Take a drive though any city or large town in Nigeria and the chances are you will come across numerous privately owned health clinics, doctor's surgeries and hospitals.
They are so widespread because Nigeria's state-run health system ranked at 197th out of 200 by the World Health Organisation is chronically underfunded and so overstretched that it simply cannot meet all the demands made on it. Private medicine fills the gap and in the best cases, at least for those who can afford it, it can provide a valuable alternative service.
But while there are many legitimate private health providers, there are many more that are completely bogus; unaccredited, unregulated 'quack' doctors - con artists and criminal scammers for the most part - who ruthlessly exploit the credulity, ignorance and desperation of the poorest and most vulnerable people in society. Indeed they are so prolific that a survey carried out in Nigeria earlier this year found that more than 50 percent of the population had received 'treatment' from the quacks at one time or another even people with very serious diseases such as typhoid and malaria.
Professor Alex Dodoo, who monitors patient safety for the World Health Organisation in West Africa and has dealt with quacks for years points out the obvious dangers of dealing with fake doctors:
"If one is not licensed by the state, anything that one does is illegal. Going to see them is dangerous. Period. Would you sit in an aeroplane where the pilot says 'OK hello, I'm the pilot, but I've not been licensed!' No way! You put your health at risk and you can die."
But it is something that has long bothered Rosemary Nwaebuni, a reporter who lives and works in Nigeria's Delta State. She has encountered many people who have suffered at the hands of fake doctors, particularly women who have been the victim of botched abortions, and she is frustrated that the authorities have not done more to stamp them out.
For this this episode of Africa Investigates, she joined up with Anas Aremeryaw Anas, an award-winning journalist from Ghana, to track down the quacks and gather evidence of their scams.
The duo's eye-opening investigation quickly unearthed a host of 'doctors' and 'nurses' using forged and fake qualifications and with little or no medical training.
The premises these fake medics operate from are invariably unsanitary and the manifestly phoney 'treatments' they offer patients risk ending in blindness, poisoning, perforated wombs and even life-threatening disfigurement and death from surgical procedures carried out by people lacking even a modicum of skill or experience. Others fall victim to the quacks' complete inability to diagnose even the most obvious diseases and conditions; mistakes that are more likely to kill or injure their patients than they ever are to heal them.
Going undercover in the guise of a patient, Rosemary was offered treatment for typhoid and malaria (even though she is perfectly healthy) and an illegal abortion (even though she is not pregnant) by quacks who had no medical qualifications whatsoever but who pretended to be experienced and licensed practitioners.
In one remarkable sting, the Africa Investigates team rented a house and invited local quacks to come and do 'home visits'. The 'patient' was again Rosemary, who with the help of a qualified medic had learned some symptoms that any genuine doctor would immediately recognise as indications of heart disease. Instead, one after another, the 'quacks' turned up and after cursory examinations wrongly claimed that Rosemary was suffering from typhoid and malaria (two commonly cited conditions) for which she need expensive drugs that only they could prescribe.
What the fake doctors did not know was that the house was rigged with secret closed circuit cameras and that their every move was being scrutinised by a genuine medical practitioner. The doctor was local to the area and asked to remain anonymous for fear of retaliation, but he was unequivocal in his condemnation of the fakes.
"This is absolute quackery," he said of one of the fakes. "All he did was just glance at the patient and then made a diagnosis and prescribed medications To take all barrage of medications for this patient with malaria and typhoid. This is wrong, this is all wrong. These drugs are poison. They cause real damage."
The team took this this and other evidence to Dr Alfred Ebiakofa, a senior medical officer working for the Nigerian Ministry of Health. He had always lacked the resources and proof to go after fake doctors but now was able to act. He called in the police to work with Anas who, as the investigation heads to a climax, devised a dramatic scheme to trap one of Nigeria's most notorious quacks in the act.
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