16 February 2013

Nigeria: At National Hospital, Patients' Files Litter Around

Hospital records of patients are supposed to be private and confidential documents but at the National Hospital, Abuja, one of Nigeria's major health facilities, they are an eyesore and litter some parts of the back end of the premises.

Walking casually down the Abuja National Hospital's premises towards the mosque and beyond penultimate Friday revealed a serene atmosphere, until coloured papers in different shade of brown, green, white and pink with burnt brown edges hit the eyes.

On approaching the documents, one of them had 'Nurses Process Records', written on it. Less than a foot away from it is a printed result of an ultra sound scan of a patient.

Among the medical records our reporter picked from the premises included details of one Mrs. Margaret O., who was delivered of a 4.5kg baby on July 7, 2005.

The laboratory test results of Elizabeth A, who was attended to by a clinician called Abubakar, was also seen. Ms A. had her blood screened on March 5, 2004 for a fee of N2, 000 and the document has every other detail of the patient's results.

Miss I. Omo also had her medical record displayed in public. The records are so detailed that one can see that Omo complained of itching on May 31, 2004, which grew worse at night. She was observed at 12 noon, treated for nasal blockage and frequent blood discharge every morning.

From the medical records found littered, not all cases are sorrowful as there is a baby I., whose mother was in prolonged labour and delivered through emergency caesarean session on March 11, 2004. The baby weighed 3.55kg.

A passerby and a regular worshipper at the hospital's mosque, Yunusa Usman, offered this explanation: "There was a fire incident in that building (pointing in the direction of the right wing of a new building still undergoing rehabilitation inside the hospital's premises) and in an effort to rescue items from the place, these files were brought down and have been flying all over the place since then."

When asked what caused the fire, spokesman of National Hospital Abuja, Dr. Jacob Adetayo Haastrup, said thus: "We had a minor fire incident in the hospital due to what professionals said was high voltage. This cut through the ceiling and extended to some part of the library room but the good news about it is that the fire service was quickly called and they were able to put out the fire."

Haastrup added that the hospital is undergoing an expansion of its facilities. "Some offices are there, there are wards there too as well as clinics. We have the medical records sections, the National Health Insurance Scheme (NHIS), where its assistant director has an office."

Although Haastrup told Weekly Trust that construction work on the building started two years ago, a female staff of the hospital who spoke on condition of anonymity said: "I don't exactly remember what year work commenced on the building but it was started under the old Chief Medical Director (CMD), Dr. Olusegun Ajuwon and that was definitely more than two years.

Our reporter also observed some of construction workers picking littered patient's file covers or their contents and tearing or folding them into halves to protect their palms while carrying glass sheets rom a Honda car into a building.

When asked about the littered files, Haastrup explained that the files are being arranged on shelves in the new building. "The ones you said are on the ground have staff arranging them on shelves," he added.

When asked if the sorting of the files were supposed to be done in the open at a car park and on the lawns, he said, "No, not outside. They can't be outside. They are within the reception area." This saying was contrary to what our reporter observed for three days in the hospital's premises.

When the spokesman was asked if he has gone to the spot to see things for himself, he kept quiet for a few seconds and said: "You see, I actually saw them; I've been there and that is why I'm telling you they were not outside as you said. It's just the arrangement that they started doing in that building."

At this point our reporter showed photos of the documents littering the ground but he still maintained his stand by saying: "You should know that we cannot litter patients' folders. But you can also see that the ones you saw maybe are the ones we want to do away with. Not the records of patients. We change the covers of these folders but the contents remain permanently and for the few contents that got burnt, we have backup on our computer system for any patient who comes with his/her card."

However, a male staff of the hospital said: "I've never heard a thing like this where patients' records are done away with anywhere in the world.

"I've worked here for about nine years. All I can say is that this incident occurred due to lack of standards and maintenance policy. See peoples' case files dating back to over 10 years just flying around here and all they have are these flimsy excuses? I hope a proper investigation is carried out so that it doesn't happen again."

On why workers were using the document as work tools, Haastrup said: "This is what I'm telling you; the covers are condemned. Although photos before him showed the hospital records being torn and used to move glasses, Haastrup said that was impossible. "They can't tear pieces of papers. These are experts in the field. We should be talking about something else," he added a little sternly.

After looking through the photos he said, "I'm telling you that there is a difference between the back of the folder and the contents."

Some patients were upset over the development and on Dr. Hasstrup's explanations. Mr. Abdullahi Adoke said, "This is absolute crap. Does the cover not have my name, information on my allergies and drugs that cannot be administered to me? How can anybody say that?

"This is a true reflection of absolute lack of diligence and care that even at individual level, we exhibit towards our responsibilities" said Mrs. Hureira Shuaibu who had brought her mother to hospital. Currently expecting her second child, Shuaibu said, "I'll be very mad to see my ultra sound scan lying on the floor like this for anybody with eyes to see. These things are precious and very sensitive and should be treated as such."

Asked if he was bothered that such vital information were left in open, Haastrup said, "There are security men all over the place. Those places where the files are kept are locked. It is only designated staff that is allowed there. The ones you saw are the ones which were scattered within this environment. We are now trying to pack them and retrieve their contents and repackage and send them back where they belong."

Reacting to his comment, a staff who spoke on condition of anonymity wondered thus: "Is it outside here or at the car park and lawns that patients' records are locked up and secured? About two weeks ago, there was an air condition fire in one of the old buildings that was quickly brought under controls and now this has happened and it seems like all efforts are being made to keep it quiet."

According to spokesman, with the presence of security men, there is nobody who can have access or make away with any of the folders. "The security men are there and I would be surprised if you had access to them. That means we need to beef up security. We are guiding the patients' folders and will continue to guard them," he said.

However, by the time this reporter visited the hospital 24 hours later, the records still litter the premises and there was no security personnel nearby to prevent passersby from having access to them.

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