•‘It is unethical for them to come to treat our patients’
• Says about 50 doctors in isolation, one dead
By Chioma Obinna
The Federal Government, last week, announced that a team of Chinese medical experts will be coming to assist health workers in the frontline to combat COVID-19 in Nigeria. Since then, there have been divergent views on the issue.
Many stakeholders in the country kicked against it. One of the health professionals which rejected the idea is the Nigerian Medical Association, NMA. But on Thursday, the 15-man Chinese team arrived Nigeria. Sunday Vanguard spoke to the President of the NMA, Dr Francis Faduyile, on why his association vehemently rejected the Chinese gesture. Excerpts:
Why is the Nigerian Medical Association, NMA, against the Chinese doctors’ visit to Nigeria?
We want to restate that we appreciate every country, individual or corporate organisation, out of its own volition, support for Nigeria in the fight against COVID-19 including the Chinese. We appreciate them, we know that this is a good gesture and we appreciate them and we know that the gesture is not under any compulsion.
However, we became curious when we heard that they will be coming to do support based containment and management of COVID-19 in Nigeria. As it is, the Nigerian health professionals are doing well in the containment of the pandemic. Even the United Nations applauded Nigerian health professionals for being able to come out stiffly to contain COVID-19.
And we have not been overwhelmed in treating our patients. It is on the basis of this that it became baffling when government decided to bring people to come and help us. There is flight restriction, so if there is flight restriction, even the most powerful man in Nigeria is not allowed to travel in and out of the country.
What is that big thing that this Chinese medical team has that it wants to impact on us? It is unethical for them to come to treat our patients. The best is to discuss with us if they say it is about hands-on experience so that we can be better informed and we believe this can be done through IT platforms.
Today we do telemedicine, tele-surgery and teleconference. We do not feel that is necessary to have their physical presence especially now that we have pandemic where human beings are the conveyor of many of these viral illnesses. And we should not forget that China is the place where this particular viral disease started from. It is on this basis, again, that the NMA believes that the Chinese medical experts have no added advantage to our treatment protocol and the management we are doing in Nigeria.
Again, while we are rejecting that, we observed that the Nigerian government, represented by the Federal Ministry of Health and the Chairman of the Presidential Task Force, PTF, on COVID-19, presented two different scenarios. At a time, they said the Chinese experts are technicians and will come to install things (equipment).
Looking at it, most of the supplies are consumables and Personal Protective Equipment, PPEs, and they are only bringing 50 ventilators. Ventilators are things that Nigerian health professionals are very conversant with. So there is no reason to ask them to come. Again, if they are coming because they have to train us, we can do it over IT platform.
This is why we say no to their visit and to also safeguard the health of Nigerians and that of our own and we say we should not have these Chinese medical experts in this country. We need to also state that symptoms or response to diseases or illnesses vary from race to race. Our response to COVID-19 by Africans, Caucasians, Mogolites are different because of our race, so you can’t just come and transmute the views of the Chinese as if we are all the same genetic makeup. This is another reason we say ‘look, we don’t need them’, that we are doing well, you don’t change the winning team, let us know what we are doing. However, government rebuffed this view that was a popular view and brought the Chinese to Nigeria.
The goods they are bringing are worth about $100, 000 which is about N40 or N50 million. Meanwhile, we have Nigerian entrepreneurs donating up to N1 billion and they were not given red carpet like they did to the Chinese when they came. This shows that there is more than meets the eye.
Meanwhile, the managing director of a Chinese company, CCECC, addressed the press that the people who were coming are immunologists, anaesthesiologists, intensivisits and nurses and these are direct career specialists in the treatment of illnesses and these cannot be technicians that have been claimed by the Ministry of Health and the Chairman of the PTF. During the press conference, the CCECC MD also stated that this group of Chinese will also treat some of the Chinese nationals in this country and we believe that it is another slap on the integrity and sovereignty of the Nigerian nation.
We remain resolute that the Chinese are not welcomed. We do not have any reason to have them come physically to Nigeria. We can learn from them but we can do that through IT platforms and what we are doing is the best for our country. We are enjoying the support of our patients and we do not need interference.
Do you think there are things the Federal Government is not telling Nigerians?
I will say it again; there is more than meets the eyes. I do not understand what they want to do and whether in their first 14 days they are going to be quarantined; if that is so, then, of what benefit? Can’t they stay in their country and send necessary files for us to read? Then, do interaction with us and discuss experience. I do not see why they must come to Nigeria.
Now that they are here, are you ready to share notes physically with them?
What this pandemic states is that we must observe social distancing. Even in Nigeria, meetings are not done by physical means. Meetings are done by social media, teleconference, Skype and other types of social appliances. So if we are in Lagos and we are doing meeting with Abuja or Ibadan, through that same way, you can do that with anybody in the world. It is not likely we are going to meet them or interact with them.
Like you said, meetings are done through social media and other IT platforms. Will NMA be ready to interact with them via IT platforms?
We don’t need them in Nigeria and that is the stand of the NMA. We are not against them assisting us but we are against them coming into the country physically and treating our patients.
How many doctors have been affected by this virus?
We have one doctor who died of coronavirus disease and we have between 40 and 50 medical officers are under isolation because they have been exposed or had contact with a positive coronavirus person.
What is the NMA stand about what happened in UBTH, where doctors committed medical blunder concerning two patients who they claimed tested negative the first time and later tested positive for COVID-19?
Every doctor is expected to observe international best practice either with a patient with COVID-19 or a patient suspected of COVID-19 or a patient that has no COVID-19. Anybody today can be a COVID-19 positive person because as it is, you cannot know who is a COVID-19 positive patient until you are tested.
So we advise our colleagues to maintain international best practice. Another wrong perception is that you must see test result before you commence treatment. Test is an integral part of the management. Sometimes, you have done your physical and clinical examination and you may start management, sometimes you may need to have a test result to confirm your thoughts, sometimes you may need to see a test result to direct you on how to go.
It is not mandatory that you must see a medical test result before you start treatment or managing. I don’t know the full scenario but I can tell you that it is a normal process in which you can see a doctor treating a patient based on his differential diagnosis pending when test result comes either confirming or bringing out the new diagnosis as the case may be.
With about 50 medical officers in isolation, do you think government has put in place adequate protective equipment in our various hospitals?
To be candid, it is not possible for government to provide all hospitals or public facilities the PPEs that are needed. Importantly, all doctors need to observe international best practice and everyone at the accident and emergency as well as isolation centre must have high index of suspicion as well as fully kitted with the PPEs. Our advice to our colleagues is, you must not do any heroic activity. You must put on the necessary gadget before you see that patient either the patient has been confirmed positive for COVID-19 or not.
The lockdown declared by the Federal Government in Lagos, Ogun and Abuja as part of measures to contain cornavirus disease spread will be ending tomorrow. How do you assess the exercise so far?
My assessment of the exercise is that it is fairly okay. We have not had this before; the level of compliance is fair but it could have been better. Many people have not been close to see the other side if we had failed to observe the lockdown government has prescribed. Unfortunately, there is a lot of hunger in the land. A lot of people are daily paid workers and it is difficult sometimes to keep them locked down in the house without having opportunity of getting their daily income. So, by and large, it has been fairly alright. It is better than if we have not locked down, it can always get improved. We need to talk more with our people so that we can get this disease eradicated from Nigeria.
How do you also assess Nigerian’s response in terms of facilities, equipment and management of the disease?
One of the most critical facilities is the laboratory centre that has to do with test and our testing process lags behind the population because we have grossly low number of test centres within the country. It is just of recent that the NCDC is trying to expand beyond the five centres in Nigeria and this has created room for us to have a backlog of people who have had contact and are waiting to be tested.
That one is not good enough. The other difficulty is the PPEs which we learnt are in short supply worldwide. We want government to look inward and see how some of our indigenous companies can start producing PPEs and other medical equipment so that we will not continue to go to other manufacturing countries for our own supplies.
What is your message to Nigerians as we battle COVID-19?
My message to Nigerians is that prevention is better and cheaper than cure. Let us put everything in place to prevent ourselves, our loved ones, our children and our parents from contracting coranavirus. Nigerians should wash their hands properly, with soap and water or use alcohol based sanitisers, maintain social distancing, when they sneeze, do it into a bended elbow or a tissue paper and discard it appropriately. People should also guard against touching the face, mouth, eyes and nose often. Nigerians should guard against public places, cluster places, shaking hands or hugging. If we keep to all these we will keep Nigeria safe.