At the mercy of fake doctors

The medical profession has been infiltrated by fake practitioners leading to avoidable deaths and complications. Innocent Duru in this report goes into the world of the dupes. 

In a not too distant past, the existence of fake doctors was restricted to only private hospitals. Not anymore, the dupes have spread their poisoned tentacles into public hospitals. How?

Within the space of two months, two suspects Nwosu Angela Njide and Martins Ugwu Okpeh, were arrested. They had plied their nefarious credentials for a long time before nemesis caught up with them.

Angela,30, claimed that she had worked with the British American Tobacco (BAT) clinic, Ibadan; the Lagos State University Teaching Hospital (LASUTH) and Rauz Hospital, Apo, Abuja, before she was arrested by the Medical and Dental Council of Nigeria (MDCN) and handed over to the police. She is said to be the first female fake doctor to have been arrested by MDCN. Strangely, a presenter with Africa Independent Television (AIT), who was once her patient, described her as a caring ‘doctor’ whose kindness, belied her alleged criminal tendencies.

Forty-four-year-old Okpeh, on the other hand, had for nine years paraded himself as a medical doctor and even rose to become the chairman of a branch of the Nigerian Medical Association (NMA) before he was arrested. The suspect, a secondary school certificate holder and father of five, confessed to having stolen copies of the medical and academic credentials of his childhood friend, Dr. George Davidson, a medical doctor based in Jos, Plateau State, and used same to secure employment in the Federal Ministry of Health. He was said to have been exposed by an anonymous petition that prompted the police to launch investigation into his activities.

He question is: how safe is medical care in a country where a fake doctor could work in a public hospital for a decade and even rise to become a branch chairman of the Nigeria Medical Association (NMA), the umbrella body of medical doctors, without being detected? This is a question that agitates the minds of many Nigerians on account of rising cases of fake medical practitioners arrested by security operatives in recent times. Findings made by our correspondent revealed that the ugly trend has shaken the faith of the people in the sector and caused them to despair in seeking medical help in hospitals across the country.

If gold rusts

Before now, the popular belief was that the existence of fake doctors was restricted to private hospitals. But recent developments have however shown that they have also infiltrated state-owned hospitals where the best hands are believed to be engaged to deliver the best of medical service to the people. How did they gate-crash into the esoteric profession? How do they treat patients who seek treatment from them? Could they have been responsible for wrong diagnosis and avoidable death of some of their patients? These and other questions have left the people bewildered.

The Head of Department of the Inspectorate Unit of the MDCN, Dr. Henry Okwuokenye, who carried out the arrest of Angela, said her cover was blown off a year ago when she went to Oyo State to register for licence to practise at the Ministry of Health under the Oyo State Director, Medical Services. Luck, however, ran out on her as the officials of the ministry became suspicious of her qualifications and approached the MDCN to verify the authenticity of her claims. Nwosu claimed to have graduated from the University of Nigeria, Nsukka Medical School in 2005 and did houseman ship at UNTH. In spite of her claims, she failed simple questions any medical student is expected to know.

After the Oyo State Ministry of Health refused to register her, she was said to have relocated to Abuja and audaciously went on her own to the MDCN to attempt to register for her licence.

According to Okwuokenye, “Nwosu came to the council to apply for a new folio number, unique to every practising doctor in Nigeria, in an attempt to get full registration. We checked and she was not on the list. She claimed to have graduated from UNN, but we went to verify and discovered that it was all lies. As at this time, she was on the run. We later got to know recently that she had been working with Rauz Hospital, Apo, for almost a year.”

Okpeh, an indigene of Ogbadibo Local Government Area of Benue State, appears to be a master in his game. He confessed that he actually took the certificates from his friend to join the Health Ministry in order to unearth the fraud and mess there as an insider. Wanting to use fraudulent means to cure a fraud?

According to him, “I never opted for clinical services to avoid the damage that might occur. I went into administration and research. It is in the health services, research and statistics that all the fraud in the health sector is found. I have great remorse, but it was the desire to save my country that pushed me into this.”

Perhaps in an attempt to justify his perfidy, he added, “I have great passion for Nigeria. I participated in the Ebola mission and much more and have not even been paid. There have been several biometric verifications and I survived all of them. I was the NMA chairman in 2008 at the Federal Ministry of Health. The Ministry is porous.”

Commenting on Okpeh’s arrest, the Deputy Force spokesman, CSP Abayomi Shogunle, said: “What was perceived as an unprofessional conduct and unwholesome behaviour of inciting trouble and blackmail by the self-acclaimed medical doctor, Martins Ugwu Okpeh, prompted an anonymous petition against him to the Federal Civil Service Commission in May 2015. Investigation conducted through the records available at the Medical and Dental Council of Nigeria showed that Okpeh adopted the identity of Dr. Davidson, a true medical doctor on residency training in Jos.

“He has been parading himself as a medical doctor in the Federal Ministry of Health in Abuja for almost one decade, and was among the medical volunteers trained by the ministry in conjunction with African-Union Support to Ebola Outbreak in West-Africa (ASEOWA) mission in Liberia.”

The suspect was said to have never passed any examination set by the ministry to warrant his promotion.

Gale of arrests

Before the arrests of Okpeh and Angela, the Independent Corrupt Practices and Other-Related Offences Commission (ICPC) had earlier arrested a suspected fake medical doctor, George Dawari, who was said to be deceiving his victims through visa scams.

Dawari, who was arrested on June 5, 2015 following a petition filed before the commission, was said to have claimed to be on the staff of the National Hospital, Abuja. It was, however, discovered during interrogation that he was neither a medical doctor nor an employee of the hospital.

ICPC’s Resident Consultant (Media and Events), Mr. Folu Olamiti, said: “After obtaining a warrant, a search on the residence of Dawari, who had earlier offered to administer drugs on one of the petitioners, a female, under the pretence of being a medical doctor, ICPC operatives discovered some medical equipment, including a stethoscope and medical coverall with his name engraved on it.

“Also discovered in the suspect’s house were six green Nigerian passports, four of which had been stamped with the United States visas. The passports were subsequently sent to the American Embassy for authentication. But the US embassy declared the visas fake and the process for its procurement fraudulent.”

Within a space of 24 hours in February 2014, nemesis caught up with another two suspected fake doctors, who identified themselves as Awotoye Ayodele and Tajudeen Dosunmu.

Awotoye, who claimed to be an undergraduate of Ladoke Akintola University of Technology, Ogbomoso, was said to have practised at Military Hospital, Yaba and St. Claire Hospital, Surulere, both in Lagos before he was arrested.

He was first arrested in December 2012 and charged to court over a forged certificate which he used to practise as a House Officer with Military Hospital, Yaba.

He was said to have written an apology letter to the MDCN after his first arrest. But while his case was being reviewed, the council was hinted that he had relocated from Yaba and had been practising with St. Claire Specialist Hospital with a different licence.

Worse still, Dosunmu, a 65-year-old man, allegedly added robbery to his medical quackery before his arrest. He was alleged to have been a member of the deadly robbery gang that attacked the Ayobo branch of Access Bank in November 2013. Before his foray into the world of crime, he claimed to have worked with the Lagos State University Teaching Hospital before establishing his personal hospital at Okeoluwa area of Igando, Alimosho Local Government Area, Lagos State.

According to him, “I attended a university in Osun State but dropped out at 400 Level. One of my elder brothers arranged my medical certificate with the help of some lecturers at the university. They paid N20, 000 for it. They also arranged my houseman ship at a university in the North and also assisted me to gain employment with the then Ikeja General Hospital now Lagos State University Teaching Hospital (LASUTH) where I worked for 14 years. I later established my own hospital.”

Dosunmu said he joined the robbery gang because he needed money to renew his operating licence, adding: “I was one of the gang’s transporters. I usually helped to transport their gas cylinders to robbery scenes. I am the owner of Boluwatife Kola Hospital, located at Igando, behind the police station. In 2012, my operating licence expired. I had no money to renew it and I closed it down.

“One of my younger brothers later introduced me to this gang and all they needed from me was to transport the gas cylinders they used in opening the ATMs (automated teller machines), after which they would give me between N20,000 to N30,000. I thought I could make some money from it and then go back to my job. But on November 1, I followed them to Ayobo. While we were waiting at the spot, we heard gunshots and I quickly drove out with my car. I didn’t know that policemen were killed in that operation, as I have not heard from any member of the gang.”

Prior to their arrests, an alleged fake gynaecologist had also been nabbed in Lagos. The suspect, who identified himself as Dr Sunday J. Bassey, claimed he was an indigene of Cross River State and had been helping the government to reduce unemployment through his nocturnal business. He claimed that he had on his payroll three midwives, a matron, a radiologist and other staff who rendered medical services to both in and out-patients.

He had on top of the one-storey building located at 163, Itire Road, Mushin, Lagos, the bold inscription ‘JOSSY-JD LTD, Obstetrics and Gynaecology.’ The poster of an expectant mother adorned the upper floor of the building, which was used as a private hospital. The poster indicated that any pregnant woman who patronised the hospital’s Radiology Department would be entitled to a gift.

The hospital was said to be a beehive of activities for couples seeking the ‘fruit of the womb’ until the scam was busted and it was sealed off by a team of medical personnel from MDCN and Health Facility Monitoring and Accreditation Agency (HEFAMAA).

He was said to have been carrying on as a medical staff of the Lagos State University Teaching Hospital (LUTH) and only went to work in the clinic after closing officially at LUTH. The 37-year-old claimed to have graduated from the University of Calabar in Cross River State before proceeding for further studies in India.

HEFAMAA’s Executive Secretary, Dr Asuni, alleged that Bassey had been operating in the area with doubtful certificates. He claimed that Bassey did not possess any certificate of competence as required by the medical profession.

“Unfortunately, he included year 2002 MDCN licence with the forged signature of Dr. Oshoba Festus who only worked with us between 2006 and 2008. It was easy to identify the fake document because the Council’s Registrar as at 2002 was Dr. Okwudili Ezeani.”

In August, 2013, the Lagos State Police Command paraded two suspected fake medical doctors for operating an unlicensed hospital named Care Hospital at Omotoba Street, Unity Estate, Iba, Lagos. The fake doctors were identified as Gabriel Onyema Ihejiero, and Stephen Nwankwo.

Nwankwo, in his confessional statement, said: “The Managing Director (Ihejiero) is my friend. He came to me for advice, I suggested to him that we should start a hospital business and he agreed. I only worked for two years in his hospital before I stopped. I trained as an auxiliary nurse in Ondo State for two years.”

The police said their investigation revealed that the two suspects never attended any medical or nursing school and that they had conducted over 80 deliveries for pregnant women in the hospital!

Corroborating the police report, Nwankwo said: “I have delivered more than 90 pregnant women of babies and they were all successful.”

In his own confession, Ihejiero, who claimed to be selling bond paper in Ghana before he began the hospital business, said: “I own the hospital located at Iba. Although I am not a medical doctor, I employed a doctor with two years medical experience.”

Later in October 2013, a 40-year-old suspected fake doctor, Adeyemi Stephen Akintolure, was arrested in Lagos. The suspect claimed to be an employee of the Lagos University Teaching Hospital (LUTH), with card No. 13541 identifying him as a surgeon and gynaecologist.

Akintolure, who claimed to hail from Ondo State, said he studied Marketing at Obafemi Awolowo University, Ife, as a part-time student and graduated in 1997.

He claimed that, “I have not treated more than 10 people. I just treat them for malaria and typhoid. I gave injections too because of my experience at Rivic Hospital in Akure.”

When asked how he got the identity card, he said he got it from a business centre and that the computer operator signed it for him.

Shaken confidence

Investigation conducted by our correspondent revealed that the activities of fake doctors are casting doubts in the minds of would-be patients about their safety in hospitals. Some of the respondents said the fear of falling into the hands of fake doctors have made them to resort to using local herbs to treat their health challenges.

Comrade Debo Adeniran, a human rights activist and Executive Director of Coalition Against Corrupt Leaders (CACOL), is one of such Nigerians.

He said: “I have always been apprehensive of going to hospital. I prefer taking care of myself using herbs. There are occasions when even qualified doctors would continue to give the same drug until you get addicted to it. They don’t vary their treatment. In fact, I don’t believe that most of the doctors are qualified. I view them with suspicion each time I have reasons to go to hospital with anybody. Many doctors would just keep administering treatment in a way that suggests that they lack knowledge of the ailment.

“If a fake doctor happened to have treated my relation, the hospital, the government, whether federal or state, the regulatory body that failed to do its duty and the doctor himself would have me to contend with at the law court. Quacks should not be allowed to take over a sensitive profession like medicine.

“We have had occasions where surgeons forgot instruments in the bodies of their patients. This kind of negligence should have no place in this age and time.

“The regulatory bodies are not diligent in controlling the practitioners. The regulatory bodies ought to be proactive, especially in the medical profession where human lives are meant to be safeguarded. There is supposed to be strict adherence to recruitment procedures, especially in the public sector, but the craze for money has affected this.”

A civil servant, who identified herself as Bose Lawal, said it was discouraging and frightening if one looks at the activities of quacks in the medical profession. “How can one be encouraged to go to hospital with all the stories we have been hearing about fake doctors? Many of us would always visit public hospitals because we weren’t sure of the expertise of many of the doctors in the private hospitals but recent developments have proved that the public hospitals have also become breeding grounds for fake doctors. Is it not disheartening?

“If you know the number of people that an average doctor attends to in a public hospital, you would begin to appreciate the harm they would have done to many lives. You really don’t know who is a fake doctor, so it is better to avoid them. For these ones to have been exposed there would be so many others out there still wreaking havoc in the name of treating patients.

“I would rather go for herbs than sacrifice my life and those of my family members in the hands of a fake doctor. At least it was herbs that our forefathers were using before orthodox medicine came.”

Chief Ladi Williams, a Senior Advocate of Nigeria, said: “I am very disturbed to hear such. It is a shock that there was such a case in a government hospital and the person was prescribing drugs, performing surgery and drawing salaries for a long time. It shows the level of decadence in the society. Does that mean if President Muhammadu Buhari had not won, this illegality would have continued unchecked?

“It is despicable. I could never have believed that there is a fake doctor. I have heard of fake lawyers but not fake doctors because theirs is a very sensitive job. It has to do directly with life. Police detectives would have to find out if there are people conniving with fake people to get employed as doctors in both private and public hospitals.

“Both the suspects and their collaborators should be prosecuted. And if any of their patients could be traced to have died as a result of their incompetence, they should be held for murder.

“In any case, the least offence they can be charged for is fraud. If I were a patient of any fake doctor, I would sue the hospital and not the doctor. The doctor is just an agent while the hospital is the principal expected to take due care in employing doctors. I will only join the doctor in the suit.

“As a legal practitioner, I have over the years taken time to scrutinise all my employees not just to make sure they have all the necessary certificates but to make sure they are competent. This is to make sure that we don’t employ anybody that could tarnish our image. Nigerians whose relations have been treated by these fake doctors should sue the hospitals.”

Dr. Dipo Okeyomi, a security expert, is of the opinion that security operatives and the regulatory bodies should immediately swing into action to nip the problem in the bud, stressing: “If the development is not arrested, it would have a telling effect on the lives of the people. This would eventually kill people’s confidence to go to the hospital when they are sick.

“Adequate punishment must be meted out to the perpetrators and those that aid and abet their activities to serve as deterrent to others. If this is not done, it will encourage so many others to continue with their unholy business. If this happens, it would spell doom for the people and the country at large.”

The sensitive nature of the profession, for Kenny Saint Best (KSB), a leading gospel artiste, is too grave for anybody to toy with.

She said: “It sounds unbelievable because the medical profession is the most sensitive in human endeavours. I believe that it is desperation and insensitivity of man to his fellow man that is responsible for this kind of thing.

“Those people have dead conscience, because if their conscience were alive, they would not venture into anything that would amount to toying with human lives. But the truth is that somebody employed these fake doctors. Why didn’t they do thorough check on their qualifications and professional competence before engaging them?

“If I find out that any of such doctors treated my child, I will sue the hospital and the doctor. If for any reason a child dies in the hands of such a doctor, I will make it an international case. It is devilish and has no justification. It must be condemned in all ramifications.

“But this does not take away the fact that we have competent and diligent doctors in the country. It is not enough for us to rubbish all the efforts and contributions of the good ones because of the callousness of the bad eggs among them.

“We saw what the Nigerian doctors could do when Ebola broke out in the country last year. It is on record that even the international community came to see what we did differently.”

Test of integrity

The Nation’s investigation revealed that the ugly trend has also left many medical doctors sad. Those who spoke with our correspondent described it as ridicule on a profession that thrives on integrity and competence.

Decrying the danger posed by the activities of fake doctors, Dr Lawal Bakare, the Executive Director of Ebola Alert, said: “I can bet that 80 per cent of what they would have done over the years was wrong. Medicine is evidence-based. I don’t need to go to the case notes to know what they have done. Even where they have done or got it right, the fact remains that their actions were illegal.

“Medical profession is a combination of skill and knowledge. I can watch my uncle dress a wound and later do the same thing, but I may not have the knowledge about why he has applied XYZ to treat a case. These fake doctors must have under-studied genuine ones for some time before embarking on their nefarious mission.”

For Dr. Sunday Amosu, a consultant at Neuro Psychiatric Hospital, Aro, Abeokuta, Ogun State, “it is the height of professional misconduct and neglect.” He said: “I don’t know how the suspect that worked in the Federal Ministry of Health found his way there. I don’t know if he had collaborators. But I know that there is no smoke without fire.

“Every doctor, after training, has temporary registration that qualifies him to do houseman ship. After this, your supervisors would sign you off for full registration. You will have a folio number and the Nigerian Medical and Dental Council number after registration. These numbers are peculiar to every doctor and cannot be used by another person.

“Even when you want to become a Fellow like me, there is another round of registration you will have to do and everything is documented. When you want to get employment, you are required to submit your original certificates for verification. This is why it is befuddling.”

Expressing concern about the patients the fake doctors must have attended to, Dr Rotimi Adesanya, a public health physician, said: “It actually calls for concern for a fake doctor to have worked his way to work as a medical doctor at the Federal Ministry of Health and worked for close to a decade before being arrested. It is a grave act of negligence.

“Most of them would have been carrying out wrong diagnosis over the years and putting the lives of unsuspecting members of the public, especially their patients, in serious danger. They must have sent a lot of innocent people to their early graves through their actions.”

Implication for genuine practitioners

Speaking on the implication of the incidents for genuine practitioners, Dr Adesanya said: “It has serious implication for us because it would make the public not to have 100 per cent belief in us. It will fuel serious doubts about our competence as medical doctors.” He is worried that these quacks are giving the profession a bad name thus making many people to travel abroad even for common ailments.

He added, “It also buttresses the point some people make for going abroad to get medical help. Developments like these justify their reasons for doing that because they can tell you that they don’t want to risk their lives in the hands of a doctor they are not sure of his competence.  Another implication is that it would aggravate the negative perception of our doctors by the international community. This would go a long way in compounding their suspicion about us. It may lead to a situation where doctors who want to go for short courses abroad would have to face strict scrutiny before he is admitted, and this may discourage a lot of people.

“Impersonation is a criminal offence. The law should be allowed to take its full course on the suspects. The name of any of them that is on the list of practising doctors should be struck out.”

The consequence in the opinion of Dr Bakare is: “If two fake doctors were exposed within a space of time, it buttresses the fact that the system is loose. These are the ones we have seen. I am sure that when you visit rural communities, you will find more of such fake doctors.

“Performance of the health sector is measured by developments such as these. It is a negative mark on all of us because it portrays us as people that are not competent enough. Foreigners who hear this kind of report would not be encouraged to go to our hospitals for treatment. Instead, they would prefer to go to their countries or a more trusted nation for treatment.”

Dr. Amosun said: “We are in bad light when things like this happen. The NMA and the MDCN should look inward. It is ridicule on the medical profession which has integrity and competence as its hallmark. This could make every doctor to be seen as a quack.”

He added: “Medical practice is a life and death profession, and this is why people who study in some non-English speaking countries still sit for examination when they want to practise in the country just to validate their competence.

“Doctors go for continuous medical education and they are expected to have a minimum of 20 units to have their licence renewed. If you don’t meet up, your licence will not be renewed. That is how serious the profession is and that is why it has integrity. It is unfortunate that some people are out to mess up the good image of the profession.”

He sees the problem as wider than where people focus on as, “The challenge we have here is that any male who works in the hospital is often called a doctor. Unfortunately, they answer when they call them so. If the trend is not arrested and people continue to die carelessly in the course of being treated by fake doctors, it is the future of the country we are mortgaging.

“In child health care management, it is a serious matter because if you kill a child, they will not take it lightly. They would tell you that it is possible that you have killed the future president.”

Solution

Dr. Lawal Bakare, the Executive Director of Ebola Alert, blamed the menace on shortage of manpower, saying: “The development clearly shows that there is shortage of manpower in the health care sector. This is why fake doctors could be employed without proper investigation. By 2050, the population of this country would be in the region of 300 million. How many doctors will Nigeria produce every year to take care of that population?

“Right now, you have a good number of doctors in Lagos State but the number reduces as you move out to other states and rural communities. This is why fake doctors would continue to spring up here and there to fill the vacuum because they know that people need health care delivery and would find ways of getting solution to their health challenges.

“The second problem we have is with regulation. The various regulatory agencies need to strengthen their operations. They should be carrying out surveillance in the manner that Federal Road Safety Commission (FRSC) and Vehicle Inspection Unit (VIO) would do to motorists. They should randomly go to hospitals to carry out checks on the personnel. They cannot tell me that they don’t have the funds to do that. They have the funds and should do it. When they do it, any hospital habouring fake doctors should be held liable. They should make the data of all doctors in the country public the way we have it abroad.

“The third solution is for the citizens to be alive to their responsibilities. Many people go to hospitals without bothering about who the doctor is. It is wrong because here, we are talking about life. It is not out of place for patients to ask for a doctor’s licence before accepting to be treated by such doctors.”

His views were also echoed by Dr Adesanya, who added that “doctors should be made to place their certificates in the consulting room. It is actually what should be the practice, but many people don’t follow it. There is also nothing wrong about doctors wearing their practice number.”

For Dr Bunmi Omoseindemi, Chairman Lagos State Traditional Medicine Board, the solution lies in total overhaul of the entire system in the country, which he said is riddled with fraudsters.

He said: “I was not surprised by the report because we have fraudulent people in every area of our society. The system is bad and regulation is not at its best. The employers of labour don’t do thorough check before employing staff. The problem is not limited to medicine; it is a societal problem and it is present in every profession. The solution should be across board and not in medical profession alone.

“If we have a national database, it would be easy to identify everybody. I can’t expressly say that there could be more of such fraudulent people in the profession. You can’t really rule it out. The MCDN should be more vigilant.”

Calls and text messages to Dr. Lanre Obembe, the national president of Nigeria Medical Association (NMA), were neither answered nor replied. The management of LASUTH has, however, denied claims by Angela and Dosunmu that they worked at the hospital before their arrest.

The Public Relations Officer, Mr Olasunkanmi Idowu, said: “We don’t have such names in our records. They have never worked here. Their claims are spurious and should be disregarded.”

But the question remains: how do we curb this game of playing kite with human lives?