To check how serious Cross River state was about screening for COVID-19, especially as the state is the only one in the federation without a single case, Taiwo Adebulu of The Cable disguises as a patient with a risky travel history and suspicious symptoms. He narrates his experience with the doctors, nurses and the test team in this undercover adventure.
Crossing Itu bridge, which marks the boundary between Cross River and Akwa Ibom states, is like a camel passing through the eye of a needle. Vehicles from Uyo, the Akwa Ibom capital, don’t go beyond the bridge. All passengers have to alight before the military checkpoint and pay their way through. While Ben Ayade, governor of Cross River, claimed he spends nights at the state’s borders as part of efforts to prevent COVID-19 from entering the state, the same location becomes a flourishing industry during daytime as security operatives and thugs cash out at the expense of travellers.
“So, why didn’t you stay in your state when you know you don’t have money to pay to cross the bridge? Did we force you to come?” a young man with bloodshot eyes asked as he scanned me viciously from head to toe.
The security officials and thugs who mounted roadblocks demanded N500 for each person to pass through. With N1,500, I scaled the border checks and proceeded to the busy motor park after the bridge. Ifiok, the motorcyclist who ferried me through the bridge, said the security officials charge each of them N3,000 daily to operate across the border. The bus I boarded from the spot where Ifiok dropped me was filled to the brim with 18 passengers in addition to the driver and his assistant. Some passengers dropped their face masks to the chin to breathe well as the rickety white bus shrieked its way to Calabar.
After a three-day tortuous journey from Lagos, I finally got to the state capital, a thriving city which appeared tucked away from all the troubles of the world. More vehicles trooped in from the boundary and discharged passengers at Essien Town at the entrance to the city. Businesses were booming, sedan taxis loaded with five passengers crisscrossed the city, while praise and worship beamed from a nearby church at Satellite Town close to the university. It was already seven days after the governor lifted the ban on religious gatherings to keep the “spiritual economy” thriving.
As it stands, Cross River is the only state in the country without a confirmed positive case of COVID-19 since the novel virus hit the country in February. According to the situation report of the Nigeria Centre for Disease Control (NCDC) for May 18, 2020, the south-south state had only tested seven samples out of its almost four million population, while neighbouring states have recorded cases and are battling community transmission.
‘I AM SCARED. EVERYONE IS SCARED’
What’s the secret behind Cross River being free of the disease? To find out, I disguised as a patient. As early as 9am, I was among a few of the patients who arrived the general outpatient clinic (GOPC) of family medicine department at the University of Calabar Teaching Hospital (UCTH) – just a few days after two nurses died from suspected symptoms at the hospital. There was palpable anxiety in the air.
“Please, do not remove your masks while talking to me. I can hear you from here,” an elderly nurse told patients sitting at the lobby. The nurse directed me to the payment point where I paid N2,600 as a new patient and I got registered immediately.
When I was ushered in for consultation, I sat on the chair quite distant from the young female doctor. She adjusted her face mask and pulled the booklets closer to listen to me. I complained about chronic headache and involuntary writhing movements on my left hand. The doctor asked if I was coughing or having shortness of breath, fever, nausea, sore throat and loss of taste or smell, symptoms of COVID-19. I answered in the negative. After a series of questions and answers about my habits, diets and activities, she said I might need to work on my eating habit and observe some safe health measures.
Then, I asked if I could get tested for COVID-19 because I was also feeling weak. I told her that I had travelled to the state from Lagos, through Uyo. She adjusted her seat and asked more intense questions and this time around, I shuttled between “Yes and No” as much as it could raise suspicion. The doctor said she was going to call the state epidemiologist and asked me to go for a malaria test first.
At that point, the doctor, whom I later learnt was Rosa Inyang, felt unsettled as she was sliding through contacts on her phone. I asked if she was scared. “Yes, I am scared. Everyone is scared,” Inyang said. “Our state has not recorded any COVID-19 case and if you have such a travel history to a flashpoint and you are insisting on COVID-19 test, it is enough to be scared. We don’t know when an index case will be recorded yet. At least, you are honest with your travel history and symptoms. So, we know how to handle this professionally and see the outcome. Some patients would come here and hide their history and end up making us live in fear.”
When my test result came back, I had malaria. The doctor asked me to wait for the state epidemiologist team who were already on their way to test me. It was a few minutes after 10am.
FIVE HOURS WAITING FOR COVID-19 TEAM
For the next few hours, Inyang checked on me repeatedly that the state team was on their way. It was 4pm and the medical officials at the GOPC had started going home. The doctor kept calling that state COVID-19 team until she got tired and went home leaving me in the empty GOPC.
While the department was virtually empty, I left UCTH. A few minutes later, the state team called me that they were around for the test. I returned to the teaching hospital. I met a man and two women who asked me a myriad of questions and collected my details.
The man later changed to the PPE suit and began the process for the testing. In about 20 minutes, he was done with the test. The women advised me to go into self-isolation pending the outcome of my result. When I asked when my result will be ready, they said it would come out in two days. So, we departed and I began another long wait for the COVID-19 test result.
CONTROVERSY ON DEATH OF TWO NURSES IN ONE WEEK AT UCTH
While I waited inside the GOPD, I familiarised myself with one of the female nurses who said I was lucky to get tested.
“You are very lucky to have detected your symptoms on time and insist on having the test. If not, they won’t come here,” she said.
“We have had patients who came here exhibiting symptoms of the disease. We will call the state team for hours and they won’t come until the patient gets tired and leaves. Most of the time, they say the patient has not exhibited the symptoms. The doctors had to complain that the state should not be the one taking the test until the NCDC team came and took over. Two of our colleagues have died within this week and they exhibited strong symptoms of COVID-19. These are people we saw with our eyes and knew the symptoms they exhibited. One was a member of staff and the other came from the general hospital.
“But when their post-mortem test results came out, we were all surprised they said negative. We don’t know what is happening. We are all scared. We are trying to be careful with each patient we manage here. Your case is the first time we will call them and they actually came.”
MEDICAL COMMUNITY IN DOUBT
In an interview with Agam Ayuk, the state chairman of the Nigerian Medical Association (NMA), he said the association has not established any evidence of a cover-up by the government, although there are suspicions that there could be cases of infection in the state.
“As it stands, we don’t have any recorded confirmed case even though the medical community still has their own doubts. The level of testing is quite low. We think there should be an upscaling of surveillance and testing. We’ve complained about delays from the state epidemiologist team,” Ayuk said.
“We have had incidences of people who meet certain signs and symptoms of suspected COVID-19 and the results, from we have heard, are negative. As medical experts, we believe that sometimes we may have false-negative results. Those are possibilities in testing. But the PCR reduces that possibility to the bare minimum.
“If I have any evidence of a cover-up by the state, I will make it public. We have a lot to lose especially putting our members at risk. We’ve drawn government’s attention to the fears of our members and we expect them to do what is right. We have members who have risk factors.”
‘WE WANT TO REMAIN COVID-19 FREE’
Inyang has been in constant touch to know my COVID-19 status so that she can also know her fate but the state epidemiology team has not communicated with me a week after they took my sample. This has fuelled suspicion among medical workers in the state. Maybe tests are not really done after samples are collected — just to maintain the “zero case” status.
When TheCable contacted Beta Edu, commissioner for health and chairperson of the state COVID-19 response team, she said the state has been performing its role effectively.
She said the team is not responsible for the delayed result of the reporter.
“All results have been sent to the hospital management. We do not publish people’s names in the media. It’s against medical ethics,” she said.
“The late nurses’ samples were sent to NCDC reference lab and results returned negative. We don’t own an accredited laboratory in the state, unless you are saying the lab results from NCDC are not true. This is over two weeks and all persons who came in contact with them including family members are all hale and hearty. Coronavirus is like pregnancy it doesn’t hide.
“We must avoid rumors and scare. It has made health workers in most states to abandon their duty post and even Association of Resident Doctors is threatening strike because of lack of PPE amongst other things. More persons are dying from other diseases and things like maternal mortality that kills over 3000 daily.
“Due to scare and the way we have magnified the disease, health workers will neglect more patients across the country that will lead to death of patients (I am glad the nurse was not neglected). We must at this point change strategy of reading out big numbers daily and supports states to get the health system to become functional or we will destroy fragile the health system more.”
Speaking on the activities of security officials and thugs who demand bribes from travellers at the borders, Christian Eta, chief press secretary to the governor, said the government is not aware of the development.
He said the government would do anything to police its borders in order to avoid the spread of the infection into the state.
“I’m not aware of incidences of that nature. It has not been brought to our notice. There is a presidential directive banning inter-state movement. How did those people get to Itu bridge? That’s a fundamental question. They said no movement. So, how did they get there?” he asked.
“We gave the responsibility of overseeing the closure of the borders to some of our commissioners. Two commissioners take the turn to superintend over the closure of that Itu bridge, both night and day. We have over 50 illegal borders with Cameroon, so we are spending a lot of money and resources manning those places. At this point in time, Cross River is COVID-19 free and we want to remain that way. We will do anything to police our border and we will do that within the ambit of the law.”
One week after my test, I am yet to get the result.
This is a special investigative project by Cable Newspaper Journalism Foundation (CNJF) in partnership with TheCable, supported by the MacArthur Foundation. Published materials are not views of the MacArthur Foundation.
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