Forty cases of quackery in the medical profession are in courts across the country. But the case of a certain Martins Ugwu who impersonated his friend, Dr. Davidson Daniel George from 2006 to 2015 is intriguing to those who have followed the case. Ugwu, who worked for nine years at the Federal Ministry of Health, pretended to be a doctor while avoiding postings that would have exposed him to clinical work. He was fished out by the Medical and Dental Council of Nigeria (MDCN) following petitions against him. Dr. Abdulmumini Ibrahim, the Registrar of MDCN told Abuja Metro why it took a long time to catch Ugwu and plans to fish out other quacks in the system. He also spoke on the link between medical tourism and the many calls by doctors to soften the law of not advertising medical expertise or hospitals.

 

For nine years a man, Martins Ugwu worked at the Federal Ministry of Health using the stolen certificates of his friend, Dr. Davidson Daniel George. Why did it take the MDCN that long to expose this fraud?

It is not the council that employed the fake doctor. The Federal Civil Service Commission (FCSC) recruited him. The body is in charge of employment and posting. He was employed and posted to the Federal Ministry of Health. It was just recently when issues started cropping up that there were petitions questioning the performance of the fake doctor. There were question marks on whether he was genuine. Some group of doctors petitioned the commission that in turn wrote to us wanting the council to verify if he was a doctor or not. We found out that it was the same man we had already been petitioned about. We got the file of the doctor and saw the pictures of the name that the CSC asked for was different from the man who was supposed to be a doctor. We then contacted the man (Dr. Daniel) who is registered with us. He confirmed that he is the real doctor and we contacted the medical school he finished from and they also confirmed that he attended the school. Besides, we don’t have any registered doctor whose details fits with Ugwu’s. We then wrote the civil service commission to say the man they inquired about is fake. We are not involved in hiring.

 

Why was it difficult for the council to detect the anomaly as doctors renew their licenses annually?

You know the fake doctor secured employment using someone else’s certificate and since then, he never came for license renewal. So in a way, the employers and his immediate supervisors also erred. If a professional is under the employ of an organization, it is the duty of such organization to request to see licenses from professional bodies. He wasn’t a genuine doctor, so he never had a need to come here for renewing his license.

 

 

So do you have an arrangement with the FCSC through which doctors who are to be employed are authenticated by the MDCN?

After the unveiling of the fake doctor, we believe they are many of his kind in the system. So we didn’t stop at just responding to the CSC, we wrote to the Head of Service and Federal Ministry of Health saying that we believe that there may be other fake doctors and we would like to have the names of all doctors in the employ of the federal government for verification. This is the stage we are in now. The FCSC has not responded, maybe, they are still compiling the list. We want to conduct thorough verification, so that we can see if we still have fakes in the system.

 

Before the Martins Ugwu case, MDCN had been involved in fishing out quacks. How successful have you been especially in the rural areas where fakes usually thrive?

As we always say in any forum we attend, anyone who suspects or comes across a doctor that is not satisfied with his/her conduct should immediately report to the council. At the state level, they can also report to the state monitoring committee, which is under director of medical services in the state’s health ministries. Through this method, we have been receiving lots of responses. Complaints have been received and we have dispatched members of our inspection team to visit those suspected to be quacks. And when they are found out to be fake, we handed such individuals to the security agencies and they prosecute them. As we speak, we have 40 cases of quackery in the courts and we continue to appear as witness.  Talking about detecting genuine doctors in rural area, the first step for patients is to look out for the display of the doctor’s certificate at the reception. If someone doesn’t see the license on display, it is their responsibility to ask the doctor for his license. By the response from the doctor, you will be able to substantiate if he is fake or a quack.

 

For you as the regulator of medical practice in Nigeria what will be a satisfactory end to the Martin Ugwu case?

We have done our bit and I am happy that the citizens of this country have expressed their joy and appreciation on how we handled the case. We didn’t sweep it under the carpet. Within a week of the request from the civil service and the petition from the doctors in the ministry, we unveiled him (Ugwu) to be a fake doctor. We handed him over to the police and you are aware that he has been arraigned. As you know, the criminal aspect of the matter has been taken up by the civil service and his salaries and allowances have been compiled with the view of having him refund it all. For us, I can say, so far, so good.

 

We have witnessed MDCN tribunals where doctors are tried for misconduct. Have they performed well under your tenure?

The act establishing the council and our subsidiary laws have clearly spelt out what professional malpractice and misconduct means. It also prescribed the sanctions for any erring members. The tribunal cannot go beyond or above what has been prescribed in the act. Even before a doctor is brought before a tribunal, such had been investigated and fair hearing is upheld. At the end of the day, if the doctor is found wanting, the case is taken to the tribunal which has the status of a high court. So any party that is not satisfied goes to the appeal court. If at the end of the day a doctor is found wanting, according to the act establishing the MDCN, the highest you can give the doctor is to completely deregister him. The next level of punishment is to suspend the doctor from practicing for six or three months. The least we can give is to admonish the doctor.

 

A major complaint that comes from patients is misdiagnosis. How is the council helping to reduce this?

We regulate practice through the practitioners. The issues of facilities and equipment are handled by other government agencies. I believe that for a well trained doctor, if you give time to your patient, using history and examination, you should get correct diagnosis, at least 70% of the time. Requesting for laboratory tests and further investigation will only assist the doctor to confirm the tentative diagnosis. So in the cases of misdiagnosis, they will be issues. Misdiagnosis is a complex matter really. In our country, you also have the issue of people moving from one hospital to another without proper referral. Misdiagnosis also happens even in advanced countries. You remember the case of a prominent former minister. She was correctly diagnosed in Nigeria at the early stage. But when she went overseas, she was told another thing. Unfortunately when the disease had advanced, she found out that what she was told in Nigeria was correct.

 

Talking about foreign health institutions, how does the council ensure that those who schooled overseas are qualified to practice here?

The mandate of the council is to regulate the training and practice of medicine, dentistry and alternative medicine. We have a guideline for the minimum standard for dental and medical education in Nigeria. Our doctors trained in Nigeria are trained in accredited schools. For our medical schools in Nigeria we know their curriculum and can attest to its standards. For those that schooled abroad, when they come back here, to see that they are up to standard, we conduct an assessment exam for them. Any doctor that returns to Nigeria and wants to be licensed to practice must pass this exam. So the young doctors that return home are exposed to remedial lessons for four months and then they appear for the exam. Most of the doctors that returned home are doing well. Studies have shown that those that had a problem are the candidates that studied in another language.

 

There is the burning issue of not allowing Nigerian hospitals or doctors advertise. But on the other hand, we see foreign hospitals advertising in Nigeria. Will the MDCN take a second look at the issue?

It’s a real burning issue like you said. There is a limit to which adverts can go in the medical profession. In fact, there is a limit to how the signboards should be and where it can be placed. Primarily, the council regulates the practitioners, so no doctor should say ‘ I am the best in this or that’. If we allow that to happen we might have to deal with impostors. But having received a lot of complaints, we are looking at distinguishing between information for service and adverts. We are working with some NGOs trying to create a compilation, even to the extent that if you Google a service you need, you will get that website where you can get a certain kind of service. The truth is that many travel without having the right information. Another thing is that studies have shown that about 60-80 percent of medical tourism is funded by government money. Only a few people are rich enough to seek medical care abroad and some of them go for services that can be found in Nigeria.

 

By KEMI YESUFU

DAILY SUN