Snake bite, Lassa Fever and the Reality of System Failure (III)

Two young women died in Nigeria this week. Ifunanya Nwangene and Dr Salome Oboyi. One was a budding celebrity singer bitten by a snake, the other a doctor who got infected with Lassa fever from a patient. They did not die because their conditions were mysterious or because medicine has no answers. They died because […]

Two young women died in Nigeria this week.

Ifunanya Nwangene and Dr Salome Oboyi. One was a budding celebrity singer bitten by a snake, the other a doctor who got infected with Lassa fever from a patient.

They did not die because their conditions were mysterious or because medicine has no answers. They died because the systems that should have saved them failed quietly, predictably, and repeatedly.

This is the third and final part of my reflections on medical negligence. And perhaps the most uncomfortable truth of all is this: sometimes negligence is not about a careless doctor or a lazy nurse. Sometimes it is about a health system that keeps setting its workers and patients up for failure.

We like simple villains. We like to name and shame. We like to ask, “Who was on duty?” We like to go on TV and spew rubbish (by the way, how did a prominent television station air that rubbish talk show, where someone said why was she ‘on drip’? Is it malaria? – I had to bury my head in shame!) 

Systems thinking forces us to ask harder questions: Why was the system structured in a way that made this outcome almost inevitable?

Take snakebite.

Nigeria records thousands of snakebites every year, particularly in rural and farming communities. We know when and where they occur. We know the species involved. We know the antidote. We know the window of time in which treatment works best. None of this is new knowledge. and yet, how many hospitals, especially secondary hospitals outside state capitals, actually have a clear, written protocol for managing snakebite?

How many emergency units’ stock effective antivenom? How many clinicians have been trained, retrained, and supported to act fast when a patient arrives gasping, swollen and terrified?

How many lives do we have to lose to snakebites before we accept that this is not a “rare emergency” but a predictable public health problem?

When a young woman dies from a snakebite in 2026, it is not enough to say, “She came late,” or “The hospital tried.” A system that works plans for the realities of its environment. In snake-prone regions, antivenom should not be an optional extra. Protocols should not exist only in textbooks or donor-funded workshops. They should be printed, visible, practiced, audited.

Next, Lassa fever

Every Nigerian doctor knows the fear, the fever that looks like malaria, the patient who deteriorates suddenly, the anxiety that spreads through the ward when the diagnosis is suspected, often too late.

And yet, every outbreak reveals the same cracks: delayed diagnosis, inadequate isolation facilities, poor infection prevention practices, and the haunting question whispered in corridors: Where is the Ribavirin?

How many doctors, nurses, and laboratory staff do we have to lose before we take infection control seriously not just as a lecture topic, but as a lived culture? System thinking demands that we stop pretending that individual vigilance alone can compensate for systemic neglect. You cannot “be careful” your way out of a poorly ventilated ward. You cannot “wash your hands” into safety when gloves are rationed and running water is unreliable. You cannot improvise Ribavirin when supply chains are broken and emergency stockpiles do not exist.

When a health worker dies of Lassa fever, it is not just a personal tragedy. It is a system failure; one that tells every remaining worker that their life is expendable.

The truth is this; health systems are perfectly designed to produce the results they produce. If our hospitals repeatedly fail snakebite victims, then our system is designed to fail them. If Lassa continues to claim the lives of both patients and caregivers, then our system is designed to be unsafe. and this is where the conversation about medical negligence must mature.

Punishing individuals without fixing systems is like mopping the floor while the tap is still running. It may make us feel morally satisfied, but it does nothing to prevent the next death. It also asks us to confront uncomfortable truths about governance. Health does not fail in isolation, procurement systems, supply chains, training institutions, oversight and leadership fails. And when leadership fails, patients die.

The two young women who died this week did not die because Nigeria lacks brilliant doctors. They died because brilliance cannot substitute for structure. No amount of individual excellence can compensate for missing protocols, empty pharmacies, or unsafe wards.

If we are serious about preventing medical negligence, then prevention must move upstream away from courtrooms alone and into boardrooms, ministries, and policy tables.

We need national snakebite management guidelines that are implemented, not just written. We need antivenom access mapped to high-risk regions and an emergency referral system. We need continuous training that is practical, not ceremonial.

We need infection prevention to be treated as infrastructure, not advice. Functional isolation spaces. Reliable personal protective equipment. Guaranteed access to Ribavirin during outbreaks, not apologies after funerals.

Most importantly, we need to stop normalizing preventable deaths.

Every time we say, “May Nigeria not happen to you,” we lower the bar of what we consider acceptable. Every time we shrug at another avoidable tragedy, we teach the system that it can continue unchanged.

The health system does not need heroes who die silently. It needs structures that protect the lives patients and providers.

So, I ask again; how many lives do we have to lose before we decide that preventable deaths are unacceptable? How many funerals before we replace improvisation with preparation?

Medical negligence is not always a bad doctor. Sometimes, it is a broken system and fixing it is a collective responsibility we can no longer postpone.