There is perhaps no greater medical nightmare than watching a person suddenly struggle to breathe. In those terrifying moments, immediate access to medical oxygen can mean the difference between life and death. Yet across Nigeria, this basic life-saving resource remains a gamble rather than a guarantee.
It is time for regulators and healthcare providers, public and private, to stop treating functional oxygen systems as optional facility upgrades and recognize them as fundamental requirements for safe medical practice.
This is not an abstract policy debate. It is a recurring reality in emergency wards across the country, where a patient’s survival can sometimes depend on whether a hospital has oxygen available precisely when it is needed.
Consider the case of Emmanuel Okoli, a Nigerian man admitted to the Federal Medical Centre, Idi-Aba, Abeokuta, in 2018. According to an account relayed by a relative to journalists, Okoli began gasping for breath barely a day after admission, only for medical staff to discover that the facility had run out of oxygen.
A nurse on duty reportedly acknowledged that the hospital was at fault, explaining that oxygen shortages were frequent and workers sometimes had to improvise depending on how critical a patient’s condition was. Okoli did not survive.
His family’s tragedy captures the consequences of a health system failing to provide something as fundamental as oxygen. It raises an uncomfortable question: “how can a patient be admitted for treatment and still lose his life because the facility cannot provide a basic emergency resource?”
Okoli’s story is not the only disturbing account. In 2017, a young Nigerian identified only as Chris reportedly died after being taken to five different hospitals, none of which could provide the oxygen he needed to stay alive. A close friend who shared the account online described watching Chris fight for his life as facility after facility reportedly failed to provide the required care.
Although such an account may be difficult to independently verify years later, the broader concern it illustrates cannot be dismissed. Patients in respiratory distress do not have the luxury of time. Every transfer from one facility to another can consume precious minutes while a patient’s condition deteriorates.
More recently, in 2026, the death of a pregnant woman, Evans Akinloye Chiamaka, at Bwari General Hospital in Abuja again triggered public concern over oxygen availability. Her sister alleged that the hospital failed to provide oxygen when it was needed. The hospital’s medical director disputed the allegation, insisting that the facility had a functional oxygen plant donated by the Global Fund and that its medical team had done everything possible before the patient died following surgery. The conflicting accounts expose another problem: the erosion of public confidence in the healthcare system.
When relatives believe a hospital failed to provide basic emergency care while the hospital insists that the necessary infrastructure was available and functional, the issue becomes not only what happened but whether the system has adequate mechanisms for establishing the truth quickly and transparently.
Nigerians have heard too many stories of preventable deaths to automatically accept either side of such disputes. Hospitals must therefore be able to demonstrate, rather than merely claim, that their emergency systems are functional. The oxygen crisis is not confined to isolated incidents.
A report by Nigeria Health Watch on the country’s medical oxygen challenge quoted a resident doctor, identified as Dr Bamidele, as saying oxygen is sometimes simply unavailable and, where available, may be unaffordable, with patients reportedly paying between ₦1,000 and ₦2,000 per hour.
The report, drawing on findings from the Lancet Commission, identified inadequate oxygen service capacity, insufficient access to pulse oximeters, unreliable oxygen supply and high costs as factors behind Nigeria’s oxygen coverage gap.
The importance of pulse oximeters cannot be overstated. A hospital cannot effectively respond to oxygen deficiency if it lacks the basic equipment needed to identify it.
Mu’azu Muhammad, Nigeria’s country champion for the Oxygen CoLab initiative, also pointed out that although the COVID-19 pandemic stimulated significant investment in oxygen infrastructure, some systems established during that period have since fallen into disuse.
That is perhaps the most troubling aspect of Nigeria’s oxygen problem. The country experienced a devastating health crisis that demonstrated, in real time, the importance of oxygen. It mobilized resources and expanded infrastructure, yet some of that capacity has reportedly been allowed to deteriorate or remain idle. Nigeria did not lack the warning. It simply failed to sustain the response.
In fact, sudden respiratory distress can result from cardiovascular complications, severe infections, asthma attacks, surgical complications, trauma and other medical conditions. Whatever the diagnosis, a patient struggling for breath cannot wait while hospital staff search for a functioning cylinder or source oxygen elsewhere.
Neither should families have to move critically ill patients from one hospital to another in search of basic emergency support. This is where regulation becomes critical.
A hospital licence should not simply certify that a facility has a building, beds, doctors and nurses. It should also certify that the facility possesses the minimum emergency infrastructure required for the level of care it claims to provide. If a hospital admits emergency patients, it must be capable of stabilizing them.
Without resort to sounding hyperbolic in this context, private healthcare facilities treat millions of Nigerians and cannot be excluded from minimum emergency standards. Any facility licensed to provide medical care should have an appropriate level of oxygen capacity. The responsibility should apply equally to public and private institutions. Private ownership does not reduce the value of lives entrusted to a hospital, while public hospitals cannot hide behind inadequate funding when basic emergency preparedness is involved.
In fact, regulatory requirements must be practical and proportionate. A primary healthcare centre cannot reasonably be expected to maintain the same oxygen infrastructure as a tertiary referral hospital. But every licensed facility should have an appropriate minimum capacity to stabilize a patient suffering respiratory distress. That minimum should include functional oxygen equipment, pulse oximeters and personnel capable of administering emergency oxygen safely.
Simply having an oxygen cylinder somewhere inside a hospital is not preparedness. A rusty, empty or defective cylinder is no more useful to a gasping patient than having none at all.
Regulators must therefore verify whether oxygen systems are functional, cylinders adequately filled, regulators and tubing working, oxygen plants operational, maintenance schedules followed and staff trained to use the equipment. The goal should be reliability, not compliance theatre.
Government must also ensure that compliance does not become an unbearable financial burden for smaller facilities. Tax incentives, low-interest financing for medical equipment, public-private partnerships and stronger local medical-gas production and maintenance networks could help expand oxygen availability.
Affordability for patients must also be addressed. If a hospital has oxygen but a poor family cannot afford to keep a critically ill relative on it, the problem has merely shifted from availability to accessibility.
The COVID-19 pandemic demonstrated that oxygen is not a luxury in modern healthcare. It is a fundamental component of emergency medicine.
Nigeria’s investments in oxygen infrastructure during the pandemic also proved that the country can expand capacity when there is sufficient political will, funding and coordination. The challenge now is sustainability.
There is little value in installing an oxygen plant if it becomes dysfunctional a few years later, purchasing cylinders if they are left empty, or acquiring sophisticated equipment if healthcare workers are not trained to use it. Nigeria must therefore move from emergency-driven investment to permanent oxygen security. It is fundamentally unfair to tell Nigerians to seek medical attention promptly and then send them to hospitals that lack the basic equipment required to keep them alive.
Healthcare facilities do not need elaborate reception areas to save patients suffering respiratory failure. They need functional oxygen systems, trained personnel, reliable electricity or appropriate backup systems, maintenance plans and dependable supply chains.
Regulatory agencies must shift from reactive investigations after deaths occur to proactive enforcement before tragedy strikes.
Hospitals should undergo routine, verifiable emergency-readiness assessments. Oxygen plants should be inspected for functionality, equipment tested, maintenance records reviewed and staff competence assessed.
Facilities that repeatedly fail basic emergency-safety requirements should face meaningful sanctions, including suspension or, where necessary, revocation of licences.
At the same time, government must provide realistic pathways for hospitals, particularly those serving low-income communities, to meet the required standards.
The objective should not be punishment for its own sake but the creation of a healthcare system in which preventable deaths become less likely.
The price of an oxygen cylinder, a pulse oximeter, a regulator or a functioning oxygen plant can be measured in naira. The value of a human life cannot.
That is why functional oxygen availability should become a mandatory requirement for every Nigerian hospital, appropriately scaled to the level of care it provides.
The stories of Emmanuel Okoli, Chris and the many unnamed patients whose deaths never became national headlines should force Nigeria to confront a simple truth: in an emergency, oxygen cannot be treated as an afterthought. A hospital that cannot reliably provide life-saving oxygen when a patient is struggling to breathe is not fully prepared to save that patient’s life. Nigeria has known this for years. It is time to act as though we mean it.
