12 October 2012

Nigerian Medical Care:A Case of Malaria vs Typhoid

I'd thoughtlessly enjoyed free healthcare in UK, to the extent where I dialled 999 and summoned an ambulance to my office one day after a particularly nasty bout of nose bleeds. The ambulance team came within minutes, laid me down in the fully-equipped bed in the back of the ambulance, checked my blood pressure, gave me aspirin, the ambulance lady asked me a ton of health-related questions and they promptly delivered me to the nearest hospital where the doctor met with me after 30 minutes of waiting to give me a nose drops-thing, and since then I haven't had another nose bleed. And I didn't pay a penny.

Kinda silly right? But I was very worried at the huge amounts of blood coming out of my nose, so for me it was an emergency! And thankfully the medical team looked after me very well.
  
Apart from that episode, I'd never been hospitalised, never broken any bones and never needed to see a doctor in England except for check-ups, but I was always glad they were available to me whenever.

The NHS (National Health Service): High quality care for all, for free.


But in Nigeria, there is no medical insurance linked to my job so I'm left on my own when it comes to healthcare, as are most other Nigerians. And funnily enough, it's in Nigeria that I've had to come face to face with my health, or lack of it. I've already described in another post about my feeling cold all the time, so that fans and ACs get me into coughing fits and a runny nose and I have to wear a scarf a lot of the time to protect my chest. I even had an episode of prolonged vomiting that lasted two days.

But I've intentionally stayed away from doctors and never want to see the inside of a Nigerian hospital as long as I'm here. They scare me. Just to see a doctor costs around N4,000. That's just to see a doctor. Then there's the costs of each prescription (my non-prescription, over-the-counter cough medicine, which lasted a week cost N2, 000), then you pay for each test (a colleague of mine was told a blood test he needed would cost N80, 000) and a night's stay in the hospital can cost around N8, 000 or more each night. It costs to have a baby in a hospital; up to N100, 000 or more depending on the quality of the hospital, and things like x-rays, CAT scans and MRIs are not only limited to few hospitals, but are also beyond the means of most Nigerians. To put it into perspective, a N50, 000 a month salary is quite good for a graduate. Being sick in Nigeria is expensive.

Even the mosquito nets that Western charities and relief agencies collect donations to fund so that "an African family can get a free mosquito net", it is not free. I've heard from reliable sources that even the poor in rural areas have to pay for these nets because those selling it to them haven't been compensated enough and have to sell it on to make a living, because the Chairmen and managers of the Nigerian organisations in charge of distributing the donations steal all the money.

(However, all the homes I've been in have mosquito netting on the windows as standard, and along with mosquito repellents this eliminates the need for an actual net around your bed, unless you live in the village).


Mosquito Nets: They're not Free!


And medical tests here seem a bit iffy for me. Since I've been here, whenever a colleague or friend is feeling unwell, they put it down to Malaria or Typhoid. Everyone that's sick has either Malaria or Typhoid. Every illness in Nigeria seems to fall into one of these two categories, probably because these are the only two tests that the doctors can confidently test for and detect. That and AIDS (tests of which are usually free). It seems that if it's not Typhoid or Malaria, they place it in the 'unknown' category and put you on a drip. A friend's brother felt feverish, and it wasn't Malaria or Typhoid so they put him on a drip and told him to spend a night in hospital.

Rare, obscure or complicated illnesses remain undetected. You'll never here that someone in Nigeria has been diagnosed with Acute Conjunctivitis or Gastroenteritis. If it's not Malaria or Typhoid, your condition is classified as unexplained. A friend, whenever she's feeling feverish, has a cough or has a temperature, she treats herself by buying Typhoid medication. If that doesn't work, she tries Malaria tablets. If it doesn't work, she tries the Typhoid medicine again, and on and on until eventually she feels better. It's crazy.

Another friend, after his Typhoid and Malaria self-treatment didn't work, resorted to drinking some traditional medicine his aunt sent him, which consisted of a green, leafy-mint smelling liquid sludge he kept in the fridge. And it worked! He was hale and hearty in record time.

In the case of accident emergencies like a car crash, victims have to depend on the kindness of fellow motorists to ferry them to the hospital as there are no ambulances, and sometimes a potential good Samaritan will refrain from taking an injured person to the hospital out of fear that he/she would be forced to pay the medical bills, or be implicated by the police in one way or another.

The ruling class have long ceased to put their faith in the country's hospitals and routinely fly out for any major and even minor ailments. Nigeria's First Lady, Patience Jonathan, is currently in Germany receiving treatment for an undisclosed illness, and prior to that visited hospitals in Dubai, Italy and Spain.

The funny thing is that there are many Nigerian doctors and nurses in many British and American hospitals, and they're very good too. It's just that the code of practice here is so poor and under-regulated that doctors put profit over their Hippocratic oaths and the condition of some hospitals leave a lot to be desired.

Because of the aspirations and brilliance of many Nigerians I meet on a daily basis, I forget that I'm in a third-world country until one experience - like paying a visit to a friend in hospital -  jolts me back to reality. 

Anyway I've got a Health Fund, money I've kept specifically that will enable be to fly back to England as soon as I feel ill. It's a necessity. And as soon as I get pregnant I will be domiciled in the UK, so that in case of anything I will be in a country where fantastic medical care is free to me simply because I am a citizen. Even if I collapse on the street, all any one has to do is dial three numbers on their phone and free medical aid is on its way.

And on my return to England, I'll have a full medical check-up and stock up on aspirins, Ibuprofens, cough medicines etc (I've heard of fake pills and medicines in Nigeria too) to keep me until my next visit.

Long live the NHS!