When Healthcare Providers Become Harmful

A recent wave of alarming instances of medical negligence has resulted in the unfortunate deaths of Nigerians and has left others requiring urgent medical assistance, mandating a comprehensive overhaul of Nigeria's healthcare system.

Over the past few months, numerous cases have come to light, including the passing of Chimamanda Ngozi Adichie’s son, who reportedly died after receiving an excessive dose of propofol and was inadequately monitored during a procedure at a Lagos hospital. Another case involves Aisha Umar, a mother of five, who died after hospital staff in Kano left surgical instruments inside her body and failed to respond to her ongoing pain complaints months later. Additionally, Peter Afolayan had hernia surgery at a hospital in Ekiti, only to later discover through scans at other facilities that both of his kidneys had been removed without his knowledge.

In this particular case, the Ekiti State Government took action by firing the surgeon involved, suspending other staff members, and promising to finance Mr. Afolayan’s kidney transplant; however, the patient remains on life support and is enduring chronic pain. While Mr. Afolayan’s circumstance may eventually be addressed at a significant financial cost, many cases of medical negligence offer no second chances for the affected individuals.

Research indicates that the prevalence of medical errors in Nigeria varies between 42.8% to 89.8%, with around 33.3% of patients suffering additional harm due to their treatment. Estimates suggest that close to 250,000 people die yearly as a result of medical errors. Though this figure cannot be independently verified, it serves as an indication of the magnitude of this crisis.

The high incidence of such issues, combined with systemic pressures resulting from inadequate doctor-to-patient ratios and poor infrastructure, has caused 61.69% of Nigerian patients to perceive healthcare professionals as arrogant and indifferent towards their health conditions. The frequent hostility faced by patients, including women in labor at public hospitals, has become so prevalent that it seems almost normalized. This situation is unacceptable.

Deteriorating work conditions have prompted a brain drain, especially in the medical field, with an estimated 16,000 doctors leaving Nigeria in just five years. Furthermore, between 2017 and 2025, an additional 16,156 Nigerian- trained nurses and midwives have been granted licenses to work in the UK. This exodus has left Nigeria with a shocking doctor-to-patient ratio of 3.9 per 10,000 (or 1:3,500), significantly below the World Health Organization's recommendation of 1:600, whereby only half of the more than 74,000 licensed doctors in Nigeria work in the country. Those who remain are often overworked, underpaid, and must deal with outdated equipment and a lack of essential medical supplies, complicating their efforts to provide adequate care.

In recognizing the numerous systemic failures that have led to countless instances of medical negligence, it is crucial to highlight that considerable gaps in legal and accountability frameworks have allowed such irresponsible actions to persist. For example, the number of formal complaints or lawsuits seeking compensation is surprisingly low relative to the number of medical negligence victims, primarily owing to the victims' lack of awareness or financial shortcomings. The average Nigerian lacks knowledge regarding the obligations their healthcare providers owe them, much less the possibility of legal action when these obligations are violated.

The government, alongside legal and medical entities, must prioritize closing this gap. It is essential to clarify and efficiently manage accountability measures for healthcare providers and the medical system, making them accessible to all Nigerians at every healthcare facility. Moreover, the government should ensure that systems are in place to provide legal representation for victims of negligent medical practices, independent from hospital management to ensure equity for both patients and medical professionals.

At present, victims have the option to pursue civil lawsuits for negligence, file criminal charges under the Criminal Code Act, or make complaints to the Medical and Dental Practitioners Disciplinary Tribunal, yet these avenues are often out of reach for many Nigerians.

Section 343 of the Criminal Code mandates that anyone who carelessly or negligently administers medical treatment in a way that jeopardizes life is guilty of a misdemeanor, while Section 317 allows for prosecution in cases of unintentional unlawful killing. Unfortunately, the current system is biased against victims, placing the burden of proof on the aggrieved party, who must supply evidence to substantiate claims of negligence against medical practitioners. This requirement does not meet the standards expected of a reasonably competent healthcare worker.

Currently, many patients are not aware of their rights, and cultural stigmas can deter them from confronting medical professionals. The continued silence of these victims only sets a precedent for further individuals to face similar or even worse outcomes. Therefore, the government and civil society organizations must implement strategies to ensure legal recourse for impoverished and uninformed Nigerians, as well as promote awareness about existing options.

The Federal Government's initiative to create a National Task Force on Clinical Governance and Patient Safety, led by the Coordinating Minister of Health, Muhammad Pate, is praiseworthy. However, more action is required beyond the committee's objectives to establish and standardize national clinical governance and patient safety protocols, enhance systems for preventing and reporting negative incidents, and expand workforce capabilities through training.

Nigeria must confront the systemic failures that contribute to this culture of negligence and increase healthcare funding beyond the current allocation of 4%. Strategic investments in the healthcare sector will not only preserve lives but also dramatically decrease Nigeria's medical tourism expenditure, currently projected at $1.3 billion annually. The era of Nigerians suffering or dying unnecessarily due to medical negligence must end, and all stakeholders need to collaborate to realize this aim.