Diagnosis Challenge In Nigerian Healthcare Facilities

Appropriate diagnoses of patients’ conditions by medical personnel, or lack thereof, in most Nigerian hospitals have come under intense public scrutiny. The worry is that, in extreme cases, such errors, when they occur, lead to avoidable loss of lives. Despite global advancement in medicine, hospitals and health facilities in sub-Saharan Africa, and in particular, Nigeria, have become, more or less, death traps, with patients constantly falling victim to what is glibly dismissed as human error. In fairness to Nigerian doctors, such errors are also noticeable in other developed economies. The complaint here is about the quantum and regularity.

By definition, misdiagnosis may occur when a health practitioner acts on often unverified information about a patient’s condition, either due to non-compliance with standard operating procedures that require thorough clinical examinations through laboratory tests or sheer incompetence. The former is possible due to the absence of the infrastructure needed to carry out such tests or the unavailability of the proper personnel. In either or both cases, the wrong prescription may be made and the wrong medication dispensed, which may lead to fatal consequences.

For instance, in a study, about 42 per cent of women and 54 per cent of men who tested negative for malaria are treated with malaria medications. This is because malaria mimics some of the highly recognisable symptoms of more severe diseases like typhoid fever and even COVID-19.

In more severe cases, a report claims that misdiagnosis kills 70 per cent of cancer patients in Nigeria. According to the report, patients in their cancer journey, especially as a result of cases of false negatives or positives, are exposed to treatments that are either inadequate or unhelpful.

While not all misdiagnoses lead to loss of lives in Nigeria, Africa and beyond, some Nigerians still die of common ailments due to doctors’ negligence as well as errors in prescription, wrong treatment and even unwarranted surgical procedures.

According to authorities, Nigeria loses $1 billion annually to medical tourism, a demonstration of loss of confidence in the services provided by the nation’s healthcare system. Medical professionals argue that reasonable care is available in the country but only in some private hospitals. It is generally believed that private hospitals are more expensive, but some government facilities have also become costly, even if inefficient. In these public facilities in Nigeria, health workers, by their conduct, leave the impression that their services are a favour.

We are compelled by the recent experience of a lawyer and journalist who relived his scary experience in the hands of Nigerian doctors after being diagnosed with prostate enlargement to draw the attention of the regulatory authorities to this threat to the nation’s healthcare delivery system. The patient was scheduled for surgery at a public hospital, which later became a huge mistake. According to information narrated by the patient, the doctors, purportedly in error, ruptured his bladder. From the intensive care unit (ICU), which costs about N150,000 per night, to several corrective surgical procedures without success, the patient would later land in an Egyptian hospital.

Before the trip to Egypt, the patient had lamented that so much was wrong with the nation’s medical system, for which he nearly paid with his life. According to him, his experience in Egyptian hospitals and with Egyptian doctors made him realise this even more – the seeming lack of empathy among many Nigerian doctors who conduct themselves as if there was no minimum standard to which they must comply.

This worrisome trend that has continued to claim the lives of many Nigerians year in and year out demands urgent attention from health authorities. Erring medical practitioners who commit these often irreversible errors are rarely brought to book. Hence, the impunity festers.

This newspaper thinks that medical professionals who engage in wrong diagnoses due to negligence or incompetence should be made to face sanctions by the Nigerian Medical and Dental Council (NMDC). However, we are also persuaded to point out that Nigerian doctors, in some hospitals, work with their bare hands literally. A visit to a typical public hospital or even the regarded high-profile private hospitals would reveal that most of the equipment they use are antiquated, many years behind modern science, further complicating the issue of wrong diagnosis. The presence of these antics in the hospitals can easily be blamed on the economic situation in the country, which is valid to a certain extent.  But most of the blame should go to corruption within the system because some of the budgetary allocations and disbursements are misapplied deliberately. These challenges are responsible for the mass exodus of more doctors out of the country, a trend popularly referred to in our local parlance as the ‘japa syndrome’. The medical practitioners abandon health facilities across Nigeria for greener pastures abroad, leaving patients in the hands of inexperienced and, in some cases, as was exposed in Jos, Plateau state, unqualified medical personnel.

In our opinion, the solution lies in intensified capacity building, aggressive resource allocation to infrastructural development, and, more importantly, attitudinal change on the part of both practitioners and their regulators. Perhaps that might save the health sector from imminent collapse.