By Job Osazuwa
Former chairman of the Association of Catholic Medical Practitioners of Nigeria (ACMPN) and chairman of the Association of General and Private Medical Practitioners of Nigeria (AGMPN), Dr. Philip Njemanze, has explained the issues surrounding the sealed 27 hospitals built by a former administration in Imo State, particularly the role of doctors.
In a press release to clarify the matters, he said: “I was at the helm of affairs of the private doctors during the period under discussion. The ACMPN and AGPMPN petitioned the Federal Government to seal all 27 hospitals in Imo State.
“The allegation was that the 27 hospitals were designed for human organ harvesting without consent from Nigerians. This is based on the ‘lacunas’ built into the National Health Act 2014 (NHAct2014) to allow collection of human organs without consent. The contentious sections of the NHAct2014 include Sections 13, 20, 43, 45, 48, 51, 53, 58, and definition of gametes, with pitfalls which are obvious to anyone applying common sense.
“The NHAct 2014 in Section 51 states that: (1) A person shall not remove tissue from a living person for transplantation in another living person or carry out the transplantation of such tissue except:- (a) in a hospital authorized for that purpose; and (b) on the written authority of: (i) the medical practitioner in charge of clinical services in that hospital or any other medical practitioner authorized by him or her; or (ii) in the case where there is no medical practitioner in charge of the clinical services at that hospital a medical practitioner authorized thereto by the person in charge of the hospital. (2) The medical practitioner stated in subsection (1)(b) shall not be the lead participant in a transplant for which he has granted authorization under that subsection. (3) For the purpose of transplantation, there shall be an independent tissue transplantation committee within any health establishment that engages in the act and practice of transplantation as prescribed.
“We pointed out that Section 51 focuses on transplantation which has no relevance to health system regulation. The entire sections on transplantation are irrelevant to health framework law. Laws on transplantation are usually addressed separately. These provisions were inserted into the NHAct2014 because of the interest of foreign sponsors of this law in human organ and ovarian egg trafficking.
“The main subject of any transplantation surgery is the donor (that provides the organ) and the patient who is the recipient (that receives the organ). This section should first acknowledge the rights and obligations of the donor and the recipient. Rather, the drafters chose to acknowledge the rights of the health administrator who has no ‘locus’ in the matter, that means he/she has nothing at stake.
“It is a fundamental legal principle: nemo dat quod non habet – ‘you cannot give, what you do not have’, in other words, the doctor cannot authorize transplantation of another person’s organ. For the first time, this universally recognized legal principle was overturned in the NHAct2014. “The doctor/administrator was given the power over the right to life of another person (the donor). The latter is a major violation of the fundamental right to life of the donor and is a major breach of the fundamental rights section of the 1999 Constitution of the Federal Republic of Nigeria.
“We suggested that, Section 51 should be null and void and of no effect. We alleged that, Section 51 was worded on purpose, because the human organ trafficking cartel who own the hospitals and the Imo 27 hospitals (sponsored by a hospital group) that are licensed for transplantation would be the place where Nigerians’ organs would be poached without consent under the NHAct2014.
“We suggested that, Section 51(b) clearly state ‘on the written informed consent of the donor’. Both AGPMPN and ACMPN were represented at the public hearing to present the memo arguing against these contentious statues of the NHAct2014. The NHAct2014 Section 51 as presently stated is a gross violation of the Helsinki Declaration on human subject written informed consent for medical procedures and research. It is a gross violation of Article 3 of the UN Universal Declaration on Human Rights, as well as a violation of the Fundamental Right to Life in Article 33 of the 1999 Constitution of the Nigeria.
“Violations of the Helsinki Declaration and UN Universal Declaration on Human Rights are very serious and could attract sanctions against Nigeria including suspension of its privileges as a UN member state! Nigeria’s human rights record could be downgraded.
“The chief sponsor of the NHAct2014 maintained on a television programme that Section 48 provides for a donor consent clause. However, we pointed out that he was wrong. Let us examine section 48: (1) Subject to the provision of section 53, a person shall not remove tissue, blood or blood product from the body of another living person for any purpose except; (a) with the informed consent of the person from whom the tissue, blood or blood product is removed granted in prescribed manner; (b) that the consent clause may be waived for medical investigations and treatment in emergency cases; and (c) in accordance with prescribed protocols by the appropriate authority.
“First, Section 48 of the NHAct2014 makes reference to Section 53: It is an offence for a person:- 1(a) who has donated tissue, blood or a blood product to receive any form of financial or other reward for such donation, except for the reimbursement of reasonable costs incurred by him or her to provide such donation; (b) to sell or trade in tissue, blood, blood products except for reasonable payments made in appropriate health establishment for the procurement of tissues, blood or blood products.
“We raised the issue that, Section 53 (b) states that, it is legal to ask for ‘reasonable payments’. So the reader should consider what is ‘reasonable payment’ for donating one of his/her kidneys. Could this cost be N10,000 or N10,000,000. The answer to this question reveals that, the preferred option of what many people would consider reasonable for risking his/her life to donate a kidney will be N10 million rather than N10,000. This is what clearly points to the deceptive language that was used. THE NHAct 2014 legalised human organ trafficking for money.
“On the so-called consent clause: Section 48 (b) waives the right to consent in emergency. What is emergency? Oxford Dictionary: A serious unexpected, and often dangerous situation requiring immediate action. Wikipedia: An emergency is a situation that poses an immediate risk to health, life, property, or environment. By the definition of ‘emergency’ in medicine most health conditions may at some point in development qualify as an emergency that requires immediate intervention. Even severe headache can present an emergency! What the NHAct2014 states is that, in all these situations regarded as ‘emergency’, “The NHAct2014 says that, informed consent of the donor maybe waved for investigations and treatment. Note that, the donor is a healthy person with reference to transplantation. The reader should understand that, the two major functions of the hospital are investigations and treatment. In other words, for all what the hospital wants to do including surgery particularly transportation, there is no legal requirement to ask the patient or donor, what should be done to him or her! Does ‘emergency’ mean that the patient or donor is mentally incompetent to give consent for a medical procedure as serious as surgery for transplantation? Of course not.”
Njemanze alleged that a former governor of Imo State in a speech announced that they had signed a Memorandum of Understanding (MOU) with a hospital group in India to equip and manage some of the new hospitals upon completion. He alleged that the hospital group in India is the second largest transplant center in the world.
Njemanze further disclosed that they had earlier been investigating some incident of collection of bone marrow samples during supposedly eye surgery in Owerri by Indian doctors involved with a foundation and some were linked to the hospital group in India.
Njemanze said: “These bone marrow tests are linked to transplantation tests for matching human organ donors to recipients. Since the tests called HLA typing are hereditary and show group similarity, anyone routinely collecting it in a given locality may build up a map of the geographic distribution in Imo State. “One possibility is that, if a kidney is needed by a patient called recipient, the HLA map could guide the doctors to the locality where one could get the donor that could match. It makes sense, to have several hospitals spread across the geographic area in Imo State, so that they can locate potential donors as fast as possible. Even though, they might not need 27 hospitals, at least 9-14 could give a good spread. The idea of 27 is for political correctness and façade as a development project.”
He said that the fact that, Imo State Government signed an MOU with the Indian hospital group made AGPMPN to start reviewing reports of illegal organ transplantation involving the group. According to him, the hospital had been indicted by the authorities and parliament for human organ trafficking.
Njemanze further said: “One very important component of a human organ trafficking business is a means of transportation from donor to recipient and a link to the international human organ trafficking cartel.”
He said they were alarmed when they learnt that, the Imo State Government had also signed an MOU with a foreign government to establish an airline.
He said that AGPMPN at the time looked into the option that, the sole purpose of the airline could be to courier the human organs collected from the hospitals in Imo State for onward distribution across Europe.
He said the alarm was raised when the three major general hospitals in the state were closed and also there were indications that they would close the private hospitals once the new hospitals become operational. According to him, “they will use any possible disguise of the real motives, from taxation to building standards and even industrial disputes. This is because if the public or private hospitals operate alongside these human organ trafficking centers, they cases could be reviewed by doctors who could alert relatives that organs have been harvested in the deceased or living relative, creating a very high liability for the government and their collaborators.
“The NHAct2014 provides the legal framework to close all Nigerian owned hospitals. The Nigerian hospitals, private, public, mission and Islamic were supposed to be closed down, 24 months from the date the NHAct2014 was signed (31st October, 2014). The closure of the existing Nigerian hospitals is based on NHAct2014, Section 13. Section 13: (1) Without being in possession of a certificate of standards, a person, entity, government or organization shall not :- (a) establish, construct, modify or acquire a health establishment, health agency or health technology; (b) increase the number of beds in, or acquire prescribed health technology at a health establishment or health agency; (c) provide prescribed health services; or (d) continue to operate a health establishment, health agency or health technology after the expiration of 24 months from the date this Bill took effect. (2) The Certificate of Standards referred to in subsection (1) of this section may be obtained by application in prescribed manner from the appropriate body of government where the facility is located. In the case of tertiary institutions the appropriate authority shall be the National Tertiary Health Institutions Standards Committee, acting through the Federal Ministry of Health.
Definition: ‘certificate of standards’ means a certificate under section 13.
“However, the standards include stringent architectural and engineering standards that are not met by current buildings for hospitals in Nigeria. On that basis, no certificate of standards would be issued to Nigerian hospitals, which are not part of the cartel network.
“The foreign organ trafficking cartel has started construction of modern mega-hospitals in Nigeria. The first is in Abuja where the NHAct2014 took immediate effect. This fact was revealed in a meeting with medical professional groups (AGPMPN and others were present) with a leading U.S. medical company that was contracted by an American billionaire businessman to build and equip the hospitals in Nigeria for initial two billion US dollars. The medical professionals present were offered the option of accepting to close down their practices in exchange for money. This proposal was turned down by the Nigerian health organizations present at the meeting in Abuja. The proposed hospitals will be built according to the international building code of hospitals. The certificate of standards for hospital buildings are based on the international building code of hospitals, which has stringent standards of construction that no hospital in Nigeria meets. The plumbing is with conduit, all wiring with conduit, high floor to roof height, wide corridors, wide window width, 24-hour lighting, 24- hour air conditioning, 24-hour water, specific humidity, airflow purification etc. “Similar standards apply for pharmacies and medical diagnostic laboratories. These standards which are difficult to meet even in advanced countries will be even more challenging in Nigeria. But more importantly, they have very minimal effects on health outcomes despite the enormous resources required to comply. For example, the United States’ maternal mortality ratio (MMR) remains worse than that of a developing country like Chile, which is only second to Canada in the Americas”
Njemanze argued Nigeria’s health indices will not improve just because we have a few dozens of ‘five star’ hospitals for human organ trafficking. He said: “However, the NHAct2014 requires strict compliance under Section 13, as a means for foreigners to monopolize the entire health sector.
“The Federal Government suspended the implementation of the NHAct2014 until now. However, what we requested from FG and the National Assembly was a repeal of the Act and its replacement with a new Act in our national interest. As far as the NHAct2014 subsists as law in Nigeria, the cartel will continue to make efforts to actualize the law using a new government if possible. It is also a national security risk, because the cartel would render Nigeria ungovernable through sponsorship of terrorism and acts of extreme violence leading to a fall of any government that, does not endorse the actualization of the NHAct2014. The Nigerian people must take ownership and demand the repeal of the NHAct2014 in its present form.”