Season of Deaths

The media has been awash with news of the escalating death toll in Kano State over the last week. Depending on whom you choose to believe, the number ranges from 500 to 700 deaths from last week alone. The figures also depend on how sensational media outlets want the headline portrayed. Several meetings and committees later, both the federal and state governments are yet to give us a plausible reason as to the cause of the mysterious rise in death rate among the population of Kano.

For residents of Kano, a rise in death toll during this time of the year is not surprising. An American researcher, Roy Machonacie, years ago, while conducting a study in the Department of Environmental Sciences, upon seeing the escalating number of deaths in March, April and May, asked his Nigerian counterpart: “Do you have a season of death in Kano?’’

This brings us to another issue: If we have been a serious population, many studies would have been written about the increasing number of deaths during these months, in the past so we have something scientific to compare. As it is, we can only speculate and take the graveyard guard at his word.

A couple of days ago, a dear friend of mine confided in me about the health of her father. He had been having recurrent fever with cough and was treated for the popular ‘Malaria and Typhoid’ at a patent medicine store. When his temperature continued to rise, she brought him to the hospital, where he was promptly admitted. The working diagnosis was that of ‘community acquired pneumonia,’ but we were both apprehensive. At her insistence, samples were taken by the Nigeria Centre for Disease Control (NCDC), which was transferred to the laboratory in Abuja as the one in Kano was being ‘fumigated’. More than 24 hours later, the results were not yet out and his condition continued to deteriorate, so much so that he needed oxygen. Several hours later, he passed away and was buried immediately, according to Islamic rites. Still, no result.

Any doctor will tell you for free that the deaths in Kano are not unrelated to COVID-19. Either directly or indirectly, this disease has continued to claim the lives of so many, especially senior citizens. The manner of deaths, ranging from hypoxia (decreased oxygen levels), stroke, dehydration and natural causes (as some were extremely old) beguiles people into thinking that the causes are unrelated. Which begs the question: Are the deaths related to the ongoing pandemic?

Testing for COVID-19 in the past weeks has been virtually non-existent in Kano, therefore, scientifically we are unable to stick out our necks and say that those who died gasping with low oxygen saturation were due to the disease.

However, this way of death is becoming increasingly frequent and is similar to the way deaths from other parts of the world are being reported. 2+2, they say, is equal to 4.

At this juncture, it is pertinent to point out that the manner in which the Kano State  Government (KNSG) has managed this issue is in a very poor taste. The news has been distorted in so many versions that it is difficult to discern which are facts and which are baseless rumours. First, they denied that testing had stopped in Kano. Later, the story was changed to make it look like testing had stopped because the lab had to be fumigated.

When rumours became rife, the NCDC was forced to make a statement, saying that the lab had become contaminated and, therefore, some of their staff were infected; hence the shutdown. What they are not saying is that the Personal Protective Equipment (PPE) given to the laboratory staff were outdated (since 2008) and that they had been complaining about their being exposed to the virus. As a result, when two staff tested positive, the lab was immediately shut down.

Why is information sharing so difficult in Nigeria? Why must we shroud everything in secrecy? Why do we involve politics in everything we do? Ideally, a task force concerning a pandemic should be made up of independent health professionals, whose salaries are not paid by the government. That way, when asked for information, people will not be giving half-truths in fear of falling out of favour with the ruling party.

Another reason for these ‘mysterious’ deaths is the near absence of private health institutions in Kano. Most of them have shut down due to the directive that private hospitals should not attempt to manage patients with COVID-19. As a result, government health facilities are overwhelmed.

Accident and emergency departments are seen to be overflowing with patients with all kinds of emergencies, but little staff available to manage them. What this situation means is that patients with unrelated emergencies like stroke, diabetics, road traffic accidents, acute appendicitis etc, may die because private hospitals, which normally help to shoulder the health care burden of the country, are closed and government facilities are over-stretched. A recipe for disaster.

Another angle, which should be considered important, is the excruciating heat in Kano. The temperatures in the past week, have been recorded to be as high as 47-48OC! And while heat stroke is a phenomenon that Nigerians are not familiar with, the reality is that it exists. How else do we explain symptoms like sudden confusion, associated with dehydration in the elderly, causing death? Especially in this Ramadan?

Agreed, this pandemic is a public health disaster for even medically sophisticated countries, but all we are asking for, is transparency in information, and that the government(both federal and state) take responsibility. Only then can we prevent Kano from being labelled the mortality capital of Nigeria.