Woro, Nuku, Ifunanya: Do our leaders really care?

The country seems to be a constant reel of avoidable misfortunes; we attract manmade destruction of lives with the regularity of a Swiss watch. This year is barely 40 days old, and already at least 210 people – those widely reported – have been killed by insurgents in Borno, Katsina, Kwara, and other northeastern parts of the country. Just last week, over 170 people were reported killed in Woro and Nuku villages by suspected Lakurawa terrorists.

Also, last week, there was the report of the unfortunate but preventable death of a bright young Abuja-based singer, Ifunanya Nwangene. She died from a snakebite in her room due to poor medical intervention. Her death was preventable because Nigeria has some of the most venomous snakes in the world: cobra, puff adder, rattlesnake, green mamba, etc., and snakebites are fairly common in the country. Snakebites are also fairly easy to treat and should not ordinarily lead to death, particularly if medical attention is sought immediately after the bite. Ifunanya’s death is simply a failure of the system/the society at several levels. The same failures are fuelling the insurgency.

Two hours to get medical help!
Reports showed that Ifunanya was bitten by the snake between 8 am and 9 am. The neighbours were said to have applied a tourniquet above the snakebite spot. A neighbour had offered to get her to a hospital, but the neighbour’s car wouldn’t start. When the car wouldn’t start, Ifunanya was said to have run about 500 metres to the estate gate where she lived to get transportation. Then, from one hospital to the next, before she was attended to. Based on the chronology of events, it took roughly two hours before Ifunanya got medical help. In such medical emergencies, two hours is a lifetime and could be the difference between life and death – and it was for the unfortunate Ifunanya.

Societal failures

Lack of community preparedness
The first failure is that of community preparedness and poor orientation. I can guess – and I won’t be wrong – that Ifunanya wasn’t the first individual to experience snakes in her estate. According to the story, she lived in a gated estate where three snakes were eventually killed following the bite. Many must have encountered snakes in that estate, none leading to fatality, thankfully. The estate community or the excos should have sought snake-knowledgeable medical experts or a toxicologist who could have prepared them for what to do and not do when a snake attacks; teach first aid for snakebites, and even how to prevent them.

It was clear that it never happened. The report said a tourniquet was tied around Ifunanya’s wrist area by neighbours to “prevent” the poison from flowing to other areas. That was what many of us heard growing up, and we believed it was the best course of action. But the World Health Organisation and the Red Cross strongly advised against using a tourniquet. Reason, it cuts off blood flow, trapping the venom in a small area, and that can lead to severe tissue damage, gangrene, and limb loss. An expert on poisoning who featured on a popular radio station in Abuja gave similar advice: avoid tourniquets in snakebites. The next mistake was Ifunanya walking several metres, 500 metres, to the gate to get transportation to the hospital. The toxicologist explained that movement helps the poison move faster through the vessels. By walking 500 metres to the estate gate, I imagined briskly out of fear that Ifunanya inadvertently helped the venom move faster. A former Director-General of the Nigeria Centre for Disease Control and Prevention (NCDC), Professor Abdulsalami Nasidi, agreed and cautioned against excessive movements following a snakebite.

Town/urban planning failure
The second failure is a town planning failure. We don’t know if this applied in Ifunanya’s case. But an Abuja resident who had problems with snake infestations in his home said he discovered that his “house was connected to Abuja’s central sewage system” through which reptiles, including snakes, easily gained access to his home. He was forced to “install non-return valve devices on all his toilets.” An average town planner/civil engineer would tell you it is dangerous to connect a public sewage system directly to a home. Among other dangers, it could lead to blockage of the house if there was ever a backflow of sewage, bringing with it serious health risks from dangerous pests, gases, bacteria, and foul odour. Backflow could also damage the house’s plumbing systems.

Absence of emergency preparedness
The third failure is perhaps the most life-threatening and dangerous: a lack of emergency preparedness in Abuja and the country as a whole. What, for instance, is the emergency line to call when citizens are in distress? I don’t know the number, and so do millions of Nigerians. In the scenario that led to Ifunanya’s death, not one person – and many people were reported to be involved: neighbours, choir group, the victim’s uncle and others – remembered to call an emergency number to get an ambulance or report the case. And the reason is simple. Nobody called because nobody knew the number and if they do nobody believed it would help. The same way the people of Woro and Nuku villages in Kwara State didn’t know who or what line to call for help when they were under attack.

I learnt the country’s national emergency number is 112. This is new to me, and to millions of Nigerians, I daresay. It appears even government agencies do not know this. The Mandate Secretary of the FCT Health Services and Environment Secretariat, Dr Adedolapo Fasawe, while debunking the claims that there were no anti-snake venoms in FCTA-owned hospitals and public health facilities and encouraging people to call ambulance services in a medical emergency never mentioned the 112. The numbers she gave were regular GSM numbers. Who remembers an 11-digit number in an emergency.

I believe governments across the country need to adopt a standard national emergency line and commence a massive and consistent orientation campaign on the national emergency number and the necessary information to give first responders in an emergency situation.

Leadership failure
It is clear that the above are directly linked to a failure of leadership. We have a weak healthcare system where charlatans and fakery thrive unhindered, where basic facilities are in most cases missing. If truly the Federal Medical Centre, Abuja administered anti-snake venom on Ifunanya, how come she never responded? She was said to be very lucid and strong when she walked into the hospital. Professor Nasidi provided a possible answer to the question: “Unfortunately, side by side with effective antivenoms, we now have fake antivenoms circulating that do not work. Even when administered, they do not protect the patient.” According to the professor, “With effective antivenom available, nobody should actually die from snakebite.”

It is always distressing that our leaders react after the facts of a problem shedding their usual crocodile tears laced with placid and choreographed platitudes, and a promise that necessary steps would be taken to ensure it does not happen again. The reaction is so predictable one could win a lottery on it. It consistently happens whenever Nigerians are attacked or killed by insurgents or kidnapped. We often hear statements like the security agencies have been ordered to apprehend the perpetrators; the perpetrators will not go unpunished; we shall do everything in our power to apprehend those responsible, etc. And after these assurances, nothing happens until the next attacks.

Playing to type
Thus, Nigerians were not disappointed when the Senate President Godswill Akpabio “ordered” hospitals across the country to stock up on antivenom and directed the National Agency for Food and Drug Administration and Control (NAFDAC) and the Health ministry “to prioritise the procurement, quality assurance, proper storage and nationwide distribution of safe, effective and affordable anti-venom.” These statements suggest they know there are fake antivenoms in the market and that antivenoms are expensive to procure. We should ask the Senate president if the procurement would be from the paltry circa 4% budgetary allocation to the health sector, which is some ways, below the 15% benchmark in the Abuja Declaration. Many African countries, such as South Africa and Ghana, spend more on healthcare than Nigeria.

It’s so heart-wrenching that our leaders continue to play the fiddle while Nigerians die unnecessary ,avoidable deaths. “They don’t really care about us” was a profound line from one of Michael Jackson’s songs. He could have been singing about Nigerian leaders.

May the souls lost to avoidable deaths this year, including Ifunanya Nwangene, find eternal peace and may the almighty console their families.