With the payment of N10, 000, sixty-six year-old Esther Ojo (purportedly a living person) who is diabetic and hypertensive, was declared dead. The irony of it was that Ojo’s body was not seen by the doctor whose signature and name was scribbled at the bottom of a death certificate which our correspondent went undercover to procure.
Our correspondent whose mission was to expose the cartel of death certificate merchants and poor process associated with the issuance of such certificates in hospitals presented Ojo as her relative who passed away last week.
Three men sat discussing at the entrance of a popular general hospital in the Surulere area of Lagos State on September 7, 2022 as our correspondent approached the facility. Two of them were clad in the uniform of the hospital’s guards while the third person was presumed to be their friend based on his energetic involvement in the discussion.
Our correspondent spoke to one of the guards, requesting a direction to the office in charge of issuing death certificates.
The man stood up, asked our correspondent to wait for a few minutes, walked a few metres and returned with an average height, dark-skinned man who wore a blue shirt.
The newcomer led our correspondent to a bench placed outside a roofed shed near a tree on the hospital premises. The man, later identified only as Wale, made a phone call before asking our correspondent, “What do you want to use it for?” The question exposed Wale as someone who’s not new to the business.
The answer to his question generated more questions such as where the corpse was and what led to the death.
He became calm when told that the presumed relative died at home and the certificate was needed to transport the corpse to her hometown in Oyo State for burial.
Feigning helplessness and sadness over the alleged loss, our correspondent requested the financial cost for the process.
Wale responded, “It is N10,000. If you want to pay it now, I will get the details. What I will need is the person’s full name. You know the full name of the person, right? So it is N10,000.” He added that the document would be issued the same day.
He then requested our correspondent to come along with him to a different location he described as “more comfortable.”
The location was outside the hospital; a gated relaxation spot a few meters from the hospital.
Properly placing two of the chairs to face a table, Wale sat on one and requested our correspondent to sit beside him.
He asked for a paper and pen to write the details of the “dead person” and when told there was neither pen nor a paper, he stood up to get both at a nearby store.
Returning with a piece of paper, he reiterated that the fee was N10,000 and the document would be available in a few minutes.
After the required details were provided and the fee paid, Wale hurriedly tucked both money and paper in his pocket and walked briskly to an undisclosed location on the hospital premises.
Seven minutes later, Wale returned with a death certificate properly filled in blue ink, with a doctor’s name and stamp of the General Hospital, Lagos State.
As he handed over the document to our correspondent, he advised that it should be concealed from prying eyes.
Asked if the document was genuine and valid for official dealings, he asserted, “Yes na.’’
Within 30 minutes, a death certificate was issued for Esther Ojo; a pseudonym generated for a supposed living being presented as dead to expose activities of death certificate merchants.
Dead, yet alive
In the second quarter, the National Pension Commission reported that only 10,541 firms complied with the statutory laws in pension and insurance covers.
As a result, the organisations remitted N59.39bn into the Retirement Savings Accounts of employees.
PenComm further stated that in March, the total assets of the Contributory Pension Scheme stood at N13.88tn.
The PUNCH however reported in August that PenComm vowed to go tough on retirees, workers and relatives who fake their deaths and that of their loved ones to obtain the death benefit payment.
The commission stated that apart from other documents needed for verification, it would begin to ask banks to permanently close the account of persons said to be deceased.
The Head, Benefits and Insurance Department, PenCom, Obiora Ibeziako, said, “Nigerians have been dying and resurrecting. If you send us a notification that you are dead, we will make sure that your bank blocks your account also.
“We have seen people fake their own deaths; we have seen spouses fake the deaths of their partners when the PFAs start the due process. In fact, in a particular case, they were processing a man’s death benefit and he walked in and everybody picked up. The wife had actually procured an obituary announcement, everything that required to be done without the man knowing.”
He also cited the case of a man who faked his death and responded in the affirmative that he arranged his death so he could get the death benefit package his next of kin or relative was supposed to receive.
PenCom further stated that it had received complaints from retirees who stated that their pension fund was being paid into the account of their next-of kin or beneficiaries while they were still alive.
In 2018, PenCom had also stated that some fraudulent persons, after providing fake documents such as death certificates, collected the pension benefits of living workers.
Also, on July 1, Bloomberg reported that gangs were fake-killing people in India for insurance payouts.
In the report, a life insurance investigator visited the house of a lady with a payout claim, passport photo and a death certificate. Interestingly, the documents had the details of the lady he met at the door. Asked if she knew the name on the death certificate, she responded, “I am Amina. I am, in fact, alive.”
Apart from the easy ways vital documents can be obtained in Nigeria without a painstaking process, the cartels involved in such dubious activities also ensure forgery of almost everything from bank statements, certificates to sundry documents.
Another easy access
After leaving the general hospital, our correspondent headed to a federal hospital tucked in the Mushin area of Lagos State. Our correspondent joined the sea of visitors who thronged the hospital.
After passing through several turns and bends on the road, the path led to a staff and cooperative club of the institution. Further down the road before a T junction is a spot dubbed, Oxygen.
On the edge of what appeared like a generator house sat two men dressed in a green leaf patterned native wear and his partner who wore a white T-shirt and black denim.
The first man responded to our correspondent’s greetings and inquiry on where to get a death certificate.
He said, “What do you need it for? Some people request the document to claim money from the bank and to get a pension.” His response also indicated he was not a newbie in the illegal trade.
He added, “The only way to get that document in this hospital is if the person died here. A doctor will be the one to confirm if the person is dead and then issue the certificate.”
After his explanations, he, however, asked our correspondent to wait while he made a phone call to someone. His intervention soothed our correspondent’s skin like balmy wind from the seaside despite the scorching sun’s aggression.
In Yoruba, he said to an unnamed person on the phone, “Someone is here who needs to get a death certificate. They said the person died at home and needs it for burial.”
He assured that the person to assist in facilitating the document was a few metres away and would join us shortly.
During the waiting time, our correspondent, still acting as a perplexed relative, inquired from him if the document would be tenable in the bank to process the contrived deceased’s pension. His response was comforting.
After about 20 minutes, a dark-skinned man drove into the location in a white coloured hearse. The man immediately pointed at the car and told our correspondent to talk to him.
Our correspondent was asked by the man later identified only as Saheed, to sit in the passenger seat and asked the same question Wale asked our correspondent.
“It is N10,000. You’ll write down the details of the person. How old was she? What was the cause of the death? What time did she die?,’’ he asked.
Saheed, who operates a funeral home, asked to be patronised to transport the corpse to the place of burial.
He charged N60,000 to transport the body to Oyo State, stating that he could prepare the body for burial if the transportation would be the next day.
While making the payment transaction, Saheed called someone on the phone presumed to be a doctor in a private hospital around the area. As he went to get the document at the private clinic, our correspondent returned to the waiting area to meet the first man while Saheed went away with the details. After some minutes and a phone call to confirm death time as 2pm, Saheed returned with a death certificate bearing a stamp and identity of a private hospital.
The time spent in the hospital to obtain the document was about two hours due to logistical issues.
Also, apart from the details filled on the death certificate, nothing else was asked. No affidavit, identity card or doctor’s report.
Getting the two death certificates for N20,000 in less than three hours without a medical report or doctor’s confirmation of death depict the ease of getting an important document in hospitals.
However, attempts to obtain another death certificate for the same fictitious person in one of the hospitals in Lagos mainland were unsuccessful. The procedure was a bit different.
The LG officer, who gave his name only as Oye, requested the same details Wale and Saheed asked. But he vehemently insisted on a medical certificate from a doctor and the National Identification Number or voter card of our correspondent who claimed to be a relative of the dead.
He said, “I will need the medical report, cause of death and the year the person died. I will need the photocopy of the NIN of the person standing to collect it and an affidavit of the cause of death.”
When our correspondent agitatedly explained that the relative died at home and no doctor confirmed her death, he offered to get the medical report from a doctor but for a fee.
Oye added, “If you want to do the affidavit here, it is N2,000. Everything will be N7,000. For the medical report, it is N5,000.”
In all, the fee was N14,000. But the requirement of an ID card prevented our correspondent from continuing with the process.
Any document can be forged in Nigeria – Lawyers
In his view on the development, a professor of Criminology and Criminal Justice at the National Open University of Nigeria, Sam Smah, stated that the corrupt nature of the Nigerian system fuelled the fraud and forgery of important documents.
He added that the desperation in the system, the loose ends of the criminal justice system and improper record keeping enabled the process.
Smah further included issues of pension, alimony, and mouth-watering scholarships for indigent orphan students as some of the reasons some persons engaged in the act.
The don said, “It takes two to tango, so someone who wants to procure a death certificate also needs to get somebody out there willing to do it. Sometimes, people can generate any form, certificate or receipt online that will look original. So, this is a big issue and it reveals some of the dark side of our society where you find people going against the law. Of course, you can see that many people who are proclaimed dead and buried, somewhere you find walking all over the place and someone will say “I come across them.”
He stated that any document obtained under false pretence attracted a jail term according to the criminal code.
Smah further decried the lack of investigation, requirement of evidence and hard facts including appropriate documentation process regarding issues of documents and certificates collection in the country.
He added that the situation hampered the progress and correctional processes offered by technology.
He noted, “A system of integrity and foolproof of all the systems of manipulation will not allow that. There should be a clear way to identify differences in the characteristics of a document. There should be some security features that must be there to distinguish what should be there and what should not be. But again, people in the system will now reveal what is there for criminals to also incorporate into their system. It is something that is worrisome. We don’t have a system that manages things like that. Even pallbearers can be a part of the system.”
On his part, a lawyer and human rights crusader, Liborous Oshoma, stated that forgery was a criminal offence in Nigeria, noting that the hurdles of prosecuting offenders were tedious.
He added that in a society where offenders were scarcely punished, impunity thrived and encouraged offenders to continue to participate in crimes.
“In Nigeria, anything can be forged; a court judgement can be forged once you have the money to procure it. But they are offences that carry a jail term ranging from two to as much as 15 years imprisonment. For criminal matters, investigation commences prosecution but most of the time, some of the cases are hardly prosecuted because the man whose document has been forged, the process to prosecute the matter is like passing through the eye of a needle,” the legal practitioner stated.
On ways to tackle the menace, Oshoma said that there was the need to reform the policing of the country and automate the process of certificate processing.
He added, “Immediately a crime is committed, the instrumentality of the law is activated to ensure that the perpetrators are brought to book and when you punish offenders consistently, it is a way to deter crime. Both the man who procured and the person that forged the document are guilty of the same offence.
“You need to automate the process to ensure that human interference is limited. That is a way of preventing people from committing the crime. Once that is done, you can no longer walk up to a hospital to procure a death certificate because there will be a central system where the moment someone dies, the pathologist enters in the information into the database of the hospital and those that will issue the certificate will get it and then give the certificate.”
Oshoma further explained that for an individual who died at home without a doctor to confirm the death, an automated system would ensure that a pathologist or medical practitioner was invited to certify the deceased and also process the document and acceptance for burial.
He also stated that the administrative lacuna in the health sector further prevented the necessary checks and processes needed in proper documentation of cases.
Also commenting on the matter, a professor of human rights law at the University of Calabar, Cross River State, Jacob Dada, said that fake medical certificates were easily procured because many medical practitioners failed to recognise and appreciate their moral, ethical and legal duty to demonstrate honesty, fidelity and professionalism in their practice.
In his book, “Legal Aspect of Medical Practice in Nigeria,’’ Dada stated that it was imperative for a doctor to “exercise great restraint in issuing medical reports and certificates. Customarily, relations and friends put medical practitioners under undue pressure to issue medical certificates particularly to excuse from duty. Certificates should be issued only to patients and no one else. Accordingly, doctors must refrain from issuing medical certificates to non-patients irrespective of his relationship with such persons.
“Even where the person in whose favour a certificate is issued is a patient properly so called, any medical report or certificate should be preceded by actual examination. In other words, no report should be made unless the doctor has seen the patient and properly examined him. No assumption should be made particularly about the date of examination and the findings. This is so because the condition of a patient may significantly change within a couple of hours. Importantly, doctors must appreciate that the accuracy and integrity of a medical report and certificate are dependent on the accuracy and credibility of the medical records. Accordingly, care must be taken to ensure the correctness and reliability of the medical records. This is assured by accurate and prompt documentation of the diagnosis and therapeutic procedure.”
He further stated that doctors who erred risked disciplinary action which included suspension, licence withdrawal and criminal prosecution.
Dada said, “Without doubt, it is for improper, fraudulent or other criminal purposes that such fake certificates are procured. Medical practitioners involved face the risk not only of professional reprobation and discipline but criminal action at the instance of the State.”
He added that an aggrieved third party could institute civil action in appropriate cases for damages.
Erring doctors risk losing licences – NMA, GMD
Reacting, President, Guild of Medical Directors, Dr Raymond Kuti, stated that it was criminal, illegal and totally unethical for a doctor to issue a death certificate without seeing the body and certifying that the signs of life were no longer in the body.
“Anyone who does it is a criminal procedure and totally illegal. It is either black or white in that situation. You must see the body, then carry out and make sure that the body is no longer alive and must determine the suspected cause of death, then sign and issue. That is the legal procedure so any doctor that does anything away from that will face the consequences,” he stated.
Kuti urged that the Chief Medical Directors in the concerned hospitals should be contacted and the evidence forwarded to the Permanent Secretary.
He stated, “Any doctor that will do that will surely lose his licence. That is a good way to lose your licence to practice medicine in Nigeria, at least. If something is illegal, irrespective of the profession, let us push the whole thing out because one bad apple will spoil the whole bunch. I believe it is a minute number that’ll do that if they do it at all.”
Also, the immediate past President, Guild of Medical Practitioners, Prof Olufemi Babalola, described the practice as unethical, urging the prosecution of offenders.
Babalola said, “I am not aware that the practices take place. But if they do, it is highly unethical. Death certificates should be issued only by the certifying doctor. He must confirm the identity of the deceased and suggest a cause of death. Individuals caught in such malpractice should be prosecuted to the full extent of the law.”
Besides, President, Nigerian Medical Association, Dr Uche Ojinmah, described the process as fraudulent and betrayed the trust patients had in doctors, affirming that the medical practice did not condone such a practice.
He further stated that doctors who engaged in the act would face the Medical and Dental Council of Nigeria and have their licences revoked.
The NMA president added that such doctors would be arrested by the police for fraud or for attesting to fraud.
Ojinmah said, “If it is a doctor, it is even worse. Apart from fraud, they have also betrayed the trust of the public in them. So, it is not just a police case, it is also a case of the Medical and Dental Council of Nigeria because trust is the bedrock of medical practice. If you don’t trust me, you won’t take the drugs I prescribe, allow me to inject you or agree to my diagnosis that you have malaria.
“Any person that is a doctor and betrays the trust of patients needs to be reported to the MDCN. It is an easy process. Do an affidavit of declaration, address it to the MDCN and they will take it up from there.”
He explained that the implication of those engaging in such a practice was that a living person could be declared dead and could have affected the life, job and the victim’s finances.
He stated, “If a man has been saving his money for retirement and a group of people defraud him with the help of a medical doctor, it could kill him and also damage his family. In the Nigeria Medical Association and the medical practice, we don’t protect doctors that don’t do the right thing. There is a consequence for good and bad behaviour. We don’t encourage that.’’