Chimamanda’s Son and Matters Arising

By Olusegun Adeniyi

Nkanu Nnamdi, the 21-month-old son of acclaimed novelist, Chimamanda Ngozi Adichie, died at Euracare Hospital in Lagos on January 6th. In a statement regarding circumstances surrounding the tragedy, Chimamanda alleged criminal negligence. According to the bereaved mother, the anesthesiologist administered excessive propofol, failed to monitor the sedated toddler and casually switched off the oxygen before carrying him to the ICU without following proper protocol. Sadly, a child who reportedly arrived the hospital unwell but stable and was scheduled to fly to Johns Hopkins Hospital in the United States the next morning, never made that flight.

First, let me commiserate with Chimamanda and her husband, Dr Ivara Esege. No tragedy can be greater for a parent than to lose their child. I pray God to comfort the family at this most difficult period. But predictably, the tragedy has also provided fodder for Nigerian social media commentators, which explains why I waited before writing this column. The subtext in most posts was clear: This is another uniquely Nigerian tragedy. It is not. The uncomfortable truth we must confront is that such systemic failures transcend geography and access to ‘world-class’ healthcare. The real issue is that other societies have developed systems to deal with the problem and we have not. For instance, in India where middle-class Nigerians travel to for their healthcare, this same problem led to the enactment of Consumer Protection Act, 1986 that gives aggrieved hospital patients an easy route to litigation. But that also opened a Pandora box and the Indian Supreme Court had to prescribe guidelines on grounds that medical practitioners would not be able to save lives if they were to practice in fear. “Such timidity forced upon a doctor would be a disservice to society,” the court reasoned before asking government to work with the Medical Council of India to prescribe guidelines.

But here is the main point from the Indian Supreme Court intervention: A private complaint “may not be entertained unless the complainant produces prima facie evidence before the court in the form of credible opinion given by another competent doctor to support the charge of rashness or negligence on the part of the accused doctor.” Incidentally, this is also the established jurisprudence in Nigeria today and it derived from the interesting case between Dr Alex Otti, the current governor of Abia State, and Excel-C Medical Centre Ltd, Lagos. “It is rudimentary law that in order to find a medical professional guilty of negligence, the situation has to be such that what he did is what professional colleagues would say that he really made a mistake and that he ought not to have made it,” the Court of Appeal ruled. “Put differently, the action would be such that falls short of the standard of a reasonably skillful medical professional.”

This for me is where Chimamanda’s claim of medical negligence by the hospital is most serious. Nkanu’s father happens to be a respected Family Doctor who was not only present throughout his son’s ordeal but also witnessed all that happened! For a medical practitioner, who was in 2009 certified by the American Board of Family Medicine, to feel so aggrieved by what he saw as to contemplate legal redress, it must be serious. Meanwhile, the tragedy has also provided opportunity for many people to share their medical experiences which suggests that we are dealing with a huge systemic problem. From forgetting a pair of surgical scissors inside the abdomen of an operated patient to wrong diagnosis and drug prescriptions, the list of Nigerians who have been sent to their untimely death through the carelessness/negligence of medical personnel is very long.

Last September, there was a highly revealing report in Mondaq (a renowned online law publication), ‘Litigating Medical Negligence in Nigeria’. The authors, Olufe J. Popoola and Olatunji Bamidele, began with a popular saying in the Nigerian medical community: ‘We care, but God cures.’ As a Christian, I cannot fault that but there is also a place for taking individual responsibility for our actions, too often lost in the Nigerian public space. “A 2017 study on medical errors in Nigeria published by the Archives of Medicine and Health Sciences revealed a negligence rate of 42.8% among 145 medical practitioners. The report indicated that the three most prevalent errors were medication prescription errors (95.2%), errors in radio-laboratory investigation (83.9%), and errors in physician diagnoses (69.4%), making medical negligence the third leading cause of death in Nigeria, following cancer and cardiovascular disease,” the duo wrote. “Yet, many patients still remain silent on issues related to medical negligence and fear taking legal action against the perpetrators of this act.”

In a way, Chimamanda is waking us up to a problem that we refuse to address. And we must not waste this moment. What compounds the problem is that quacks have taken over most professions. These days, even auxiliary nurses and hospital ward attendants adopt the appellation of ‘Dr Somebody’, performing surgical operations on the unwary and sometimes desperate patients. And let’s not talk about regulatory oversight. About a decade ago, a fake medical doctor was discovered to have served in the Federal Ministry of Health (FMoH) for nine years. He not only rose to Grade Level 13 in the ministry but had also worked in the Department of Hospital Services before he was eventually detected as a fraud!

The practice of medicine is regulated by the Medical and Dental Council of Nigeria (MDCN) which has both an Investigating Panel and Disciplinary Tribunal. But the case of Dr Ferdinand Ejike Orji is indicative of the challenge we face in the sector. On 20th January 2023, Orji was convicted of criminal negligence by the Lagos State High Court in the treatment that led to the deformity of the left limb/leg of a 16-year-old patient named Somi Ezi-ashi. The summary of the case is that the boy sustained the injury while playing basketball on 26 July 2018 and was taken to Excel Medical Centre where Orji allegedly gave some non-medical personnel surgical gloves to wear, injected the boy with sedatives and then wrapped his leg with a fiber glass cast without performing any x-ray to determine the nature of the fracture. All this in the presence of the boy’s distraught mother, Mrs Ngozi Ezi-ashi. With the boy practically crippled and the police investigation affirming Orji’s culpability, he was charged to court by the Lagos State government and convicted in 2023. But having secured an Abuja court reprieve over his suspension by the MDCN, Orji may still be in practice, even while the case is on appeal.

I have highlighted the foregoing not to disparage medical practitioners or healthcare delivery in Nigeria as some are doing. But rather to point out the issues we must address. In any case, I have written several sympathetic columns on our healthcare delivery, including ‘Who Wants to be a Doctor?’ and ‘The Exodus of Nigerian Doctors’, both of which dwelt on the frustrations that go with the practice of medicine in our country. In December 2019, I was also the speakerat the 36th Annual General Meeting and Scientific Conference of the Association of Resident Doctors, University of Ilorin Teaching Hospital and my paper, (Medical Tourism and the Challenge of Healthcare Delivery in Nigeria – THISDAYLIVE) spoke to the same issue. But we cannot continue to gloss over this problem of medical negligence. We must confront it as other countries are doing.

For the benefit of the ‘May Nigeria never happen to you’ crowd, let me drop this quickly. In 2016, a study conducted by the John Hopkins University revealed the magnitude of preventable medical mistakes in the United States. Using hospital admission rates from 2013, the report concluded that out of 35,416,020 hospitalizations, 251,454 deaths occurred as a result of medical error. The researchers therefore urged the Center for Disease Control and Prevention (CDC) to add medical errors to its annual report of leading causes of death. Based on that recommendation, CDC currently lists medical error as the third leading cause of death in the United States.

What the number indicates is that despite their best efforts, even a country like the United States has not been able to deal effectively with the challenge. In November 1999, the United States Institute of Medicine released a report, ‘To Err Is Human: Building a Safer Health System’ which was about health care providers in the country. “Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That’s more than die from motor vehicle accidents, breast cancer, or AIDS–three causes that receive far more public attention,” according to the report which set a minimum goal of 50 percent reduction in errors over a period of five years. “Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems.”

The foregoing is not to justify negligence in our hospitals. It is for us to understand that our healthcare professionals are not necessarily worse than their counterparts abroad. But too many have gotten away lightly after committing grievous medical havoc. According to a 2022 survey by the American Medical Association (AMA), 31.2% of U.S. physicians have been sued for medical malpractice at some point in their careers, with about 17,000 to 20,000 malpractice lawsuits filed annually in the country. It must be noted that about 78% of these civil cases are dropped, dismissed, or withdrawn without a finding of negligence. Only in about 10 percent of cases are medical negligence proved. But the realisation that there are consequences for professional misconduct or fatal error is enough to make a medical personnel exercise due diligence and extra caution when dealing with patients, regardless of their social status. It is not the same in Nigeria.

When a system is strained beyond capacity like ours and healthcare workers are stretched to breaking point, what you witness is accountability mechanisms that bend toward power rather than patients. In Nigeria, we see this in doctors working 120-hour weeks for less than a dollar an hour, in the exodus of 15,000 doctors between 2020 and 2024, in elite hospitals that function as ‘diagnostic stopgaps’ before real treatment can be had abroad. We must all remember: Our former president spent about 250 days of his stewardship on medical trips to London, with one single sojourn in 2017 lasting 104 days. Despite all the disguises, our current president has not done badly in that regard too, though the destination is Paris. That says everything about institutional trust.

Now that Chimamanda’s tragedy has forced us into a long-overdue reckoning, health authorities and stakeholders in the sector should seize the moment. Lagos State has ordered an investigation and we all await the report while the Healthcare Facilities Monitoring and Accreditation Agency (HEFAMAA) has promised transparency. These are necessary steps. But it should not end there. All these must lead to systemic change, stronger oversight, protection for overworked doctors, enforceable professional standards, and consequences for negligence.

The lesson of Chimamanda’s loss is not that Nigeria is uniquely broken. It is that healthcare delivery in our country is only as strong as the accountability we demand, the investment we make, and the value we place on every life. To fix it, we must fund infrastructure, enforce standards and build a system that is not only rewarding but can also hold negligent medical practitioners accountable.

Lewis Obi: The Editor of Editors

There can be no better tribute to Mr Lewis Obi who died last week at age 77 than the one paid by Senator Babafemi Ojudu. Although at different times, Obi was also my Editor-in-Chief and Managing Director at African Concord magazine. As Ojudu attested, Obi was not only a thoroughbred professional but also a fantastic human being. For those who may have missed it, below are excerpts from Ojudu’s tribute which I wholeheartedly endorse:

Lewis Obi was a master prose stylist—deeply committed to clarity, rhythm, and precision. He believed in the power of the perfect sentence and the exact phrase, and he worked assiduously toward both. Sloppiness never survived his desk. Editing under Lewis Obi was rigorous, sometimes exhausting, but always purposeful: he was not trying to wound egos; he was trying to elevate craft.This was a time when personal computers were still a distant promise. Obi wrote longhand—writing, crossing out, rewriting, and crossing out again. His manuscripts were dense forests of thought, scarred by relentless revision. Reading them was a challenge in itself. In fact, there was only one man who could consistently make sense of his handwriting: Mr. Adeyemi, a retired Army stenographer who served as our typist. Even then, Obi was never finished. After the text had been typed, he would return to it again, crossing and recrossing sentences, reshaping ideas, refining diction, and polishing language in an almost obsessive pursuit of elegance and accuracy.Yet for all that intensity, I never once saw him angry. Even when a reporter’s behaviour left him flabbergasted, he expressed it not with raised voices or tantrums, but with a wry smile that conveyed disappointment more effectively than rage ever could. His calm was disarming; his restraint, deeply instructive.Lewis Obi loved freedom—and trusted it. He allowed his reporters and writers to do their work without fear, regardless of ideological inclination. What mattered to him was not where you stood, but how honestly and rigorously you stood there. If you were hardworking, truthful, intellectually curious, and committed to facts, you became his darling. In his newsroom, merit trumped hierarchy.He was completely detribalised, yet firmly rooted in the manners, values, and philosophical depth of his Igbo heritage. His recruitment style, personal elan, and worldview were those of a cosmopolitan man—one who saw humanity as a single enterprise. Tribe, religion, or background meant nothing at African Concord; only integrity and professionalism counted. “Bayo, are you sure this is real? Have you checked all the facts with the reporters? Are there other things we could do to be doubly sure?” he would often ask Mr. Bayo Onanuga, his then deputy who managed the newsroom. Once convinced of a story’s facts and veracity, his decision was swift and firm: let it go. Courage, for him, flowed naturally from truth.At editorial meetings, Obi listened more than he spoke. He allowed every idea its space, never interrupting, never imposing himself too early. Only at the end would he come in—quietly—to sharpen arguments, refine angles, and improve collective thinking. He did not dominate rooms; he elevated them.Lewis Obi belonged to a generation of editors who saw journalism as a calling, not a career. He shaped writers without spectacle, mentored without theatrics, and enforced standards without cruelty. Many of us still carry his influence—often unconsciously—each time we pause over a sentence, question a fact, or insist on getting a story right. He is gone, but his discipline, grace, and belief in journalism endure.

Still in my twenties when I worked under him at African Concord, I learnt a lot from Lewis Obi whose impact was felt more by the power of his example. He also wrote the foreword to my book, ‘Abiola’s Travails’, now part of the collection, ‘The Ghost of June 12’. May God comfort the family he left behind.

Jacob Olupona at 75

Harvard Professor, Jacob Kehinde Olupona, who has for the past two decades been my mentor, is 75 today. A professor of African Traditional Religion and member of the American Academy of Arts and Sciences, Olupona began his career as a lecturer at the then University of Ife before moving to the University of California, United States where he became a tenured professor. In 2006, he joined Harvard University. Olupona holds an honorary doctorate from the University of Edinburgh in Scotland and is a recipient of the Nigerian National Order of Merit (NNOM), the Martin E. Marty Award for the Public Understanding of Religion among several other international laurels.

Olupona is the founder of the annual Ife Institute of Advanced Studies which plays host to hundreds of in-resident early-career, doctoral, and post-doctoral scholars, and others who join remotely for two weeks of critical conversation, workshops, and mentoring sessions. With renowned academics invited from all over the world to serve as faculties, Olupona is helping to advance the careers of many our lecturers. “The Institute is designed to foster connections, networking opportunities, and collaborations among participants, encouraging the exchange of ideas and best practices,” Olupona once told me. “By building communities of practice, we can drive sustainable development and innovation across Africa.”

As he clocks 75, I can only wish Professor Olupona happy birthday, long life and good health. Igba odun, Ojo kan!

• You can follow me on my X (formerly Twitter) handle, @Olusegunverdict and on www.olusegunadeniyi.com