[afro-nets] Disasters, Death, Forensic and Mortuary Services in Nigeria

[A. Odutola <chpss_abo2@yahoo.com>]

Disasters, Death, Forensic and Mortuary Services in Nigeria
-----------------------------------------------------------

The two recent air disasters (October 23, and December 10, 2005)
have once again exposed the underbelly of a grossly inadequate
health system in Nigeria among many other woes of course.

Several disaster-related reports tell tales of woeful first re-
sponder services. Mortuaries, where they exist at all close to
disaster areas are routinely ill-equipped, lack steady power and
are unhygienic. Forensic expertise and resources for the identi-
fication of remains of victims of disasters are grossly inade-
quate or near non-existent. Human resources for forensic pathol-
ogy are scare; there are probably no more than six certified fo-
rensic pathologists to serve a nation of 120 million people!

In a nation where registration of births is not routinely imple-
mented, it is simply wishful thinking to expect availability of
organized dental records, finger prints or DNA databanks for use
in victims' identification. With no suitable victims' identifi-
cation process, closure for relatives of disaster victims is
hard or impossible and this is compounded by the lack of immedi-
ate and long term publicly available post-traumatic counselling
services. Oh, what pain!

Check this out! This story is typical. With approximately 22
teaching hospitals that are ironically dubbed "Centres of Excel-
lence", badly burned but still identifiable bodies of air crash
victims are reportedly placed on the floor, occasionally "sprin-
kled with disinfectant" ostensibly "in a university teaching
hospital mortuary room with no refrigeration or aircondition-
ing".
(http://news.bbc.co.uk/2/hi/africa/4518564.stm BBC, 12/11/05)

Notwithstanding Nigeria's much touted recent health reform that
does not make healthier people and communities the centrepiece
of its promise and over 100 million dollars recently committed
to refurbish teaching hospitals in order to bring them to "five-
star status of international standards", the truth is, Nigeria's
basic health system is deplorable and hardly serves the populace
with any decency and dignity. The pain and price being paid by
all for this infamy is humongous.

Why is this so?

The reasons are legion: There is obvious visionary, leadership
and planning coordination vacuum in Nigeria's health system.
There is policy agenda distortion among key internal and exter-
nal players and actors. There is high stake political conflict
of interest that fuels distortion of health services planning
and implementation in favour of unsustainable acute health care
white elephants projects. There is budgetary inadequacy at all
levels. There is poor human capital management and above all the
populace served is so dis-empowered to serve as its own advocate
for better services. What voice does anyone living on less than
a $1 dollar a day have in an ironically oil-rich nation?

What can be done? Well, Nigeria's health policy makers, plan-
ners, managers and diverse stakeholders will need to commit to
basics. Embrace the basic essentials of public health and make
medicine serve people rather than medicine serving government
and politics. In a nation as complex as Nigeria with highly cen-
tralized, but largely uninformed power structures, this seem-
ingly simple solution would so readily be consumed in a whirl-
pool of intrigue, organized inaction as well as unorganized ac-
tion to make it a no solution.

My heart goes out to relatives of disaster victims in Nigeria,
they simply are caught in a triple whammy of personal tragedy;
Disaster, Death and inauspicious Closure! What pain indeed!

A. Odutola
mailto:chpss_abo2@yahoo.com