Workplace Violence Against Health Workers in Nigeria: A Critical Analysis and Legal Implications

Workplace violence is a common phenomenon which cuts across all work settings. Its prevalence is particularly high in the health sector and adversely affect service delivery. However, in Nigeria, it's becoming an epidemic and a rising societal problem that needs urgent attention.
The health workers are people who have taken a vow to save lives so one will wonder why they have become victims of their patient's rage.
Some people may argue that health workers are the cause of violence. In this write up we would see a short analysis of the situation and decide for ourselves on who the true victims are.

An incident occurred on January 9 in Maitama District Hospital, Abuja, where a female doctor was beaten and stripped by relatives of a patient she was treating, was a trend on the social media this year.
Also at the Nnamdi Azikiwe University Teaching Hospital in Nnewi, Anambra State two male doctors on call at the special Care Baby Unit were beaten by a patient's relatives in the wee hours of January 14 this year. This was after the perpetrators lost a newborn baby to neonatal Asphyxia despite adequate resuscitation.

In the course of this discussion, I would like to give a working definition of some terms which includes

• violence: An action intended to cause destruction, pain or suffering to a thing or person.
• Workplace: Any health care facility, whatever the size, location( urban or rural) and the type of service provided.
• Victim: Any person who is the object of acts of violence or violent behaviours.
• Neonatal Asphyxia: The medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm especially to the brain.
• Cannula: A medical tube inserted in the body to drain or inject fluid.

CAUSES OF WORKPLACE VIOLENCE AGAINST HEALTH WORKERS IN NIGERIA
Now the question is what are the causes of workplace violence in Nigeria? Here we would look at it from the health workers side and the patient side.
Possible causes for violence from the health workers side may include

• The System: In Nigeria, dangers arise from exposure to violent individuals combined with the absence of strong violence prevention programs and protective regulations within the hospital. Here we would see a doctor alone in a room with a patient and there is no CCTV camera available or no 'call for danger' alarm just in case help is needed. These factors work to increase violence
• Administration: It's more like doctors now bear the brunt of the failure of Nigeria's health care system. Many times the doctors have to improvise while doing their job because the government have not provided most of the equipment in the hospital. Funny enough the doctors too are victims here! Sometime this month of January a doctor died because there was no cannula(a medical friend told me this tube is just 200naira!!!) in the hospital. So a lot of doctors too die daily due to the failed health care system. Imagine that moment a patient is in the hospital and seriously needs attention but there is no equipment for the doctors to use.
• Shortage of Doctors as against Increase patients. The Nigeria doctors are overwhelmed, we have a ratio of one doctor to about 5000 patients. So If a doctor is seeing more than 1000 patients in a day, how effective do you want them to perform? Most doctors in Nigeria work for 48hours none stop and it's wrong. This can be compared to the U.S. where the ratio is a doctor to 338 people or Qatar ( a north African country) where it's a doctor to 129 patients. What we see here is that even before a patient enters the hospital the doctors are exhausted already. Truth be told is a doctor in this situation will not be as enthusiastic as you would love them too.
• Now from the patient side, the major cause of violence is basically due to the tension of the moment which triggers a lot of psychological and emotional rage. Hence rage and a need to vent the anger of ones lost to another person also contributes to the causes. Here patient's relatives tend to find the doctors guilty for the loss of their loved ones which gives them a justification to inflict violent act on the health workers. Other reasons too may include a mental disorder suffered by the patient or relatives.

  POSSIBLE SOLUTIONS 
What then is the way forward. From the causes mentioned one will notice that most of the causes of violence are factors outside the will of the doctors or health workers. However possible solutions may include.

• Nigeria government needs to increase its budget in the health sector. The health sector deals with lives and what better way to improve on their performance than through the construction of more hospitals.
• Also, more health workers need to be employed in the system, it's just sad to see a hospital with just 5 doctors.
• Hospitals need to have a security-friendly environment and the health workers should be educated on how to make use of it so that they will be protected while doing their job of saving lives.
• Patients too need to be aware that inflicting violence on a health worker won't save the situation.

Whichever way you look at it, no person works well in an environment where his/her safety is not checked. The psychological trauma of violence alone is capable of reducing the performance of health workers.
They save lives and don't deserve to be put in danger while doing so.

THE LEGAL POSITION OF WORKPLACE VIOLENCE 
You might want to think twice before inflicting an act of violence against a health worker.
 Article 1 of the Universal Declaration of Human Rights provides that “all human beings are born equal in dignity and rights. ... This right prohibits any form of degrading treatment or inhuman treatment of another irrespective of tribe, sex, colour, religion or nationality. 
This article is now entrenched in Section 34(1) of the Nigeria Constitution 1999 which provides that “every Nigerian citizen is entitled to respect for the dignity of his person and accordingly (a) No person shall be subjected to torture or to inhuman or degrading treatment. Therefore no person in Nigeria can be subjected to any form of degrading treatment no matter the situation especially when the person is on the verge of saving lives like in the case of health workers 

Also, violence against a health worker can lead to a charge of assault which as provided in the Criminal Code in Section 252 provides 
“A person who strikes, touches, or moves, or otherwise applies force of any kind to the person of another, either directly or indirectly, without his consent, or with his consent, if the consent is obtained by fraud, or who by any bodily act or gesture attempts or threatens to apply force of any kind to the person of another without his consent, in such circumstances that the person making the attempt or threat has actually or apparently, a present ability to effect his purpose, is said to assault that other person, and the act is called an assault.”

 Section 351 of the Criminal Code Act punishes “assault.”It provides thus: “Any person who unlawfully assaults another is guilty of a misdemeanour, and is liable to, if no greater punishment is provided, to imprisonment for one year.

In conclusion, no form of violence can be justified and therefore we should all desist from it.

All Vehicles are Parked at Owner's Risk- Analysing It Effects on Motorist

"All Vehicles are parked at owner's risk" is an inscription that has become a norm in most car parks.

Imagine buying your dream car and on deciding to move around a little, you reach your destination and the next thing is seeing such a signage!!!!! Worse is maybe the car gets stolen and the manager of the hotel or bank denies liability on the basis of the inscription on the symbol. Don't forget this is a brand new car, and hey you went there has a consumer to patronise the hotel or bank. "How would you feel?"

THE LEGAL MEANING OF THE SIGNAGE
Now let's flex our law books small!!
This signage in law is known as Caveat Emptor, it serves as a means of exonerating the hotels, bank, etc for the liability arising from the negligence of their gatekeepers in the event that parked cars are stolen within their premises.
First, in law the act of you parking your car at such premises is called bailment and bailment can simply be said to mean the act of a person called the bailor transferring his possessory right in his goods to another person called the bailee for safe keeping, maintenance, carriage or repairs. The bailee is under an obligation to return same at the appointed period or ensure that the said good is recoverable by the bailor in good condition.
Now in such cases, the law guiding this areas includes the law of Negligence, Bailment, Contract, etc. Now what does the law say about this signage?

WHAT IS THE POSITION OF THE LAW HERE
(Please oo , this is not the normal negligence in English Language)
Negligence is one area of law that is very difficult to prove. Negligence connotes an omission or failure to do something which a reasonable man, under same circumstances would do or doing something which a reasonable man would not do. This was held in Odinake v Moghalu
One day I said to a friend that he did not act as a reasonable man and he said "are you insulting me?"  Lollll. I spent three hours explaining myself. But I will break it down for easy understanding.

Who then is a reasonable man capable of committing Negligence? In U.I.T.H v Adegunde, it was said that a reasonable man mean a person who acts sensibly, does things diligently and takes proper but not excessive precaution.
From these, three elements make up Negligence:
There is a duty of care
The duty was breached
The victim suffered damages
In the case of the car owner, he must prove these three elements exist before he can win a case. As simple as they seem, these elements can be the most difficult thing one can ever prove because of the rules and technicalities guiding it.

What has the court said about this matter?
It is on this basis that the court gave judgement in IMO Concord Hotel Ltd v Justice Kalu Anyah. Here Justice Kalu had gone to Owerri for a book launch and went to Imo Concord Hotel Ltd and booked accommodation for a night. At the gate of the hotel, the security at the gate registered the number plate of Kalu and issued him with a plastic disc number 2. Kalu drove in and parked his car, the next day when he checkout of the hotel , on reaching the parking lot, his car was gone!! He sued the Hotel for the value of the car. The court gave judgement for the hotel. That is the court held that the hotel is not liable because Kalu did not prove that the car was stolen, that is he failed in proving the three elements of Negligence. (Remember when I said it's so difficult to prove).

WHAT ARE THE CONDITIONS UNDER WHICH A CASE LIKE THIS WILL BE SUCCESSFUL
This is almost an impossible burden to prove by the motorist. However where ever there is a law, there is an exception.
The exception to this ridiculous rule and a condition for liability of hotel proprietors, bank mangers, etc was laid in the same case.

To break down the conditions, we say for a motorist to win a case of lost of vehicle in parking lots, the following must be kept. He must:

• Collect the metal/plastic disc at the gate of the hotel
• Park his car within the premises of the hotel
• Notify the security men where the car is parked and
• Hand over the key of the car to the security person on duty.

Where these conditions are met, then the manager of any hotel, bank , etc can not disclaim liability on the basis of "cars parked at owner's risk".

WHAT THEN IS THE REASON FOR THIS CONDITIONS
The rationale given for this is that the hotel itself has its own properties to protect and cannot be said to owe duty of care to motorist or car owners owing to the presence of security men in its premises.
Accordingly, the hotel disc is only to enable the institutions to regulate the number of cars in their premises at any time and if the discs are exhausted, no vehicle are allowed in as that indicates that no more parking spaces are available.
So next time when you go out parking your cars, you know what to do !!!

Do you agree with this position? Or should it be improve to protect the motorist more. Share your thoughts in the comment section.

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Nollywood movies and it's Viewers

CHRONICLES OF NOLLYWOOD MOVIES
So, days ago I watched a Nigerian movie and the scene is that typical one where the director wishes to depicts a pupil as very intelligent. Her private tutor asked her who amalgamated the Northern and Southern protectorate of Nigeria, before I knew it the young beautiful charming young girl who was supposedly very intelligent responded ' Usman Dan Fodio' and the tutor said 'correct clap for yourself'! I was like somebody just switch off something in my brain. I went off!!!

Truth be told, the Nollywood industry has been quite a famous industry in both Nigeria and worldwide and this is the case despite the poor technology cinematography work, the lack of care by the crew members, the fact that the director don't want to spend a penny in producing the movie: like even a plate will not be broken in the shooting of the movie ooo, the stinginess to employ other crew members: here you will see something like Chinua Adekunle is the producer, director and script writer, Chinua Akinlola( the younger brother) is the camera man, editor and costume, and maybe their cousin will be the executive producer! 

Despite all these the movie market seems to grow very well. One wonders which group of Nigerians are watching those movies. In the word's of Chimamanda Adichie ' Nollywood is a perfect example of Nigerians consuming what they produce'.

So basically there are different types of Nigerians base on the Nollywood movies viewers.

1. The first are the ones who don't even mention the word 'Nollywood'. These ones are so angry and have lost all hope when it comes to Nollywood.
2. The second are those who don't watch Nollywood movies but do watch any that becomes a blockbuster. These ones are 'amibo'(gossipers), they can't do without knowing what is trending
3. Thirdly are those who are patiently waiting for Nollywood movies of high quality, the likes of Wedding Party, When Love Happens Again, Isoken, Lotanna, etc. These ones are monitoring spirit, they just keep monitoring till they get what they want.
4. Another group are those that because of lack of subscription to download and maybe no access to channels on their Television are unable to watch other movies so they are just stick with Nollywood movies, I call them stuckers.
5. Also , there are those who take Nollywood as strictly business. They are just enduring it because of the payment, example the actress, actors, crew members. The Labour market is tight oo.
6. Finally are those that will kill for Nollywood movies. These ones astonish me. Their perseverance is alarming and sometimes infuriating. They are core viewers of Nollywood and watch nothing except this.

Deep within my heart I know the group I fall into and so do you. However to focus on the bad side is simply to dispossess Nigeria of its diversity. *Nigeria no dey carry last*. When I look at Nollywood movies, the likes of Lion's Heart, Isoken, Her Excellency, etc. I smile and wipe my tears.

Menstruation Hygiene FOR Young Girls'

Menstruation is not really something our parents want to discuss with us and even if they do, it is always in whispers so that others don't hear of it, and we hear all kinds of myths about it, while some just see the topic as female related and so shouldn't concern them. These misconceptions are what will be tackled in this short write up, so dear readers fasten your seat belt as we are about to drive into the world of' whispers. Menstruation generally also called period is simply when blood and tissue from your uterus comes out of your vagina. It happens every month.

Facts about menstrual cycle.
Menstrual cycle helps the body prepare for pregnancy every month. It also makes you have a period if you are not pregnant. Menstrual cycle is controlled by hormones like estrogen and progesterone.

How it works;
You have two ovaries and each one holds a bunch of eggs (enough to make one million babies!!!) Eggs are super tiny. During the menstrual cycle hormones make the eggs in the ovaries mature, which means it's ready to be fertilized by a sperm cell. This hormones also make the lining of the uterus thick and spongy. So if your egg does get fertilized, it is an ice crush place to land and start a pregnancy. About half way through your menstrual cycle, your hormones tell one of your ovaries to release a
Mature egg, this is called OVULATION.
Most people don't feel it when they ovulate, but some OVULATION symptoms are bloating, spotting, or a little pain in your lower belly that you may only feel on one side. Once the egg leaves the ovary, it travels through the fallopian tube toward the uterus.
If pregnancy doesn't happen, the body doesn't need the thick lining in the uterus. The lining breaks down and the blood nutrients and tissue flow out of the body through vagina. Voila, it's your period!
If pregnancy is not involved, the body needs the lining- that's why menstrual cycle stops during pregnancy. The first period usually begins between 12-15 years of age, appoint in time called menarche. Though it can start as young as 8 years old. The usual length of time between the first day of one's period and the first day of the next is 21-45 days in young women and 21-31 days in adult. Bleeding last for 2-7days.
Menstruation stops occurring after menopause occurs between 45-55 years of age. Also stops during pregnancy and typically doesn't resume during the initial months of breastfeeding. Signs and symptoms include: acne, tender breast, bloating, feeling tired, irritability and mood changes. A lack of period called AMENORRHEA is when periods don't occur by age 15 years or have not occurred in 40days. Some women experience emotional disturbance stating one or two weeks before their period and
Stop on or after the period has started.

MENSTRUAL CRAMPS
Many women experience painful cramps also called DYSMENORRHEA during MENSTRUATION. Painful menstrual cramps that results from an excess of prostaglandins in release called Primary DYSMENORRHEA.
Primary DYSMENORRHEA usually begins within a year or two of menarche, typically with the onset of OVULATION cycles.
For many women primary DYSMENORRHEA gradually subsides in late 2nd generation. Pregnancy also lessen the severity of DYSMENORRHEA when MENSTRUATION resumes. However it can continue until menopause. 5-15% women experience symptoms severe enough to interfere with daily activities.
Secondary DYSMENORRHEA is the diagnosis given when MENSTRUATION pain is secondary cause to another disorder example certain cancer, pelvic infections, etc

MENSTRUAL HEALTH/HYGIENE
This stage is a very vulnerable stage for every woman and so one cannot afford not to keep a good hygiene. Things to do during MENSTRUATION to keep you healthy include; using a good pad. There are several kinds of sanitary pads in Nigeria and so one has to be careful to choose the right kind. However, you can go for the more affordable ones. Also you need to engage in exercise in which case it even serve as pain reliever to some girls especially when done before menstrual cycle ,you can jug, do some body swings e.t.c
Eat good food containing Iron, Folate and vitamin B-12, you need to know that lots of nutrients are contained in the menses and your body need regain them back.You can do this by eating lots of fruits, balanced diets and drink enough water. Keep your environment clean. Be HEALTHY!!!!

MYTH/MISCONCEPTION ABOUT MENSTRUATION
Nigeria as a case study is a country clothed in superstition, which transcends even the educated individuals, so you must have heard of many myth about Menstruation such as; don't let any boy touch you else you will get pregnant, menstrual cramps happens to virgins alone, for menstrual cramp to end for virgins, one must have sex as sex happens to be the pills to take for relief.
At this point you need to be cleared that these things aren't real. So beautiful ladies, if you want to know anything about your health and Menstruation, please do make use of Google, or read your biology textbook for those in senior secondary while the juniors can read basic science or other rich subjects that talk about health. But remember to stay healthy and happy because it is a beautiful thing to experience.

SELF ESTEEM FOR YOUR HEALTH
Menstruation isn't something you should be afraid of or be sad about, it is part of your experience as a woman and is something you should be proud of, so I will leave you with something to live with. Dr Nathaniel Braden, a Psychotherapist and a writer known for his work in the psychology of self-esteem summed it up well, he said Self-esteem has two interrelated components: One is the sense of basic confidence in the face of life's challenges. Second is a sense of being worthy of happiness: self-respect. Self-esteem is therefore the disposition to believe oneself components to cope with the basic challenges of life and to be worthy of happiness.