The discovery of a makeshift clinic along the Lagos–Badagry Expressway is not merely an outrageous story about an illegal medical facility. It is a brutal reminder of what happens when poverty, weak regulation and inadequate access to affordable healthcare collide.
There are some photographs that require no caption.
A patient lying beside a roadside.
An IV line hanging above them.
A makeshift structure nearby.
And beneath it all, a gutter.
According to reports circulating this week, Lagos State enforcement officials discovered a makeshift clinic operating along the Lagos–Badagry Expressway, where a patient was reportedly receiving treatment through an IV drip inside a gutter. The discovery has been attributed to an enforcement operation by Lagos State authorities.
It is difficult to look at that image and not ask:
How did we get here?
How does a country with doctors, nurses, teaching hospitals, medical schools, pharmaceutical companies, health agencies and billions of naira allocated to healthcare reach the point where a human being can be receiving an intravenous infusion beside a drainage channel?
And perhaps the most uncomfortable question is this:
Is this what “Renewed Hope” looks like at street level?
Because while government reports may describe healthcare transformation, a sick Nigerian experiencing healthcare from inside a gutter is experiencing something very different.
The gutter is not the story. The gutter is the symptom.
It would be easy to make this story entirely about the people operating the roadside clinic.
And they should absolutely face scrutiny.
Lagos has a dedicated Health Facility Monitoring and Accreditation Agency, HEFAMAA, whose mandate includes monitoring public and private health facilities and ensuring that healthcare facilities operating in the state are registered and accredited.
A medical facility operating from an unsafe roadside environment raises obvious questions about licensing, sanitation, professional standards, patient safety and regulatory enforcement.
But there is a bigger story underneath the illegal clinic.
Why did a healthcare market emerge there in the first place?
People do not normally choose gutters over hospitals because they love gutters.
They go where they believe they can obtain treatment.
They go where they can afford treatment.
They go where somebody will see them.
They go where they do not have to produce money they don't have before receiving care.
That is the part of the story we cannot afford to ignore.
Welcome to Nigeria's healthcare economy
Nigeria has a healthcare paradox.
The country has enormous medical expertise.
Yet access to that expertise remains deeply unequal.
There are world-class private hospitals.
There are excellent doctors.
There are teaching hospitals.
There are primary healthcare centres.
There are specialist facilities.
And there are Nigerians who self-medicate, buy drugs from informal vendors, visit unlicensed practitioners and—apparently—receive IV treatment beside gutters.
These realities exist simultaneously.
The problem is not simply that Nigeria lacks healthcare infrastructure.
It is that access to safe healthcare remains deeply connected to money.
The Commonwealth Fund's 2026 Nigeria profile reports that out-of-pocket spending accounted for 70.94% of healthcare expenditure in 2023, far above the average for lower-middle-income countries. It also reports that Nigeria's annual health expenditure was only about $70 per person in 2022, of which $48.70 was paid out of pocket.
That statistic is more revealing than any government slogan.
Because when approximately seven out of every ten dollars spent on healthcare comes directly from people's pockets, sickness becomes a financial crisis.
For wealthy Nigerians, that crisis may mean paying a large hospital bill.
For poor Nigerians, it can mean postponing treatment.
Borrowing money.
Selling property.
Buying incomplete medication.
Going to an informal provider.
Or accepting treatment in conditions nobody should have to tolerate.
Poverty can make dangerous medicine look affordable
This is the uncomfortable economics behind informal healthcare.
Suppose a legitimate hospital charges an amount that a low-income patient cannot afford.
Then someone operating from a makeshift facility offers treatment at a fraction of that cost.
The patient knows the environment isn't ideal.
But the alternative is going home untreated.
What choice does desperation make?
That is how unsafe medical markets survive.
Not necessarily because everyone using them is ignorant.
Sometimes people understand the risk perfectly well.
They simply cannot afford the alternative.
And that is why blaming the patient would be profoundly unfair.
A patient receiving an IV in a gutter is not evidence that Nigerians don't care about healthcare.
It may be evidence that the healthcare system has failed to make safe care accessible enough.
And this is where the “Renewed Hope” contradiction begins
The Federal Government has made healthcare a central component of its Renewed Hope Agenda.
Its official health-sector reform programme says the administration is seeking to build a stronger health system and improve healthcare for Nigerians.
The government has also announced substantial investments.
In May 2026, President Bola Tinubu commissioned health infrastructure projects across the country, including facilities spanning primary, secondary and tertiary healthcare. The Federal Government also announced 145 tricycle ambulances as part of efforts to strengthen emergency medical response.
The government has reported progress in primary healthcare as well. In July 2026, the Presidency said revitalisation had commenced in 4,161 primary healthcare centres, with 3,158 completed and another 1,002 ongoing.
Those investments matter.
They should not be dismissed simply because an illegal clinic was discovered.
But neither should government announcements be allowed to obscure the reality experienced by people at the bottom of the system.
Because the ultimate test of healthcare reform is not how many facilities are commissioned.
It is whether people actually use safe facilities when they are sick.
You cannot build your way out of a financing crisis
Nigeria can build hospitals all day.
But if ordinary Nigerians cannot afford treatment inside them, the problem remains.
You can build a beautiful health centre.
But if there is no doctor available, its impact is limited.
You can purchase medical equipment.
But if there is no electricity, maintenance or trained personnel, the equipment may sit unused.
You can announce insurance expansion.
But if millions remain outside effective financial protection, people will continue paying directly when they become sick.
Healthcare is therefore not simply an infrastructure problem.
It is a financing problem, workforce problem, regulation problem and accessibility problem.
The World Health Organization's universal-health-coverage framework makes this distinction clear: universal health coverage means people should be able to obtain needed quality services without financial hardship.
Nigeria cannot claim meaningful progress toward that goal simply because more hospitals exist.
The question is:
Can an ordinary Nigerian afford to enter the healthcare system when they need it?
The irony of the Abuja Declaration
There is another uncomfortable number.
Nigeria committed decades ago, alongside other African countries, to the Abuja Declaration's target of allocating at least 15% of national budgets to health.
Yet health spending has remained substantially below that benchmark.
Data analysis by Dataphyte, for example, found that Nigeria's 2024 health allocation was about ₦1.34 trillion—an increase from 2023 but only around 5% of the national budget, far below the Abuja target.
The argument should not simply be:
“Nigeria must spend 15% because Abuja said so.”
The more important question is:
What level of investment is actually necessary to provide safe, accessible healthcare to a population of more than 200 million people?
Because percentages can become political talking points.
Patients cannot eat percentages.
They need doctors.
They need medicines.
They need laboratories.
They need emergency care.
They need affordable treatment.
They need hospitals that function.
The patient in the gutter is also a regulatory failure
We should not romanticise informal healthcare.
There is a reason facilities are regulated.
IV administration is not something that should casually happen anywhere simply because someone has a drip bag and a willing patient.
There are risks involving infection, incorrect medication, dosage errors, fluid overload, allergic reactions, complications and delayed treatment of serious underlying conditions.
The environment matters.
Sterility matters.
Professional supervision matters.
Emergency preparedness matters.
And Lagos already has a regulatory institution specifically tasked with ensuring health facilities meet required standards.
So the discovery raises a second uncomfortable question:
How long had this facility been operating before authorities found it?
Was it a one-off?
Was it serving a regular clientele?
Were residents aware?
Were other unlicensed facilities operating nearby?
How many patients had already passed through it?
These questions matter because enforcement should not simply happen after a shocking image becomes viral.
Regulation should be continuous.
But enforcement alone won't solve the problem
Suppose authorities shut down every illegal roadside clinic tomorrow.
Good.
But what happens to the patients who were using them?
If they cannot afford legitimate care, the demand doesn't disappear.
It simply moves somewhere else.
That is why enforcement must be accompanied by accessible alternatives.
Close the illegal clinic.
Then strengthen the nearby primary healthcare centre.
Make it affordable.
Ensure staff are present.
Ensure essential medicines are available.
Ensure referrals work.
Ensure emergency transport exists.
Ensure health insurance can actually pay for services.
Otherwise, regulation becomes a game of whack-a-mole.
Close one illegal provider.
Another appears two kilometres away.
The government's own agenda acknowledges the problem
Interestingly, Nigeria's health-sector reform framework recognises many of these challenges.
The government's Universal Health Coverage Compact calls for increased funding and timely releases for primary healthcare, immunisation, family planning and public health. It also calls on state and local governments to increase funding for primary healthcare services.
The National Health Insurance Authority has similarly described the sector-renewal programme as focusing on investment, infrastructure, equipment and workforce development.
So the problem is not necessarily a lack of policy documents.
Nigeria has plenty of them.
The problem is implementation.
The distance between:
what government says
and
what citizens experience.
That distance is where the gutter lives.
We should stop calling Nigerians “resilient” when they are being abandoned
There is something almost cruel about constantly celebrating Nigerian resilience.
Nigerians survive power outages.
They survive terrible roads.
They survive inflation.
They survive unemployment.
They survive broken public services.
They survive healthcare crises.
And then politicians point to this survival instinct as evidence of the people's strength.
But resilience should never become an excuse for institutional failure.
A mother who sells her belongings to pay a hospital bill is resilient.
A father who borrows money for emergency surgery is resilient.
A patient who travels across the city searching for affordable treatment is resilient.
But none of those situations should be normal.
Citizens deserve systems that work without requiring extraordinary personal resilience.
The “beautiful” healthcare system Nigerians actually need
Perhaps the most sarcastic question we can ask is:
What exactly does a beautiful healthcare system look like?
Is it a newly commissioned building?
A giant sign bearing the names of politicians?
A ribbon-cutting ceremony?
A press release announcing another initiative?
Or is it something much less glamorous?
A pregnant woman arriving at a clinic and finding a qualified health worker.
A child receiving treatment without the parents selling everything they own.
An elderly Nigerian obtaining medication without choosing between food and healthcare.
An accident victim reaching emergency care quickly.
A poor worker receiving treatment without borrowing money.
A patient receiving an IV drip inside a clean, properly licensed facility rather than a gutter.
That is what healthcare success looks like.
It is not spectacular.
It is ordinary.
And that is precisely the point.
The gutter should become a national embarrassment—not a viral joke
The temptation will be to laugh at the absurdity.
Nigeria's internet will turn the image into memes.
People will make jokes.
Politicians will be tagged.
The story will trend.
Then another scandal will arrive.
And we will move on.
But the person in that gutter was not a meme.
They were sick.
Someone thought that was an acceptable place to seek treatment—or perhaps had no better option.
That should bother every Nigerian.
Not because Nigeria is uniquely incapable of producing good healthcare.
It isn't.
Nigeria has extraordinary medical professionals.
It has institutions capable of world-class work.
It has enormous human capital.
The problem is that quality healthcare remains too unevenly distributed and too financially inaccessible.
And until that changes, informal and unsafe alternatives will continue finding customers.
So, is this Renewed Hope?
The government has every right to point to its healthcare investments.
The reported PHC revitalisation figures, new infrastructure and emergency-response initiatives are legitimate areas to evaluate.
But government should also accept the other side of the equation.
A system can be improving and still be failing people.
A new hospital does not erase an unaffordable hospital bill.
A renovated primary health centre does not automatically guarantee a doctor.
An ambulance does not guarantee emergency care.
A policy does not guarantee implementation.
And a budget allocation does not automatically become healthcare at the point of service.
The roadside clinic is therefore not proof that nothing is changing.
It is something more useful:
a reminder of how much remains to change.
Because the ultimate measure of Renewed Hope should not be found in Abuja's conference rooms.
It should be found on Lagos's streets.
In Badagry.
In rural communities.
In overcrowded hospitals.
In primary healthcare centres.
And, most painfully, beside the gutter where a sick Nigerian should never have had to receive medical treatment.
Nigeria does not need healthcare that looks beautiful in official photographs.
It needs healthcare that is safe, affordable, accessible and dignified.
Until then, perhaps the most uncomfortable symbol of Nigeria's health crisis is not the hospital we haven't built.
It is the patient we have allowed to believe that a gutter is good enough.
That is not the healthcare Nigerians were promised.
And it should never become the healthcare Nigerians learn to accept.
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