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Friday, March 29, 2024

Postlogue on Death by Medical Mission

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I obviously did not count on the unintended consequences of my story on Death by Medical Mission.  It is actually the first of four fictionalized realities on how the practice of handing out potent and dangerous pharmaceuticals sourced from all over the world to old, poor, and ignorant people without any scheme of clinical continuity falls below any conceivable standard of care. That practice is as unethical as it is dangerous and should be abrogated. It is not medical mission; it is an unintentional tort that has occasioned harm to many poor and ignorant folks and should be stopped forthwith.
That is not not to recognize that the medical mission comes at a great personal sacrifice to many genuine missionaries.  That is not to say that other acts of medical missions not involving dispensing potent pharmaceuticals to old, poor and ignorant folks is not beneficial.  My story was directed specifically at that one dangerous practice of handing out drugs with no clinical follow up.
Medical missionaries can hand out vitamins. Great contributions. At least for the thirty days its lasts, these poor and impoverished people can enjoy a boost to their nutritional profile.  Medical missionaries can screen people for diseases and encourage them to contact their doctors for treatment. Great contribution.  Medical missionaries can screen for cancer and where they can meet a reasonable standard of care, carry out lumpectomies etc. Great contribution.  Medical missionaries can gather ignorant nurses like Caro and UK, who are apparently at the front line of healthcare in our State and educate them on the proper management of common primary health issues. Great contribution.
Medical missionaries can in fact go one step further to issue, free of charge, basic diagnostic equipments like Sphygs, thermometers, glucose meters, stethoscopes to nurses like Caro and UK and teach them basic stuff. Great contributions. Medical missionaries can organize mobile laboratory, who on a year round basis, can be going from one market square to the other, screening people for hypertension and diabetes etc and distributing leaflets on preventive medicine. Great contributions.  Without exhausting the litany of what is acceptable medical mission, and in fact, without, trying to deprecate the good intentions of many good missionaries, it bears further emphasis that distributing dangerous substances to ignorant people is not medical mission.  There is no problem handing out these drugs to local doctors and encouraging our folks to follow up with their primary care doctors.  That falls within a reasonable standard of care. But to triage ignorant people and hand over limited supplies of highly potent pharmaceuticals to them is very dangerous.
The story ended up calling not for the abrogation of medical mission but for its regulation by the Ministry of Health.
The story was directed to no one particular organization but textually and expressly directed to individuals and organizations at every level. We have private doctors, town unions, state unions, organizations and societies organizing medical missions and many who unwittingly hand out drugs to poor and ignorant people.  I did not even have ASA-USA necessarily in mind. The protagonists in my story specifically said that they obtained their medicine from our folks in Obodo Oyibo and in one instance even mentioned an individual doctor who handed  medicine to them.
 
Distinguished healthcare practitioners like Drs. Okenwa Nwosu, Ndubuisi Okoye, Uche Umeh, Chinwe Enemchukwu understood exactly the dangers and, no doubt, responded positively, but that little story had the unintended effect of smoking out a bunch of bounty hunters.
Judging from the defensive tone of ASA-USA, it has become sadly clear that that erstwhile great organization has been hijacked … by bounty hunters.  ASA’s medical mission, no doubt peopled by many well meaning volunteers, is to some unscrupulous elements, unfortunately, a platform for bounty hunting. That secret has always been well known. My good friend, bounty hunter, and great loya who for the longest time deprecated ASA-USA appears to have suddenly found the association a veritable ground for bounty hunting.  While expecting a well made brief on whether the practice of handing out pharmaceuticals to ignorant and poor people meets or falls below a reasonable standard of care, my great loya couldn’t  even distinguish between a writ at crime and a writ at  tort and showed that he was probably out bounty hunting when his law school professors discussed the actus reus and mens rea of crime.   That conclusion, “you are calling our volunteers killers,” was a great a loyaly remark as any bounty hunter can make.  Way to go bros. Put up that brief and I will send you to school.
Our great loya appears to be suggesting to fellow bounty hunters that a proper defense to medical tort or wrongful death is to proffer evidence on how many others have been saved.  Folks, every life is precious and there is no such thing as cost benefit analysis when avoidable harm has been done to many people. Folks, and this goes to the DC Executioner, there is no doubt that some people have benefitted from medical mission, but the unintentional and avoidable harm to even a single individual is actionable and in fact, is a complete legal ground to shut down the entire mission.  We are not asking anyone to be perfect. All we are asking is to stop paying blind eye to obvious clinical dangers. Igbo land is today teeming with Papa Ntonys who have a dangerous stockpile of expired and unexpired drugs and who are absolutely convinced that if a drug comes from Obodo Oyibo, it can do no harm.  Isn’t the danger obvious without first waiting for Gwogwolo to advocate for these people?
For the bounty hunters, I, Gwongwolo, am a sacred python poised to strike and yours, the piercing cry.  I need not caution my other good friend also named Charlie on the hazards of bounty hunting, particularly as a hired gun.   If the story of Papa Ntony had the unintended effect of smoking out a bunch of bounty hunters, wait until you hear the story of Catechist Ukegbu, blinded by Medical mission; of Papa Ben, another death by Medical mission and of my beloved friend, Uche, very dead by medical mission. If our bounty hunters think that these stories are not based on actual experiences, then these missions are even more dangerous than I thought.
 
Respectfully,
Aniedobe

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