By Sam Eyoboka
THE ‘resurrection’ of 70-year-old Amos Otene after he was certified dead by medical practitioners and made to spend over 30 hours in a mortuary in Makurdi, Benue State capital has thrown up a debate. Doctors, according to a report, at a private hospital in the town had, on Wednesday, August 26, 2015, certified Otene dead at 4.30 a.m. and wheeled him into the mortuary, awaiting instructions from members of the family for embalming.
The report stated that, but for the visit by the son of the ‘deceased’ to confirm the news, the Otene family would have been preparing to inter the agriculturalist who retired from Benue State civil service three years ago. The old man had toothache and was rushed to the private clinic, on Tuesday, August 25. A day later, he was certified dead and the doctors whose names were not mentioned in the report could have immediately ordered his embalming, but there was no family member to give the go-ahead. So they wheeled him to the morgue.
30 hours thereafter, Eche Otene, the son of the ‘deceased’, who lives in Lafia, Nasarawa State, came visiting and the hospital was thrown into confusion when the father raised his hand to acknowledge the presence of his son and followed that gesture by sitting up on the mortuary trolley.
The question now is: Was the man sentenced to death by an inexperienced medical team or he actually died but was brought back to life by God?
To the science-inclined minds, Pa Otene could not have died in the first place and the question of resurrection was out of the question. The only explanation, according to a Makurdi-based medical practitioner, Dr. Ameh Edace, is that the retiree could only have been “in a long coma”.
The Medical Director of Rekiya Memorial Hospital, Kaduna, Dr. Bello Mohammed, said that “in the history of medicine, there has not been any case of anybody coming back to life after being certified dead.” He added: “If a person is pronounced clinically dead, he remains dead and there is no way he can come back to life, certainly not after 24 hours. On this case in question, the only medical explanation is that the patient was in a long coma.”
To this school of thought therefore, if doctors had certified Pa Otene dead, then the competence of such doctors should be called to question. In other words, something must be amiss with the death certification.
Head of God
The miracle school of thought, however, is quick to differ from the medical point of view, arguing that miracles are real and what happened in Pa Otene’s case could only have been the hand of God at work. Benue State Chairman of the Christian Association of Nigeria, CAN, Archbishop Yimam Orkwar, had not read the story when we called him, but, as a believer, he described the debate as unnecessary, urging Nigerians and indeed the world at large not to doubt the ability of God to heal or even bring back to life anybody certified dead by man.
According to him, this can only be a miracle of God and not a medical error because it’s not possible for a man erroneously pronounced dead to survive 30 hours in the morgue. “It must have been God, who had promised to do great miracles in our time, who raised the man to life and at the time he did,” the archbishop submitted.
Warri-based God’s Kingdom Society, GKS, affirmed that stories of dead people coming back to life after they had been certified dead abound with some waking up in the mortuary, others reviving while lying in state, some others just before the grave is covered. The church recalled that several years ago, in England, the ambulance conveying a corpse to the graveyard had an accident and the man rose up.
The church stated: “In several of these cases, one cannot escape the conclusion that the persons were not yet dead though they were not exhibiting signs of life anymore. Human beings are imperfect. Medical doctors could certify someone dead whereas there is still life in him. Matter of life is in the hands of God. The Bible says that in the hands of God Almighty is the soul (life) of every living thing, and the breaths of all mankind”.
The GKS’s Publicity Secretary, Brother Benedict Hart, argued that despite the advances made in science, it is only God who knows all there is to know about life. Hart went on: “The medical people have their limitations. Someone could still have life in him whereas doctors could have certified him dead, going by what the books say or what they have been taught.
“Another point is that it is a very easy thing for God to raise people back to life to show man that He exists and that He is the Owner of life. Such miracle will move people to fear Him and praise His name. God told Pharoah: `And in very deed for this cause have I raised thee up, for to shew in thee my power; and that my name may be declared throughout all the earth.’ (Exodus 9:16)
“The second book of Kings has the record of casket bearers who, on seeing a band of marauders, abandoned the body they were carrying. Incidentally, the corpse fell into the burial place of Elisha and the man `revived, and stood up on his feet’ (2 Kings 13:21). This was a clear case of God doing a miracle to revive the belief of the people in His power over life and death. Death is one of the ways God instils in man the somber reality that he is mortal; that, no matter how powerful a man may be, he is still subject to death. He alone has power to bring a man from dead condition back to life. Some of the cases of those who came back to life fall into this category; they had actually died but were raised by the Almighty, just to make the point about the infinitude of His power and pointedly declare to man his limitations.
“Even if someone had been in the mortuary for four days, and God wants to make a statement by bringing him back to life, nothing with Him is impossible (Jeremiah 32:27, 17). How many days was Lazarus in the grave before Jesus Christ brought him back to life? In fact, Christ told Martha, `…I am the resurrection, and the life: he that believeth in me, though he were dead, yet shall he live” (John 11:25).
There is a third school of thought made up of those who had had reason to rush close relations to some of the nation’s health institutions at the various levels. About 90 per cent of respondents from different parts of the country agree that the medical sector is not dead but in slumber with several arguing that, as a result, business is booming for traditional healers and alternative medicine practitioners, especially herbal preparations from Asia and other parts of the world.
Delta State, a major oil and agricultural producing state, was created by military fiat on August 27, 1991.
Thus far, the state government has spent ¦ 5,463,776,470.82 on the procurement of equipment for its hospitals and health centres.
Despite this, the General Hospital in Agbarho, Delta State has been disconnected from the national grid in the last two years as a result of technical challenges. When the electricity authority, in collaboration with the Agbarho Urhobo Improvement Union, AUIU, fixed the fault this year, the Benin Electricity Distribution Company slammed the secondary health institution with a bill of over N1 million which the hospital’s resources could ill afford. Since then, except you make personal arrangement to supply diesel to power its generator, if your pregnant wife requires surgery to deliver your baby, your best bet is to look elsewhere because a visit to the hospital at night is a sorry sight.
The story of Ughelli Central Hospital and its counterpart in Warri may not be that pathetic, but they are no better as the facilities are in dire need of maintenance and stories abound of patients who leave the state’s various healthcare facilities worse off because there are several breeding grounds for malaria-bearing mosquitoes whenever it rains. Roads to most accident and emergency wards in the state are ridden with yawning potholes that make ambulances and their passengers, mostly persons who require utmost tranquility, dance to strange rhythms.
These developments are not perculiar to Delta State. Neighboring Edo State plays host to a number of tertiary health institutions, some owned by the federal and the state governments. A visit to the University of Benin Teaching Hospital commissioned in 1973 as the sixth of the first generation teaching hospitals in Nigeria, to complement her sister institution, University of Benin, and provide secondary and tertiary care to the then Midwestern Region (now Edo and Delta States) and environs, easily exposed the tragedy that is our nation’s healthcare delivery system.
At inception, its goals were encapsulated in her motto: Healing, Research and Training. Initially commissioned as a 300-bed hospital in 1973, UBTH is said to have expanded her facilities tremendously over the years such that it now has facilities for over 500 in-patients.
On September 2, 2015, a middle-aged man was rushed to the Accident and Emergency Ward of UBTH and, after preliminary examinations, the medical team on duty prescribed drugs for him. The wife, after enquiries, sped off in search of the pharmacy. For a first timer, the process of procurement of drugs at UBTH, to say the least, can be arduous. The lady walked the long distance to the pharmacy where she was further directed to the revenue unit to make payments before returning to collect the drugs. While she was in the process, her husband was reported to have rolled from the bed he had been put and fallen face down on the concrete floor of the ward. He allegedly died even as an army of paramedics, porters, nurses and several doctors watched.
Poor lady! It was bad enough that her husband of seven years passed on leaving her with three hapless mouths to feed. She went hysterical, screaming and screaming. There are claims of several of such incident in the hospital.
One of the objectives of UBTH is to provide facilities for training of high and middle level manpower for the health industry and spearhead research opportunities for lecturers in the university and other interested persons with local morbidity burden as research question.
Asemota Ebhonhon, not real name, whose father allegedly died after two weeks at the Neorology Ward A5 of the hospital, concluded that the only focus of the UBTH was manpower development, arguing that all the days the father spent in the ward could have been beneficial if the experienced medical practitioners devoted more time to doing their duties. According to Asemota, “these non-committed young lads are made to gamble with patients while the doctors, registrars, consultants come once in a while to flip through medical case notes without appreciable inputs to help dying patients. Where there are obvious mistakes by the boys and girls on housemanship, patients are not carried along and, at the end, they are made to bear the consequence of the laxity.”
Asemota, a UK-based medical student, maintained that the consultants are more pre-occupied with their private clinics, stressing: “Can you imagine a UBTH without a CT scan machine? Instead, they will recommend you to some private diagnostic outfits in town. My father had stroke and was rushed here and they kept pumping intravenous fluids into his system until he was bloated. My elementary knowledge tells me that the objective of IV fluid is to carefully achieve and maintain a euvolemic and isotonic environment within the body as well as to provide for a variety of nutritional and pharma-cologic interventions. They did this without consideration for the ability of the patient to sustain fluid volume changes that result from intravenous administration of salt and water.”
Lamenting the poor state of the nation’s healthcare system, a Delta State-born medical practitioner described the situation as “pathetic”, maintaining that the National Hospital, Abuja, established under Decree 36 of 1999 and commissioned on May 22, 1999 by Gen. Abdusalami Abubakar (retd), with state-of-the-art technology, could not respond to Senator Godswill Akpabio’s injuries arising from an accident.
Akpabio, the immediate past governor of Akwa Ibom State, sustained injuries in an accident in Abuja but preferred to seek medical help overseas than do so at the N30 billion Ibom Specialist Hospital, Uyo, he commissioned before leaving office last May. Unveiling the facility then, Akpabio told Nigerians the hospital was of world-class specialist standard with ultra-modern medical facilities that would attract medical tourism to the state.
A doctor friend, who wanted to remain anonymous, blamed politicians for the sorry state of our healthcare delivery system, saying: “Our politicians travel abroad for ailments that can be handled by our doctors. I recall a situation whereby a Nigerian parliamentarian was diagnosed for a life-threatening ailment by a medical practitioner who recommended surgery. The politician left and took the next available plane to the U.S. for the surgery. The good news was that he had to wait three additional days before the surgery was done by the same doctor he rejected in Lagos, paying five times the original charge. Death is the cheapest commodity in Nigeria, and it is available mostly for the poor”. This position was echoed by several medical practitioners during the course of our survey.
There is also a conspiracy theory that suggests that doctors and other practitioners in the health care sector cover up for each other’s failures and faults. An 88-year old woman was rushed to a private clinic in Agbarho, Delta State, on Sunday, August 30, 2015 with complications arising from high blood pressure. She was praying to God to spare her life as she walked into the clinic where an array of auxiliary nurses held sway while the medical director was said to be out of town. One of the nurses, after preliminary investigation in the absence of a qualified medical practitioner, decided to administer an injection which immediately sent the old woman to a coma. Nobody has admitted the obvious medical error. The children have since then committed huge sums to revive the old woman and may be considering a legal action against the private clinic.
Nigeria is said to have one of the highest maternal and infant mortality rates in the world and this necessitated the greater attention given to maternal and child health (MCH) services in the country’s Bamako Initiative (BI) programme. MCH consumers, who are often poor, are also at extraordinary risk of receiving poor or no health care. Nigeria’s infant mortality rate is about 96 per 1,000 live births in rural area against 75 per 1,000 live births in urban area (East African Medical Journal, 2004).
Infant mortality (death of children under one year) and under-five mortality are 100 and 210 per 1000 live births respectively and these deaths from preventable causes such as malaria (24%), pneumonia (20%), diarrhea (16%), measles (6%) and HIV/AIDS account for more than 71% of the estimated one million under five death in Nigeria in 2004 (FMOTT, 2007).
Some of the contributory factors to infant mortality in Nigeria include malnutrition, poor environmental hygiene, low access and utilization of quality health care services by women and children; others include but not limited to low female literacy level, poor family health care practices and lack of access to safe water.
An overview of healthcare financing in Nigeria, published in International Journal of Health Policy Management on January 2, 2015, noted: “The situation in Nigeria shows that government funding for the health sector has been unsatisfactory over the years. Evidence reveals that, by the early 1980s, the annual government allocation to health was estimated at $533.6 million. However, it nose-dived, reaching a trough of $58.8 million in 1987. Between 1996 and 1999, there was an increase, and by 2002, it rose to $524.4 million, then climaxing to about $1.79 billion in 2013.
“The irregularity in budgetary allocation to health reflects in the percentage of total yearly budget, as evidence reveals a pattern from as low as 3.6 per cent in 1996 increasing to 5.0 per cent in 1997; then declining to 2.7 per cent in 2000 and then rising marginally to 5.6 per cent by 2013. Some reports even reveal it remained at about 1 per cent in the 1990s to just under 5 per cent in the last decade”.
According to a study published in the Nigerian Medical Journal titled: ‘Community based healthcare financing: An untapped option to a more effective healthcare funding in Nigeria’, “between 1996 and 2000, federal budgetary allocation to health in Nigeria ranged from N4,838 million in 1996 to N17,581.9 million in 2000. Health budget as a percentage of total Federal Government budget had adopted a rather irregular pattern from as low as 3.4 per cent in 1996, increasing to just 5.0 per cent in 1997 and declining to a paltry 2.7 per cent in 2000.
“This irregularity in pattern has also been reflected in the allocation to capital expenditure, which had ranged from N1,659.6 million to N11,579.6 million over the period of 1996 to 2000.”
According to another study on health care expenditure, health status and national productivity in Nigeria (1999-2012), published in Journal of Economics and International Finance, between 2005 and 2012, Nigeria’s Health Development Index (HDI) value increased from 0.434 to 0.471, an average annual increase of about 1.2 per cent.
However, health spending as a proportion of the Federal Government expenditures shrank from an average of 3.5 per cent in the 1970s to less than two per cent in the 1980s and 1990s.
Nigeria was ranked 187th among the 191 United Nations member states in 2000. That same year, Nigeria spent 4USD per capita on health, below WHO’s minimum benchmark of 14USD per capita for developing countries.
By 2002, total health expenditure was a dismal 4.7 per cent. In 2012, total health expenditure as percentage of GDP stood at 5.3 per cent, ranked 153 out of 187th countries and territories.