The stark contrast between emergency care in Nigeria and the United States was highlighted recently when a police dog named Bruno fell from a highway overpass in Utah and received prompt medical attention, while gospel singer Toluwanisings was turned away from eight hospitals in Ibadan, Nigeria, ultimately leading to his death. These two incidents, occurring just a month apart, underscore the significant gap in emergency care infrastructure between the two countries. Nigeria's emergency care system is plagued by inadequate infrastructure, insufficient resources, and a lack of coordination.
Nigeria's road traffic death toll is alarmingly high, with 5,421 deaths recorded in 2024 alone. The country has a shortage of equipped emergency units, and bystanders often have to take charge in emergency situations due to the lack of trained responders. The case of Anthony Joshua, a two-time world heavyweight champion, who was involved in a crash on the Lagos-Ibadan Expressway, highlights the need for a functioning emergency care system. Joshua survived with minor injuries, but his friends, Sina Ghami and Kevin "Latif" Ayodele, died at the scene due to the lack of prompt medical attention.
The Nigerian government has taken steps to address the emergency care crisis, including the launch of the National Emergency Medical Service and Ambulance System (NEMSAS) in 2022, which dispatches ambulances and funds the first 48 hours of care. However, the system is not yet fully operational, and there is a need for a dedicated tier of Urgent and Emergency Care Centres, physically positioned on expressways and in major cities. These centres would provide specialist-led care, rapid diagnostics, and air stabilisation capability.
The National Health Act 2014 provides a framework for emergency care, with Section 20 stating that healthcare providers shall not refuse emergency medical treatment for any reason. However, the law is often not enforced, and hospitals that treat patients first are often not paid, leading to a lack of motivation to provide emergency care. The penalty for refusing emergency medical treatment is a fine of ₦100,000, up to six months in prison, or both, but this is rarely enforced.
The skill and expertise to provide emergency care are available in Nigeria, but access to care is often limited by a lack of resources and infrastructure. A relative of the author received timely and effective care at University College Hospital, Ibadan, but this was largely due to personal connections and privilege. The author argues that no Nigerian should need the right phone numbers to survive, and that a functioning emergency care system should be in place to provide care to all citizens.
To address the emergency care crisis, Nigeria needs a funded federal scheme that reimburses hospitals that comply with emergency care protocols. The government should also enforce Section 20 of the National Health Act, build urgent care centres along major expressways and in cities, and give the National Emergency Management Agency the mandate to run them. Additionally, a coordination system that tracks which emergency unit has a bed, scanner, and team in real-time is essential.
The way forward is to stabilise patients first and bill later, through a funded federal scheme that reimburses hospitals that comply. The government must also invest in infrastructure, including equipped emergency units, ambulances, and trained responders. With a functional emergency care system, Nigeria can reduce its road traffic death toll and provide timely and effective care to its citizens. Key points: Nigeria's emergency care system is failing due to a lack of infrastructure and resources; a funded federal scheme is needed to reimburse hospitals that comply with emergency care protocols; and a coordination system is essential to track which emergency unit has a bed, scanner, and team in real-time.
