Good night at noontime: Lamenting the death of a loved one

When I wrote what l thought was a thought provoking article on the steady descent of Nigerian socioeconomic environment into a situation that is comparable to an Intensive Care Unit, ICU of a hospital, l had no inkling that l will sooner than later be a victim of an ICU situation.

The piece titled “Nigeria Now Looking Like An Intensive Care Unit, ICU” which was published on both online and mainstream media platforms on 7th of June last year , evoked a lot of anxiety across a broad spectrum of Nigerian society, particularly politicians in both the ruling and opposition parties.

When l shared the view, l felt l was literally sounding a wake up call to the authorities as the ruling party, APC was marking its first year anniversary in office.

But after l wheeled my daughter Kikaose Ebiye -Onyibe, a second year law undergraduate at the university of Birmingham, U.K into the ICU at Gold Cross Hospital on Bourdillon road, ikoyi lagos, and she did not come out of the hospital alive on that fateful April 12th, l realized that l had practically appropriated the sad ICU experience which was a mere essay that l had penned to prick the conscience of our leaders.

The sad incident of Kikaose being snatched away by the cold hands of death on that fateful day under strange circumstances (12 days after the April 1st-APRIL FOOLs day) , when practical jokes are pulled on friends; made the tragic event worse for me, because l could hardly believe that l had watched my vivacious and highly talented Kikaose who was very passionate about God , take her last breath in an ICU.

How did the forces that snatched Kikaose away from us compelling us to bid our 18 years old daughter goodnight-at-noontime , so cleverly elude detection?

According to medical records from Bournbrook Varsity Medical Centre in Birmingham, England, where Kikaose received medical attention , it all started on January 7, when she thought she had mistakenly eaten an unhygienically prepared or poorly preserved pizza.

She was examined and a pain killer Buscopan and a minty substance were administered on her simply because the physician that examined her believed that the mint would soothe away the spasm that the young lady was experiencing and which was at that point diagnosed as Irritable Bowel Syndrome, IBS.

The second visit for same ailment followed with a third, fourth and fifth visits to Bournbrook Varsity Medical  Centre, where she was attended to by three different doctors in a period spanning four months, (7th January to April 5)  only suggested that kikaose had gastritis and later Urinary Track Infection, UTI for which the antibiotic Nitroforentoin was prescribed with only three days dosage.

Her mother (my wife) was relieved that after about four months of what seemed like medical rigmarole in Birmingham , the seemingly elusive ailment had been identified.

With the triumphant gusto of Eureka-a sound that a scientist like Alexander Fleming might have made in 1929 when he discovered penicillin -the first antibiotic medication, my wife invited Kikaose home to Nigeria for proper treatment with a generous dosage of antibiotics (which is not allowed to be applied in the advanced society) as it is used or abused in the developing world such as Nigeria.

But unbeknownst to her, kikaose had become another casualty of the failing UK public health system controlled by a scheme known as National Health Service, NHS which operates under the principle  of insurance.

Incidentally, scandals emanating from NHS and medical professionals misconducts constitute salacious news in tabloids such as The Mail, The Telegraph and The Sun , amongst others in the UK which on regular basis feature articles on NHS service failures.
It turned out that diagnosing or rather misdiagnosing kikaose’s ailment first as, lBS and later Gastritis  and finally as, UTI which required treatment with antibiotics, were all false alarm.

This is so because when the GP finally got round to  testing Kikaose’s blood after the initial wrong diagnosis and several months of dilly dallying  , it was discovered in late March that rather than UTI, there was infection in her blood stream, perhaps from her appendix which had ruptured at that time.

Evidently, it is a major flaw in the Uk public health system, that without carrying out blood test or scanning her lower abdomen to properly identify the specific cause of the persistent pain in Kikaose’s  stomach over a period of four months,they wrongly diagnosed UTI, then prescribed and administered antibiotics in breach.

On arriving Nigeria in the wee hours of Tuesday 11th April, kikaose was taken to a medical facility where the doctor recommended that she should do CT scan which revealed that she had a ruptured appendix.

How can appendicitis elude doctors in the Uk for nearly four months and perhaps weeks after it ruptured , you may wonder ?
The answer could be traced to the NHS which according to sources familiar with the system focuses more on the business aspect of

Medicare as opposed to providing comprehensive health management service for the sick.

Allow me justify the foregoing conclusion:

NHS operates under the insurance principle of pooling resources from many people through affordable subscriptions with the hope that not many people will fall sick at the same time so the collective contribution of subscribers would adequately take care of the limited number of those who may be falling ill.

Owing to the excessive focus on profit, under the NHS scheme,there is a cap on how much health facilities are allowed to spend on patients in order to save money. The capping of the cost per patient may also be due to excessive or bogus bills presented by some hospitals to the NHS.

It is worthy to note that the motivating factor for health care providers under insurance scheme is profit, as opposed to the duty of care for humanity as enshrined in the hypodermic oath of doctors. In the light of the above, not escalating the treatment of patients in order to avoid incurring more expenses, drives physicians and hospitals in the scheme into offering limited care of which Kikaose became a hapless victim.

For instance, it is believed that  if a patient had gone to same hospital( Bournebrook Varsity Medical Center or Queen Elizabeth Hospital in Birmingham ) as a private patient, proper diagnoses would have been undertaken from the first visit. This is because payment without recourse to NHS would have been made by the patient but attending to the complaints of a patient in any way that would result in more costs to NHS is considered wasteful and imprudent on the part of a physician and the hospital, hence patients don’t receive optimum attention.

So in a rather befuddling manner, in some western countries, especially the Uk,insurance has taken over control of healthcare service instead of medical doctors and other health care practitioners who should have been making the decisions on life and death of patients.

Therein lies the dilemma of parents like us who pay surcharge for healthcare to the schools in England as part of the mandatory fees and living charges with the hope that our wards or children are protected from the harm of disease or avoidable death through provision of robust healthcare.

Hitherto, I used to take the popular saying ‘ignorance is bliss’ to heart but l have now learnt the hard way that ignorance is not always bliss.

This is because unbeknown to us, NHS is a horrendously dysfunctional platform and other health insurance options like Bhupa amongst others had filled the yawning health care gaps that NHS has wrought on the Uk public health care system.

Upon the revelation by a Nigerian radiologist that Kikaose had been living with ruptured appendix , the iniitial plan was to immediately fly her back to the Uk for the surgery procedure and the opinion of over a dozen doctors was sought but there was a consensus that Kikaose couldn’t travel back to the UK with a ruptured  appendix without grave consequences of death possibly on the flight back.

We then settled for the surgery procedure to be performed in Gold Cross hospital on Bourdilon road ikoyi, lagos, (within the opulent vicinity of the aristocrats in Nigeria) but incredibly, the doctors whom Kikaose trusted to save her precious little life , failed her woefully.

Amongst other shortcomings, the hospital lacked a simple but very critical life saving equipment that could have independently kept Kikaose’s heart pumping as well as sustain her breathing when her organs, already severely damaged by the toxins oozing from her appendix into her stomach cavity, collapsed.

For crying out loud, Jack Schumacher the racing car legend and crash victim is still breathing through the aid of a life support device several years after he fell into coma after an auto accident ,how much more an 18 years old kikaose that survived ruptured appendix perhaps for two weeks before traveling across the Atlantic Ocean from London to lagos bearing the pain.

Why am l engaging in the lamentation in this piece ?

It’s not because l would get a kick from lampooning the UK medical system as symbolized by NHS or that l want to diss Gold Cross hospital because my daughter passed away in the facility due to gross negligence on the part of the medical institutions and systems cited.

But l’m embarking on this voyage of exposition purely to share my experience from the very hard lessons learnt from the loss of a special daughter (with an uncommon passion for God)  through professional negligence arising from service delivery failure in the Uk and lack of critical life saving equipments in Nigerian hospitals.

My good intention is to sensitize other parents who were perhaps ignorant like me (l had no UK experience as l went to school in the USA) about the fact that entrusting the lives of their children into the hands of school authorities in England without a back up arrangement of registering them in private hospitals is risky and dangerous.

As such, my advise is after paying the mandatory healthcare charges embedded in the overall school  fees, parents should subscribe to private sector driven health insurance service such as Bhupa or get the child registered in a private medical facility to avoid becoming a victim of the most horrific tragedy of burying ones offsprings in their prime which is tantamount to bidding them good- night-at-noontime.

Fortuitously, (although it may be a co-incidence) the trail blazing governor of lagos state Akinwunmi  Ambode , in the same period of Kikaose’s tragedy, was reported to have ordered the shut down of 160 medical facilities in lagos state for lacking adequate hospitals ostensibly due to deplorable  conditions in the facilities .

That’s another feather to the Gov’s cap.

By setting minimum standards for hospitals to comply with , he would  be saving many lives as l’m convinced that many cases like that of Kikaose abound in Nigeria but they remain undocumented.

The assertion above is derived from the belief that in more ways than one, most Nigerians who are unable to afford exorbitant health care charges are ‘walking corpses’.

The foregoing assumption is underscored by the fact that in case of any health emergency situations, most ordinary Nigerians are as good as dead owing to the parlous state of Nigeria’s health care system.

Even the so called ‘bigmen’ are not exactly safe if they are not where they can safely be airlifted to Europe, lndia or Isreal for proper medicare because most of our so called top class, exorbitant fees charging hospitals lack critical life saving infrastructures.

That’s obviously a further sordid confirmation that our health care system has been on a downward slippery slope as evidenced by the number of Nigerian presidents or heads of state that have sought medical care abroad in the past four decades.

Take president Muhamadu Buhari who has recently been facing health challenges, for instance.

Despite his patently strong passion to make Nigeria greater through  revolutionary changes which he promised the electorate, his failing health has prevented him from vigorously pursuing his vision.

After spending 49 days in the Uk from January to  March receiving medical care, in this month of May, he has returned to the UK for more care to enable him recover faster.

Unsurprisingly, politics has beclouded the judgement of some Nigerians who have been mischievously speculating that mr president’s health had deteriorated so badly that he was unable to perform his duties despite his recent appearance at his desk to put a lie to the rumors before his latest trip.

Whereas Nigerians should have been sympathizing with president Buhari and wishing him speedy recovery like the British do whenever Queen Elizabeth of England and her husband were hospitalized, it would appear that some are making political capital out of mr president’s illness.

What has happened to the milk of human kindness and the spirit of brotherly care of which Nigerians are legendary?

Incidentally, l had expressed same indignation when late president Yar’Adua’s failing health was politicized seven years ago and did same when the ailing, immediate past, First Lady, Patience Jonathan became a hotly debated issue in the polity three years ago.

In any case, in the current instance, and in previous cases, the presidency is not exactly blameless for the public opprobrium generated by our president’s health challenge. What l’m saying is that the wall of secrecy that Aso Rock builds around the health status of our political leaders drives a wedge between them and the masses . I’m convinced that it is the veil of secrecy and mysticism around Aso Rock dwellers that create the impression that presidents are super humans and thus invincible or not susceptible to illness. That’s what sets the populace against their leaders.

Trust me, if Nigerians know how the first family feeds, and that they  dwell in Aso Rock villa like normal humans through exposure of existential realities of the first family , they will earn public  sympathy and cry when they cry. But on the contrary, every Aso Rock occupant (even as masses oriented some people aver that Buhari is) live in a bubble as soon as they get to the corridor of power, forgetting the down trodden masses who lifted them into the  exalted places.

How many times has the president hosted the aged, widows, and the handicapped to a banquet to enable them enjoy the grandeur of the magnificent Aso Rock banquet room ? Any good brand strategist  would readily attest to the efficacy of such good gestures which are guaranteed to generate goodwill for leaders that connect with the populace. Any wonder billionaires like Bill Gates , Warren Buffett and Aliko Dangote, Jim Ovia as well as Tony Elumelu have foundations doling out largess to the less privileged?

Before now, former First Lady patience , wife of immediate past president, Goodluck Jonathan had also fallen terribly ill some  three years ago, compelling her to embark on medical tourism abroad that kept her away for a lengthy period of time resulting in wild speculations on whether she was alive of dead.

It may also be recalled that in 2010, former president, Umaru Yar’Adua of blessed memory passed away after going on medical tourism to Saudi Arabia.

Similarly, ex military president, lbrahim Badamasi Babangida, lBB, famously went to Germany to seek medical attention for his foot disease referred to as ‘radiculopathy’.

How long would Nigerians and their leaders keep going on medical tourism instead of getting medical care at home? If as a nation we have been able to build a world class financial  system, why can’t we develop an outstanding medical system?. I’m not talking about the likes of National Hospital, Abuja that was built under Sani Abacha’s regime but got run down shortly after due to civil service bureaucracy.  But I mean superb private sector driven health care facilities and services.

Is is not preposterous that despite the huge budgetary provisions for health care in Nigeria (in excess of N55b in 2017) Nigeria seem not to have been able to take health care beyond the very rudimentary stage where the colonialists left it before independence nearly sixty (60) years ago?

For the purpose of clarity, a sound health system is not a factor of how wealthy the people are or how economically buoyant a country is. If those were the measure, Cuba would not have one of the best medical services in the world because it is a relatively poor country. Cubans are so good in Medicare even Americans go to there to obtain health care services.

According to data from the National Bureau of Statistics, an estimated $2 billion is spent annually by Nigerians on medical tourism to mainly India and Israel especially for organ transplant.

In the light of the foregoing narrative, is it not time that hospitals in Nigeria,(public or private) based on the capacity, quality of facilities and ability of the medical personnel managing them, are upgraded and categorized as the Central Bank of Nigeria, CBN does with banks which are divided into micro finance, regional and national banks depending on the size of their balance sheet and branch network?

Lagos state Gov Ambode should pioneer the initiative of setting minimum standards for various categories of health care facilities and establish monitoring teams that would visit the hospitals to ensure compliance with the set standards.

Hospitals should also be compelled to put in conspicuous locations in their premises, the services that they have capacity to render, with the types and number of medical gadgets available for patients to see and enable them make the life and death decisions on whether to patronize the hospitals or otherwise. It is fraudulent, in my view, for hospitals to tout or create wrong impressions about their capacity and ability.

In the event any one thinks my suggestions are weird or obnoxious , they should remember that tobacco producers were compelled by law to emblazon on their products the message: Cigarette Smoking is Dangerous to Health.

So no precautionary measures to save life should be too much.

Is it not for similar reasons that  Federal Road Safety Corps, FRSC is advocating that car owners be compelled to fix speed limiting gadgets in cars/vehicles in Nigeria?

What’s more, activists in many countries including the USA have stepped up agitation for fizzy or carbonated soft drinks like Coca-Cola etc to be taxed more heavily ; have labels on the product packaging boldly warning about the sugar content; and also clearly remind consumers that excess sugar can kill.

Certainly, my recommendations are not too draconian measures   to prevent Nigerians, especially our children who are the future, from dying unnecessarily.

Given the critical role of our children in the future of our country, isn’t it time Nigeria and Nigerians engaged more in critical thinking of how to hand over a better nation to our offsprings who are the leaders of tomorrow than dwelling on the politics that divide us as a nation like tongue, tribe, religion or creed?

Onyibe, a development strategist and former member of Delta State Govt, sent this piece from Toronto, Canada, where his family is trying to ‘reset’ after the shock of their loss.