MANY indigent residents of Benue State are dying at the hands of unqualified medical personnel due to shortage of qualified medical doctors in most rural communities in the state. Auxiliary nurses and laboratory scientists across the state posing as medical doctors often send hapless patients to their early graves. Ameh EJEKWONYILO reports.

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 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.

“When we asked ‘Dr. Onuh’ why Stella’s health was getting worse by the day, he responded that, ‘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 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 the oxygen but to no avail.

Relating Stella’s last moments, her grieving aunt said, “Stella said she didn’t want to die, but as 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 an 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.

Stella’s heart-rending story is similar to that of a 12-year-old boy, Gabriel Oche, of  Ijege-Amejo in Okpokwu LGA of Benue State, who 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.

“By the time I got 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 1^st 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 communities of Apa and Agatu LGAs of Benue State, two families are grieving over the tragic demise of their loved ones.

A 25-year-old housewife,  Alice Ohepo’s two children are still dazed by their mother’s death in January 2020,  Jonathan Ohepo said of the agony his wife’s death had brought 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 shaking. I took her to a clinic her 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 in the state is still asking for justice even after two years of their daughter’s 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 learnt later was operating in Ugbokpo, Apa LGA, but ran away to our community after he carried out some surgeries on people in the area 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 at Gboko South councilof the state, as 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 in Makurdi said is “Ototoxity”, that is, hearing loss. After taking my father’s medical history and the latest treatment he received in October last year at a dispensary in Gboko for a 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 Vandeikya, Katsina-Ala LGA of the state in 2018.

“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, noting, “in a typical African society like the 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 council area, the family of a 36-year-old housewife, Helen Raphael, is cursing an auxiliary nurse, whose poor delivery midwifery skills allegedly lead to the deceased’s tragic passing 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 of 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 submitting her to someone who was unlicensed to deliver a pregnancy,”  Raphael lamented.

When our correspondent 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.

The NMA chairman in the state,  Samuel Otene, said, “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.”

The NMA boss 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 per cent 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,” the NMA said.

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.

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 approvals 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.

“He continued: “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 per cent 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.

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.

“I as a consult 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 a proper reference not,” Gyoh narrated his experience in tackling the menace.

…To be concluded tomorrow

This report was supported by the Institute of War and Peace Reporting (IWPR) and the International Centre for Investigative Reporting (ICIR).