Abuja — Time was when many would not take the sick to University of Maiduguri Teaching Hospital (UMTH). For one reason, the belief was widely held that it was a place where no better than student doctors use people on admission as objects for learning.

For a second reason: mainly because being a specialist hospital where the most difficult of health conditions are referred to and where death rate is therefore high, many felt it was a place to go and die.

Residents of Maiduguri and much of the rest of Borno State now know better and have come to view the hospital for what it is: a centre of medical excellence. On its own, however, the new consciousness has long created a fresh problem. The hospital that once suffered low patronage now has not just the level of patronage that justifies government's investment on it but patronage that comes with what a comedian calls excess luggage.

This is how it works out. Many Shuwa Arab and Kanuri-speaking natives and many residents from other ethnic groups living in Maiduguri have, either through intermarriage or long interaction with the natives, cultivated a unique culture of sharing, of merry-making and of love for one another, which is characteristic of the people of Borno towards their neighbours.

It is said that an average Kanuri woman may threaten divorce if her husband cannot afford a ram for the naming ceremony of her new born. The new mother does not wish to miss the gathering of fellow women to eat, drink, and possibly offer gifts.

When a person is sick either at home or in the hospital in Borno, relatives and neighbours congregate to express their love. Everyone tries hard to show some presence in order not to be ignored should they similarly need company and compassion in future. This practice has steered much sense of neighbourliness among the people.

As President of Borno Museum Society, Alhaji Mohammed Adam, would note, this act of hospitality, which is embedded in Islam, can sometimes carry far enough as to encroach on some other established but opposing systems.

The Kanuri and Shuwa women and children that turn up in large numbers to either celebrate the coming of a new born or the solemnization of marriage, are the same who will visit the sick, wherever they are, in similarly large numbers.

"The people will readily flock to spend time with the sick or relatives of the sick," Adam said.

The University of Maiduguri Teaching Hospital has had occasions to express concern over surging turnouts of relatives of patients into the hospital daily. This intractable development, according to the management, is affecting smooth operations and compounding existing problem of congestion.

According to the Chief Medical Director of the UMTH Professor Uthman Kyari, about 10 years ago the hospital management had to set up what was called Hospital Community Relations Committee, the aim of which was to convince people to patronize the teaching hospital after misconceptions made it unattractive to many.

Today, the story has changed. From being a lowly patronized hospital, UMTH has became a Mecca not only for patients with illnesses that demand tertiary care but also for those with common illnesses such as malaria, cold, diarrhoea, and so on; cases that should have gone to primary health care centres.

They troop instead to the UMTH. They do this, as you will have guessed by now, with relatives, friends, neighbours, name them: five, seven, ten in number, or more, to tend for their patients mostly from dawn to dusk.

The patient's companions are everywhere: in the wards, around the corridors, in the toilets, almost wherever there is space. They congest the facilities at the expense of the sick who need such facilities most.

This affects the recovery of patients and the psyche of medical workers. According to a doctor at the Yar'adua Ultra-Modern Hospital in Bulumkutu area in Maiduguri, "Every day, I spend about an hour trying to drive away patients' relatives in a crowded ward before I can start work, a time I would have devoted to see other patients."

The doctor said the story is almost the same at the more frequented UMTH.

This has not always been the case. Like the extremity of patients once keeping the UMCH at arm's length and then coming to embrace it with gusto, the milling crowd of family and friends of the sick that now throng to the UMCH was simply not there in the beginning.

Professor Kyari recalled that when UMTH started, "before my very own eyes" in the early 1980s, it could be compared with any hospital in Europe.

He told Daily Trust, "Patients' relatives were only allowed within the hours of 4pm and 6pm, and only two relations per patient were let in within that given period. But you also have to remember that in those days, all the services were free; the drugs, patients' feeding, admissions and all the investigations that time, the hospital was wholly serving the community."

He also called to mind when one 'very senior citizen' died in the hospital one night those days: "That time we did not have this easy communication. You could only contact a patient's relatives when they came visiting. Unfortunately, the relatives in this case did not come the day he died because they didn't know. They turned up in the afternoon of the next day. This was sad, considering our tradition and from the Islamic point of view. Therefore, the management at that time took the decision that the hospital should no longer be rigid but allow unrestricted contact between patients and their relatives."

The decision by the management at that time to allow unhindered access, coupled with rapid population growth and the failure of political leaders to build primary and secondary healthcare facilities has resulted to the influx of patients. In turn, the culture of the people attracts the incredible crowd of relatives of patients that mass in today.

Unknown to these people, many that come with simple illnesses like malaria contract a second disease, while many that apparently are healthy go back home to realize that they have become ill themselves.

"Little children whose immunity is not yet developed are particularly very vulnerable to infectious diseases," Professor Kyari noted.

Dr. Baba Goni of the Infectious Disease Unit of UMTH argued that chances of infections to infants and even adults are made worse by the absence of Universal Precaution Services in the hospital.

Many observers in Maiduguri feel it is only when a hospital is well staffed for all services that the management can justifiably restrict the movement of relatives of patients. They note that today, unlike in the past, it is the patients' relatives that bring to the attention of a nurse when there is an emergency or alert the nurses when the drip has finished. It is the relative that rush to the laboratories or pharmacy to buy drugs.

The relative of a patient asked, "When you say no to relatives, can the hospital do all these?"

But there is more to it than a need for people to attend to the extra-medical needs of patients.

One particular story of a nursing mother at the hospital is memorable. According to her, she is lucky to have come from an extended family. Therefore, hardly does a week pass without a reason to visit a sick relative or associate in hospitals within and outside Maiduguri. Such a visit means an opportunity for her and her young children to eat a decent meal.

"As you know, those that have money prepare good meals to the sick and because the sick person does not have appetite, we eat the food." the nursing mother said. She added that her husband hardly provides sufficient food for the family: "So when an opportunity like this comes, I don't miss it."

For many, because of the problems of electricity and water supply outside the premises of the UMTH, people who visit to see relatives spend time looking after themselves. They take full advantage of the electricity and water in the hospital.

Anyhow, the culture of identifying with the sick is not about to be dropped by Borno people. Alhaji Adam said, "I disagree that this practice is for anything other than showing love and offering some psychological encouragement to the sick person. Mind you, such visits are done even to homes. It is not restricted to the hospital. In fact, some people travel from villages and far places just to visit the sick. It is part of an enduring tradition."