliary nurses run private hospitals where major medical surgeries are carried out often leading to needless fatalities. These unlicensed hospitals could be described as mortuaries owing to the unwholesome practices being carried out by quacks.”
Government response
While speaking to our reporter in his office in Makurdi, the Benue State Commissioner for Health and Human Services, Dr Emmanuel Ikwulono (who unfortunately died last week), did not deny knowledge of the existence of quacks in the state. He even emphasised how dangerous they could be.
“Going to the field to investigate this kind of issue, you may be shocked at what you will find; because these quacks are actually very dangerous; they can physically attack you if they know that you are out to expose them. If you go to some villages, they will eat you raw. The quacks would mobilise thugs against you. They are very powerful people, who would not mind killing whoever that wants to expose their criminal activities,” the commissioner had stated.
However, when pressed to comment on what the government was doing to address the problem, particularly the allegation of “abdication of responsibilities in the areas of prosecution of quacks, access to health services and the parlous condition of public hospitals in Benue” by the NMA and other experts on the issue, Dr Ikwulono declined comment.
Rather, he asked the reporter to write a formal letter to his office, requesting vital information concerning the investigative story, so as to enable him to respond appropriately. In fact, the commissioner queried the reporter for speaking to people in the state about the issue without “clearance” from his office.
“Where are the investigative proposal and ethical clearance for this story you are doing? You cannot just go into the field and begin to interact with our people without any form of clearance.
“This is so because you will need to publish data on morbidity and mortality on medical quackery in the state. This will reveal the extent of the problem being caused by quacks in Benue,” the commissioner had argued.
But when an application was submitted on August 25, 2020, requesting data on mortality and morbidity on victims of quackery, statistics on a number of doctors in the state’s employment as well as data on a number of registered private and public health institutions in the state, Ikwulono did not respond and neither did the ministry respond to the enquiry as at the time of going to press.
Nevertheless, findings by the reporter revealed that there are about 40 doctors in the state’s permanent employment. A source at the Benue State Hospitals Management Board in Makurdi confided in our reporter that “there are 120 part-time doctors, who are called Bond Doctors. They are fresh doctors from the medical school, who were given financial aid while studying, so when they finished their studies, they are back in the state to pay back,” the source explained, adding that the “state is in dire need of medical doctors due to the shortage of trained manpower in the system.”
House of Assembly promises to act
On its part, the Benue State House of Assembly Committee on Health and Human Services condemned the activities of quacks but pledged to look into the problem through its oversight duty on the health ministry.
“So, in our oversight, we look at the activities of government agencies, but it is the responsibility of the Ministry to regulate the activities of the private sector, especially these quacks in the medical field. Most of these people operate without a license; posing huge risks to human lives. Therefore, our responsibility as a parliament in the state is to legislate against such obnoxious practices in the state,” said Joseph Okponya, House Committee Chairman on Health.
“In our oversight, we will demand to know how far the Commissioner of Health has gone in dealing with the endemic problem of medical quackery in Benue,” he stated further.
Benue State Police Command reacts
When this reporter, in a text message, drew the attention of the Benue State Police Command to its “unwillingness to prosecute quacks,” the police spokesperson, DSP Catherine Anene, said she could not react to the allegation. “(The) Commissioner of Police may have nothing to say about this (allegation) because it’s not his jurisdiction, please.”
But when the reporter pressed further to have a face-to-face interaction with the PPRO for clarification on allegations of a cover-up and general lack of will by the police authorities to prosecute quacks in the state, Anene replied with a text message that states: “I’m not in the office. I am part of the ongoing police recruitment” [exercise.]
Health as a human right
However, in a telephone conversation on the claim by the police spokesperson that it was not within its purview to prosecute quacks, human rights lawyer, Femi Falana (SAN), countered the authorities.
“No, no, no. What the NMA should do is to petition the Inspector General of Police by virtue of Section 4 of the Police Act. All criminal offences shall be investigated and prosecuted by the police.
The right to health is enforceable in Nigeria by virtue of Article 16 of the African Charter on Human and Peoples Rights Act. Every Nigerian by the provisions of the Act is entitled to healthcare. It is a human right that is beyond Chapter 2 of the 1999 Constitution of the Federal Republic of Nigeria.
“People should learn to enforce the law; the NMA should also petition the Attorney General of Benue State who will then direct the State Commissioner of Police to prosecute the medical quacks in the state. The NMA themselves can also get a lawyer, get some of the investigation done, and then ask for the right of private prosecution. People are not using the law, so we are in trouble. For instance, I have told the Governor of Benue State repeatedly, ‘don’t cry, and don’t say you are helpless,” Falana argued.
On the issue of non-justiciability of health matters in Chapter 2 of the Nigerian Constitution where citizens find it difficult to demand their rights to quality healthcare from the court, Falana said: “The right to health is enforceable in Nigeria by virtue of Article 16 of the African Charter on Human and Peoples Rights Act. Every Nigerian by the provisions of the Act is entitled to healthcare. It is a human right that is beyond Chapter 2 of the 1999 Constitution of the Federal Republic of Nigeria.
“The courts have held that the provisions of the African Charter are applicable in Nigeria. There are judgments of the court where the African Charter had been applied on right to health. For instance, the case of Odafe vs Attorney General of the Federation, where some prisoners required special treatment and they were imprisoned in Port-Harcourt, Rivers State, and the court ordered that they should be removed from the prison, put in a specialist hospital at the expense of the government.”
Another lawyer who specialises in the prosecution of quacks and erring medical doctors before the Medical and Dental Council of Nigeria, Ahmed Adetola-Kazeem, said the extant laws against medical quackery in Nigeria are the Criminal Code Act, Penal Code Act, the criminal and penal laws of various states.
He lamented that corruption has remained the bane of an effective legal battle against medical quackery in Nigeria.
“The level of prosecution (of quacks) is low because of the lackadaisical attitude of the police and their failure to work hand in hand with the complainant(s) which is often times the Medical and Dental Council of Nigeria in ensuring that cases are followed to a logical conclusion.”
“It is the responsibility of the State and the Federal Ministry of Justice as well as the police to prosecute quacks, provided that the police prosecutor is a lawyer in view of section 66(1) of the Nigeria Police Act 2020,” Adetola-Kazeem explained.
Way forward
In charting the way forward in combating the nefarious activities of quacks in the state, Dr Otene opined that the state government has to take a systematic approach.
He said: “There are no problems without solutions, but the solutions have to be systemic. It has to be a systematic solution covering everything. For instance, the health system has to be strengthened; especially the primary healthcare system in Nigeria has to be strengthened because that is the health sector that is supposed to take healthcare to the grassroots. It is not properly funded. It is well-organised on paper but in actual sense, it is not organised as it should be because people do not have these primary healthcare centres functional and comprehensive within reach in their communities and villages. They are forced to patronise alternatives that might end up either maiming them or taking their lives.
“If we strengthen our primary healthcare system and our universal health coverage, we strengthen our national health insurance scheme or community-based insurance scheme; because with the national health insurance scheme or community health-based insurance scheme, what we are actually doing is to get a better financing option for healthcare for our population, so that people that get sick do not nurse the fear that, ‘Oh my God, if I go to the hospital, I have no money on me to pay.’ So, when all these are in place, they would know that when they go to the hospital, they can access healthcare from an insurance scheme that is on the ground.
“So, Nigeria has to, apart from strengthening its primary healthcare scheme, strengthen our health insurance scheme; make healthcare more accessible and affordable to the average Nigerian.
“When Nigerians can differentiate a qualified medical doctor from a quack and can reach a doctor as fast and easily as a quack and will pay with little difference to the quack as I pay the qualified medical doctor. Nigerians are not fools; most people will prefer to be seen by those they know are better trained to see them. But when you take options off the hands of a human being, then you leave them with whatever is left at their disposal.
“It is a complex problem and the solution has to be multi-pronged. Eventually, there has to be better financing of healthcare. We always say we are committed to budget 15% of our national budget annually to healthcare, but I doubt if we have ever crossed 5% of that. Sometimes, the budget is 3.9% or 3.7%, 4%. We hardly cross 5% and we are supposed to commit 15% minimum of our annual budget to health and health-related issues.
“Clearly, just like every other sector in the country, health is not as funded as it should be.”
On his part, Dr Mohammed said: “So, there should be regular, periodic inspection of healthcare centres to ensure there is compliance with laid down rules and procedures of service delivery in the medical profession. They are not doing this, and I guess it is because of logistic challenges or so.”
For Adetola-Kazeem, the problem can be dealt with in a decisive manner: “The [Benue] State [government] should work more with the Medical and Dental Council of Nigeria as the institution that licenses medical and dental practitioners and has the absolute authority to determine who is a real or fake doctor.
“The state should also properly monitor and ensure that Police Officers are properly trained to be able to effectively investigate and gather evidence that will lead to the eventual conviction of quack doctors. The state should also ensure that the police are properly monitored to ensure there is no compromise and to make sure those who compromise are brought to book. The prosecutors should also be properly trained to ensure a positive result at the trial.”
This report was supported by the Institute of War and Peace Reporting (IWPR) and the International Centre for Investigative Reporting (ICIR).
