How poor emergency medical response makes Nigerian highways riskier

In this report, BENJAMIN ALADE x-rays the gap in Nigeria’s road emergency response system and the urgent need to address the associated challenges to provide a lifeline to accident victims and prevent needless deaths on highways.

On Saturday, October 14, 2023, Dayo Okuneye packed his family for a vacation in his hometown, Omu Aran, Kwara state.

While the journey continued, some 20 kilometres to entering Omu Aran, he had a flat tyre and, in the process, an accident occurred that claimed the family of four.

Perhaps, the lives of a family of four would have been saved if there were emergency health care or centres on the highway.

The same fate befell Ozioma Obikwe, who also had an accident on the highway heading to the East. Before emergency rescue/response was available, Obikwe had lost so much blood. He died.

With over 36 thousand kilometres of federal roads spread across the country, only a handful have emergency response systems. For instance, the Lagos-Ibadan expressway has five emergency response service centres managed by the Federal Road Safety Corps (FRSC). Also, on the 250-kilometre Sagamu-Benin highway, there are about five centres on the highway. That means there is an average of one centre for a 50km stretch.

There is no doubt that highway service is a necessity as too many people who have lost their lives on many roads could have been saved with such a service.

Yet, ad-hoc arrangements, even if convenient, will never work where institutionalised propriety is needed. Those who are lucky to have one kind of emergency response system or the other suffer inadequacy in one form of dilapidation or the other.

According to data, secondary routes make up around 18,000 kilometres of the total network while 17,000 kilometres are trunk routes and 343 kilometres are branch roads.

While reckless driving could be a major contributor to accidents on the highway, over-speeding, driving against traffic and daredevil over-taking by irresponsible drivers, drunkenness and drug abuse are causative factors of fatal road accidents.

Accidents may be a part of modern connectivity, emergencies such as ambulances fitted with functional first aid and hospitals located along busy roads are steps that can stem the tide of a high number of accident fatalities.

Amid inadequate emergency responses are social factors such as a lack of empathy on the part of Nigerians who witness incidents when they occur fresh.
Indeed, deaths on the highways are not strictly restricted to accidents alone but to emergency health needs such as sudden seizures, epileptic situations and heart attacks among other health-related challenges.

There is a need for governments and citizens around emergency incidents to act swiftly to prevent casualties of accidents on highways to help safeguard the lives of victims suffering from emergency response.

Similarly, last month, Nigerians lamented poor response to emergency and lack of empathy. This follows the death of a man who had a seizure along the Ilorin-Ogbomoso expressway.

A social media user, Abeni Okin, who was on the same bus with the man had raised the alarm after he began to display difficulties in breathing and sought medical help, but none was able to arrive in time before he unfortunately breathed his last.

“I need help, please. I’m around Ilorin and Ogbomoso expressway, our car broke down along the road, there’s an old man in the bus, I don’t know what is wrong with him, he has been shaking for 20 minutes”, she raised the alarm.

The FRSC got to the scene of the incident late, but police were nowhere to be found.

Narrating, Okin said: “The most heartbreaking thing about this case, a nurse was inside the bus and she checked his blood pressure but she was scared to do CPR and I wish I could do more but God knows best.

“For Nigerians, we should have redress in finding our core values, which the number one value should be the readiness to help those in need.

“Help came late. I wish we had gotten the ambulance or cab very early. May God forgive the dead and have mercy on his soul.”

Speaking on what Nigerians need to do in such a case of emergency, Bobby Egemba popularly known as Aproko Doctor said: “Get the affected person out of the vehicle first. Remove that seat belt and any tight pieces of clothing around him. Lay him flat, preferably on his left side. Make sure there’s space around him, don’t crowd. Time exactly when these started, it should not be more than 30 minutes.

Lamenting the lack of a quick response, Godwin Ukeje said: “This incident is a stark reminder of the chronic issues in Nigeria’s healthcare system, which sadly, I’m all too familiar with. I similarly lost my dad.

“Seizures lasting almost three hours would suggest something severe like status epilepticus, where the brain is in a state of continuous seizure activity. This is life-threatening and needs immediate medical intervention, which he tragically didn’t get.

“The lack of a timely ambulance and police support is not surprising but remains deeply concerning. This scenario illustrates the larger systemic problems plaguing emergency medical services in Nigeria, poor infrastructure, inadequate resources, and sometimes, a lack of trained personnel ready to respond.

“In an effective system, emergency services would’ve been on the scene promptly with potentially lifesaving interventions. This not only underscores the reliability of services in more developed healthcare systems but also highlights why Nigerians living abroad might feel uneasy about returning, especially if they or their families require dependable medical care. “Also, the so-called investors would stay away from a country with such a healthcare system.”

Such healthcare failures reinforce the notion that health is wealth, he said, adding that without a reliable system in place, the very foundation of a society remains shaky. This situation is a clear example of why comprehensive healthcare reform is crucial for Nigeria.

Ukeje said: “Nigeria is the wrong place or country to fall sick. How do we educate many Nigerians on health issues and what to do in terms of emergency?

“How do adults /teenagers know and identify someone having an episode of seizures? For 20 minutes they stood and did nothing but film. However, avoidable deaths such as mentioned above can be minimised if there are emergency centres on the highway to apply first aid.”

There is a need for the government to station emergency services, like hospitals or health centres around the major highways in the country to provide emergency response to accident victims on the highways.

Also, citizens have a major role to play in helping victims involved in crashes on the highways. Their response time to accident victims must be quick and apt to save lives and properties on highways.

But the notion that the Nigerian government is not doing anything to change the situation was refuted by the Lagos State Commander, FRSC, Babatunde Farinloye, who disclosed that the Corp has put in place strategies to ensure that personnel reach victims of road crashes within five minutes with the instrumentality of both the regular and special marshals.

This, the FRSC said, was part of the United Nations rule that within any crash the corps must deliver a response to road traffic crash victims within 15 minutes of the occurrence.

Although the FRSC got to the scene of the incident late, Police were nowhere to be found.

According to Farinloye, there are over 2000 special marshals in Lagos, stating that they are more on the road and share the same responsibilities as regular marshals.

He said the primary function of the road safety personnel is to save lives and properties on the highway.

He said: “This is part of our strategic goal for the year to reduce fatality on roads by five per cent every year. This is in tandem with the United Nations Second Decade of Action 2021 to 2030.

“So that by 2030 we must have reduced traffic crashes and injuries by 50 per cent. We also carry out domestic PE, in this regard we go to churches, parks and mosques and rallies, town hall meetings among others to sensitize them about road safety crashes and accidents. We have stakeholders’ engagement.

He explained: “We have community first responders, these people are trained and are located in crash-prone areas, we have equipped them with first aid kits and they have access to our toll-free lines where they can call marshals to command to come to their aid.

“There is this thing called safety load. It is geared towards standards in white cargo haulage. We do an annual campaign against the intake of alcohol. We are now deploying breathalysers to all fleet operators to ensure their drivers are not under the influence of alcohol. These are part of the modalities we put in place to ensure fatalities are reduced on roads.

Speaking on the usefulness of passenger manifest, he said the passenger manifest is not just starting today, even the airlines adopted it.

He said: “We use the passenger manifest to trace the number of people in vehicles in case of accidents. Passenger manifest is used to determine the number of persons in vehicles to trace relatives of passengers on board the vehicle. Passenger manifest is very important in road transportation in the country.”