To check how serious Cross River state was about screening
for COVID-19, especially as the state is the only one in Nigeria without
a single case, Taiwo Adebulu disguises as a patient with a risky travel history
and suspicious symptoms. He narrates his experience with the doctors, nurses
and the test team in this undercover adventure.
Crossing Itu bridge, which marks the boundary between Cross
River and Akwa Ibom states, is like a camel passing through the eye of a
needle. Vehicles from Uyo, the Akwa Ibom capital, don’t go beyond the bridge.
All passengers have to alight before the military checkpoint and pay their way
through. While Ben Ayade, governor of Cross River, claimed he spends nights at
the state’s borders as part of efforts to prevent COVID-19 from entering the
state, the same location becomes a flourishing industry during daytime as
security operatives and thugs cash out at the expense of travellers.
“So, why didn’t you stay in your state when you know you
don’t have money to pay to cross the bridge? Did we force you to come?” a young
man with bloodshot eyes asked as he scanned me viciously from head to toe.
The security officials and thugs who mounted roadblocks
demanded N500 for each person to pass through. With N1,500, I scaled the border
checks and proceeded to the busy motor park after the bridge. Ifiok, the
motorcyclist who ferried me through the bridge, said the security officials
charge each of them N3,000 daily to operate across the border. The bus I
boarded from the spot where Ifiok dropped me was filled to the brim with 18
passengers in addition to the driver and his assistant. Some passengers dropped
their face masks to the chin to breathe well as the rickety white bus shrieked
its way to Calabar.
After a three-day tortuous journey from Lagos, I finally
got to the state capital, a thriving city which appeared tucked away from all
the troubles of the world. More vehicles trooped in from the boundary and
discharged passengers at Essien Town at the entrance to the city. Businesses
were booming, sedan taxis loaded with five passengers crisscrossed the city,
while praise and worship beamed from a nearby church at Satellite Town close to
the university. It was already seven days after the governor lifted the ban on
religious gatherings to keep the “spiritual economy” thriving.
As it stands, Cross River is the only state in the country
without a confirmed positive case of COVID-19 since the novel virus hit the
country in February. According to the situation report of the Nigeria Centre
for Disease Control (NCDC) for May 18, 2020, the south-south state had only
tested seven samples out of its almost four million population, while
neighbouring states have recorded cases and are battling community
transmission.
‘I AM SCARED. EVERYONE IS SCARED’
What’s the secret behind Cross River being free of the disease? To find out, I disguised as a patient. As early as 9am, I was among a few of the patients who arrived the general outpatient clinic (GOPC) of family medicine department at the University of Calabar Teaching Hospital (UCTH) – just a few days after two nurses died from suspected symptoms at the hospital. There was palpable anxiety in the air.
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| OUT-PATIENTS AT THE GOPC |
“Please, do not remove your masks while talking to me. I
can hear you from here,” an elderly nurse told patients sitting at the lobby.
The nurse directed me to the payment point where I paid N2,600 as a new patient
and I got registered immediately.
When I was ushered in for consultation, I sat on the chair
quite distant from the young female doctor. She adjusted her face mask and
pulled the booklets closer to listen to me. I complained about chronic headache
and involuntary writhing movements on my left hand. The doctor asked if I was
coughing or having shortness of breath, fever, nausea, sore throat and loss of
taste or smell, symptoms of COVID-19. I answered in the negative. After a
series of questions and answers about my habits, diets and activities, she said
I might need to work on my eating habit and observe some safe health measures.
Then, I asked if I could get tested for COVID-19 because I
was also feeling weak. I told her that I had travelled to the state from Lagos,
through Uyo. She adjusted her seat and asked more intense questions and this
time around, I shuttled between “Yes and No” as much as it could raise
suspicion. The doctor said she was going to call the state epidemiologist and
asked me to go for a malaria test first.
At 4pm, the GOPC is empty with the reporter waiting for the
COVID-19 team
At that point, the doctor, whom I later learnt was Rosa
Inyang, felt unsettled as she was sliding through contacts on her phone. I
asked if she was scared. “Yes, I am scared. Everyone is scared,” Inyang said.
“Our state has not recorded any COVID-19 case and if you have such a travel
history to a flashpoint and you are insisting on COVID-19 test, it is enough to
be scared. We don’t know when an index case will be recorded yet. At least, you
are honest with your travel history and symptoms. So, we know how to handle
this professionally and see the outcome. Some patients would come here and hide
their history and end up making us live in fear.”
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| INYANG CALLING THE STATE COVID-19 TEAM |
When my test result came back, I had malaria. The doctor
asked me to wait for the state epidemiologist team who were already on their
way to test me. It was a few minutes after 10am.
FIVE HOURS WAITING FOR COVID-19 TEAM
While I waited inside the GOPD, I familiarized myself with
one of the female nurses who said I was lucky to get tested.
“You are very lucky to have detected your symptoms on time
and insist on having the test. If not, they won’t come here,” she said.
“We have had patients who came here exhibiting symptoms of
the disease. We will call the state team for hours and they won’t come until
the patient gets tired and leaves. Most of the time, they say the patient has
not exhibited the symptoms. The doctors had to complain that the state should
not be the one taking the test until the NCDC team came and took over. Two of
our colleagues have died within this week and they exhibited strong symptoms of
COVID-19. These are people we saw with our eyes and knew the symptoms they
exhibited. One was a member of staff and the other came from the general
hospital.
“But when their post-mortem test results came out, we were
all surprised they said negative. We don’t know what is happening. We are all
scared. We are trying to be careful with each patient we manage here. Your case
is the first time we will call them and they actually came.”
MEDICAL COMMUNITY IN DOUBT
In an interview with Agam Ayuk, the state chairman of the
Nigerian Medical Association (NMA), he said the association has not established
any evidence of a cover-up by the government, although there are suspicions
that there could be cases of infection in the state.
“As it stands, we don’t have any recorded confirmed case
even though the medical community still has their own doubts. The level of
testing is quite low. We think there should be an upscaling of surveillance and
testing. We’ve complained about delays from the state epidemiologist team,”
Ayuk said.
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| CROSS RIVER STATE STATE CHAIRMAN OF NMA, AGAM AYUK |
“We have had incidences of people who meet certain signs
and symptoms of suspected COVID-19 and the results, from we have heard, are
negative. As medical experts, we believe that sometimes we may have
false-negative results. Those are possibilities in testing. But the PCR reduces
that possibility to the bare minimum.
“If I have any evidence of a cover-up by the state, I will
make it public. We have a lot to lose especially putting our members at risk.
We’ve drawn government’s attention to the fears of our members and we expect
them to do what is right. We have members who have risk factors.”
‘WE WANT TO REMAIN COVID-19 FREE’
Inyang has been in constant touch to know my COVID-19
status so that she can also know her fate but the state epidemiology team has
not communicated with me a week after they took my sample. This has fuelled
suspicion among medical workers in the state. Maybe tests are not really done
after samples are collected — just to maintain the “zero case” status.
When TheCable contacted Betta Edu, commissioner for health
and chairperson of the state COVID-19 response team, she said the state has
been performing its role effectively.
She said the team is not responsible for the delayed result
of the reporter.
“All results have been sent to the hospital management. We
do not publish people’s names in the media. It’s against medical ethics,” she
said.
“The late nurses’ samples were sent to NCDC reference lab
and results returned negative. We don’t own an accredited laboratory in the
state, unless you are saying the lab results from NCDC are not true. This is
over two weeks and all persons who came in contact with them including family
members are all hale and hearty. Coronavirus is like pregnancy it doesn’t hide.
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| CROSS RIVER STATE COMMISSIONER FOR HEALTH BETTA EDU |
“We must avoid rumors and scare. It has made health workers
in most states to abandon their duty post and even Association of Resident
Doctors is threatening strike because of lack of PPE amongst other things. More
persons are dying from other diseases and things like maternal mortality that
kills over 3000 daily.
“Due to scare and the way we have magnified the disease,
health workers will neglect more patients across the country that will lead to
death of patients (I am glad the nurse was not neglected). We must at this
point change strategy of reading out big numbers daily and supports states to
get the health system to become functional or we will destroy fragile the
health system more.”
Speaking on the activities of security officials and thugs
who demand bribes from travellers at the borders, Christian Eta, chief press
secretary to the governor, said the government is not aware of the development.
He said the government would do anything to police its
borders in order to avoid the spread of the infection into the state.
“I’m not aware of incidences of that nature. It has not
been brought to our notice. There is a presidential directive banning
inter-state movement. How did those people get to Itu bridge? That’s a
fundamental question. They said no movement. So, how did they get there?” he
asked.
“We gave the responsibility of overseeing the closure of
the borders to some of our commissioners. Two commissioners take the turn to
superintend over the closure of that Itu bridge, both night and day. We have
over 50 illegal borders with Cameroon, so we are spending a lot of money and
resources manning those places. At this point in time, Cross River is COVID-19
free and we want to remain that way. We will do anything to police our border
and we will do that within the ambit of the law.”
One week after my test, I am yet to get the result.
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