In a remarkable display of integrity and courage, Dr. Kara Adams a principal medical officer at the Federal Medical Centre in Bauchi State, has taken a bold stand against entrenched corruption within the institution. 

Dr. Adams, who has served at the medical center for a remarkable 20 years – 8 as a member of the Anticorruption and Transparency Unit of the Independent Corrupt Practices Commission (ICPC) department of the hospital – has exposed numerous fraudulent activities, leading to significant reforms and the recovery of millions of naira in misappropriated funds. His efforts have garnered widespread acclaim from both colleagues and the community, positioning him as an inspiration in the fight against corruption in Nigeria’s healthcare sector. His efforts have seen him rewarded by the hospital for his outstanding integrity and honesty.

In Nigeria, corruption in the healthcare sector is a widespread issue with devastating consequences for patients and society as a whole. From pharmaceutical companies engaging in illegal kickbacks, to healthcare providers falsifying medical records, corruption can erode public trust in the healthcare system. It can also lead to over-prescription of unnecessary medications, and ultimately undermine the quality and safety of healthcare services.

In a 2017 report by the World Health Organization (WHO), It was reported that at least 400 million people have no access to essential health services due to corruption and other related crimes. It also found that 40% of the world’s population lack social protection. 

According to WaterAid, around 4 million people lack access to adequate water, sanitation, and hygiene services, which significantly affects health outcomes and  leads to frequent disease outbreaks such as cholera.

One important aspect of anticorruption efforts is the implementation of robust monitoring and reporting systems, which Dr. Adams has incorporated into the various roles he’s held to aid his relentless fight against corruption and promote transparency in the health sector.

He says the Anti-corruption and Transparency Unit (ATU) is responsible for maintaining order, instilling ethical standards, undertaking investigations and making recommendations for action.

“In the ATU, we ensure the right thing is done in the right way and when complaints are made, undertake investigation and make recommendations for action steps. I have attended several integrity workshops of the ICPC to enable us to function better in an accountable and transparent manner,” he said.

Dr. Adams further revealed that to be a member of the unit, there is a lot of scrutiny as the job of tackling corruption and other related issues demands specific skills and attributes.

“To be a member of the unit, the Medical Director is solely responsible for selecting six persons from different professions at the hospital who he deems to have integrity. The names are submitted to ICPC for ratification and inauguration occurs when persons proposed are not found wanting. The tenure for each member lapses every three years, but based on my performance, I was inaugurated for a second tenure,” he noted.

In 2015, the ACTU of Ken Saro Wiwa Polytechnicin Bori City, Rivers State, investigated a case of staff overpayment of salaries. The unit interviewed 38 members of staff in connection with the case involving N34,329,906.37. At the end of the investigation, a total of 27 staff were found guilt. Sanctions included a mix of dismissals, suspensions and refunds. The unit also recommended that the institution’s payroll system be overhauled to block the loopholes identified by the ACTU in the course of its investigation. This underscores the importance of that unit to public institutions in the country.

Dr. Adams believes that in order to tackle corruption, transparency is essential. Measures such as public disclosure of financial transactions, clinical trials, and medical research can help to deter unethical behavior and ensure that medical decisions are made based on scientific evidence rather than financial incentives.

“It is essential to ensure transparency and accountability in the health  centers, as the primary responsibilities of every department in the hospital differs from one unit to the other. As a doctor, I ensure every patient gets treated satisfactorily. I also check other things to promote transparency and accountability. 

“I check the receipt in the patient’s file to ensure the patients have paid although the revenue officers are there to check. When the patient goes to run the necessary prescribed test, I check the stamp that shows the consultation or test was done within the hospital because on no account should a staff direct a patient to go to a private hospital to run investigations except such facility is not in the hospital as you have cases where some people do that because it’s their own establishment or money paid to them for referral,” he firmly retorted that this practice would reduce the chances of corruption in case the revenue officer missed it. 

The Principal Medical Officer recalled how his team of Anti-corruption and Transparency Unit pursued a case of illegal extortion of patients perpetrated by a staff of the hospital.

“On submitting the report to the management, our recommendation of suspension was dismissed. Rather for the staff to be suspended for a period of time as recommended, the staff was totally dismissed. The unit petitioned the management and officially wrote to them stating their dismissal of or recommendation was not in accordance with the civil service ethics and law”. 

“We pursued this until a new set of management was inaugurated. We reopened the case again with the new management who instructed for a new committee to be set up and the matter reinvestigated. The new committee made the same recommendation as initially submitted and the dismissed staff got reinstated.

“As one tries to enforce ethics of governance, we must also try to keep fighting for what is right and just,” he declared.

Dr. Adams also recalled another scenario where the medical director was petitioned by a staff member due to abuse of office.

“Investigation was carried out and we discovered they had both conducted a transaction with each other that didn’t end well and using his influence, the MD suspended him indefinitely. 

“After investigation, we discovered the offense between both parties did not warrant the punishment melted on the staff. It was a tough fight at the beginning of the case because of who was involved but eventually, we made our recommendation stating this and he was recalled. Both parties were counseled on the matter and their right disclosed to them and needful correction proposed. The MD was counseled accordingly and told the implication of his action and the deviation from the normal civil service rule and it was resolved,”  he added.

It is against this backdrop that the anti-corruption unit carries out  advocacy campaigns regularly to sensitize staff regarding what to do outside their primary work in the interest of the hospital, t, abide by civil service rules and not conduct any misconduct. 

“We stand our ground and ensure we are removed from outside influences because if not, there would be no need for this compliance unit. When a report is submitted to management and a copy sent to ICPC as well, we ensure management follows such recommendations. If for any reason such a recommendation goes wrong, the management only needs to publish the report.

“I have set principles for myself which I abide by. When I get to work, I ensure I see patients based on time of arrival as arranged by the files the attendant gives to me. I ensure I do not see any patient without due process being followed to ensure I give everyone equal rights irrespective of who you are. Even when friends of mine come to get consultation without paying the needful, I refuse as each person must show their card proving payment has been made except in exceptional cases of emergency,” he said.

Confirming his attitude to work, Yakubu Doris Shonto, one of the many patients who had received medical treatment under Adams, praised and confirmed him to be a kind-hearted individual who does his work with a height of humility and integrity.

“Dr. Adams is a kind-hearted man and makes sure he treats his patients well. I have known him for 3 years in which time he has been my doctor. He does his work with humility and integrity,” Yakubu admitted.

Dr. Kara Adam’s dedication to his work and compassionate approach continue to set a high standard in the medical community.

This report is championed by Accountability Lab Nigeria and sponsored by The John D. and Catherine D. MacArthur Foundation and Luminate