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11.04.2010 Nigeria

Medico-Legal & Sociology of Yar’Adua’s Illness

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Health is defined as not only the absence of disease but also a state of mental, physical, psychological and spiritual wellbeing, according to the World Health Organisation. It is public knowledge now that Nigeria's elected President, Umaru Musa Yar A'dua has been indisposed for sometime and he has sought medical intervention severally outside the shores of Nigeria. Anyone, no matter how highly placed can be a victim of ill health at anytime, but the difference here is that we have the most senior public officer of a nation in chronic state of health.

Nigerian have been denied access to information or report of the true state of health of Yar Adua, not because Nigerians have not bothered to know or no effort have been made in that direction, but simply by careless, illegal and irresponsible game of power play and intrigue which has now reduced to the barest minimum the sympathy that should have been enjoyed by our ailing president to common speculation, innuendoes and ridicule. Some people who believed that they love the President more than Nigerians who elected him are culpable of this obnoxious state of affairs.

Since his alleged returned to the country under the cover of darkness on the 24th February 2010, he has not been seen or heard and every effort by the government he led to see him have been rebuffed by his wife, Turai Yar Adua. I would not think that the President who has served Nigeria and Nigerians so much when his health allowed him would have consented voluntarily to this kind of occultic sequestration from the public. His record of service to Nigeria is enviable, first as a governor and then the president, so Nigerian would want to sympathise with him, pray for him and provide for him.

Rather than being given that chance by the people closest to him, we have been fed with lies and deceitful information. This is a hostage situation we have on our hands in Nigeria. It is simply a crime to hold someone against his wishes when no conviction has been made by a court of law. Really, this scenario shows the weakness or lacuna of our laws and the unevenness of its application. If we were to apply the English Law, UMYA has lost his capacity under the Mental Capacity Act 2005, he cannot make informed decision any longer. By this it means he would not pass the basic capacity test i.e. under the provision of the Act, a person is unable to make a decision for himself if he is unable— (a) to understand the information relevant to the decision, (b) to retain that information, (c) to use or weigh that information as part of the process of making the decision, or (d) to communicate his decision (whether by talking, using sign language or any other means).

For UMYA to have been uncommunicative over the last 4 months, it is indicative that, his level of incapacity is most arguably permanent. This is the test that should be administered to the President in his sick state to determine this, but the failure of any government official to see him due to the intransigence of his wife, has prevented this happening. For the purposes of this Act, a person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain.

(2) It does not matter whether the impairment or disturbance is permanent or temporary.

(3) A lack of capacity cannot be established merely by reference to— (a) a person's age or appearance, or (b) a condition of his, or an aspect of his behaviour, which might lead others to make unjustified assumptions about his capacity.

In situations like this, being a public figure, and Nigerian President, whatever is done for the him should be done on the basis of best interest principles to safeguard the interest and welfare of the sick person. The EXCOF should be well advised and proactive about this and should not be seen to be negligent or bereft of common sense principles in these circumstances. They need to arrange for this assessment and make a formal declaration of this and then arrange for a lasting power of attorney to look after his affairs, both personal and financial welfare to safeguard him against abuse of any kind such as what we are seeing now, by the so called handlers.

I think, Nigeria, particularly our leaders are failing our President now at his most hours of need. The cost of inaction is greater and it is setting a very bad precedent for our nation. Nigeria govt is guilty of neglect although some may argue that Turai has prevented any meaningful action in this regard, but again in reality there is an aspect of the law that caters for this kind of situation. Turai can be removed as the nearest relative or next of kin, in the best interest of the sick, so that the best intervention of care can be provided for him without any prejudice or sentiment. It is obvious that the

First Lady is in denial and in a state of shock affecting her ability to make rational judgement or decision on what is the best interest of UMYA. This is expected given the sudden role transition i.e. from a powerful First Lady to a carer in a 'hospice' looking after a terminally ill relative with unexpectedly prolonged illness. There is the social aspect of health that states that when a member of a family and particularly, a breadwinner is infirmed in a family system, there is a collateral and induced illness in the other family members.

So she is really going through serious adjustment disorder with possible depressive reaction, the signs are very clear in the way and manner she has taken this whole matter. Nigeria did not wish her evil, but really given normal circumstances, Nigerians would want to console her and support her at these hours of great personal difficulties.

The current scenario is an attestation to the obvious gap in our legal framework or perhaps, the failure of implementation of our law. The new EXCOF have a responsibility to act in the best interest of the country and more so, in the best interest of the sick President within the confines of the laid down principle that governs situation of chronic incapacitating health.

I have written before on the sociology of illness...

Dr Olayiwola Ajileye

Media and Publicity Coordinator

Champions for Nigeria

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