COVID 19: The Rich Also Cry!

Dr Nuruddeen Muhammad
MBBS, MWACP, FMCPsych

As I left my consulting room this afternoon I was forced to reflect on how fortunate I am to be healthy and what a tragedy it is to be sick. Tragically so when one is sick but cannot afford their treatment. And the biggest of both tragedies is when that sickness involves a life and death situation. You however see many of such when you are a doctor here, most especially in our public hospitals. People who will turn their backs on you with the certainty that they will die because they cannot afford a twenty thousand Naira; sometimes even muchless. Nothing exposes one to the realities of poverty in Nigeria like a career in medicine. The poor perpetually cries and dies in this country. But the irony is that the rich too may soon join!

The Corona virus is hitting hard on humanity. It is a mark of it's self confidence that it decided to first take on us from our strongest positions. The world's strongest economies, health systems, institutions and healthiest populations are humbled and a few even overwhelmed. Covid 19 is no respecter of wealth, ideology or race!

The global West, North America and the affluent Asians are a very serious minded lot and respecters of life too. They value living so well that the only thing they haven't conquered in it's wake is death itself. Cutting edge scientific breakthroughs have pushed the frontiers of life to conquer ageing, deployed molecular genetics to defeat:hitherto fatal end organ damages and dedicate amazing speed and precision to handle life threatening emergencies. For example, in the state of New York USA, any emergency call that isn't responded to in under nine and half minutes is audited and heads could roll

There is however a certain perverse ignorance among the elite class in Nigeria that seeks to enjoy the best of both worlds; the eight months of summer here at home and the health security abroad. Nigerians of means have become so accustomed to health tourism. And as a health professional, one must have met a few folks who would spit that right on to your face. There is a certain condescension that says, 'Oh your hospitals aren't for me'. But the bitter truth is, when it matters most, and in the most dramatic of medical emergencies, one's life is totally dependent on the quality of the health services in their neigbourhood or one at most an hour away. Many, including those who can otherwise afford the most expensive health services anywhere in the world die daily of heart attacks and related illnesses. This is before they could even get first aid due to our poor preparadeness and response to emergencies generally.

Nothing drives this truth home than the on going Corona virus pandemic. In it's severest forms, Covid 19 chokes and drowns it's victim as a result of extensive damage and fibrosis in the lungs. Under such extreme circumstances, almost all patients will require some oxygen and not a few will have their life depend on a respirator (ventilator).

A ventilator is a medical appliance for artificial respiration that in most instances requires specialised doctors (Anaesthetists) to operate and monitor patients. Italy is today short of both, though it is among the top ten countries with the most advanced healthcare resources in the world. In northern Italy few and worn out doctors decide on who lives and who dies as they assign even fewer ventilators to their critically ill patients

There are important lessons here that Nigerians and our various governments should learn. First, we must intensify and deepen existing preventive and containment measures. Those who return home from overseas pleasantly comment that we are already doing well at the entry points. That is very commendable. But we can and must do more.

Reports this morning of some National Assembly members resisting basic screenings at airports is not only (dis)honorable but patently irresponsible, unparliamentary and ignorant. It exposes the inherent weakness in our systems and further feeds into the narratives of those dangerous elite privileges that eventually destroys even them. It is very appropriate that the President has through his chief of staff written a strongly worded letter to the leadership of both chambers to warn agaisnt the dangers of such behaviours.

The general public too must brace up and further embrace the prescribed safety behaviours of social distancing, frequent handwashing and staying home where that is practical. And then we fervently pray; pray as hard as we have never done in our lives for divine intervention

Because there are probably not morethan two hundred ventilators in Nigeria that are unevenly spread across the country. Then add that to the existing deficit of personnel, regular everyday equipments/consumables and even bed spaces. Therefore in the event of a full blown Covid 19 outbreak (God forbid), Nigeria has neither the capacity nor the resources or infrastructure to respond. It will be an apocalypse. The only twist this time around is that we shall all eat from the same pot. Those who can run and had habitually run to procure health abroad would have nowhere to run to. The world may be a global village, but rich or poor, home is home and is eventually where we all belong. With Corona, we all die here, both literally and figuratively

There will be enduring and bitter lessons when this is finally over. This home called Nigeria must reinvent itself and reconfigure it's priorities. With Covid 19, health has once more reaffirmed it's primacy in the affairs of men. Health is clearly the most priceless of all wealth and viruses perhaps the future weapons of mass destruction.

I am accordingly of the informed opinion that the post Corona world will in all probability respond in kind. It will amass deterrence - just as it did with the nuclear threat - but this time around in the form of more refined knowledge, information and breathtaking scientific innovations through investment in both health infrastructures and resources.

Nigeria must quit shooting blank and consciously position itself in this imminent new world order. It is in our enlightened self interest to reflect hard and fix our collective vulnerabilities; one must be there for all and all must stand for one. A new health system must emerge from the rubbles of Corona. In matters involving life and death, none of us, rich or poor should cry.