By Kele Chukwumu
It’s unimaginable that a doctor would treat a patient in the way that Mr Stephen was treated.
Medical practice should be about saving lives as quickly as possible. Isn’t it absurd that a healthcare provider would distract himself with something like a home movie during consultation.?
READ PART ONE: Lagos State Health Sector: Task before next governor
Mrs Priscilla whose case file got lost twice but found prior to her goitre surgery at Ikorodu general hospital has her post- surgery monitoring, halted for more than a year because till this moment, the file is yet to be found. She recalled that during pre-surgery period, while stressed up due to loss of her case file, one of the doctors on duty on a particular day, invited her to his private clinic to have the surgery for 400 thousand naira which he said, was negotiable.
Somehow one is tempted to conclude that the issue of loss of case files and the hostile behaviors of doctors in public hospitals are deliberate because each time patients find themselves in situations such as explained earlier, you’ll notice that the doctors would be on the sideline waiting to corner the patients to their own private hospitals.
A good number of them act as gbogbonishe (jack of all trade) doctors in their private clinics and oftentimes, end up referring the patients to the same public hospitals they were lured from, once something beyond them goes wrong.
Relevant regulatory authorities as a matter of urgency, must constantly supervise activities of private hospitals. They must ensure that doctors consult strictly according to their specialisation.
What we have presently is a situation whereby a general practitioner, GP, is known both as gynecologist and surgeon, and even pediatrician. This is not supposed to be so. So much quackery has sent and is sending people to their early graves.
Imagine that the MD of a private hospital, Manifel, located along Ijegun road, Ikotun, Lagos, had to consult his book in the presence of a sick and very weak child and her young and naive mother, before admistering a blood injection. In actual as the mother discovered later, what the child needed was a drip and anti malarial drugs admistered through IV because she wasn’t tolerating food and drugs. “The blood injection was given to her on a Friday because she was anaemic and I was asked to bring her back on Monday for blood transfussion but she died the next day being Saturday. It’s so had to overcome the pain of losing a child but the worst is that while we discovered changes in her breathing that Saturday night, we rushed back to the same Manifel. The doctor on duty observed her and rudely commanded us to ‘take this thing away’ even when we tried to explain that it was his MD that saw her yesterday. His attitude was more painful than the death of our child.”, Mrs Maureen Obinna recounted.
Government must also look into diverse forms of exploitation going on in public hospitals. For instance, Patients pay the stipulated amount for dressing their injuries or operation scars but oftentimes, wait in vain to be attended to. The dressing pads are seldomly available. What happens is that rather than wait till eternity, they are directed to go outside the hospital to purchase dressing pads, gloves etc. The story is that its either that some of the health personnel own those shops or they get commission for directing patients to the shops.
Cases of individuals with very high blood pressure who died immediately after they were given injection, abound. Who knows, their cases may not have been handled by experts.
It is deliberate that this article is not particular about infrastructure and equipment in the hospitals because most often, governments try to pay or pretend to pay attention to them, ignoring attitude of the healthcare personnel to the detriment of patients.
If all hospital staff are qualified, careful, and do their jobs assiduously and with all honesty, then, nobody will die of treatable and preventable diseases.
It must be emphasised at this juncture that healthcare providers and patients’ relationship must be that of trust. At present, due to heartbreaking stories of avoidable deaths, hostility, carelessness, too much stress on patients and exploitation which are rampant in hospitals especially public hospitals, people are no more comfortable with visiting the hospital but rather, have resorted to self medication.
Pastor Chukwudi who has had high blood pressure for years, visited Ijede general hospital after he noticed inexplicable general weakness and pain all over his body. He was sent for diagnosis covering xray, blood and urine etc . “The results came out and the doctor said everything was okay that the weakness was as a result of HBP not properly managed. I told him I’ve been taking my drugs so he prescribed additional drugs that he said will make me better. Weeks later, my condition became worse. I couldn’t sleep at night because I couldn’t breath. I lost appetite. I sweated so much and my body became bloated. My legs and stomach were the worst hit. I was almost giving up. My wife called a friend doctor who immediately prescribed a duretic and asked that she sent the results of the tests. She did and the doctor called back to say my heart had failed, which was reason for the retention of fluid in the body. The heart he noted had also expanded. He prescribed sone drugs with which I started getting better. Later, I went back to Ijede general hospital. This time, I met another doctor, an elderly doctor actually and the first thing he asked after studying my case file was that I showed him my legs. He expressed surprise that they were not swollen due to my level of heart failure. Then, I narrated to him how I came back to life.”
Pastor Chukwudi is alive to tell his story, who knows how many couldn’t, as a result of carelessness.
Another crucial area government must look into is the traditional birth homes and some nurses using their homes as maternity centers. Are these birth centres approved? Are the operators qualified to take deliveries? Are their maternity homes well equipped to undertake such crucial task? What if complications arise during delivery, how do they manage the situations, are some of the questions begging for answer.
Once, a neighbour (from Ijaw, Delta State) had her maternity home booming. Pregnant women came from far; even outside our community, on ante-natal days which made her home look like a market place on such days.
A year later, she became pregnant
She decided to take the delivery of her own child during labour. It turned out that the baby was over weight. The rest part of the baby refused to follow the head which was already out. The baby died still hanging there. Hours past and she was taken to the hospital for a cesarean section. Soon, she died of exhaustion.
And just last January, a neighbour’s daughter-in-law also died during child birth at a traditional birth place, living behind her baby girl. Very sad cases one must say.
It was gathered that some women who visited the likes of maternity homes described above, do so because according to them, it’s cheap. It’s also because they can’t afford to go through the rigours of using the public hospitals more so, they’ll be asked for blood donation. The next option is a private clinic but many accused private hospitals of always being in a hurry to perform a CS so that their bill will be much.
Where do we go from here.?
What awaits the incoming governor of Lagos state in the health sector, is quite a herculean task.
It is high time authorities stopped announcing any supervisory visits that offered health care personnel ample time to sweep their mess under the carpet only to pick them up as soon the governor, commissioner of health or supervisors leave. Supervisors can go as undercovers to observe what happens in the hospitals and they will be alarmed at the level of corruption and carelessness going on.
Was is not at the Health Centre in Festac Town that a nurse almost killed a 6 year old child with overdose. The mother of the child explained that “My daughter had malaria and I took her to the Health Centre. The doctor prescribed drugs which I bought from their pharmacy. I discovered she was getting very weak and we were afraid. In the night of same day, we rushed her back to the Health Centre but there was no doctor on duty. After we explained ourselves, the nurse on duty, prepared an injection, which we later found out was chloroquine. I became afraid without being able to explain why. I compelled my husband who was angry that I was delaying his daughter’s quick recovery, to call a doctor friend. After inquiring the drugs she had taken which included anti-malarial, the doctor warned us not to allow the nurse to give the child the injection but rather, give her ORT and run some tests. We obeyed the doctor and left the nurse with her injection. Our daughter got well afterwards and is doing fine.”
Who knows how many blunders that nurse has committed in the course of her duty.
And does it not sound abnormal that there was no doctor on duty that night to attend to the sick child. May I also tell you that even the doctor that attended to the child in the morning, was a youth corp member.
Regarding shortage of doctors and its effects on individuals wellbeing,
Mrs Edna Matthew recalled how she was refered to Island Maternity Lagos, from Igando General Hospital in Alimosho Local Government Area, Lagos, for delivery of her son. “I registered for ante-natal at Igando General Hospital. I signed for elective Cesarean Section, CS which was due in April, during Easter celebration which fell on the 12th. I wasn’t told anything about referral until on the 9th when I went for normal clinic. I was given a referral letter to Island Maternity Lagos and was told that doctors would be on Easter break and so wouldn’t be available for the CS. From there, I went home, picked up my bag and with my husband, went straight to Island maternity. That same day, I was delivered of my son but I almost bled to death. I was later told that I was supposed to have been admitted before the CS, but that they hurried up the process because they don’t like keeping patients due to inadequate beds. That was true because we were discharged on the 5th day just when my blood level came up to 22 from 14 percent after blood transfussion. We were sent back to Igando General Hospital for removal of stitches. If not for the stress of moving about, the movement would have been a great relieve as we had giant mosquitoes in their thousands, to contend with in the Maternity. Trust me, I came down with malaria that week.”
If not for shortage of doctors, why would a whole general hospital be without doctors all because of a holiday?
Any sincere government must be concerned about the issue of shortage of health personnel especially doctors. And so, must begin to map out strategies towards helping to address the brain drain factor. Nigeria is blessed with enough resources to lure her foreign based doctors back home to do the needful as their coming back will reduce stress on the existing ones, address issue of carelessness and improve quality of general Healthcare delivery.
In addition to developing infrastructure in the health sector, government should ensure hospital environment both in and outside, is conducive to encourage speedy healing.
Most of our public hospitals are unkempt. You’ll find cobwebs, cockroaches and mosquitoes contending with every available space. Even the lockers where patients on admission are required to keep their stuffs, look repulsive. Just like we are advised by experts to change our tooth brushes every three months, relevant authorities in the health care sector must have a stipulated period of time that such item and other equipment are to be changed.
It is worthy of note that in the absence of a vibrant healthcare sector, our quest for a sustainable and viable economy and social growth will remain a mirage.
Of great importance is the fact that, it is only when political office holders at all levels of government and ofcourse, from the top, are banned completely from embarking on medical tourism, that government at every level will see the very need to deal with the legion of problems undermining the growth of the entire Nigerian health sector.