Health-Seeking Behaviour in Nigeria – A call for a Change
Introduction
Having observed with dismay the attitude of an average Nigerian in seeking health, I was left with little or no option than to drop this piece; hoping that per adventure it might help to curb the the menace of drug abuse and quackery in our health system.
In Nigeria today, when someone is sick, the first thing most persons do is to get drugs from a patent medicine dealer/pharmacist, others would decide to go to lab test. Only few go to see a doctor as first line of action. This has done more harm than good.
What to do When you are sick in Nigeria
When you are sick, the first thing to do is to see a doctor. That is the most fundamental thing. The reason is because it will be easy for your doctor to diagnose you properly at that initial time of disease onset. The symptoms would be clear to the doctor, that he can make accurate diagnosis in 99% of the times.
Unfortunately, most persons are their own doctors. The keep treating themselves, only to present to the doctor when issues become awkward. Sadly, they would not tell the doctor how far they have gone in self medicating. The end result is that it becomes difficult to know if you are suffering from a complication of self medication or the actual disease.
That’s not all. When you see your doctor, he will ask you a lot of questions (history taking), after which he will examine you. In more than 95% of the cases, your doctor makes diagnosis with just history taking and physical examination. Laboratory tests may not be necessary. If there would be need for lab tests, the doctor would request for the appropriate lab tests.
It is very inappropriate for you to start going to lab on your own. What exactly are going to test. Malaria and typhoid? This is the unfortunate part. You hardly see anyone that goes to lab without coming out with malaria and typhoid positive result.
It is now like a default result: malaria and typhoid. For your information, Widal test is outdated. It is no more diagnostic of enteric fever (typhoid). But they will not tell you this.
A friend of mine chatted me few days. That he went to lab, and had raised ESR, and was asking the causes of high high ESR. This is like asking a mechanic, what are the causes of your car refusing to start. Where exactly do you want him to start explaining?
Doctors do not treat lab results. We treat the individual. In other words, it is possible you’ll have an abnormal lab result, yet the clinical scenario says otherwise. That is, what is on the lab papers is not in tandem with the clinical outlook. The guiding principle for the doctor is first your clinical state, and not the lab results.
Sequel to the foregoing, the need to lessen dependence and inordinate craving for lab tests cannot be overemphasized. It is not advisable. In most cases, you end up spending your money on irrelevant investigations.
However, it would be foolhardy to feign ignorance of the genesis of the problem. Looking on the other side of the coin, who would not want an expert diagnosis? I guess none. The average woman on the street would first check, instead of using the only 5000 naira on her to pay for consultation fee, she would use it to go straight to the drug shop and buy drugs. Is this a better alternative? Absolutely no!
So many cancers would have been prevented if the patients presented early to the doctor. Other cancers would have been detected early if the patients were not busy treating malaria and typhoid. Leukaemia and malaria almost present the same way. All that “fevers” is not malaria and typhoid. These two diseases (malaria and typhoid) have suffered a lot in the hands of so many Nigerians.
What is the Solution?
The government should make primary health care cheap. Let patients feel how cheap it is to see a doctor before buying drugs or heading for the lab. In this way, so many malignant diseases would be detected early.
Even in the interim, while we wait for government, please, do not look at money when health is involved. An Igbo adage said: aghara ndu kpaa aku, onye iro erie uru (when you go after wealth at the expense of your life, the enemy will enjoy the profits). Even if it means borrowing, please do. Even if it means calling for help from social groups you belong (like church) , please do.
Finally, if you see a doctor, and still feel unsatisfied, see another. Do not make hasty conclusions from an untoward experience you had from a particular doctor.
I believe this helps you. Onye nu ya koro agbataobi ya (Anyone that hears, should tell their neighbour).
Thank you.