NIGERIAN DOCTORS AND DRUG ABUSE

Sunkanmi Vaughan argues that medical doctors contribute largely to drug abuse by the youths

The facts support the view of most Nigerians who believe that the Nigerian Medical Association (NMA) is responsible for exacerbating problems of Tramadol/Codeine abuse among the Nigerian youths and the Joint Health Sector Union (JOHESU) strike that has resulted in the shutdown of the public health institutions since April 16. However, I will focus on the facts that made NMA culpable for worsening the abuse of drugs such as tramadol and codeine among the Nigerian youths. It’s not a coincidence that both political appointees for the senior and junior ministers of health and the minister of labour in this current government are all members of the NMA. It has not always been so.

In 1991, the then Minister of Health, Professor Olikoye Ransome-Kuti got the IBB-led military government to approve a special salary scale for all the members of his professional group,NMA, and since then ‘things fell apart and the centre can not hold’ in the Nigerian health sector. To support this fact, the president of the Pharmaceutical Society of Nigeria, (PSN) Ahmed Yakassai, in his recent interview with The Punch newspaper, stated that “it is important to take a walk down memory lane that contrary to the superiority mentality created in some quarters, pharmacists and doctors entered the public service on the same grade level up until 1991.” From 1991 till date, there has been a progressive debilitating and systematic mismatch between the human resources of the Nigerian medical doctors and the actual primary role they are supposed to play in healthcare, unlike their counterparts in other countries with better health indices than Nigeria. It is therefore so unpatriotic of NMA that has consistently categorised Nigeria as having insufficient number of medical doctors not to have discovered yet that most of the experienced hands among its members have cornered one political appointments or another thereby significantly reducing their individual inputs in direct medical practice. These political appointments bonanza for NMA members include appointment as Ministers of Health, Commissioners of Health ,Chief Medical Directors of public health institutions, Heads of MDAs to even MOH agencies of states and federal governments that are statutorily meant to be headed by other healthcare professionals like the case of the National Agency For Food, Drug Administration and Control (NAFDAC), where a medical doctor, Dr. Paul Orhih, was appointed to head and run NAFDAC for seven years from 2009 to 2015; the Nursing and Midwifery Council of Nigeria (NMCN) where a medical doctor, Dr Abisola Clark was appointed in 2013 in a most shocking and bizarre manner, to head the governing board of the apex regulatory board for nurses in Nigeria, followed by the hostile belligerent attempt by medical doctors to regulate the practice of medical laboratory science until it was resolved in favour of medical laboratory scientists by the judgment of Justice Esowe of the National Industrial Court(NIC) , Abuja, who in his judgment in 2013 stated that “I hold that, based on the evidence before me, there is no conflict whatsoever between the job schedules of pathologist(a medical doctor) and that of a medical laboratory scientist. The position is reinforced by the fact that their trainings, professional qualifications and schemes of service are different from each other...”

The effect of this switch of roles by Nigerian medical doctors from medicine to politics denied the country of value for her investment in producing experienced doctors and in turn , made these “politicians in white lab coats” shift their focus away from medical practice and the training of young doctors to playing hardcore politics in the hospitals and healthcare organisations.

Due to the limitations of the training of Nigerian doctors in management and areas outside their scope of training in healthcare, their tenures as chief executives in government agencies and most federal and state hospitals turned out to be monumental disasters. With the unfair manner they achieved the political conquest of Nigerian health sector, members of the NMA attracted opprobrium from members of the public and their counterparts in the business of healthcare because they are seen as greedy and incompetent. The period of Dr Paul Orhih, for example, reversed the positive grounds covered by the sterling performance of a pharmacist like Prof. Dora Akunyili, who as Orhih’s predecessor, had competently occupied the office of the Chief Executive Officer of NAFDAC because of her training and her professional experience as a drug control and administration expert. During the reign of Dr.Orhih , NAFDAC became an ineffective organisation. NAFDAC was chased out from the ports in 2011 thus allowing unchecked increase in the entry of these psychoactive drugs into Nigeria and the culture of using third parties for supply of sensitive equipment became rife leading to accusations and counter accusations of corruption between Dr Orhih and members of staff when most of these equipment were discovered to be of substandard quality.

The most debilitating effect was the dismantling of all structures that was professionally put in place by his pharmacist-predecessor for effective drug control and administration because the medical doctor forced by the political machinery of NMA on a pharmacist’s seat in NAFDAC.

The results from a research done and published in the journal of Advanced in Psychology and Neuroscience by researchers from the School of Mental Health, University of Maiduguri, on

Tramadol abuse among patients attending an addiction clinic in North-Eastern Nigeria between June, 2012 and June, 2016, could not have revealed the monumental disaster in the nation’s drug control under the administration of Dr Orhih better. According to these researchers,”In terms of the Tramadol formulation, the overwhelming majority of the respondents (96.1% of the addicts) used the tablet form and almost two-thirds used multiple frequency dosing.This could be attributed to the ubiquitous availability of drugs without regard for locality due mainly to the activities of drug vendors who dispense these drugs without prescriptions.” While the incidence of drug abuse was already in place in Nigeria, the appointment of a professionally incompetent person led the avoidable worsening of the drug abuse plaque among Nigerian youths as there was free and regular supply of codeine syrup and tramadol tablets.