By Levi Obijiofor
The Federal Government last week shocked the nation when it criticised what it claimed to be deplorable medical care accorded to patients by doctors and healthcare workers in public hospitals. Health Minister, Dr. Osagie Ehanire, said at a meeting with directors of government hospitals in the Federal Capital Territory (FCT) that the government had received reports of sick people being refused medical attention in hospitals on the grounds of insufficient beds. The situation, the minister said, led to some of the sick people dying as they looked for medical care in hospitals.
The minister said existing poor services in hospitals can no longer be tolerated. Looking unashamed and blameless, the minister said: “We cannot afford to continue to lose so many of our people, who have found their way to hospitals, only to lose their lives to health conditions, some of which could have been cured. We know that not all emergencies are COVID-19 and we also know that our professional oaths oblige us to save lives and do something medically possible for those who come to us for help. Our calling as doctors and health workers is simply to save lives. We cannot, at this time, abandon such divine responsibility, especially in case of emergency, when our services are most needed.”
The minister said further: “I am also aware that many patients are left unattended after admission or even die while waiting for the result of their COVID-19 or other tests, which sometimes take as long as three to six days to be released. This has to change and, to address it, I have directed that a side laboratory for GeneXpert COVID-19 diagnostic machines, which deliver results within one hour, should be deployed and activated at the National Hospital, Abuja, and University of Abuja Teaching Hospital (UATH) to cut down waiting time.”
The health minister was pretentious. He understands quite well the appalling state of public hospitals in the country. He must confront the problem. The problem is the government, not the doctors. The problem is the lack of facilities, beds, testing kit, personal protective equipment, and other ancillary support services. Medical doctors and other staff of public hospitals cannot give what they do not have. If they do not have basic facilities to assist patients, they cannot turn to magic to procure those facilities.
The assurances given by the minister that the government has provided sufficient personal protective equipment (PPE), and laid out protocols to be observed to control and reduce likely infection by healthcare workers are best tested in public hospitals. It would be silly for any medical doctor and other hospital staff to accept the minister’s assurances on face value. Healthcare workers must not expose themselves to COVID-19 on the basis that the government has given verbal assurances. How many times have the government made promises that it failed to uphold?
Professional and high quality medical practice in Nigeria is hindered by too many problems such as lack of medical facilities, lack of hi-tech diagnostic equipment, poor understanding of the urgency of emergency cases, participation in medical practice by people who have no professional qualification to render that service, doctors prioritising financial gains over patient care, unethical conduct by medical officials, and other problems. These issues have generated the question: Why should the government establish hospitals, if there is no commitment to fund and equip the hospitals?
People continue to die in hospitals unnecessarily because hospitals are ill-equipped and unable to respond to patients’ needs. The best prayer anyone could offer to their family and relatives in Nigeria is that they must never fall critically ill or have the need for emergency medical care. I have lost relatives, including a sister, because of the failure of our hospitals and a so-called university teaching hospital to demonstrate knowledge and understanding of patient care.
Many people are walking dead but believe they are alive and doing well. Healthcare in Nigeria is illusory. Politicians do not care. The government does not regard the health sector as a problem that requires priority attention.
Increasing deaths of patients in hospitals across the country are direct outcomes of the government’s failure to live up to its obligations to the sector. For many years, the public hospital system struggled to rise from its state of unconsciousness. The government has an obligation to administer that life-saving injection to revive that important institution. Public hospitals in Nigeria have been described as a place where sick people go to die, not to be treated or have their health restored. That description is apt.
A government that refuses to provide funds and other support services to hospitals has no business blaming doctors in public hospitals for failing to treat patients or for allowing them to die. If public hospitals have good diagnostic equipment, if they have specialists in various branches of medicine, if they have doctors, registered nurses (RN), and supporting paramedical staff, the number of patients who die would not be that high.
There are different reasons why people are dying in public hospitals. The health minister must accept this fact. One reason is the cavalier attitude of many people to their personal health. People are dying as a result of poverty or apathy or ignorance or a combination of all three factors. They do not undertake regular health checks. They go to hospitals only when they are not feeling well, or they seek the services of traditional medicine practitioners. By the time illness sets in and the cause is diagnosed, it is often too late to save their lives.
One important lesson that COVID-19 conveyed to national and state leaders is the importance of maintaining a good hospital system to take care of everyone’s health in good times and in bad times. For many years, political and military leaders overlooked public healthcare system, relying on their wealth and other ill-acquired resources to fly to overseas medical facilities whenever they felt a murmur in their heart.
Unfortunately, COVID-19 took the world by surprise. Nigeria was unprepared. Our healthcare system was left to rot before the pandemic arrived. The failure to improve public hospitals provided a perfect terrain for the novel coronavirus to cause havoc.
With many people grounded in the country, anyone who contracted the disease was treated at the same decrepit hospital that our leaders failed to mend. A problem that could have been fixed many decades ago has ballooned into a major national catastrophe. COVID-19 arrived as a status leveller. Both the rich and the poor, women and men, children and adults, the healthy and the frail have been gravely affected by the virus. As someone noted derisively, with COVID-19, we are all in the crisis together.
Every year, the government allocates a huge sum of money to the healthcare sector. Every year nothing happens. No one asks questions. No one scrutinises the government, particularly the health minister, about what was done with the money set aside to improve the health sector.
We have a weak civil society. Nothing incapacitates a country as a spineless civil society.
A nation unprepared for health crises
By Levi Obijiofor