Examining legislations on medical treatment for victims of gunshots, accidents

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By Ise-Oluwa Ige

In this report, Vanguard’s Law & Human Rights examines the plight of victims of gunshots and accidents in Nigeria in the last half a century and available relevant laws for their medical treatment and care with a stakeholders’ critique of the extant legislations and infers that time is now for medicine, law and criminal justice system to deliberately interrelate for effective enforcement of the constitutional provisions on the sanctity of human life.

Background

On September 20, 2009, a gang of assassins, murdered Mr Bayo Ohu, a 45-year old Assistant News Editor with The Guardian newspaper in his three-bedroom apartment in Egbeda, a Lagos suburb.

On that day, Ohu was just getting set to attend church service after seeing off his wife, Ochuko, and sister-in-law, to the early morning service when the gunmen came knocking on his door at about 6.52 a.m.

According to eye-witnesses, the gang came in a white Toyota Camry saloon car.

As Ohu made for the door to ask who was knocking, the gunmen rained a volley of bullets on him, confirmed him lifeless before leaving the scene with only his laptop and mobile phone handset.

They made no attempt to enter any other apartment in the four-flat house.

However, one of Ohu’s neighbours who rushed to him after the assailants made their exit, noticed that his pulse was still strong, a development which made other neighbours to quickly mobilise to rush him to a nearby private clinic, just three minutes drive from the victim’s residence.

But at the hospital, the staff on duty insisted on a Police Report before any first aid could be administered on him.

When all entreaties to treat him first fell on deaf ears and noticing he was losing much blood, the neighbours, in frustration, headed to the Ikeja General Hospital.

But Ohu did not make it there as doctors pronounced him dead on arrival.

The police, at the time, hinted it was a clear assassination job given the kind of expended bullet cartridges found at the scene of the crime.

Ohu’s life, however, could have been saved were the private hospital workers attended to him as soon as he was brought in for medical attention.

Vanguard reports that even though it is a common knowledge that in trauma or emergency care, if patient receives medical care within 60 minutes of the occurrence of an injury otherwise called the “golden hour” for victims, the probability of survival is high, yet, the workers at the private clinic did not attend to Ohu for fear of police harassment even though the 1999 Constitution specifically provides for the sanctity of human lives.

Ohu eventually died, leaving behind five children: the eldest being 16 years, while the youngest at the time was nine months old, a housewife, who was a part-time student of the Olabisi Onabanjo University, Ago-Iwoye and an aged father.

Bayo Ohu’s case is a classic example of the glaring disconnect between medicine, law and the criminal justice system, an anomaly that had serially claimed many precious lives under similar circumstance in the last half a

Why gunshot victims are not treated by hospitals, healthcare centres

Over time, the need for immediate medical attention for gunshot victims in Nigeria has been shrouded in controversy with divided opinions on what, how and when medical attention should be given to gunshot victims.

Between 1970 and 2017, gunshot victims are routinely rejected by hospitals as a result of the tendency of the police to harass and incriminate medical personnel for commencing treatment without obtaining its clearance.

For almost half a century, the police appear to thrive on the erroneous assumption that every gunshot victim was wounded as a result of engaging in criminal activities.

Ohu’s case is one in a thousand that puts the lie to that assumption.

While it is expected that victims of gunshots are instantly given medical attention irrespective of the reason they were shot in obeisance to the right to life guaranteed by the nation’s constitution , hospitals or healthcare centres unfortunately refuse to treat them.

That was so because the police had issued a directive nationwide banning emergency medical attention for gunshot victims without its prior permission.

The directive itself was issued in furtherance of its efforts to obey the provisions of the Robbery and Firearms (Special Provision) Decree No. 47 of 1970 (now Robbery and Firearms Act, CAP R11 LFN, 2004.

What does Decree 47 of 1970 say about treatment and care for victims of gunshots

According to a lawyer and research fellow at the National Institutefor Legislative and Democratic Studies, Dr Chinedu Ikpeazu, though there was Decree No. 47 of 1970 (now Robbery and Firearms Act, CAP R11 LFN, 2004, requiring medical practitioners to get police report before treating victims of gunshots, the police appeared to have misapplied the law.

Giving background to the promulgation of the law, Ikpeazu explained that with the end of the Nigerian Civil war, armed robbery became a significant phenomenon in the country for more reasons than one including that both the separatist forces and some members of Nigeria`s Armed Forces, especially volunteers and those who were conscripted, had just been disbanded and much of the arms used in prosecuting the war had not been effectively mopped up while the temptation to go into armed robbery increased due to the economic setback and austerity which followed the end of the war as many people lost their means of livelihood and property to the war.

According to her, the Federal Military Government at the time responded by promulgating the Robbery and Firearms (Special Provision) Decree No. 47 of 1970 (now Robbery and Firearms Act, CAP R11 LFN, 2004 in order to deal with the menace.

“Unfortunately, the incidents of robbery were still on the increase, as some perpetrators of the robberies who got wounded would escape and get themselves treated, and resume their terrorization of the citizenry,” she observed, adding that the Government, in order to enable the police to arrest and prosecute wounded armed robbers, amended the Robbery and Firearms (Special Provisions) Decree No. 21 of 1984 in 1986 by inserting a new provision in Section 4(2) of the Decree.

The section provides that “It shall be the duty of any person, hospital, or clinic that admits, treats, or administers any drug to any person suspected of having bullet wounds to immediately report the matter to the police and it shall be an offence punishable under this Act for any person to knowingly house, shelter, or give quarters to any person who has committed an offence under section 1 (2) of this Act.

The law also provides that any person convicted of an offence under subsections (1) and (3) of this section shall be Iiable (a) in the case of an individual, to imprisonment for a term not exceeding five years; and (b) in the case of a hospital or clinic, to a tune of ten thousand naira and in addition, the hospital or clinic shall be closed down.

Ikpeazu said the provisions above represented the pivot which the police used in issuing a directive banning emergency medical attention for gunshot victims without prior police permission when the objective of the Act, was largely to facilitate easy apprehension of criminals carrying gunshot wounds when they seek medical attention.

She argued that many innocent victims of armed robbers, hired assassins, stray bullets and so on had lost their precious lives following the commitment of the Nigeria Police to implement the provisions of the Act.

The birth of Compulsory Treatment and Care for Victims of Gunshot Act 2017

The concerns raised in many fora over the purported misapplication of the provisions of the Robbery and Firearms (Special provision) Act Cap R11 LFN, 2004 by the Nigeria Police gave birth to the Compulsory Treatment and Care for Victims of Gunshot Bill which was assented to law in December 2017 by President Muhammadu Buhari.

Under the new regime, the law provides for the compulsory treatment and care for the victims of gunshots regardless of the reason for which they were shot.

Section 1 of the Compulsory Treatment and Care of Victims of Gunshot Act of 2017 provides that every hospital in Nigeria whether public or private shall accept or receive, for immediate and adequate treatment with or without police clearance, any person with a gunshot wound. The Act further provides that payment shall not be a pre-condition for treatment.

According to the Vice Chairman of Ijebu Ode chapter of the Nigerian Bar Association (NBA), Mr Moruff Balogun, the Act is a regulation enacted to ensure that victims of gunshot wounds receive prompt and adequate medical treatment and care.

The Act aims to protect the rights of individuals who have been injured by firearms and to establish a framework for their access to medical services without unnecessary delays or financial barriers.

Besides the legislation on the compulsory treatment and care for victims of gunshots, Balogun said that Section 20(1) of the National Health Act (2014) signed into law by former President Goodluck Jonathan also provides that “a health care provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason while section 10(4)(z) of the Federal Road Safety Commission (Establishment) Act of 2007 empowers Road Safety officers to arrest and prosecute hospital or medical personnel that rejects accident victims.

But notwithstanding the clusters of legislations on compulsory medical treatment and care for victims of gunshots or accidents, managements of hospitals and health care centres still reject emergency cases who are victims of gunshots or accidents.

Vanguard recalls the case of Ms Greatness Olorunfunmi, a one-chance victim and member of the Yali network in Abuja, who tragically passed away after the Maitama General Hospital allegedly denied her treatment for not providing a police report.

The victim was severely injured after she was thrown out of a vehicle along the Maitama-Kubwa Express by “one chance” robbers on September 26, 2023.

A witness identified as West Robinson, narrated in a video, with the victim lying on the floor, that he and some bystanders had rushed her to the hospital, where she died after she was denied treatment.

Although police reports were prerequisites for treating victims in the past, this was annulled years ago.

The hospital’s action violates the National Health Act, which criminalises the demand for police reports before administering treatments to gunshots or accident victims.

Former President Goodluck Jonathan signed the law in December 2014. It was reviewed into the Compulsory Treatment and Care of Victims of Gunshots Act by his successor, Muhammadu Buhari, in 2017.

Why hospitals still reject victims of gunshots, accidents

According to the Head (Legal Services), Lagos University Teaching Hospital, Barrister Olusesan Olajide, he saidit must be acknowledged that even though the primary responsibility of hospitals and healthcare personnel is to save lives and ameliorate the suffering of their patients, economic considerations are crucial to the survival of healthcare facilities.

“It is common knowledge that in Nigeria, healthcare is mostly settled out-of-pocket as many citizens do not have health insurance. Who settles the bill when victims and their relations fail to do so?This aspect of the challenges associated with emergency medical treatment is not peculiar to Nigeria.  We should also note that under the NHA, for a ‘reasonable cause,’ a hospital may be excused from providing the needed emergency medical treatment.

“Section 64 provides that “reasonable cause” means any extenuating circumstance that prevents the healthcare provider, worker or establishment from providing emergency medical treatment to a person. Thus, the lack of capacity in terms of human and material resources may constitute a reasonable cause and this must be addressed,” he explained.

Source: Vanguard

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