Hepatitis and Company Employment in Nigeria

I have received anonymous emails from couple of people on this subject, and I took my time to do some research, online and offline, before coming up with this piece.

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First, to put things in perspective, hepatitis is endemic the world over, with over 400 million chronically infected persons, more than 20 million of whom are in Nigeria. With our population put at about 160 million, what that means is that 1 out of every 8 Nigerians is infected. That is how widespread it is. But the good – and equally dangerous – thing about it is that it doesn’t manifest early, and more than half of the people carrying it are not even aware.

Since medicals is compulsory before employment in virtually every organization that matters, hepatitis is one of the tests most, if not all, of the employers look out for. The hiring decisions of employers based on positive hepatitis status in a prospective employee after medicals can be grouped into 3:

1, Outright rejection: Some organizations see this as failure of medicals, and reject such candidate outright. Some tell the candidate that is the reason, some will not even get back, and that is the end of recruitment process for such person. Some organizations, like Nigerian Navy (and other forces, I think) will even put it as part of the conditions for employment from the onset, even before application. For many others, it doesn’t come up until medicals stage, after the candidate would have gone through and passed tests and interviews. Many Nigerian banks belong to this category.

2, Conditional acceptance: In the course of my research, I met someone that told me he was given the job even though his medicals showed he was hepatitis positive, but with the condition that his medical insurance coverage will not extend to that; meaning, he will be responsible for his treatment. The person works in one of the biggest Nigerian banks.

3, Unconditional acceptance: Some companies do not consider hepatitis condition a failure of medicals, so they give infected candidates job unconditionally, with the company’s insurance also covering its management.

However, there are some companies, especially SMEs, that don’t do medicals at all, or rigorous medicals, probably because they are not ready to bear the cost or because they are so unstructured, like some one-man businesses (Alhaji Mai Dogo Transport Limited, Uche & Brothers, Asaaje Consulting etc). But most structured companies, those that will pay you N100,000 and above per month, will do medicals.

Also, the nature of some jobs makes it compulsory that the worker is not hepatitis positive. Jobs like nursing, medical laboratory science and others that deal with contact with human blood and use of sharp objects cannot be done by someone that is hepatitis positive; else there is risk of transmission. So, most hospitals and labs may not employ someone that is positive.

Another implication of being hepatitis positive on employment is that such a person may not be able to get foreign employment in most countries, at least I know Qatar, UAE, Malaysia and, I think but not sure, USA, where you will not be given residency/living visa if you are hepatitis positive. So you may not be able to travel abroad for employment in these countries.

Now, a big question: is the rejection policy by some Nigerian companies not stigmatization and discrimination? I have not laid my hands on Nigerian labour laws, so I may not be able to tell from legal perspective.

Generally, from my research on this subject, I think hepatitis is a serious health challenge in Nigeria. I have stated the endemic rate of 12.5% in the opening part of this article. I think the figure is high because of the highly contagious nature of the disease – it can spread from as seemingly harmless action as contact with the sweat of an infected (remember 1 out of every 8 Nigerians is infected, and many don’t know). The virus is also said to have the ability to stay active in a place it has contact with, like toilet, for as many as 7 days! But the good thing is, the B-type, which is the most common, is vaccine-preventable. For as low as N3000, you get the vaccine, which is said to have 95% success rate (i.e once vaccinated, your chance of contracting Hepatitis B, if not positive already, is as low as 5%, even with contact with infected blood).

This vaccination has been part of the Nigeria Health Policy in the last decade I think, so children born in recognized private and public hospitals (not sure whether this is also the case in the semi-urban and rural areas) are compulsorily vaccinated and immune. Those born earlier need to voluntarily go and test themselves, and if still negative (chance is 7/8), should go and start vaccine immediately. Only B is vaccine-preventable though, I learnt C does not have vaccine yet, which means that with vaccine, you cannot contract B again, but you can still contract C, but it is not endemic in Nigeria. Note also, that the hepatitis I am talking about with respect to employment is hepatitis B and C. A-type is not a chronic and not  tested in company medicals. Infact, most companies test only B.

Another point on hepatitis and employment, is, even in companies that reject infected candidates, if you have some rare skills or coming as a top management staff, you may be so badly needed that they will be willing to waive such.