Posted on: Mon 12-10-2020

Chairman, Nigerian Medical Association in Plateau State, Dr Innocent Emmanuel, speaks to JAMES ABRAHAM about rising cases of COVID-19 in the state, challenges facing doctors, among other issues

Plateau State has overtaken most states and only behind Lagos and Abuja in the number of COVID-19 cases, what do you think has been responsible for it?

It is simply because the state government has been doing the right thing. I mean, they have been testing more people. The implication of that is the confirmation of more cases. If you test 10 persons in your state and you have only 10 cases, and 300 persons are tested elsewhere and they get 300 cases, then it is obvious that the state that has done more testing is doing better because when you do more tests, you will get more cases. So, Plateau State has shown responsibility by following in the footsteps of places doing well like Lagos and Abuja. You know, generally in Nigeria, the rate of testing is very low but Plateau State has shown leadership in this sub-region by testing more people.

There are states in Nigeria that have even denied the presence of COVID-19 like Kogi and Cross River states. I don’t know whether they have started allowing the authorities to have access so that their people can be tested. However, Plateau State has nothing to hide. But then, I think it will be fair for us to report the number of persons tested and not the number of people who tested positive alone. In other words, we should be able to say that we have tested this number of people and this is the number of cases that we have.

Did you see this coming?

The hike in the number of COVID-19 cases in Plateau State did not come as a surprise to us as an association. The truth is that the number could have even been more than what we have at the moment if the state had tested more residents. If we increase our testing capacity to one million tests per day, for instance, the cases will definitely be very high. If other states test more of their people than Plateau State, I believe they will even have more cases than what we have in Plateau, especially states that have been living in denial. This is because since they do not believe in the existence of the pandemic, they have not been maintaining the protocols, so the spread will be massive in those areas. We know at the moment, it kills only about 0.2 per cent of infected persons but if it is a disease that kills 2 to 20 per cent of those infected, the population of countries would have been depleted, especially in places where they have not been following the protocols.

How has the situation stretched health facilities in the state?

The situation has stretched facilities in our various health institutions and isolation centres. At the outset, our members did not have adequate personal protective equipment. People were afraid and the mortality of the disease was not really known. Although, there seems to be an improvement in the availability of personal protective equipment, however, the government still needs to do more so that our people can have confidence while doing their job. As we speak, the isolation centres are witnessing an increase in the number of COVID-19 patients and this has been a challenge. But we – doctors and members of the NMA – are trying our best to enlighten the public about the disease.

We also try as much as we can to see that all the patients in our domain have the appropriate treatment they should have. That’s why the mortality of the disease in Plateau State is very low. We try as much as possible to treat the patients well and ensure that the isolation centres are habitable for them as much as possible, although more needs to be done in this regard because as more tests are done, the isolation centres become crowded and then, there will be no space for patients. So, as more testing is being done, more also needs to be done to expand the isolation centres and improve the welfare of doctors and other health care workers so that we can be motivated to do more in the fight against the disease.

Are there no other specific factors that you think pushed the figure up in the state?

There is no other factor responsible for the hike as far as I know because I have been to neighbouring states and read reports. I have asked my colleagues elsewhere about what is going on there and I understand that our lifestyle in Plateau is the same as what you will find elsewhere. Nigerians are the same. Plateau State is not even as populated as some other states. We also have states that have recorded more deaths than Plateau. Some states where causes of death are unknown still have less mortality than Plateau State. So, I think the transparency in the way the authorities are handling the matter in the state is responsible for the figures we are getting.

What can you say about the attitude of people in the state as regards maintaining social distance and observing other protocols?

The attitude of the people towards COVID-19 and efforts to contain the spread of the disease is actually not very encouraging. You see people moving about without face masks, people in crowded spaces and other things like that .I think generally; it is like it is in any other place in Nigeria. I think Nigerians need to be more serious about dealing with this despite its low mortality in Nigeria. Even if one person dies, that life is gone forever. It is important for us to change our attitude towards the disease because even if we think we cannot die of the disease, we might infect someone who might die.

Religious houses and primary and secondary schools have opened, do you think the various governments should have waited longer before opening them?

I think the government and the Presidential Task Force are on top of the situation and when they say it is wise for the schools and other institutions to reopen, I think Nigerians should have nothing to fear. Even in Wuhan community in China where the disease originated from has started to reopen its economy and schools have also reopened in those places. Nigeria should also follow the same path and reopen its schools and other critical aspects of the economy. If not, the poverty situation in the country is likely to get worse. For me, what is needed is to encourage citizens to take the guidelines more seriously.

How has the situation affected doctors and other health workers in the state?

The situation has not been easy for doctors in the state. Some of us had to go on isolation after testing positive for the disease. One or two of our colleagues have died. Some are scared because sometimes you need to treat patients without adequate protective equipment and that is very challenging but that notwithstanding, we still have to find a way to attend to the patients within the confines of the available resources at our disposal and ensure that they are well. We are also facing the challenge of welfare for doctors because some of our members have not been paid their allowances, including their COVID-19 allowance promised them by the government.

You know, motivation is important in a work environment. I think the government should do the needful to address some of these challenges to motivate our members to do more. Members of the Nigerian Medical Association and the entire body of doctors in Plateau State are committed to the well-being of the people. All critical stakeholders, including the government should also do their part so that together, we can make the health of the citizenry better.

The leader of the nurses and midwives’ association in the state recently said they were being paid N1, 000   as hazard allowance, how would you describe the welfare provided for doctors?

Currently, the hazard allowance for doctors is N5,000 per month and there is the need for the government to increase it and we have been talking to them about it. When the COVID-19 outbreak started, that was when some top government officials at the state and the national levels told us that they did not actually know that was the amount we were being paid. Now, COVID-19 has brought the issue to the public domain. I think the government should act quickly and increase our welfare package. They have done much by giving us some percentage of our salary for three months – April, May and June as our COVID-19 allowance but I think it should be a permanent arrangement. Generally, our current welfare package is not good. From records, over 70,000 doctors have graduated in Nigeria but half of them have left the country in search of greener pastures, mainly because of the challenges I have stated.

That’s why we are saying that they should be addressed without further delay so that some of our doctors will have no reason to leave their country for other countries. This is important because presently, the number of doctors operating in Nigeria still falls below the number recommended by the World Health Organisation in relation to the population of Nigeria.

What are the biggest challenges doctors face in the state?

The number one challenge is that the number of doctors in the rural areas and in the health institutions in the state is grossly inadequate. We need more doctors. There are some states that have more doctors. I think if we have more doctors in our primary and secondary health care centres, we can cater for people in a better way. This is important because having fewer doctors means that they will be overstretched and won’t be able to give their best.

Another challenge has to do with the equipment we work with as doctors. There is the need for improvement in doctors’ welfare. At the moment, this is a serious challenge that needs to be addressed. The next challenge is the issue of remuneration which I mentioned earlier.

You have spoken about how many doctors are leaving for greener pastures, how many have left in Plateau in the last one year or two?

We don’t have the data at the moment but what we know is that we need more doctors on the ground and we will be glad if the issue can be looked into so that we can have more doctors, especially in the rural areas and health institutions in the urban areas as well. This will surely reduce the number of cases that come to the tertiary health institutions as referrals.

What do you think could be done to bring the number of COVID-19 cases in the state down or flatten the curve?

The major thing that needs to be done is for us to observe the protocols of COVID-19 strictly. If we abide by the rules and guidelines, I have no doubt that we will flatten the curve. People need to stay away from crowded areas and wash their hands with water or use the alcohol based hand sanitisers. Again, we should try as much as possible to use face masks and in the hospitals, health workers must be encouraged in every way to discharge their responsibilities with confidence. That way, we will not only flatten the curve of COVID-19, we will win the war against the dreaded disease in the state.

Source: Punch

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