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Nigeria of Today and Emergency Services

I was in faraway Geneva facilitating a session in World Health Organisation’s Headquarters on ‘Disseminating Research to Non-Scientific Audience’ for 2014 Annual Research Methodology Course when the news came to me that in my state ‘Kano’ a bomb was detonated at the Federal College of Education (FCE) followed by gun shots with many causalities of death and injuries . I followed the event henceforth in anguish and despair. Many as I was told were rushed to hospitals but some died not because of the severity of the injuries but because there weren’t enough facilities to respond to emergency and critical conditions at the same time. In essence they died because of the delay within the hospitals due to shortage of emergency facilities. I wasn’t sure such angle was reported by the media. I was also informed that the 3 most influential people in the state visited both the scene of the crime and the hospitals to commiserate with the school authority and the victims. Dr Rabiu Musa Kwankwaso (Executive Governor), Mallam Ibrahim Shekarau (Minister of Education and Former Governor), His Highness Alhaji Muhammad Sanusi 11 (Emir of Kano). While their actions were commendable, however it must be followed by a concerted effort to establish a fully funded emergency medical services that can respond to emergencies with the capacity to deploy services with the slightest need.

The veteran journalist and vice chairman of the Sun Newspapers, Dimgba Igwe died on September 6th, 2014 from injuries he sustained in an accident by a hit and run driver that knocked him down by a car while jogging near his home in the Okota area of Lagos. It was reported the incidence happened around 6am and he died around 10am. There were 4 hours to save his life as he was bleeding profusely. It was reported that he was 1st taken to one hospital as they couldn’t stabilized him was referred and rushed to another one. What killed Dimgba Igwe was the delay to institute emergency services just like it happened to the Kano victims. Where he was when he was knocked down there weren’t emergency services, no stationed ambulance by the side of the road to quickly mobilize to site. At a meeting in Abuja with Health Journalists on Thursday 11th September 2014, I raised this matter and expressed my disappointment that I expected the media to write many editorials and headlines calling on not only Lagos State Government but all the 36 governors to invest in emergency services, to use their meagre resources to buy and empower ambulances not to be stationed inside hospitals but to be stationed by the side of the road on alert just like the road safety vehicles. It is only in doing such similar deaths could be averted.

The re-occurring insecurity in our nation has also brought a new challenge to all of us with respect to ensuring adequate emergency services in place. Imagine a scenario where a pregnant woman is being transported to a health facility under a critical condition of profuse vaginal bleeding or fitting or prolonged/obstructed labour in a private or commercial vehicle and meet a security check point that delays her transportation for an hour. In another scenario, a child is fitting due to high grade fever or gasping for air due to severe pneumonia or has lost a lot of blood due to road traffic accident. How will be conveyer of such a child in a private or commercial vehicle navigates heavy traffic and security check points on the road to reach to a health facility? It could equally be a middle age or old man with complications of Diabetes mellitus, severe hypertension, stroke, difficulty in urination to mention but few.

I can go on and on citing examples, but most importantly these problems are happening in many states. They may not be reported or documented the way I put it, but we shouldn’t ignore their occurrence and refuse to begin to brainstorm for a workable solution to allow vehicles carrying people under critical health conditions to pass through security road check points with ease. How do we engage our politicians to see the need for creating a small agency charged with the responsibility of providing adequate emergency services not only in the hospitals but at the scene of accidents and where people live and work?

To what extend can our health system provides a new policy direction and framework of  action  to provide emergency ambulances stocked with necessary resuscitative drugs and items and to be station in the community in a primary health care outfit, district or ward heads residences or road sides ? Stationed emergency ambulances could provide on the spot resuscitation as well as transport women and children in critical health conditions to nearby health facilities and for the fact that they are conveyed in a siren blared ambulances, security personnel at check points will pave a way for smooth passes.

Another policy shift is to provide more community midwives equipped with necessary tools and drugs to deliver pregnant women safely and attend to babies. This will improve access to quality health care as well as reduce the delay that could happen at security check points.  These cadres of midwives and community health workers should be giving special training of life saving skills to respond to emergencies.

Some useful incentives and motivation to these cadres could be;

  1. Housing and/or transportation allowance
  2. Health insurance and free training
  3. Performance-based incentives like awards and recognition

There is no alternative to emergency medical services, Nigeria must invest in it and it is time for that clarion call and action.

This article is 1st published in Daily Trust Newspaper by Dr Aminu Magashi on 30th Sept 2014. He can be reached at healthweekly@yahoo.com and follow @HReporters 

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