TheCable

For years, the process of obtaining yellow card in Nigeria has been fraught with irregularities. Applicants have complained about corruption and disregard for international vaccination rules. When the federal government introduced the new e-yellow card, many heaved a sigh of relief but findings by TheCable show that the process is still mired in controversies.

August 1, 2018 marked the official expiry date of the old yellow card and commencement of issuance of electronic yellow card, otherwise called the international certificate of vaccination or prophylaxis. The card, which is machine-readable, and has the ability to store vaccination history of the holder, was designed to put an end to the era of fake yellow card issued by unauthorised personnel for years. The card has also increasingly become an essential travel document, with several embassies making it a prerequisite for visa application.

A few weeks into the implementation of the new policy, TheCable paid three visits to the Port Health Services at the Murtala Muhammed International Airport, Lagos – the only place where the e-card is being issued in the state. Of a truth, vaccination was given before cards were issued, (a change from what it had been in the past), but what was found was far below expectation.

WRONG WEBSITE

On the first day of visit, September 5, 2018, a poster in tatters, sellotaped to the wall, displayed five “easy steps” to obtain the yellow card. However, the website on this poster – www.yellowcard.health.gov.ng – was searched many times with nothing meaningful found. This same dysfunctional web address was on all posters at the centre. It appears this is the first step in the wrong direction for intending applicants. And anyone who gets this wrong would most likely find the remaining process chaotic.

On a big notice board inside the hall was another poster announcing the steps to obtain yellow card. A close look showed the information on it was outdated. Apparently, it was pasted on the wall since 2016, and two years after, it is still announcing the procedure for a process that has been renewed. Yet another poster, this one handwritten, displayed a different website – www.yellowcardnigeria.com. The website, though very slow, is the one that actually takes applicants through the registration process.

Before this reporter found the handwritten poster, she had approached a tall security man whose gait is slightly bent for information on how to get things done. The choice of making inquiries from a man who was supposed to be manning the gate was informed by the absence of officials to respond to questions from applicants.

The security man pointed in the direction of a cyber café, saying: “Just go to that place, where they write, Food is Ready, you will do a photocopy of passport page for N100, write your name and email address on it, after, take it inside. You will pay N2000, but the café will collect commission oh.”

This gave a hint of how the authorities have been collaborating with certain individuals to rip-off applicants who throng there on a daily basis. From the register placed on a table in the hall, TheCable found that the average number of applicants seeking the card since the beginning of August, ranged between 66 and 156, on a daily basis.

On this day, the register showed that 84 applicants visited the centre. Some lost their passports and other personal belongings as a result of the rowdiness. Bedlam broke out each time the female nurse emerges from the vaccination room to reel out the names of applicants to be vaccinated. Though she shouted on top of her voice, the rumbling within the hall made it difficult to hear what she was saying. This increased the chance of getting wrong information and falling prey to touts. There was no official stationed to control the crowd.

Do-it-yourself registration

On visiting www.yellowcardnigeria.com, it takes the user just one step towards generating a Remita retrieval reference (RRR code) for payment. The official payment of N2000 can simply be made at any bank, after which he/she is to submit a payment slip to the port health office for vaccination before collecting it. All this shouldn’t take more than 30 minutes but because the information handed out is not clear, applicants are misled, hence, they besiege the port health office, lamenting their plight.

“The information is not clear. There is nothing like a checklist of steps to take, displayed here,” Dokun Ogudeji, an applicant who needed yellow card for Italian visa, told TheCable.

“When you come here, you start asking anybody, what do I do? They didn’t tell us we can pay online by ourselves. In fact, someone told me I cannot go to the bank, that I should come and pay here.”

JUMBO PROFIT

N2000 is supposed to be paid via www.remita.com – an easy-to-do, self-help method but for whatever reason, the system is such that hundreds of applicants who seek the card are practically mandated to pay between N2700 and N3000 to the cyber cafes, which are located inside the offices of the port health. It was understood that the cyber café operators are not staff of the port health, and thus thrive on the commission of between N700-N1000 per applicant. If therefore 156 applicants visit the port health everyday, the business centres can make as much as N156,000 in a day!

According to the World Health Organization’s rule on vaccination against yellow fever, the vaccine must be administered at least 10 days prior to the travel. But a traveller would thank his stars if he gets the card one day to the travel date.

On the second day of visit, TheCable saw several applicants with their boarding passes in their hand, shunting long queues and rushing straight to the nurses’ office few hours before departure.
A lady travelling to Kenya came with two of her co-travellers,

“Our flight is in two hours, this is my boarding pass, please ma, we have reached the airport, but were asked to come here and get yellow card otherwise they will not allow us in,” she told the matron on duty in a respectful manner.

The matron, moved by compassion and not by international vaccine protocol, openly pleaded with the crowd to allow her to take her vaccination ahead of other applicants, an outright breach of vaccination practice. Clearly written on the wall in front of the matron is the statement “Vaccination must be given 10 days before travel.”

WHAT IS YELLOW FEVER?

The benefits of observing the rule is in the interest of both the traveller and the country he or she is travelling to. Yellow fever is an acute viral haemorahgic disease which is transmitted by mosquitoes, belonging to the aedes and haemogogus species.

This fever, which causes jaundice (yellowing of the skin), organ damage and bleeding within 7-10 days, is still very much endemic in Nigeria, and the good news is -one shot of vaccination confers a lifetime immunity.

Talking about its endemic nature, there was an outbreak in Kwara state in September last year and this spread to 62 local government areas in 16 states. The WHO reference lab in Dakar, Senegal, showed that there were 358 confirmed and suspected cases. There were reportedly at least 54 deaths. Apart from Nigeria, 47 countries in Africa, as well as Central and South America, have endemic regions for yellow fever.

Guards at the entrance

Doyin Odubanjo, chairman, Association of Public Health Physician of Nigeria, condemned the delay and shoddiness on the part of port health authorities.

“There is no guarantee that the person will be protected against yellow fever, if he/she goes to areas that are endemic. He/she may contact yellow fever or he may introduce yellow fever,” he said.

“It is a general immunization rule that once you immunize, it takes some time for the body to produce harmless antibodies, that is the reason for the 10 days. But a lot of people do not know that the vaccination is for their own good.”

The vaccine contains a live, weakened form of the yellow fever virus, which works by stimulating the body’s immune response to this virus without causing the disease. Since the body needs time to develop these antibodies, the certificate is not valid until after 10 days.