The Nigerian Scapegoat

Every once in a while, the senate of the Federal Republic of Nigeria tries to remind us that it is working. You know? That they aren’t just bench warmers sitting idly discussing Natasha Vs Yahaya Bello or how to secure their seats come 2027. No; the Nigerian population must know that they are vastly intellectual people who are capable of making highly intelligent decisions.

Because how do you explain this recent latest attempt to address emergency medical care by proposing a six-month jail term or a fine of up to N300,000 for hospitals and healthcare workers who fail to provide emergency treatment? In this Nigeria?

I laugh in Fulfulde!

At first glance, it sounds like a noble intervention. After all, nobody should be turned away from a hospital when their life is at risk. We have heard heartbreaking stories of patients who died because hospitals demanded police reports, deposits or other administrative requirements before attending to them. These are unacceptable practices, and any serious attempt to address them deserves attention. Abi?

The bill, sponsored by Senator Abdulaziz Musa Yar’Adua, seeks to amend the National Health Act of 2014. Among other provisions, it proposes that emergency patients should be assessed within 15 minutes, initial stabilisation commenced within 30 minutes, and a hospital bed provided within two hours where admission is necessary and space is available. It also proposes mandatory emergency-care training and sanctions for violations. The bill has passed its second reading and is undergoing further legislative consideration.

The almighty question to Senator Yaradua is this: Who takes responsibility when a hospital cannot provide emergency treatment because the government has failed to provide the resources required to deliver it?

These timelines sound impressive on paper. However, anyone who has spent time working in a Nigerian hospital knows that emergency medicine isn’t practised on paper, but practised in environments where the availability of basic equipment, personnel, electricity, oxygen, drugs and consumables can determine whether a patient survives. Where is the electricity to power the oxygen concentrator? Where is the electricity to keep blood in the refrigerator at optimum temperature so that there is always blood available in the hospital? Where is the bed space or couch or even the stretcher to resuscitate the patient on? Where are the defibrillators? How many times have our emergencies run out of basic IV Fluids? Sometimes we don’t even have gloves!

Have our distinguished senators entered a labour ward during a major obstetric emergency? Have they seen a woman arrive convulsing from eclampsia, another bleeding profusely from postpartum haemorrhage, or an unconscious patient requiring immediate resuscitation? These aren’t situations where a doctor simply writes a prescription and waits for the patient to get better. They require functioning equipment, trained personnel, intravenous medications, oxygen, blood products, monitoring equipment and, sometimes, immediate access to an operating theatre.

If there is no available bed, where do you place the convulsing woman? If there is no oxygen supply, how do you stabilise a patient in respiratory distress? If the blood bank has no compatible blood, what exactly is the doctor expected to do for a woman bleeding to death? Should the attending physician be sent to prison because the hospital has no blood to transfuse? When the hospital has no electricity, the generator has run out of diesel, or the oxygen plant is not functioning? Are these criminal offences committed by the doctor on duty?

Talking about criminal activity, who is even going to the jail sef? Is it the physician working in the emergency ward or the CMD of the hospital?

Make this law make sense. Dear legislators, please understand the difference between refusing to treat a patient and being unable to provide a particular intervention because the necessary resources are unavailable. They aren’t the same thing. A hospital that deliberately turns away an emergency patient despite having the capacity to provide care should be held accountable.

But a hospital struggling with inadequate infrastructure and essential supplies cannot reasonably be expected to deliver services that the system has failed to support.

Perhaps our senators should first ask themselves whether the Nigerian government has fulfilled its own obligations to the hospitals it expects to deliver these services.

Have we invested adequately in emergency departments? Are public hospitals consistently supplied with oxygen, essential medicines, blood products and basic consumables? Are ambulances available, functional and adequately equipped? Are referral systems coordinated? Do hospitals have enough beds, trained personnel and functional theatres? Can we guarantee reliable electricity and water supply in our health facilities?

We cannot legislate away these structural problems by threatening doctors and hospital administrators with imprisonment.

Interestingly, Nigeria already has provisions in Section 20 of the National Health Act 2014 prohibiting the refusal of emergency medical treatment. The challenge, therefore, isn’t simply the absence of legislation, but the persistent gap between what our laws prescribe and what our health system can actually deliver.

Dear Senators, healthcare workers aren’t magicians. We work within systems, and the quality of care we deliver is often determined by the resources available to us. A doctor cannot manufacture oxygen, create a hospital bed, generate electricity or summon an ambulance that does not exist.

If the Senate genuinely wants to reduce preventable deaths from medical emergencies, it should be asking harder questions about health financing, infrastructure, workforce shortages and the availability of essential medical supplies. It should be pushing for functional emergency departments, well-equipped ambulances, stronger referral networks and adequately funded public hospitals. It should also demand accountability from governments and hospital managements for persistent failures in providing essential services.

We must stop making healthcare workers the scapegoats for a system that successive governments have failed to adequately strengthen. If our senators want to hold hospitals accountable, they must also be prepared to hold government accountable.

Thank you for your attention to this matter.