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Pulse Blogger Lagos Molue and the ‘procrustean physician’ palaver

Lately, I have had cause to use Lagos most [in]famous city bus called molue on several occasions.

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Lagos Molue and the ‘procrustean physician’ palaver play

Lagos Molue and the ‘procrustean physician’ palaver

Lately, I have had cause to use Lagos most [in]famous city bus called molue on several occasions. There is something about the bus that makes it one of the real faces of Lagos city life.

Riding on it presents fascinating tides of drama that can be often hilarious but also fatiguing with sights of bustles and hustles. One thing is sure, like the busy honey hives that can be likened to Lagos city life itself, a ride in a molue has no dull moments. From the point of getting on the bus to where one is to disembark, one is sure of full entertainment.

The first point of call with a molue brings you head-on with the bus conductors who always seem to bubble with untold energy as if there is a live wire conducting some form of live currents through them.

These lovely people seem to always appear in similar fashion – they wear long faces with dazzling frown like a burning burner and have coax voices drooling names of places their buses are intended to go through often to a point that a potential passenger is left confused as to the directions their buses are intended. For me, figuring out which of the buses to use requires double-checking with either the conductors or fellow commuters:

‘Mile 2 right?’, ‘yes, enter with your change-ooh’.

Before the last word expires from his mouth, you would have found yourself being pushed along with others streaming onto the bus through the narrow passage/thoroughfare to find yourself a ‘space’.

That ‘space’ could either be on a seat or among the crowded passengers standing along the central aisle or along the other two leading to the two exits. The level of congestion in a molue has been well captured by Fela Anikulapo Kuti, the iconic Nigerian artist cum activist.

In his Afrobeat hit titled: “Suffering and Smiling”. Fela describes molues as having “44 [passengers] sitting, 99 standing; suffering and smiling….” Among those standing, hardly is there a differentiated distance of privacy maintained.

Who cares? Whether the person next to you oozes scents that almost wants you to convulse or not, the larger interest of getting to your destination at a cheaper cost is enough to keep you gallant through the huddle. This culture of enduring discomfort, including sharing a congested space, is another reason why molue is a real face of Lagos.

During one of my molue adventures, I once heard a story about a certain man who was positioned standing behind a curvy lady, the kind that often leaves the eyes piercing with desires.

The man was thrown into cloud nine by the elegance of curves and textures of the lady whose skin is as fine as the sand dunes. In no time, his rod gave way to a long stretch that soon culminated in a loud cry of tears pouring out fumes.

Once the woman realised what power had gone out of her, she turned and landed the young man a hot slap (you know the type that leaves the ear hearing wee sounds as if there is a siren blowing right inside the ear). Taken aback by the woman’s action, other passengers asked why she did what she did. The woman pointed to the man’s downstream sector which lays out self-evidential proof that says: ‘guilty as charged’. Poor man!

There is another set of people that cause me concern whenever I use the molue. These people epitomise for me, the famous Greek mythology of Procrustes, a certain robber who operates his scheme somewhere in Attica, a neighbourhood of Eleusis in ancient Greece.

In his operation, he owns an iron bed whose length never fits anyone. Procrustes, also known as Procoptas would compel his guests to lie on it. If a guest is shorter than the bed, he/she is stretched by a hammer so that he/she can fit into the bed. If the guest is longer than the bed, Procrustes would make the victim short by chopping off the legs to fit in the bed.

In either case, the victim would suffer severe hurts and eventual death which give Procrustes free hand to possess his victim’s possessions. It is from this myth that human history has the proverbial ‘procrustean bed’. Procrustean bed as a concept describes any arbitrary attempt to ‘force someone or something to fit into an unnatural scheme or pattern’.

The Procrusteses of Lagos molue are usually found on the left-hand side of the aisle which has three-passenger-seats on a row. Often, they take the third row from the front so that they can be seen by most passengers.

With a mounted microphone over their head that is attached to a small speaker hanging down from the roof of the bus, they lash out their forceful words to compel their guests to ‘fit in’ well into their many ‘beds’. Unlike Procrustes though, their beds come in different forms but are of the genre of medicine (sometimes you find religious ‘beds’ too).

In my last encounter from Oshodi to Mile 2, our Procrustes was offering a certain Nu-Beta, an acclaimed liquid calcium as a solution to all human medical conditions. From perennial headaches to joint aches, toilet infections and fertility problems; all of them were coerced into a box of problems that the tablet can solve.

And like my other encounters, libido problems was given a special treatment (it might interest you to know that the story I narrated earlier was told by one of the Procrusteses during an operation). Here is one version of the man’s jingles which I have tried to recreate:

Oga mi, you de hear! Ehem, if you dey here wey you no fit last on your woman, na your solution be this. This medicine go make you de karakaka sotey na your woman go de beg say e don do mi ooh.

As far as our Procrustes is concerned, there is no limit as to what Nu-Beta can do. In other words, all kinds of health issues that the passengers have were either stretched or shortened to fit into the problems that the medicine can solve. You would not believe the many people whose possessions were dispossessed by the whimsical whip of the molue Procrustes. 

Come to think of this modern Procrustean trend, it is not peculiar to experiences on a bus alone nor is it an exclusively Lagos feature. Motor parks, market squares and streets across Nigeria are constant witnesses to Procrusteses going about their business unchallenged. I am of the opinion that the goodwill they enjoy, which makes their businesses to thrive, is a function of decay in our health sector as reflected by poor health management regimes.

For many Nigerians, access to standard health care services is an illusory or a luxury that they can hardly afford. One explanation for this is that there is not enough health centres to carter for our ‘oversized’ population, and the ones available are grossly equipped humanly and infrastructure wise to offer needed services.

For instance, a study by World Health Organisation (WHO) Regional Office for Africa in 2004 titled: Country System Profiles, Nigeria reported that Nigeria has a total of 23,640 health facilities comprising Primary (including health posts, clinics and centres), Secondary and Tertiary Health Care facilities in 2000. Of this number, 61.8% were public while 38.1% belong to the private.

When one considers that as at then, Nigeria’s population estimate was already over 135 million, the case of low density of facilities relative to population becomes glaring. Of course, this does not mean that health facilities are evenly distributed across the federation.

In terms of human resources in the health sector, some reports have often rated Nigeria highly in comparison to only Egypt and South Africa in the African continent. However, Needs Assessment of The Nigerian Health Sector by International Organisation for Migration (IOM) in May 2014 reveals that such reports underestimate the challenges in Nigeria’s health sector.

According to Dr Elizabeth Omoluabi, the author of the study, Nigeria’s stock of practising physicians is 30, 232 doctors (by 31 December, 2013). Consequently, the density of physicians is 0.17 doctors to 1,000 population which ranks Nigeria among the lowest in Africa with an unfavourable comparison with South Africa (5.5).

This is close to WHO‘s conclusion on Nigeria’s health sector that the country “has densities of nurses, midwives and doctors that are still too low to effectively deliver essential health services (1.95 per 1,000)”.

Considering the foregoing, it is no surprise that latest report on Monitoring Health for the Sustainable Development Goals (SDGs) released by WHO in 2016 should indicates that Nigeria has the sixth lowest proportion of births attended by skilled health personnel (35%) between 2006 and 2014 in Africa.

This is in contrast to performances of countries like Botswana (100%), Mauritius (100%), Seychelles (99%), Algeria (97%) and Congo (94%), the top five in the continent. In view of this finding, one can understand why lots of Nigerians consider patronising alternative health practices including unwittingly submitting themselves to the hospitality of Procrustean physicians.

The distribution of available human resources in health sector is grossly inefficient and insufficient to serve the health needs of the nation.

There is also the concern that medical services offered by mainstream medical units are at unbearable costs to most people especially, for the low income earners who constitute a majority in Nigeria’s demography. The costs are extended beyond monetary terms to also include bureaucratic red-tapes, especially with public health care centres.

Let me narrate one of my experiences in this regard. Sometimes in March 2005, I went to Lagos State University Teaching Hospital (LASUTH) at Ikeja in company of my uncle for a serious eye complaint.

After going through rigorous processes of getting cards ‘here’ and paying fees ‘there’, we finally queued behind hundreds of others to see an eye specialist. When it finally reached my turn and I was ushered in, the specialist only looked into my eyes with a help of ‘torchlight’ and simply scribbled something on my card that says, ‘return back on February 20 2006’.

I was bewildered and angry that nearly three hours (not counting the hours spent in transit from Ajegunle-Ilo at the far end of Lagos-Abeokota express road from where we had come to the hospital) was spent without getting any proper help. At the end, my uncle and I had to go elsewhere – a privately owned eye clinic in Ikeja – to get the needed service; and of course, at a high cost.

One reason why the monetary cost of quality medical care is a challenge for many Nigerians is because most payment for health services are made out-of-pocket.

In fact, it is in record that Nigeria has one of the highest out-of-pocket health expenditure in the world. According to a World Bank data of 2016, of total private health expenditure in Nigeria in 1995, out-of-pocket health expenditure was 94.6%.

Other than reducing overtime, in 2014 it slightly increased by 1.1%. In a related study, P.G. Oyibo argues that reliance on out-of-pocket payment for medical services makes it difficult for people to access medical care during financial difficulties.

As an alternative, most people resolve to self-medication, while some delay seeking health care, patronise herbalists or ignore their health problems entirely. To these classes of people therefore, molue procrustean physicians and their sugar-coated marketing gimmicks are cheap handy help.

I think the public needs to know the danger that these procrustean self-made physicians pose. Aside the general knowledge that self-medication is open to drug abuse, I bet that most times, people end up getting wrong medication for a particular medical conditions with wrong guidelines as to the manner in which it is to be administered. There is also that awful awareness that fake drugs are among the collections exchanging hands in our communities.

Against this trend, some level of policy actions with punitive measures on the side of erring individuals and corrective measures to put aright our health sector are needed. Of the latter, any of those measures should include a holistic medical plan that can put low income earners (both in formal and informal sectors) on medical insurance cover to militate against the difficulty of accessing health services as a result of economic hardship. To do thisI believe that if the political will is there, this is possible. As for our molue, it is just another necessary evil in Nigeria’s biggest city transport system and I do not see it going away anytime soon.

Written by Okoliko Dominic Ayegba

Dominic is a social critics, a poet, and an essayist with works published on Words Rhymes and Rhythm, Nigeria News24, Poemhunters and others. He writes from Lagos, Nigeria.

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