JOINT STATEMENT BY THE NIGERIAN MEDICAL ASSOCIATION (NMA), THE PHARMACEUTICAL SOCIETY OF NIGERIA (PSN) AND THE NATIONAL ASSOCIATION OF NIGERIAN NURSES AND MIDWIVES (NANNM) ON THE CONTAINMENT OF COVID-19 PANDEMIC MENACE IN NIGERIA
The novel Coronavirus disease (COVID-19) has been spreading at a rapid rate across the world, which made World health organization (WHO) to declare it a pandemic. Today the number of confirmed cases in Nigeria has risen to 323 in 20 states and the FCT with 85 discharges and 10 deaths as at April 13, 2020 as announced by the Nigeria Centre for Disease Control (NCDC). While we acknowledge the efforts of the Federal Ministry of Health and the Presidential Task Force (PTF) to control the pandemic so far, we advise that efforts should be intensified to stem community spread of the disease.
On behalf of all our members, we the Presidents of the three health professional associations, i.e. NMA, PSN and NANNM, hereby salute all healthcare workers who have been at the forefront in the battle to contain the onslaught of the deadly virus at the various isolation centres across the nation. We also appreciate them for keeping health services delivery ongoing despite the difficulties, especially in getting to the workplace.
We acknowledge that the greatest killer of our people as at today is not COVID-19. Infact, Lassa fever, malaria, other infectious diseases, as well as non-communicable diseases are still rife and actually killing more patients. We salute our members for being there when majority of our fellow citizens has been asked to stay safe in their homes.
The times we are living in requires both government and frontline actors to focus on a set of immediate targeted emergency actions. The health workforce is facing the most acute crisis our members have ever been confronted with in recent years, except perhaps in 2014 when Ebola virus disease was also imported into our country. Health workers represent about 12% of the COVID19 infected population globally, and the death toll is getting unbearable.
We mourn with a great sense of sorrow the demise of Dr. Aliyu Yakubu, a Katsina State private medical practitioner who is the first casualty from our community of practitioners. Our members continue to serve under the most atrocious conditions: understaffing, shortage of Personal Protection Equipment (PPEs), long working hours, poor salary and risk allowance, and the unpreparedness of our weak health system despite our persistent early warnings and by the WHO, that health workers are exposed at work to fatal hazards that threaten their health, their families’ health, putting in peril the capacity of the health system to respond to the emergency of COVID-19 pandemic.
The shortage of equipment including ventilators, ICU beds and ordinary examination beds, testing kits, laboratories and biologics is impeding the chances to save lives and worsening the working conditions. A nationwide survey conducted by the Nigerian Medical Association which we will share subsequently attests to our nation’s health system’s unpreparedness when COVID-19 is already here with us.
Government should provide PPEs to all workers’ exposed to high risk of contagion while at work (healthcare, care of the elderly, home care, transport, ambulance, policemen, firefighters, correctional centres and detention facilities, including IDPs camps, shop assistants and cashiers, workers in essential production lines, etc.). For COVID19 pandemic in particular, Government must provide adequate numbers of ventilators, test kits and all other essential equipment and devices to enable the health workers deliver safe and effective care to patients. Our nation should also fast track capacity building in the area of validation of every imported test kits.
There is a global shortage of these vital equipment because every nation affected by the pandemic is looking to procure the same items, therefore to achieve this, we ask governments at all levels to collaborate with local factories to see possibilities of re-purposing their installed factory lines to the production of these highly essential equipment and commodities. This is in addition to awakening the Standards Organization of Nigeria (SON) on its responsibility of ensuring that imports and locally produced equipment and other essential goods are of the highest quality. NAFDAC should also be empowered to wake up now more than ever to guarantee drug safety, as an adulterated or fake drug may be worse than no drug at all. The Government, through NAFDAC, is also advised to facilitate the availability of pharmaceutical products that are necessary for the treatment of COVID-19
Government should recruit more health professionals to reduce the workload on hospital staff and reduce the risk of contagion. There is urgent need to replace workers who may need to self-isolate when they mingle with COVID19 patients.
We reaffirm our call on the Nigerian Government, at all levels, to support all Nigerians to cope with this precarious time, more especially to demonstrate practically that healthcare workers are the frontline ‘soldiers’ and allies of the people in the war against COVID-19. In this regard, we ask for regular and timely payment of salaries, emoluments and other incentives including paid leave, childcare and security to all workers who must continue working.
The fact that healthcare workers are still being kidnapped by criminals or harassed by security agents on their way to work leaves much to be desired. Government at all levels must take practical steps to safeguard all health workers. We do not want health workers who save lives to be called heroes. They are not heroes! They are professionals who claim and deserve respect, dignity, the right to protection, recognition, decent wages and decent working conditions.
We are ready to engage with government, development agencies and International Financial Institutions (IFIs), like the World Bank, to attract the injection of adequate resources, without conditionalities.
We equally urge Nigerian government to provide urgent, inclusive and rights-based solutions to displaced persons living in camps, because there is the high risk that concentration of thousands of people in restricted areas without access to healthcare services, clean water and sanitation can turn into a public health catastrophe of unimaginable scale. The country while being realistic in anticipating escalation due to community transmission should consider IDP camps as quasi isolation centres and given the attention they deserve.
While we appreciate the spirited efforts being made by the Nigerian Government to combat the pandemic, we also hereby express our dismay that the Federal Government, up till now has not deemed it necessary to involve the healthcare professional associations in the Presidential Task Force (PTF) or its Technical Committee or other committees set up to eradicate COVID-19. This is an anomaly though late, should be corrected.
Health workers need a strong reassurance in practical terms that should they pay the ultimate price while fighting on the frontlines in the war against COVID-19, their wards would have a life line to forge ahead in life. Up till now, we regret to observe that no mention has been made about life insurance plans and other compensatory packages. Why then do institutions like the Nigeria Social Insurance Trust Fund (NSITF) exist in Nigeria? We note with envy what other nations of the world, especially nearby African neighbours, are doing for theirs. We deserve even better.
Let us restate that we are still willing and ready to work with government as partners. We are open to collaborating with governments at all levels in the fight against this pandemic. To this end we have jointly established a Special Health Response Squad of volunteers from the three Associations to provide a pool of well trained professionals to complement what the government already has on ground. The Special Health Response Squad would be well kitted with adequate PPEs. The Squad would be divided into different categories according to areas of need; with some working at the isolation centres while some will engage in information, education and communication with the public. The information dissemination would be done through radio/TV jingles, posters, flyers, handbills and possibly physically in the communities which would be produced in English, Hausa, Igbo and Yoruba languages.
Finally, we are strongly appalled that despite all the evidence based warnings from the various health professional associations and other stakeholders in our country against the invitation of Chinese healthcare professionals into the country, such advisories and protests were ignored and the Chinese are now in the country. We therefore warn that under no condition should they be allowed near any Nigerian patient directly or remotely. They must observe supervised mandatory quarantine for 14 days and tested for COVID19 appropriately, as per protocol, before they are allowed into the streets or buildings in Nigeria.
We encourage our fellow citizens to observe all the precautions that have been issued to the public by NCDC to prevent COVID-19. We should practice social distancing, washing our hands with soap and running water, and cover our mouths when coughing and sneezing so as not to contaminate the persons, atmosphere and surfaces near us.
Despite the few mortalities recorded so far, if we obey instructions and place life first, above all other considerations, we will once again celebrate victory over COVID-19, as we did against Ebola in 2014. Stay safe!
God bless The Federal Republic of Nigeria.
Dr. Francis A. Faduyile Pharm. Mazi Sam Ohuabunwa, FPSN, OFR, MON
NMA President PSN President
Nurse Adeniji A. Abdulrafiu, mni NANNM President