ON March 26, the Nigerian Medical Association, NMA, Kano State branch urged its members to make use of their two months hazard allowance in the face of COVID – 19 pandemic, to purchase Personal Protective Equipment, PPE, for themselves in health facilities where it is unavailable.

In a memo announced by the association which was confirmed by the state chairman, Sanusi Muhd Bala, to The ICIR, it cited the rising number of COVID – 19 infections among doctors and health workers globally, which it described as alarming. The doctors were advised to consider the move as a priority to protect themselves while carrying out their duties.

Speaking to The ICIR in a telephone interview, Bala painted a grim picture of scarce protective equipment for doctors in the state, and their anxieties with the government for failing to adequately prepare for a potential COVID – 19 outbreak.

“The government has failed to make protective kits available to health workers despite the repeated appeal we’ve made to them in the past, especially during the Lassa fever outbreak in Kano State which claimed the lives of two doctors earlier this year who contracted the disease from their patients,” he said.

Muhammed Bala, a consultant nephrologist at the Aminu Kano Teaching Hospital, Kano and currently overseeing the welfare of doctors in the state, is one of the thousands of doctors in Nigeria without PPE, including masks, gowns and eye gear while treating patients.

“The hazard fee paid to doctors in this country is N5,000 which is very small, for instance, if a doctor on the frontline contracts a disease while treating a patient and loses his life there is no financial cover or insurance that covers him or his family.

“When we lost two doctors to Lassa fever early this year their families were given N1 million each and that was the end of it no other form of compensation has been made to-date, despite our letter to them,” he said.

Though Kano State has not officially recorded a confirmed case of COVID – 19, the lack of critical infrastructure for doctors is a source for worry in case of an outbreak.

For doctors at the forefront of containing the COVID -19 pandemic in Nigeria, the federal government pays doctors in public hospitals a monthly hazard fee of N5,000 monthly, which is equivalent to $13.64, for any risk they might encounter while carrying out their duties.

Their counterparts in Sierra Leone who attend to Ebola patients earn $115 weekly for the period they are working, which translates into a monthly payment of $460, more than 30 times what is earned by Nigerian doctors as hazard claims.

In Liberia, during the Ebola epidemic, which claimed the lives of 95 medical personnel, the Liberian government-paid health workers in the frontlines a monthly hazard pay of $435 while doctors received $825 monthly apart from their salaries which was almost doubled.

However, in some other African countries, the situation is different as doctors are not paid hazard allowances but have compulsory insurance indemnities for medical induced risks they could face in the course of offering treatment to patients.

On March 28, Ghana’s Minister of Health, Kweku Agyeman, announced a special life insurance cover for 10,000 medical personnel in Ghana who would be deployed to the frontlines in a COVID – 19 national pandemic response which is expected to last for a period of one year.

The total premium for the medical personnel was pegged at GH₵10,309,919 which is equivalent to $1,786,646 consisting of temporal disability from any cause during the period at GH₵10,000 per life, for the case of a critical illness within the time frame of the insurance is GH₵25,000 per life and a group life insurance plan to cover GH₵350,000 per life.

This means that if a Ghanian doctor treating a COVID – 19 patient contracts the disease the insurance fee that would be paid by the Ghanian government to the doctor is GH₵25,000 which is estimated to be $4,332 translating to $361 monthly.

In Congo DR, doctors who are first responders during the Ebola outbreak received $250 as hazard pay alongside their salary though complaints are rife among Congolese health workers who say that the risk they were exposed to was way higher compared to the pay they received.

Available data on hazard allowance to doctors in several African countries is not publicly accessible as some countries resort to offer a full insurance premium for their doctors to cover their indemnities.

Section 17 of Nigeria’s amended Employee’s Compensation Act requires that if death results from the injury of an employee, compensation shall be paid to the dependants of the deceased which if two or more children, a monthly payment of a sum equal to 90 per cent of the total monthly remuneration of the employee as at the date of death.

Maurice Elike, a paediatrician at the University of Abuja Teaching hospital, Gwagalada, speaking to The ICIR said the hazard pay was fair but if a doctor died from a disease contracted while treating a patient there was no insurance to cover such a doctor.

“The hazard pay is not substantial but it would be fitting to have full insurance to cover doctors who may die from a disease or contract the disease while treating a patient unfortunately that is not the case,” he said.

According to a study published on medRxiv, doctors who attend to COVID – 19 patients are prone to be exposed to the risks of getting infected without an insurance cover.

“However, as many individuals in the community may be asymptomatic carriers, physicians across specialities are at risk of acquiring the disease as a part of the patient contact during care delivery,” the study says.