Mary Echor, a pregnant 34-year-old mother of two, was at a church prayer meeting when she entered labor. Narrating the experience to SaharaReporters, she said that the other parishioners prayed with her in solidarity as she headed to the Medical Centre in Mararaba, a suburb of the Federal Capital Territory in Nigeria.
She had chosen the center because it was the only government medical center where she was sure of receiving quality medical care. However, her confidence in the care for forthcoming birth of her child would soon be cut short.
Mrs. Echor and one other woman were seated in the hospital’s labor room as early as 4am on the day when Dr. Benjamin Ikechukwu, who was on call to assist with her premature delivery, arrived to meet her.
She delivered a baby girl following a cesarean operation that Dr. Ikechukwu recommended. He advised Mrs. Echor to have the caesarean delivery to avoid the pain and discomfort associated with labor.
Medical reports from the hospital revealed that in the course of the operation the doctor had struck a vein, demobilizing her left leg. Mrs. Echor later discovered from medical reports that when Dr. Ikechukwu sutured her wound he unintentionally stitched a piece of her intestines to her skin.
Following the successful cesarean delivery, Mrs. Echor was discharged from the hospital with her medical issues undetected by her hospital caretakers.
According to a conversation with SaharaReporters, not long after she was discharged from the medial center, her fresh wound ruptured as she limped to the bathroom emptying part of her intestine and abdomen onto the floor.
“I almost died. My husband and brothers were all afraid and I was returned to the Medical Centre from where the doctor was queried, and I was rushed to the National Hospital, Abuja where the doctor’s mistake was corrected.
“My family wanted to go to the court but I stopped them. I heard from other staff in the medical center that I was lucky to have made it as many other women whom he operated upon died in the process. God had already shown me mercy so I don’t want to be responsible for taking him to jail,” Mrs. Echor said.
An investigation by SaharaReporters found that the doctor was only hired on a part-time basis to treat minor medical cases. Hospital sources disclosed that the practice of bringing on part-time doctors is because many medical facilities suffer from a shortage of doctors and budgets to hire full-time staff.
Regarding Dr. Ikechukwu, a hospital source said he took advantage of the volume of medical cases to dive into areas for which he was not trained.
SaharaReporters also discovered that he was not registered with the Medical and Dental Council of Nigeria (MDCN), the statutory entity responsible for regulating the practice of medicine, dentistry, and alternative medicine in Nigeria.
Ikechukwu continues to treat patients despite his poor qualifications and lack of registration.
Introducing the ‘Dodgy Doctors’ Investigative Series
The ‘Dodgy Doctors’ investigative report series by SaharaReporters aims to explore the issue and underlying causes of quack, or unlicensed, doctors throughout Nigeria. This series will frame the burgeoning quack issue in Nigeria by exploring the financial, institutional, and human costs on Nigerians stemming from unlicensed and unregistered individuals practicing medicine.
These investigative reports utilize this online 'Dodgy Doctors' tool developed by Code for Africa, in partnership with Code for Nigeria and the International Center for Journalists, which allows users to search the MDCN registry and learn whether their doctor is registered as required by law.
The MDCN registry list, provided to Code for Nigeria by the council, is itself incomplete because it has not been updated since 2006 despite every bona fide doctor and dentist in Nigeria being required to pay membership fees to the council.
Sources at the MDCN, speaking to SaharaReporters on the condition of anonymity, disclosed that the doctor registry has not been updated because some council officials have been embezzling and stealing doctors’ membership fees. The inevitable consequence of the this larceny, according to this same source, is that quack doctors are able to hide in plain sight by masquerading as their bona fide, and credentialed, counterparts.
Temi Adeoye, the Lead Technologist for Code for Nigeria, disclosed during a panel conversation in February 2016 that the registry list given to them from the MDCN matches the paper list exactly with about 40,000 registered medical doctors.
Mr. Adeoye added that the MDCN officials told him confidentially many doctors listed on the registry are “either dead or out of the country” through the council “claims to currently have roughly 80,000 doctors [registered] but don’t have records of death, disability, immigration” of those on the registry.
SaharaReporters contacted MDCN officials to discuss details of this registry but no official would confirm our findings on the record. However, following SaharaReporters inquiries, a public notice on the MDCN website ostensibly disowning the registry of doctors the council provided to Code for Nigeria and denied it was supplied by them.
How Impostors Evade Capture
SaharaReporters has unearthed numerous instances of Nigerians being maimed, and even killed, from being in the hands of unlicensed and unqualified quack doctors. These investigative findings show that quacks often prey on the poorest, most destitute, and least educated Nigerians whose circumstances limit their options for medical treatment.
Dr. Theophillus Adole Ochonu, a medical doctor with the Federal Medical Centre in Keffi, discussed the quack crisis confronting Nigeria, even acknowledging the rise in quackery around Nasarawa State.
Dr. Ochonu pointed out to SaharaReporters that there is a high concentration of private medical clinics along the Nyanya-Maraba-Masaka axis of Nasarawa State because public hospitals are so few. Nigerians in this area are therefore more likely to patronize these private facilities that sometimes escape from government regulation and oversight.
He disclosed during a conversation that, “the high level of poverty [in Nigeria] is the driving force behind people patronizing quacks. Most of the residents are very poor and cannot afford to pay for quality medical treatments and this is what the quacks take advantage of.”
Dr. Ochonu added that even in the instances which some impoverished Nigerians are aware of the quack’s substandard care, they risk patronizing them because they are desperate for some kind of medical attention.
Sources at the MDCN, requesting anonymity from SaharaReporters, acknowledged that the quacks in Nigeria constitute a national emergency. This source said that curbing the rising number of quacks, and prosecuting medical impostors, remains a significant challenge because poverty deters victims from reaching out to authorities.
According to this medical expert, many victims lack the income to entangle themselves in Nigeria’s byzantine legal system. Financial impediments range from costs to hire an attorney, afford travel to courthouses, and the burdens associated with leaving work to pursue justice.
The sluggish, administratively challenged, judicial system in Nigeria represents a significant institutional barrier for MDCN officials to prosecute the quacks they do identify. The MDCN source stated that “the situation as it is now makes it very hard for us to successfully prosecute any case. The Council, on its part, has been carrying out its mandate but if the police and judiciary would cooperate the rate of prosecution could be greater.”
According to the Nigeria Medical Association, the doctor to patient ratio in Nigeria is 1:6300 which negatively impacts the quality of healthcare, oversight of medical facilities, and creates an environment for impostors to flourish. The broken heath system is exacerbated by corruption in the MDCN, sluggish legal processes, and the flight of qualified medical professionals from Nigeria to better healthcare systems abroad.
Mr. Adeoye, the Lead Technologist for Code for Nigeria, appealed to the MDCN officials that they make the updated 2015 doctor registry—which they claim to have but have not provided evidence of—available to the public. He told SaharaReporters that “the officials need to make due with their promises to digitize their registry” and that “they should make this valuable information ‘open data’ so the entire Nigerian public can make data-driven decisions related to their health.”
If you believe you know of an unlicensed or quack doctor operating in Nigeria you can report your concern to the MDCN here. If you want to know whether your healthcare provider is registered you can search for them in the ‘Dodgy Doctor’ tool on the SaharaHealth website. If you are a medical professional, and know you should be on the MDCN registry but have not found your name, you can report your concern to them here: [email protected] or [email protected]
Some of the names or places in this report are pseudonyms to protect individuals not convicted of a crime.