States in Nigeria, especially Lagos, seem to be currently experiencing an improving awareness and encouraging statistics around emergency response. Beaming with a very vast experience in Emergency Cardiovascular Care (ECC) and Acute Medical And Trauma Emergencies, the Managing Director and Training Center Co-coordinator of a leading emergency training institute, Cardinal Academy of Emergency Care Ltd, Dr. Busuyi Alabi, is an American Heart Association (AHA) certified instructor for a wide range of ECC courses, he is also an instructor with the Resuscitation Council of Southern Africa (RCSA), registered instructor with Emergency Care and Safety Institute (ECSI), USA, and a member of the Medical and Dental Council of Nigeria (MDCN). He has facilitated over 1000 ECC courses and trained not less than 15,000 first responders in the last 10 years across Nigeria. Dr. Alabi shared immense insights into emergency response issues, challenges and opportunities in Nigeria with the Executive Editor of Impact Watch Network, Akinlabi Hassan.

Excerpts:

IWN: How do you think the current characters, perceptions and values held towards safety is improving considering people’s attitudes to safety in Nigeria in the past, are we currently experiencing an improvement or paradigm shift?

Dr. Alabi: Well, there’s going to be a change and a paradigm shift, as you put it. In the last decade, I have seen improvement in people’s attitude towards safety and emergency response partly due to different players in that field like the American Heart Association, Safety Institute and all of that. In more recent times, we have also seen government intervening in official capacity, for example, the Lagos State Government created the Safety Commission recently which they did not have before and there’s a global interconnectivity of safety enthusiasts. I am aware of a conference, where I was invited as a speaker, that was held in Lagos, and it was an international safety conference and the previous one held in Singapore. So it is becoming a movement. Naturally, human beings were born to be safety conscious but some of the codes that are instructing the society towards safety were shrouded in mixed esoterism. For instance, that you don’t need to go somewhere as there is a demon that will appear to your there and people withdrew. But now the society is civilized and there is industrialization, and mechanization. Those tools that our forefathers were not used to now serve us in many advantageous capacity and also present formidable threats to our existence. So we need to learn them and be aware of specific safety issues they pose. Now we have curriculum, certification that people are doing and there are regulations that are compelling companies now to have safety officers and to be safety conscious. So those things put together are changing the landscape and will continue to do that.

IWN: How do you see key stakeholders supporting these efforts towards paradigm shift, especially the government in terms of enabling laws and policies to support first responders actions?

Dr. Alabi: I know Lagos State is doing better than any other state in the country and they have to because having over 20 million people crowded in a small place, if they downplay safety, we are going to be in trouble. So there are regulations and they have task forces that visit some companies to hold them to some standards. The law is there but the implementation still has some loopholes that they still need to fill. For instance, for schools and school children, we still have some schools that don’t have AEDs, certified first aid trainers, and even first aid boxes, and making it an optional thing. Meanwhile, where we keep our kids and younger ones, even in the interest of the staff, it is not debatable, there must be safety things there. All these are the much that needs to be done in that area and more of the implementation of the extant policies.

IWN: Looking at the challenges that first responders get to face in the cause of assisting accident or incident victims, what are the key measures that need to be put in place to support these efforts?

Dr. Alabi: One of the limitations or challenges is the absence of enabling laws, people are usually hesitant because they want to be sure that they won’t be in trouble for playing the good Samaritan, the good Samaritan law does not exist yet in the country. So we need the good Samaritan law in Nigeria to revolutionalize the disposition of people to emergency response. And again the law enforcement and justice system of the country needs to improve. Like the short story where the elephant was passing by and met an antelope running and he asked: why are you running? And the antelope responded: There is a new law that says that all goats must be arrested and jailed for 20 years. The elephant asked again: but you are not a goat? The antelope replied again: Yes it will take me 20 years to prove that in a Nigerian Law Court. So the elephant also started running. So here police can robe anything on you. When we had this training for a group of Mobile Policemen in Alausa, I was shocked when some of them, off duty, were expressing that they could also be in trouble. So all those things with awareness, have to change. When there is awareness that it is our civic responsibility to be our brother’s keeper and there won’t be a place to hide anymore for people who want to take advantage of that to punish those who are sincerely trying to help others.Another challenge is absence of programs because all of these things are better located in what we call the System of Care and it has different components which include programs. An example of such programs done in other climes is called the PAD, Public Access Defibrilation program where they recommend and put an External Defibrilation Devices (AEDs) in public places, like in Monaco, AEDs are placed at every minute walk. So in such places, if you say: “Activate emergency response and get me an AED”, people already know what to do. But today we have hospitals that don’t even have AEDs yet and then a lot of public places. So such programs should be implemented to put the necessary equipment where they should be. The ambulance system, again, has to be strengthened. This is because ideally, there are lost of cases that are best to be treated as “Stay and Play” rather than “Load and Go”. For instance, if someone has cardiac arrest, it should be “Stay and Play” so what you should do is call emergency response who are expected to have a call-to-response time that is reasonable and while you are expecting them stay there and be doing CPR. But because they haven’t inspired much confidence, you would think it is safer to start moving the victim and once you start loading and going, for a cardiac arrest patient, by the time they get to the hospital, it is always too late, and this is usually classified as brought-in-dead.

IWN: In terms of provision of equipment, facilities and infrastructure, how far have you been able to prompt and engage key stakeholders to have them in place to support emergency response?

Dr. Alabi: We haven’t made much progress in terms of stimulating the authorities, even though we keep nagging at them. But where we have recorded progress is where we had our experiences, most of them are negative experiences, for instance a church that lost a pastor or member due to unavailability of AED, or other places, will then make the decision to provide AED in their premises. Or most of the organizations, like oil and gas sector, who have international stakeholders or who are looking for certain accreditation are more safety-conscious. Hence, they are including them in their demand. So those are the people that are buying more and more into it. But there are more that could be done, in 2010, I was in South Africa during the World Cup football competition, a single individual just like our Dangote here, bought 230 AEDs for the city of Johannesburg to enhance emergency response because he knew a lot of people would be coming into the country from Europe, America and all over the world. He bought this to enhance what the city already had. For some of our big people like Dangote, Otedola, this is one the things they can do as their corporate social responsibility. So in that time they routed their local emergency number in South Africa to 911, so if you re coming from your country, you don’t need to cram the local emergency number, you had to just call your 911.

IWN: How can this awareness be sustainable considering the need to uphold emergency response as part of health-related targets to achieve our SDGs in Nigeria?

Dr. Alabi: We can start by introducing them to some of our institutions as part of school curriculum, as life skills, from secondary schools. There are some countries that have done that very successfully. All the Northern Europe, Scandinavians have implemented CPR in school programmes. Even the NYSC should implement it during the orientation camp and should be a mandatory part of their activities. Also other opportunities we have in religious institutions, mosques, and churches should have seminars for different people.

IWN: What data, statistics or facts on emergency response are currently encouraging in the country?

Dr. Alabi: The encouraging statistics on emergency response in particular is that the number of AEDs is on the rise, the demand for AEDs procurement or purchase that my organization has processed has witnessed unprecedented increase in recent time compared to 10 years ago that when we mentioned it they don’t really know what it means. I think that’s a positive thing and then, we now have private Emergency Medical Services (EMS) systems springing up, like ambulance system and people in estates are now feeling the need to have subscription to ambulance services for emergency response. Also. First responders are also on the increase as well as awareness.

IWN: Considering all these rigorous activities that emergency response entail, how would you describe your typical workday?

Dr. Alabi: Yes, my typical workday is busy. It is either I am running a training or developing new training modules from some of the data we are gathering, or perfecting documentation for some of the trainees that require international certification or meeting stakeholders. So I have a typically busy day that starts 7am and ends at 7pm.

IWN: So in all of these, how do you relax?

Dr. Alabi: Well sometimes during the weekends that I don’t have trainings, I take some time off, we do team-bonding exercises, hangout either with friends or family. My hobbies for relaxation includes listening to music or watching a movie. I love epic movies, historical epics, or fictional epics that show the medieval period, and sword-fighting. I love to see the warriors and their courage in battle and I get inspirations from there.