LOOKING FOR YOUNG FERTILE WOMEN
“Not everything in life is for sale, nor should it be” Jerry Brown, Governor of California, USA
I was inspired to write this piece after reading Obi Onochie’s contribution to the Guardian Newspaper’s Rise Youth Speak column on Friday March 14th 2014. The piece titled “What manner of hospitals?” presented a picture of the serious lapses that exist in the healthcare sector in Nigeria due to a weak regulatory health ministry. The presence of a large number of unregulated health providers in the country means that many Nigerians are at the mercy of incompetent medical personnel who continue to sustain national death indices. A clear mandate conferred on the Federal Ministry of Health is to safeguarding the health of the nation primarily through the formulation of policies that promote wellbeing and longevity. That mandate is on paper but the reality is quite different.
The National Health Bill controversy that raged on for the greater part of 2012 to 2013 has resurfaced in 2014. The satirical ‘problem has changed name’ best describes what the proponents of the NHB 2014 have failed to grasp. For those of you with little knowledge of the genesis of this debate, let it suffice to say that a change of numbering from Article 53 to Articles 51, 52 & 53 means very little when the essence of the message remains the same. One would expect our legislators to be concerned that nothing untoward or detrimental to the common good of the citizens of its country enters into law ‘by mistake’. Whether out of laziness or through monetary inducements by interested stakeholders, we cannot excuse the apparently ‘altruistic’ concerns of certain lawmakers that the passing of this bill will be the panacea to all health concerns in Nigeria. I hear you!
I would like to present an argument with the hope that discerning Nigerians will draw the right conclusions and begin to demand for answers. Last year, a young undergraduate of the University of Lagos ended up in the Intensive Care Unit of the University’s teaching hospital. She came in with a distended abdomen caused by her ovaries that had ballooned to ten times their original size. This disorder occurred as a direct reaction to the high levels of hormones administered to stimulate her ovaries to produce dozens of eggs. These eggs were destined to be harvested and sent to an IVF clinic that had requested for egg donations from young women who were kind enough to help other women have children – be part of a miracle and help someone have a family! The incentive offered was N20, 000. As much as this selfless act appears to be, it certainly is a risky gamble to trade in one’s health and fertility for another.
The award-winning 2013 documentary “Eggsploitation” is a must watch. A free viewing took place in my office on a late Friday afternoon, as expected all interested parties were female. As expected the reaction was one of disbelief expressed in familiar terms “It’s not true!” as if expressed denial would wipe out the import of the words and images before them. Briefly, the documentary is an exposé of egg donation and its consequences. The story centred around six young American women who donated their eggs and now live out the consequences everyday of their lives – from a partial stroke to breast cancer, a perforated ovary to an oophorectomy…one will never have biological children of her own. The basic message was about caution. The lack of medical research to follow up on the effect of egg donation on the general health and fertility of these anonymous donors is telling.
Now enter the NHB debate. This is Nigeria. I bet you that the Health ministry will be hard pressed to produce statistics to indicate the exact number of clinics and hospitals in Nigeria. I stand to be corrected. Egg donor clinics can be found in Lagos, Kaduna, Ilorin and in many more cities. Do women donate their eggs at these clinics freely? Are they informed of the risks that this procedure might have on their ability to have children in the future? Are they monitored in the long term to ensure that there is no adverse reaction to the volume of hormones pumped into their systems? Could there be the added danger that masses of young, ignorant and poor women will be coerced into giving up their eggs without due consent? You know better than I what the answers to these questions will be.
Nigeria and the third world as a whole is a virtual minefield for the fertility industry. Our women will not produce enough eggs fast enough to fuel the insatiable demand needed for stem cell research and assisted reproduction. I see a market economy of supply and demand where monetary gain supersedes any humane considerations. I remember the images of those young illiterate women found in the so-called baby factory in Abia State who sold their infants for money. Egg donor programmes will be conducted without ethical informed consent, but on the basis of ‘food for eggs’. Egg-trafficking, organ-trafficking, child-trafficking, women-trafficking…all join!
A February 2011 Report from Global Financial Integrity about Transnational Crime In The Developing World estimates that the illegal organ trade generates profits between $600 million and $1.2 billion per year, India suffered the effects of unregulated organ transplant industry that led to an increasing number of poor peasants losing their vitals (without their consent) to people willing to pay any price to secure an organ. As a result, India’s lawmakers passed the Transplantation of Human Organs Act in 1994 giving clear guidelines regarding authority for removal of human organs, regulation and registration of hospitals, appropriate authority, offences and penalties.
The proposed NHB opens the door to abuses because our legislators have not cared enough to read between the lines, or quite frankly do not care what passes as long as the price is right. Here are the key concerns about the bill as related to the theme of this article. Firstly, articles 48, 51 & 52 contain blanket statements such as the ‘removal of tissue’. Not being qualified, this could represent a spectrum spanning from the insignificant removal of a finger nail to life-threatening actions like the removal of a heart or viable foetus. Read between the lines…this is an opening that could be used to justify a range of unethical practices. Secondly, Article 51 contains a serious ambiguity. It states the prohibition of cloning and all forms of genetic manipulation but then goes further to state otherwise that a prior written approval of the minister is required. The big question is – if the minister gives a written approval, then what? Does the proscription no longer stand? And what happens if the minister is on the payroll of the big international research institutions that need this sort of legitimacy? This Was In The 2013 Bill Which was reworded in the 2014 bill.
As strictly regulatory laws exist in Europe and in the United States have made certain experiments and procedures difficult to perform, these international pharmaceutical companies have relocated to developing countries where governments have little or no legislation and law enforcement structures in place to protect women and bring under control the unethical practice of trafficking in human embryos, tissues and in vitro fertilization as required by the Helsinki Declaration. Africa is currently the world’s largest exporter of embryonic stem cells. In 2004, South Africa became the first African nation country to set up a stem cell bank and hence created a new economic sector – stem cell tourism. Meissner-Roloff and Pepper in their 2013 research article titled ‘Curbing stem cell tourism in South Africa’ published in the Applied & Translational Genomics Journal expressed concern about this development citing RSA as a virtual haven of un-regulation, limited knowledge about the scientific concepts involved in stem cell research and in particular, the vulnerability of the subjects.
Poverty and loopholes in legislation contribute to the illegal transatlantic trafficking in human eggs, embryos, cloning and embryonic stem cell research. With the health and wellbeing of our citizens on a balance, we need to show more active concern. No one will love us for ourselves. We need to learn to re-love and respect ourselves, our children and our neigbours. May God forbid that we as a nation collectively sign away our children, our organs, our tissue for the sake of money…where are we headed? The egg donor programmes are conducted without ethical informed consent, but on the basis of ‘food for eggs’, targeting the most vulnerable in society. Most donors are not even aware of the health risks involved in subjecting themselves to such a procedure. The recent protest march to condemn the abduction of school girls by the Boko Haram group in the North was a sign that the winds of change are slowly blowing over our collective sense of kinship. Small steps have become giant leaps in other areas of human endeavour. Let us show more concern for the current debate about the National Health Bill that has drawn so much attention. Lend your voice and resist any attempt to further undermine and degrade our human dignity.