Opinion

Challenges Of Paediatric Surgery In Nigeria

Published

2 years ago

December 8, 2023

According to the United Nations Children’s Fund (UNICEF), Nigeria is a ‘country of the young’ with 92 million of its over 200 million population under the age of 15 years. Also, according to Professor of Paediatric Surgery at the University of Lagos, and former Chief Medical Director (CMD) of University of Lagos Teaching Hospital (LUTH), Prof Christopher Bode, the number of children under 5 years old in Nigeria are over 30 million, with about 7 million new babies being born yearly. Prof Bode was the keynote speaker at the second edition of memorial lecture, held last week at the University of Port Harcourt, in honour of one of the pioneers of paediatric surgery practice in Nigeria, late Dr. Melford Graham-Douglas.
According to him, paediatric medicine is the medical care of children, a broad name for treatments for those from zero to 15 years of age, of whom Prof Bode observed are tender and voiceless, because they mostly can’t speak for themselves, depending on their parents for important lifecare decisions. Paediatric surgery which deals with surgical cares, mostly of birth defects in babies, demands the utmost skilled personnel, equipment and specialist handling, considering the tenderness of babies. Since the introduction of paediatric surgery in Nigeria, child-care professionals have continued to champion the awareness that children need specialised healthcare and infrastructure more customised to their needs as distinct from general medical practice.
Despite the achievements made so far in Nigeria in reducing infant mortality rates from previously untreatable birth defects, thanks to the foresightedness of pioneer paediatric surgeons like the late Dr Melford Graham-Douglas, enormous challenges still face the discipline from achieving its full objectives.As part of the general challenges of the Nigeria healthcare system, health screenings for disorders are mostly relegated out of ignorance, to the effect that paediatric cases requiring earlier surgeries are presented late, while most children are unable to communicate their health challenges. Where emergencies occur, paediatric surgeons have had to wait endlessly, for the general surgeons to free-up adult theatres before they could exercise efforts to rescew babies in critical conditions.
Considering that children are different in size and physiology, their cases become more delicate. Their body surface to mass ratios are much higher than in adults, that they dissipate body heat faster in normal ambient temperatures, and easily catch cold in the cold conditions of adult surgical theatres. Warmer surgical theatres designed and dedicated for children are always needed or they easily succumb to life-treathening hypothermia. Basic amenities are also needed to transport children in warm ambulances, especially babies, from hospitals of first call, to the centre of definite care.Paediatric surgeons also need to monitor children’s blood levels with specialist care because children have very low blood volumes that a minor loss could tip the balance between life and death. Due to anatomic differences from adults, children need special anaesthesia to undergo successful surgeries, and careful drug calculations to cope with their tender metabolic systems, their airways being so narrow, many routine anaestetic steps in adults are unsuitable for newborns and infants.
Drugs and the amount of fluid infusion to be administered to a child must be carefully calculated to conform with body weight, and in isothermic conditions. These are reasons paediatric surgery is such a speciality area that requires the skills set and infrastructure it deserves. It has been a huge challenge to practitioners who have had to work in poorly equipped environments. Paediatric surgery units in Nigeria should therefore be provided with neonatal intensive care units (NICUs) and paediatric intensive care units (PICUs) to ensure adequate post-surgery cares for babies and children, in addition to providing exracorporeal membrane oxygenation (ECMO) machines.Prof Bode however regrets that low man power remains a challenge in the field. According to him, in a survey conducted in Nigeria, about 2.9 million Nigerian children live with surgically correctable conditions, meanwhile there are just 38 treatment centres and only 115 paediatric surgeons in the country, some of whom have left for greener pastures, leaving a workload of about 25,000 patients per surgeon. There are only 22 professors of paediatric surgery to train needed personnel. There is therefore a need to create significant incentives that reverse the exodus of skills.
The labours of specialist surgeons like the late Dr Melford Graham-Douglas, who worked tirelessly to save lives remain commendable and they need being immortalised as an encouragement to others. There is need to celebrate those who served humanity selflessly and bequeathed a legacy of patriotism and hardwork.Late Dr Melford Graham-Douglas was the first African surgeon under the British Technical Assistance Scheme. He was a fellow of the British Association of Paediatric Surgeons, a fellow of the Royal College of Surgeons of Edinburg and England and a fellow of the American College of Surgeons. He was the first registrar of the Nigerian Medical Council, was among the founding fathers of the University of Lagos, as well as being a council member of the universities of Ibadan and Port Harcourt, respectively. Back home, he served the Rivers State Ministry of Health as permanent secretary who laid the foundation of health infrastructure in the state. He was honoured with the Order of the Federal Republic (OFR).
An icon of the Orubibi Group of Houses in Abonnema, the University of Port Harcourt honours late Dr Melford Graham-Douglas with a Professorial Chair in Paediatric Surgery at the university’s College of Health Sciences, in recognition of his contributions to humanity. The chair, currently occupied by Prof Amabra Dodiyi-Manuel, is dedicated to research and development in paediatric surgery.Government should build upon the foundations established by men like late Dt Graham-Douglas to equip the College of Health Sciences of the great University of Port Harcourt, with state of the art facilities in paediatric surgery, as a centre of reference within the South-South region. As it stands today, there is no significant paediatric surgery centre in the region. The management of UNIPORT should engage both federal, state and regional stakeholders to ensure this becomes a reality.

By: Joseph Nwankwo

Opinion

Beyond the Adichie Tragedy

Published

12 hours ago

March 16, 2026

The Tide

Quote:: “Justice must never depend on fame, wealth, or connections. The child of a roadside trader deserves the same standard of care as the child of a globally celebrated writer. When accountability works only for the prominent, public trust in institutions quietly erodes.”

Public reaction to the suspension of doctors by the Medical and Dental Council of Nigeria (MDCN) following the death of the son of celebrated Nigerian writer Chimamanda Ngozi Adichie reveals something deeper than outrage over a single tragedy. Across social media and public commentary, a recurring sentiment stands out: many Nigerians believe justice was served only because of the prominence of the family involved. Comments such as “The doctors were punished because Chimamanda is well known,” or “If it was a poor man’s child, the case would have been swept under the carpet,” capture a troubling lack of faith in the system.

Whether these perceptions are always accurate is not the most important issue. What should concern the nation is that so many citizens instinctively believe that justice in Nigeria often depends on status, wealth, or influence.The tragedy that befell the Adichie family is heartbreaking. No parent should have to bury a child, particularly under circumstances that raise questions about professional responsibility. But beyond the grief lies a larger national concern: medical negligence in Nigeria is far more widespread than the few cases that attract public attention. Across the country, families quietly lose loved ones in hospitals and clinics under troubling circumstances. Patients are sometimes misdiagnosed. Emergency cases may be delayed. Surgical procedures may be mishandled, while basic standards of care can be compromised due to negligence, poor supervision, or systemic pressure on medical staff.

In many situations, grieving families simply accept their loss and move on, believing there is little they can do. The result is what can only be described as a silent epidemic of unreported medical negligence.In more developed healthcare systems, such incidents rarely go unexamined. Independent regulatory bodies investigate complaints, enforce professional standards, and sanction erring practitioners. In the United Kingdom, for instance, the Care Quality Commission inspects hospitals, clinics, and care providers to ensure strict compliance with safety and quality standards.Nigeria does have oversight institutions, notably the Medical and Dental Council of Nigeria. However, enforcement often appears inconsistent, and many cases of negligence never reach the stage where regulators can intervene. Sometimes victims are unaware of the complaint process. In other cases, fear, cost, or bureaucracy discourage families from seeking justice.

While government institutions must improve their oversight mechanisms, citizens must also confront a difficult truth: Nigerians often fail to pursue their rights when they are violated. Too frequently, when injustice occurs, people retreat into resignation. Instead of filing complaints or seeking legal remedies, many respond with the familiar phrase: “God will judge them.” Faith is important, but it should not replace civic responsibility. A society that leaves accountability solely to divine intervention risks allowing negligence and impunity to flourish. Some commentators have suggested that the Adichie family likely pursued the matter relentlessly through petitions and formal complaints before authorities acted. If that is the case, it demonstrates a path other citizens can follow. When malpractice occurs, persistence in seeking justice can make institutions respond.

If more families reported cases of medical negligence to the appropriate authorities, regulatory bodies would have stronger grounds to investigate. Public pressure would also push healthcare institutions to improve their standards. Negligence, as defined by Nigeria’s Supreme Court in Odinaka v. Moghalu, refers to the failure to do what a reasonable and prudent person would have done under similar circumstances. Within medical ethics, physicians are expected to provide competent care with compassion and respect for human dignity. These principles form the foundation of the duty of care that patients rely upon. Citizens must therefore be able to recognise signs of negligence and take appropriate steps to seek redress. Patients and families should learn to document incidents, keep medical records, ask questions about treatment decisions, and report suspicious circumstances surrounding medical care.

Where necessary, formal complaints should be lodged with regulatory authorities or pursued through the courts. Civil society organisations, advocacy groups, and the media also play a crucial role. By exposing cases of negligence and demanding accountability, they help ensure such incidents do not disappear into silence. A healthcare system shielded from scrutiny cannot improve. Nevertheless, responsibility cannot rest solely on citizens. Government must take decisive steps to strengthen healthcare regulation and reduce medical negligence. Hospitals and clinics—both public and private—should undergo regular inspections to ensure compliance with professional standards, safety protocols, and ethical guidelines. Persistent violations must attract meaningful sanctions. Legal practitioner and Senior Advocate of Nigeria Olisa Agbakoba has suggested the creation of an independent health regulatory authority and the restoration of Chief Medical Officers at federal and state levels.

In the past, these officials, alongside health inspectors, helped enforce professional standards and ensured accountability within healthcare facilities. Government must also invest more seriously in the training and continuous education of healthcare professionals. Medicine is an evolving field, and practitioners must constantly update their knowledge and skills. Mandatory professional development programmes, stricter licensing renewal requirements, and improved mentorship systems could help reduce errors arising from outdated practices or inadequate training. At the same time, systemic challenges within the healthcare system cannot be ignored. Many Nigerian doctors and nurses work under extremely difficult conditions—overcrowded hospitals, outdated equipment, staff shortages, and overwhelming patient loads. Such pressures increase the risk of mistakes and professional burnout.

Improving healthcare infrastructure, funding, and staffing is therefore not merely an administrative matter; it is a fundamental requirement for patients’ safety. Equally important is transparency when allegations of negligence arise. Investigations must be timely, credible, and accessible. Families deserve to know what happened to their loved ones and whether professional standards were breached. Regulatory bodies must ensure that findings are communicated clearly so that public confidence in the healthcare system is strengthened. The tragedy that drew national attention to medical negligence should not be treated as an isolated incident involving a prominent personality. Rather, it should serve as a wake-up call for systemic reform.

Every Nigerian life carries equal value. Justice must not depend on prominence or privilege. When citizens demand accountability and institutions respond with fairness and transparency, trust begins to grow. Nigeria’s health sector is filled with dedicated doctors, nurses, and medical workers who save lives daily despite difficult conditions. Recognising their commitment, however, should not prevent society from confronting the reality that negligence sometimes occurs—and when it does, it must be addressed firmly. If this painful moment encourages Nigerians to speak up, demand accountability, and push for stronger regulatory systems, it may yet produce meaningful reform. Citizens must refuse to accept negligence as fate, while government strengthens oversight and improves healthcare conditions. Only through this collective effort can Nigeria build a healthcare system where every patient—regardless of social status—receives safe, responsible, and dignified care.

By: Calista Ezeaku

Opinion

As The World Celebrates Women

Published

12 hours ago

March 16, 2026

The Tide

Quote:” “Every woman who works tirelessly to raise her children, run a business, support her family or contribute to her community is shaping the future of society. These quiet, everyday efforts may not always make headlines, but they remain the foundation upon which strong families, communities and nations are built.”

The celebration of International Women’s Day offers another important moment to reflect on the strength, resilience and achievements of women across the world. It is a time not only to celebrate the progress made over the years, but also to recognise the courage, determination and commitment that continue to define women’s contributions in every sphere of society. Across the globe, women are steadily breaking barriers and redefining possibilities. From leadership and governance to science, education and enterprise, women continue to prove that their capacity to contribute meaningfully to development is limitless. Particularly inspiring are the strides being made by women across Africa and here in Nigeria. In many instances, these achievements are recorded despite limited access to resources and opportunities when compared with their counterparts in other parts of the world. Yet, through determination, hard work and resilience, women continue to rise above these challenges and make their mark

In Nigeria today, the role of women in national development is increasingly evident. Women are actively shaping policies, building businesses, strengthening institutions and supporting communities. Their influence can be seen in sectors such as healthcare, education, media, technology and public administration. Through dedication and innovation, they contribute significantly to the growth and stability of the nation. In Rivers State, women have also distinguished themselves in remarkable ways. Across different sectors, they continue to make meaningful contributions to the political, economic and social advancement of the state. Many are thriving as entrepreneurs, running successful businesses, supporting their families and creating opportunities for others. Others are making valuable contributions within the healthcare sector, working tirelessly as doctors, nurses and administrators to improve the wellbeing of communities.

Women in the state are also excelling in academia, nurturing young minds and contributing to knowledge through teaching and research. In the media and communication sector, they play critical roles in information dissemination, shaping public conversations and telling the stories that matter to society. Within government institutions and the civil service, women continue to demonstrate professionalism, competence and dedication to duty. Over the years, Rivers State has produced women whose accomplishments have earned them respect and admiration both within and outside the state. The Deputy Governor of Rivers State, Professor Ngozi Nma Odu, stands as one such example. A seasoned academic and public servant, she continues to demonstrate the capacity of women to contribute meaningfully to governance and policy development. Her presence in such a high office serves as encouragement to young women who aspire to leadership and public service.

Similarly, the Head of Service of Rivers State, Dr. (Mrs.) Inyingi S. I. Brown, has demonstrated strong leadership within the public service. Her role in coordinating and strengthening the activities of the civil service reflects years of dedication, professionalism and commitment to service. Another notable example is Justice Mary Odili, whose distinguished career in the judiciary stands as a testament to discipline, excellence and commitment to justice. Her years of service at the highest level of Nigeria’s judicial system have made her a respected figure and a source of inspiration to many. While these women have earned public recognition for their contributions, it is equally important to acknowledge the countless women whose efforts often go unnoticed. Across homes, workplaces and communities, many women continue to make sacrifices that sustain families and strengthen society. Every woman who works tirelessly to raise her children, run a business to support her family, contribute to community development or serve diligently in her workplace is also making a significant impact.

These everyday efforts, often carried out quietly, remain vital to the growth and stability of society. As we reflect on the significance of this occasion, it is important to remember that every woman’s contribution matters. Whether in leadership positions or within the everyday responsibilities of life, the role of women remains central to the progress of our communities.To every woman striving to achieve her dreams despite the challenges along the way, your efforts are valid, seen and meaningful. Your journey matters. Your resilience, dedication and determination continue to inspire hope for a better and more inclusive society.

Happy International Women’s Day.

By: Ledornubari@star

Opinion

Agony In Ivory Tower

Published

7 days ago

March 9, 2026

The Tide

Quote: A university that tolerates missing scripts, result manipulation and ‘sorting’ is not merely failing students—it is quietly destroying the moral foundation of education itself.”

The sad cases of missing scripts, compulsory Sorting, inputting of wrong results and other obnoxious practices in some public universities, leave much to be desired. One cannot imagine how a student will be compelled to suffer consequences of the flagrant negligence of a Head of Department, a lecturer, Department staff or an ICT staff.Many academic and non academic staff in several public universities seem to be performing far below standard, thus unproductive to the university system. The unacceptable cases of sorting, missing scripts, missing results, inputting of wrong grades to students, should not be mentioned in a university, not even in any academic community. This is because people who are employed to work in various positions should have cognate work experience and unquestionable competence. They should not be seen as certificate welding illiterates but people who have been proven to be worthy in learning and character, diligent and competent to carry out assigned responsibilities with minimal or no supervision.

The university as a citadel of learning should boast of men of integrity, people who are repositories of applied knowledge and competence to drive the much desired holistic development in a nation that functions on quality teaching and learning. A situation where a student having gone through the crucibles of learning and written a prescribed semester examination or class-based evaluation test, is told that his or her script is missing or that he or she did not participate in that academic exercise, or must sort to pass, is an unpardonable error and a height of callousness. In fact some lecturers and staff of Departments are using the seeming systemic defect (which is their architecture) as an opportunity to extort students. Sometimes it is discovered much to students chagrin that the supposed missing script was later discovered when a ransom was paid.

Since a lecturer, or Head of Department has in their disposal both Yam and the knife and determines who takes what (if they wish to give without strings), students have no alternative but to submit to their importunate demands in order to graduate at record time.Such practices should be unheard of in an institution that should be a vanguard of moral and ethical values and conduct. What people learn in school constitute their behavioural patterns in the society. Where the school as an agency of socialisation cannot drive positive change first in its immediate environment, then the objective of education as a bedrock for the development of society, is inevitably compromised and counter-productive. The German Reformer, Dr. Martins Luther was quoted as saying, “I advise parents not to put their wards or children in any school where the Bible is not being used as a rule of life because such institutions will unnecessarily be corrupt”.

Gleaning from Luther’s sentiment one can deduce that the lack of respect and regard for values as well as the absence of the fear of God is the greatest undoing of most public schools. Another major challenge is that lack of Information, Communication and Technology literacy or compliance on the part of some lecturers and heads of department, may have informed the decision to give students’ scripts to secretaries to compile and input students results thereby making the secretaries the determinants of students’ fate. It is not saying a new thing that some of the secretaries in the process of compiling results have inputted wrong results, omitted names or down graded some students or given unmerited grades to others.Society today is ICT-driven and ICT-literacy enhances efficiency, speed and a reasonable degree of accuracy if the person behind the computer is level headed, articulate, competent, alive to responsibilities and is aware that negligence on his or her part is not only tantamount to a disservice to the university but to the students who may not graduate at record time because of his or her (computer operator’s) gross ineptitude or carelessness.

The ICT era makes the carrying of hard copy of results obsolete as lecturers through the Heads of Department can log on to the central server of the Exams and Records (if any) or ICT unit and input students’ results directly. By so doing the incessant cases where result on spread sheet is different from the one published online, more often than not, caused by abject negligence, will be avoided. The process will also end the intermediary services of some staff in the universities’ Information, Communication and Technology Department which has become a money spinner-a lucrative source of income to many of them. In fact some ICT staff reserved the power to award grades to students depending on students’ degree of compliance to terms and conditions. They can dubiously make or unmake a student. The university community should be considered too lofty to have careless, negligent, immoral and academic or professionally deficient people as academic or non-academic staff.

The Governing Councils and Senates of universities should be proactive in addressing the menace of missing Script, inputting of wrong results and sorting. This is necessary to end the slogan “Education is scam” so the system can produce quality students who are truly found worthy in learning and in character by operators who exemplify diligence, moral and ethical values. The much-needed reform must begin within the institutions themselves, because the future of any society is shaped in its classrooms.

By: Igbiki Benibo