Fighting malpractices: Nigeria’s small steps

He simply told the regulators to shove it, and got to work – at Asokoro District Hospital, one of the major hospitals in Nigeria’s capital, Abuja. When plainclothes policemen came for his arrest, they waited for the time it took for Basina to finish a craniotomy surgery he’d started hours before.He’d done similar surgeries – […]

He simply told the regulators to shove it, and got to work – at Asokoro District Hospital, one of the major hospitals in Nigeria’s capital, Abuja. When plainclothes policemen came for his arrest, they waited for the time it took for Basina to finish a craniotomy surgery he’d started hours before.
He’d done similar surgeries – all without licence from the Medical and Dental Council of Nigeria, which regulates medical practice for all Nigerian-schooled doctors and grants practice licence to foreign-schooled doctors.
Among documents Basina filed in his application are photocopies of credentials from Nazims Institute of Medical Sciences and Rangaraya Medical College.
For Basina, getting a licence to practice in Nigeria is too tedious.

At a point, he insisted practice licences were easily ordered over the phone in India or took less than two days in the US.
“Can I do this in India? I go to India, I apply, and while waiting for them, I start practising?” questioned Dr Henry Okwuokenye, head of the MDCN’s inspectorate.
He insists an “application is not equivalent to licence.”
The council’s grievance is about Basina already working at the hospital months before he applied for a licence. And he was already into the second year of his contract at the hospital.
The council questioned how he was hired and his contract renewed by the administration of the Federal Capital Territory whose establishment unit and health secretariat centrally hires and posts doctors to district hospitals, managed by the Hospitals Management Board.
Basina didn’t make it before the council’s tribunal before he got his licence, but dozens of doctors are beginning to appear before the tribunal on malpractice charges.
The tribunal has the status of a high court; its decision is final and can only be challenged before an appeal court.
 Patients continue to hold their doctors next to God, but widening moves to sanitise the profession is tearing doctors from their pedestal. It is fishing out quacks and at the same time holding the work of doctors up to intense scrutiny.
“If someone doesn’t behave like a doctor, make a report. That little suspicion can give him away,” says Okwuokenye. “There is nothing wrong about reporting a doctor to us.”
Uwa Osagie reported his doctor’s treatment of a gunshot wound to his leg in March 2013.
He claimed his doctor, Sunday Olusoji, did not do an x-ray before binding his shot leg, leaving pellets still embedded within, resulting in a later amputation of his right leg.
His case is among over a dozen that’s come before the tribunal this year. Four on-call doctors at Federal Medical Centre in Lokoja have stood trial for failing to attend to a patient’s surgery need until the patient died.
Uyo-based Dr Fabian Upuji appeared before the tribunal on charges of negligence after he did a myomectomy on a patient, even though he wasn’t a consultant obstetrician and gynaecologist, and failed to refer the patient when complications set in.
Port Harcourt-based Dr Asemota Orhi’s patient was given sedatives without adequate monitoring. By contrast, Dr Richardson Ajayi came before the tribunal in 2013 after an interview he granted CNN’s Christian Purefoy in which he claimed to be the first to establish an IVF clinic in Nigeria.
The tribunal can go after doctors gone wrong for things as missing treatment protocol, if a patient is bold enough to report it.
When Mary Ubi was due to give birth, she was hospitalized at Kubwa General Hospital in Abuja. She was induced into labour at 12.40p.m. was due for review every four hours, but her doctor Freeman Miri didn’t do any reviews until nearly eight hours later.
He merely stated his patient was “in painful distress”, did not indicate her vital signs, concluded she was in second stage of labour, and referred her to a sister hospital but made no arrangement for her transfer.
Ubi died, prompting investigation into Miri’s practice, but he failed to honour the tribunal’s invitation three times, prosecutors said.
The cases abound – patients whose bladders are ruptured in a hernia surgery and referral fails in resulting peritonitis. The veneer of mystery that surrounds a white coat and stethoscope is lifting and bringing in the cases.
“They are on the increase because people are becoming aware of their rights,” says Dr Abdulmumini Ibrahim, registrar of MDCN. “In the past, people say a doctor is next to God, but people are becoming aware and that statement does not hold water.
“For anyone who errs, there is somewhere you can report that doctor and he will be thoroughly probed to know whether he is doing his job right or not.”
But that only works with qualified doctors over whom the tribunal has powers. Quacks are a different set of trouble, because it can do no more than hand them over to the police for prosecution.
The worry is whether the public can tell a quake from a misbehaving doctor.
MDCN regulations require doctors to display their updated practice licence on their office walls visibly to patients.
“If you are going to pay somebody for treatment, you have a right to demand to see their licence,” says Okwuokenye. It is a simple rule of thumb.
“Fakes most times will get angry. But if it is displayed, you don’t have to ask.” :
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