Why Do Nigerians Die? – Bibobrah Emretane

As one who has seen the temporal nature of life in the course of my journey through medical school; one who has witnessed the sleight dexterity of mortality’s strong hands; one who has heard muted breaths, seen eyes wide shut and experienced the tumultuous outpouring of grief, I stared at the computer screen and thought long and hard about this title, Why do we die? Yes, why do people die? It might seem like a question oozing from the pores of an existentialist thinker. My numb mind tried to find an answer. Or maybe answers. But my mind was tabula rasa, like a bare whiteboard. Suddenly, then I realized that there isn't any one answer. Again, maybe the answer isn't direct like when a patient dies and the family asks, “why did he die doctor”? or “why did we lose him”? The answer isn't that his heart stopped or that the cancer spread to his brain. The answer sometimes is a story, a story I wish wasn't real.

I would start from the fact that we are born as Nigerians, the largest concentration of black people in the world. A land of promise, one stuffed with abundant resources from above and underneath the hard earth. I love my country but I guess it’s a story for another day. We don't choose our families and they don't choose us. If you are lucky to be born to an educated, middle class (and above) family then your story may be slightly different.
If not, your tale may begin from day one!

'Poverty is a carcinogen', I didn't come up with that myself (though I wish I had). It’s a statement that has been in my head since I heard it for the first time in a lecture on cervical cancer. Talking about cancer, it’s become a silent killer in the land today. However, I'd like to rephrase that aphorism - poverty is not just a carcinogen, it’s a pathogen, a cankerworm, a thief and a murderer! It’s one of the reasons my people die. Poverty might have become the number one cause of death among many Nigerians.

I say this because I've seen it first hand, poverty and her younger sister, Ignorance.

We lash out at the unemployed mother who brought her child to the emergency room after stooling and vomiting for three days. We tell her that her child is gone and somewhere amidst the chaos that ensued you wonder whether she had ever heard of the life saving salt sugar solution. We wonder if she knew that it was her lack of knowledge, her insidious expression of ignorance that killed the child. And then, you caution yourself. You also follow up with a pertinent

question - Is it her fault that she is poor? Her only crime being that she felt government hospitals were a last resort and believed so strongly in Mama Bola’s remedy for diarrhea. After all, Mama Bola had some bragging rights. She has had seven children. Before you can mourn the dead, they bring in another child who didn't cry at birth. This is her third day of life. You begin to wonder where she was born. If they knew that a child's cry was indeed her first breath of life. Then you remember it’s an answer you know all too well. She was born in a traditional birth attendant home. Well, kindly try to fill in the gaps.
The parents look agitated but you caution yourself not judge them...

'Time of death - 9.42 pm'.
And yet they cry and wail, “death stole our children”! “Death is wicked”.
Those who scale through their childhood years have ready made health problems especially for adults; hypertension, diabetes, cancer etc. A sad trend is that when people begin to seek healthcare, the time has already ticked and its countdown to doomsday.  For the single mother who sells at Yaba, she just had to ignore the breast lump. After all it wasn't painful. “Na just one small thing. E no matter”, she mutters to herself. If she wanted to go to the health center she had to sell off all her tomatoes from the day before, no one would buy stale ones. She had to find somewhere to keep ‘Bom boy'. She doesn’t trust her co-tenants with her pot of soup, let alone her only son. The lump would have to wait, but in waiting it grew, until the smell from the ulcer it had created warded off customers. By that time, she was told it was too late. Why then did Mama Bom Boy Die?

Ahhh, for the danger of telling a single story, Chimamanda Ngozie Adichie warns. The danger of presenting a single narrative that obscures the complexities of the system. Painting a Nigeria where poverty is everyone's friend and sickness and disease are close relatives. This scenario won’t be a fair portrayal. There are poor people in Nigeria but there are also poor people anywhere else in the world. The diseases of the rich are here as well, indeed the rich also cry and sadly, they also die. Cancer, Heart diseases ,Hypertension, Road traffic accidents kill, sometimes they don't even look at socio-economic class before they attack.

So then why do Nigerians die? The more I try to answer the question, the more questions keep pouring in like pop-up windows on an internet explorer. They come in torrents - why do we lack knowledge? Why is the average life expectancy about fifty years? Why are there so many people living on less than a dollar a day? Why is there an economic gulf and social dichotomy between the North and the South? Why are there so few doctors compared to the large and teeming population? Who is brain drain and why is it swallowing all our healthcare professionals?

I believe we can all have a better chance at living, rich or poor, if good governance meant good governance. Would it not be nice, if free education was at an acceptable standard, available and compulsory for all? What if there were more industries ready to employ our youth. What if good health care is affordable, available, and accessible for all? Imagine that we were enlightened to seek care and do so early. Can you picture in your mind’s eye that the transportation network were upgraded all around the country not just in Lagos, Port Harcourt, Benin or Abuja.

Death and life unite us, rich or poor. Perhaps, this Latin dictum would serve us all too well; Vivere disce, cogita mori - Learn to live; Remember death. And in remembrance of death, the question still craves for an answer - why do Nigerians die? 

Written By : Dr Bibobrah Emretane