Of quacks and victims

If you ever have to undergo surgery at a Nigerian hospital, you may need to play safe by undertaking inventory scan of your body organs before and after the surgery, just so to be sure the organs remain intact. That is the lesson to learn from the experience of the Kamal couple in Jos, Plateau State. The couple has been in the news over alleged harvesting of one of the kidneys of the wife, Kehinde Kamal, by a neighbourhood practitioner who the victim’s husband, Busari Kamal, recently dealt out to the police. The ‘doctor’ is Noah Kekere and the ‘hospital’ is Murna Clinic and Maternity located in Yanshanu community, Jos North council area.

The police in Plateau State took Kekere into custody after Busari Kamal, a businessman, reported him to the Nasarawa Gwom police division, accusing him of having removed his wife’s right kidney during a surgery in 2018. The surgery Kekere conducted on Mrs. Kamal had nothing to do with her kidneys, but he allegedly invaded that region of her body anyway and harvested one of the vital organs. Kekere reportedly had been practising in the community for more than 25 years and was a favourite of residents who thronged his outfit because he presumably exemplified the Hippocratic Oath: he charged less compared to other centres and even performed some surgeries on credit, if only to safeguard the primacy of life.

What took the Kamals to Kekere in 2018 was a complaint of severe stomach pain by the wife, upon which she was rushed to the clinic and whereby Kekere diagnosed ruptured appendicitis and advised urgent surgery. Busari Kamal recounted to journalists that he got to know Kekere and his clinic through a medical treatment his mother earlier underwent there: “About eight years ago, my mum was sick, so she was directed to a hospital owned by one Dr. Noah Kekere at Yanshanu, Nasarawa Gwom community of Jos North local government area, and in the process of going to see my mum at the hospital, I got acquainted with the doctor. When my wife fell ill in 2018, complaining of severe stomach pain, my mum encouraged us to take her there because my wife used to follow my mum to see the doctor when she was sick.” The narrative of how the surgery eventually came about was given by Kamal as follows: “We got to the clinic and the doctor did a scan and said my wife had ruptured appendicitis and must be operated on immediately, and he charged us N140,000. When I called some people to ask about the high bill, as I planned to take her to JUTH (Jos University Teaching Hospital), they advised we just go ahead and save her life. The doctor asked how much I had and I said N80,000, apart from other charges for drugs… The day the doctor conducted the operation, he started from 12 noon till 8p.m.” 

That surgery, however, didn’t end maters for the Kamals. “For the past five years, my wife kept complaining of severe stomach pain. I continued to take her to the same hospital because I did not want to change the doctor that started her treatment. But as she continued to have the pains, I decided to go to the Jos University Teaching Hospital, where we discovered that one of my wife’s kidneys had been removed,” the husband said.

The organ harvest victim has herself been speaking of her bitter experience. She recalled that she stayed six days at Kekere’s hospital following the purported appendicitis surgery, only to thereafter experience fresh complications: “After six months, the side of the operation started causing me pain. My husband said I should go back to Dr. Kekere to lay my complaint, which I did. He prescribed some medicines for me. After taking the medicine the pain was eased for some time; but not long after, the pain started again.” Kehinde Kamal said she continued reporting to Kekere about the pain at regular intervals. “Whenever I complained, he would either give me some tablets or injections, but a few days after, the pain would return. When I kept complaining, he told me I needed another surgery as another disease was discovered in my stomach and would cost me N60,000. But I thought: what if the second operation was carried out and it was also not successful? I was scared because the first operation was yet to be healed and the doctor was suggesting another one. I then decided to go to JUTH for further consultation.”

“So, if Kekere is a quack, how has he managed to practice unapprehended for more than a quarter of a century?”

According to Mrs. Kamal, when the outcome of the evaluation at JUTH revealed that one of her kidneys was removed, she at first didn’t even understand what it was all about. “When my abdomen kept paining me, I approached JUTH for further examination of my health status so as to understand what the cause really was. On getting to JUTH, a doctor, after hearing my complaint, thoroughly examined my stomach and asked me to go for scanning. After the scanning and the results were out, the doctor asked me which kind of operation I underwent that my stomach was cut to that magnitude. I told him it was the appendix. The doctor further asked where the first operation was carried out and I told him it was at Murna Clinic. He then disclosed to me that one of my kidneys was removed. Kidney? I asked. I didn’t know what kidney meant, but I quickly called my husband to inform him that the result of the evaluation at JUTH indicated that my kidney was removed.” She added that when the couple confronted Kekere with the discovery, he denied having anything to do with it. After the police were brought in, they ordered that another scan be done at a hospital in Jos South council area, where the result showed same verdict. And it wasn’t that she had any record of surgery before the encounter with Kekere. “I was never in my lifetime admitted in a hospital or underwent surgery until 2018 when I was first operated on by Dr. Kekere. I gave birth to all my four children in JUTH and never had any record of surgery,” she said.

It is a wonder how Mrs. Kamal has lived on one kidney without even being conscious, so as to take necessary precautions in such circumstance. But Kekere’s credentials do not speak for him and he never should have performed the surgery on her. The Nigerian Medical Association (NMA), which launched an investigation of the suspect’s credentials after he was arrested by the police, said it has found he isn’t a doctor. “Our records do not show that the person accused is a medical doctor. From what we have at our secretariat and the investigation we have carried out, he is actually not a doctor and therefore not our member” the chair of the Plateau State chapter of the association, Dr. Bapigaan William Audu, told journalists.

So, if Kekere is a quack, how has he managed to practice unapprehended for more than a quarter of a century? That sheer fact is an indictment of monitoring and standards oversight in the medical profession in Nigeria, and more so the nation’s security establishment. In Kekere’s 25 years-plus of practice, the Kamal woman wouldn’t be his only victim of ambush organ harvesting, if truly the man is into that business. The Kamals must only be the vocal victims. There is need to interrogate the history of medicare by Murna Clinic and ascertain whether there haven’t been strange deaths of ex-patients, or whether all living ex-patients recovered fully from their challenges and are presently in good health. If there have been strange deaths or ill-health complications suffered by ex-patients, it shows the porosity of societal safeguards that these had gone on for many years without catching the attention of security agencies and regulatory authorities of the medical profession. It is bad enough that the standard of medicare in Nigeria is low, it is worse that the system can be predatory without safeguards for hapless citizens.

A more knotty issue is the legal framework available to the Kamals to pursue remedy. The accused practitioner has been arrested by the police, but what is to be done with him even if proven guilty? Kehinde Kamal can’t have her right kidney back anyway and will have to live on the remaining one. But it is doubtful there are specific legal provisions stipulating the price Kekere should pay if found guilty – both as remedy for the victim and in self-recompense before the law. It is double jeopardy for the victim when there is no law to redress the offence.