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General hospitals: A tale of sorrow, frustration, avoidable deaths

•I was asked to stay in same room with corpses —Patient •Hospitals understaffed but... —Deputy CMD •We are working to improve services —Govt

BOLA BADMUS, SHOLA ADEKOLA, NEWTON-RAY UKWUOMA, KEHINDE AKINSEHINDE-JAIYEOBA, NAZA OKOLI and SYLVESTER OKORUWA help Lagosians tell their sordid stories patronising state-owned general hospitals.

PUBLIC health services are not on the list of things that a sizable number of residents in Lagos State are presently very cheery about. But the government says that it is not unaware of the state of affairs in its hospitals and, therefore, is giving the populace the assurance of something far removed from a raw deal health-wise. It says it is taking drastic steps to make this phase in its health sector pass.

“The government is out to address all issues that pertain to quality of care,” says the Commissioner for Health, Dr Jide Idris.

In the meantime, many residents agree that negligence on the part of hospital management, doctors and nurses are some of the factors militating against quality health services in these facilities.

Most of the general hospitals, which once served as the last hope of the masses who tried to avoid the killing charges of private hospitals, are found to have become almost inaccessible to this class of people because of systemic problems.

At the general hospitals, the idea of getting quick attention from the personnel, it was gathered, has become a wishful thinking. It has been claimed that a sick person who arrives as early as 8.00 a.m. may be unable to see a doctor before 4.00 p.m. or the following day, for “frivolous reasons.” Against this background, there are said to be a flurry of complaints about the state hospitals.

Carelessness on the part of the health officials despite the huge funds the state government has sunk into the hospitals has been blamed as the number one cause of sorrow for patients seeking medical succour at these facilities.

Allegations are rife as to how emergency patients are always neglected due to bottlenecks created by health officials for no genuine reasons. “It is either a competent doctor is not on the ground or there is a shortage of doctors or the nurses to prepare the patient who is between life and death for admission or consultant is in one corner attending to other extraneous, non-important issues. Many patients on critical list have died for these obvious facts while others have become frustrated and discouraged by the unpalatable experiences they went through at the hands of the hospital officials,” a respondent who sought anonymity told Saturday Tribune.

The alleged unprofessional attitude of the health officials has reportedly pushed many patients to the hands of exploitative private hospitals while those who do not have the financial muscle to approach private hospitals have remained at the mercy of workers at the general hospitals.

 

Our stories –Patients, relatives

Many have described the state hospitals as places of negligence and frustration with many stories of woe to tell.

Mrs Lolade Olaoye, who once went to a certain general hospital (name withheld) to treat her infected leg, lamented the experience she passed through for the three days she was in the hospital before she finally begged to be discharged to seek treatment elsewhere. The woman, who claimed she got to the hospital around 11.00 p.m., said she was attended to at the emergency ward of the hospital where she was given prescriptions and later admitted to a female ward of the hospital, which was on the first floor.

She recounted her consternation when she was asked to stay in the same ward with what turned out to be two corpses. Upon inquiry from the nurses around as to why corpses were kept in the ward rather than evacuated to the mortuary, she said she was told that was the norm in the hospital to allow corpses of patients that died after 6.00 p.m. to remain in the wards till when mortuary attendants would resume duty, in the morning.

Olaoye, unable to sleep around the dead, said she asked to be returned to the emergency ward, where she stayed till the following morning.

“Out of fear, that night, my wife left for the emergency ward where her condition became worse until morning, when she returned to that ward,” the husband, Mr Olaoye, corroborated her wife’s claim, stating other miseries they faced in the hospital.

“That Thursday morning when I got there to check her at the ward, I was not allowed access until 4.30 p.m., before I could pay for drugs and blood sample test. They said they needed two blood samples but I went to the nurses on duty to tell them my frustration. They informed me that they didn’t take blood samples; that only a doctor could do that and there was no doctor on duty.”

Also to the chagrin of everyone, no doctor was available to attend to his wife as of the time he first visited his wife in the hospital.

“And patients died like fowls within the three days I stayed in the female ward,” Mrs Olaoye interjected.

According to her, at least, 10 deaths were recorded daily for the three days she spent in the hospital before she begged for an immediate discharge to seek better treatment elsewhere.

The distraught woman also narrated the tale of an accident victim who was rushed to the same hospital in the night in a serious condition. She said it took almost an hour before the nurses on duty could be woken up to attend to the man. According to her, by the time the doctor came around, the victim had given up the ghost.

“My wife was forced to request to be discharged from the hospital because of the ugly incident and lack of care for life on the part of the hospital management. Even for drugs and prescriptions to be administered on you, you are at their mercy; you have to beg. I was the one that was begging them. But services at the payment points were effective,” Mr Olaoye said.

The story was not different at another general hospital (name withheld), where Saturday Tribune visited. A doctor was said to have recently told a man who brought his father for treatment to look for another health facility if he actually loved his father and wanted to continue to have him around.

Another source, who only spoke on the condition of anonymity, told of how a friend of his, whose son had convulsion, was refused admission at the same hospital. “A friend of mine took his son suffering from convulsion to the general hospital. The son was inside the car twisting and turning for hours. No admission. The doctors were not just there,” he said.

Only a few months ago, the News Agency of Nigeria (NAN) reported the story of a woman whose husband’s corpse was “seized” by a general hospital in Lagos (name withheld) after the woman had failed to pay for the blood transfusion given to her husband before he died. However, the woman (identified as Esther Solomon) had alleged that her husband who was admitted to the emergency unit died due to negligence on the part of the hospital management.

“I paid N4,500 before they brought the blood and transfused it in my husband and I was told the money was made for the processing of the blood. Now, my husband is dead and they said I should pay N15,000 for the blood or bring someone who will donate the blood to the hospital because the blood was borrowed,” she said.

Solomon said her husband would have survived but for a power failure in the hospital which occurred moments after her husband was “placed on oxygen.”

“Immediately the light went off, it was not up to five minutes before I discovered that my husband who had been placed on oxygen had stopped breathing and when I shook him I was convinced that he was dead,” she added.

According to the report, Solomon’s account was corroborated by a witness (identified as Blessing) whose mother was at the hospital at the time.

Relating her own experience, Blessing said: “When we brought my mother to the hospital I rushed to the emergency unit to alert the nurses of our arrival so that my mother would be taken into the ward. But they said we should bring her in by ourselves and there was no way only I and my brother could carry her into the emergency unit.

“We had to look for a wheel chair by ourselves before we could bring in my mother into the ward. Even when the power outage occurred in the health facility, I thought they would switch on the generator immediately but it took about thirty minutes before power was restored in the ward. I had to start fanning my mother who was also placed on oxygen, using a hand fan pending when the light would be restored.”

 

More bodies, fewer hands

hospital-sick-patients2At another general hospital in the state, it is always a beehive of activities from as early as 6.00 a.m. to late in the night, especially at the maternity clinic of the centre. A routine ante-natal clinic has been noted to be an all-day affair as the number of patients was obviously more than the number of hands to attend to them.

Saturday Tribune gathered that gynaecologists and obstetricians at the hospital were not more than five, thus they could not afford to go on shifts. However, the teeming pregnant women, who are mostly left stranded despite that these doctors work round the clock, undermine the doctors’ efforts.

Kemi, a pregnant patient, during her ante-natal check-up, told Saturday Tribune that sometime last year when she came with a friend who had a  missed abortion, the same doctor who attended to them in the morning was also the one who carried out the evacuation of the dead foetus late at night.

“We got here around 7.00 a.m. and went through the usual checks but could not see the doctor till 1.00 p.m. The doctor we met on ground checked my friend and asked us to do a pelvic scan. After doing the scan, we got back to the hospital around 4pm, and the same doctor said an evacuation will be done. At about 10.00 p.m., my friend went in for the minor surgery done by this same doctor, which made me wonder how he could attend to patients from morning to midnight.

“Midway through the procedure, the light went off. My friend’s husband had to go in and help hold the touch for the doctor to see. Even when there was light, the theatre lamp was not illuminating enough as the nurse held a torch for the doctor too,” Kemi said.

“I wouldn’t lie to you, we see more than 200 patients a day, both in and out patients. We sometimes get exhausted handling them,” one of the pharmacists confessed to Saturday Tribune. She spoke like someone carrying a weight of silence:

“The government should employ more nurses and doctors. There are a lot of them out there looking for jobs. There is no division of labour here. For instance, I am the only one doing evaluation and assessment for over 200 patients. We also have a problem of space. We have not enough rooms to take in patients. A part of the wall was leaking until we were moved. More houses should be built for pharmacy section. We are joined with every unit. That is why everybody comes here, making this place jam-packed.”

Dr Keshinro, the Deputy Chief Medical Officer in one of the hospitals, Ifako Ijaye General Hospital, spoke to Saturday Tribune after attending to many patients himself. “Sometimes we have this upsurge of patients. You know, this place is centrally located. People have easy access to the facility here. For a good number of days, we have been experiencing that. I think the reason is that it is easy for people to have access to the general hospitals than any other hospitals. Some of our patients come from outside Lagos. At times, it stresses the doctors, who have had to work harder. Sometimes they have to close for work later than they should,” he explained.

He also responded to inquiries about the hospital structure and staffing. “We try to maintain what we have here. We update and replace our facility from time to time. But as long as any of our facility is still working we continue to use it, except it breaks down or shows sign of it.

“Shortage of staff is not only peculiar to here alone. It is everywhere. However, we are coping with what we have. Building more hospitals or expanding existing ones can never put the government at disadvantage. Hospitals can never be more than enough. Even if they build twice the size of this, they still need to build more blocks to expand it because the population keeps growing.”

Another senior officer who pleaded anonymity explained that most cases of unprofessionalism were not solely the fault of the doctors but as a result of being overburdened. He said there was still a large gap in the patient-doctor ratio which at times meant the patients were treated by other doctors outside of their specialisation. He said this was one of the causes of preventable deaths in these hospitals.

 

Indelible pains

An elderly woman (who didn’t want her name in print) tearfully recalled how her husband died in a certain general hospital eight years ago.

“On that fateful day, my children and I rushed him to xxxx General Hospital. At the emergency section, the doctor gave my husband insulin injection even when my husband was not a diabetic patient after I told him not to give him the insulin injection. The insulin injection led to serious complication which led to his death. But my daughter, a journalist, called the then commissioner for health who pleaded with the family not to take legal action,” she said.

A female reporter with a popular television station, recently, at a press conference organised by the Lagos State Ministry of Health with the Commissioner of Health in attendance, recalled, in tears, how she lost her second child due to negligence.

“On that fateful day in December 2014, while feeling like my due date to deliver was close, I went to one of the Lagos State general hospitals. Incidentally, it was a public holiday. There was no doctor to attend to me. I called the commissioner for health who called one of the doctors to attend to me. The doctor came and examined me. After the examination, I felt my baby was no longer moving after three days. I went back to the hospital only to be told that my baby was dead.”

 

A doctor’s defence

The Chief Medical Director, Federal Neuropsychiatric Hospital Yaba, Dr Richard Adebayo, said the case of negligence and unprofessionalism should be viewed in two broad ways; the system and then the professionals themselves.

“Those are the areas we need to look at. Does the system give room for negligence? When you have scarcity of staff, when you have infrastructural decay, what do you expect the workers to do? No matter how competent they may be, they will still have problems. When power can go off and on in a hospital theatre during operation and the generator is not functioning well, what will you expect the competent physician to do?

“So, when we have systemic problems like these, we cannot expect patients to be properly treated. We are in a system where the equipment are obsolete, where drugs are substandard. We have to be very sincere; we cannot blame professionals all the time in all cases of negligence. Because these same practitioners, when they leave the shores of this country where there are laws guiding the profession, where the system allows for excellence, it is very rare for them to complain about negligence.

“Our health officials when they travel abroad, they are celebrated, the same people that we condemn here. The problem is not only about infrastructure or number of staff, how about laws? Do we have health bills that have been passed and are being implemented? What of staff remuneration? There are a lot of staff who are being owed salary here and there. This is beyond Lagos State. When you talk about negligence, it permeates the entire country. We hear that doctors are being paid half salary. How can you get the best input from these people? The system is one aspect of it.

“The second aspect is the professionals themselves. I agree that some professionals are to blame as regards the issue of medical ethics. We handle lives. And we must handle lives with utmost professionalism, with utmost respect and dignity. But unfortunately a lot of health workers have abandoned this. It is appalling. It is disgusting. Because you have issues with the government, is that enough reason to abandon the patients? You don’t care about their condition as if they are the ones you are fighting, people we have admitted; people in our care. It is all disheartening. I think we need to wake up. Both the government and health workers need to wake up. I believe that if lives are lost and people don’t take it as the will of God and they sue hospitals, both the management and government will wake up.”

 

Government speaks

Reacting, the state Commissioner for Health, Dr Jide Idris, told Saturday Tribune that the state government would not rest until the situation is put under control.

“We are aware that the hospitals are staff starved. However, that there is a shortage of staff is not enough reason for unprofessionalism. We will not condone that. We are currently addressing the issue of staff shortage. People are feeling it much particularly because of the pressure on our system. The population of Lagos keeps increasing. We have upsurge of people coming from other states to Lagos. And we are also trying to address that as a government. The governor is very keen on addressing this issue. He has been discussing how best to tackle the issue.

“We are also looking to involve the private sector because of the load on our system. Currently there is a plan to renovate most of the general hospitals. It is going to commence in a few weeks. Everything cannot be done in one fell swoop. We have started here and we will get to all the levels of healthcare in the state.

“With respect to staff attitude, I want to believe that in every family, there is the black sheep. One major thing we are trying to address especially as it relates to the quality of care is a campaign on attitudinal change. Our attitude to healthcare must change.

“Secondly we also need to retrain people. We are increasing monitoring activities right from the ministry to every government-owned health care centre. We are involving the private sector.

“We are involving civil society and community members to give us situational reports so that we know how to address things. We are also involving people, we want those who have these experiences to come to us. Let us know. We need mystery shoppers to visit these hospitals and brief us on the quality of service delivery reports. We will address any report we get. And let me say again that any case we confirm as due to negligence will attract sanction on those involved.

“Now, there is what is called Maternal Death Review. Any mother who dies during delivery will be investigated. If it is caused by negligence, we handle the case and if it is inexperience, we train them.

“I know there are bad eggs but all I am saying is that the government is out to address all issues that pertain to quality of care,” he said.