Vanguard (Lagos)

Nigerian Hospitals - Houses of Health or Homes of Death?

ARE Nigerian hospitals houses of health or homes of death? Do the sick go to healthcare centres to cure or procure ailments. This is the big question on the lips of patients seeking healthcare services in government health institutions in Nigeria today. Even in the face of unacceptably poor health indices, the scenario isn't doing much to remedy the already bad situation. Little or no succour is offered to those who ail.

Cases of patients slumping or even dying on the queue while waiting to see the doctor are commonplace. Granted, many health government health institutions are overwhelmed and their facilities overstretched, but the problem goes deeper.

At the primary level- the erstwhile first point of care - nothing works, nothing is given and nothing is obtained. At the secondary level, activity is at best sub-optimal. There is shortage of everything from drugs and beds, bandages and syringes, to health workers, critical equipment and funds. But perhaps the most telling of all is shortage of patients. It is not surprising that general hospitals have lost the confidence of patients.

Today, the bulk of the health service delivery in hospitals falls squarely at the doorstep of tertiary health institutions - primarily established to carry out research as well as handle delicate referral cases that cannot be handled at the primary and secondary levels.

But service delivery even at this apex level is fraught with ill-motivated staff, poor time management, strikes, and decaying or decayed equipment and other inadequacies too numerous to mention. Here, the average patient is eternally confronted by endless waiting, bad staff attitude, and indistinct or unmarked service points. Half the time in a typical tertiary health institution is spent battling legion of inconsistencies.

The challenge of seeking and obtaining attention as a patient needs to be experienced to be believed.

As the first patient for the day, you do not get to see the doctor before 10:30-11:00am. And just perish the thought of seeing a senior doctor or consultant. This cadre doesn't resume work this early.

A case at hand is the current situation at the Lagos State University Teaching Hospital, LASUTH. By 5.00am, it is a common sight to see hordes of patients hanging around the premises, either standing in the open or lying on the bare floor. Several left their homes as early as 3.00am or spent the night within the premises in order to be in good position at the head of the lengthy queue in the morning. But quite often, the first-come, first-served arrangement is scrapped.

At five minutes to 8:00 am, patients are turned back, even those on appointment.

Most times patients leave the hospitals worse than they came.

Janet, a patient at the eye clinic department says: "To beat the 8:00am rule is never a problem but the most harrowing experience is getting here by 6:00am and not having a place to sit until they are ready to attend to you."

Janet who has attended the clinic in the last one year claimed to have met a consultant just once. "My pain is not only spending the whole of the day here, it is most disturbing that I am going blind. The consultant who sent me for laboratory test has not seen the result. At each appointment, I am given another date or asked to go for another test hoping that the consultant would have been around by then."

Alli, another patient, said his doctors are yet to decipher exactly the problem with his eyes since he started attending the clinic months ago.

"I was first diagnosed of immature cataract, later, they said there was nothing in my eyes and I was sent to another private laboratory. But the two test results are yet to be interpreted by the consultant."

These patients are not faced by these challenges alone, many of them complained that the condition at which they are left outside the waiting room only aggravate their conditions.

From the moment you enter into the hospital no matter how sick you may be you are not allowed into the waiting room. There are no seats. Every patient is forced to stand including the elderly, pregnant women and children.

Standing is just the beginning. If you cannot stand for long, simply find somewhere to perch.

In the absence of the consultants, the younger doctors hold sway, but only to book you for another appointment in three months without consideration for the state of your health. "How will a very sick person survive?" One aggrieved patient queried.

The situation is not much different at the Lagos University Teaching Hospital, LUTH, Idiaraba. On clinic day at the surgery department, just 10 patients are seen by the consultant. No matter how early you arrive, forget about getting attention if your card fails to be among the first 10 cards submitted. You better just go back home.

These hospital scenarios call to question when long waits at public hospitals will really be over. It could be recalled that the Federal Ministry of Health in partnership with SERVICOM, last year gathered all the chief medical directors of university teaching hospitals, specialist hospitals and the medical directors of Federal Medical Centres in Abuja to brainstorm on how to roll out a pilot programme aimed at reducing patients' waiting time at the General Out Patient Department, GOPD, of hospitals in the country developed by the Servicom office.

There were reports that the pilot implemented at the Federal Medical Centre, Keffi by the SERVICOM office reduced waiting time at the GOPD from seven hours to 30 minutes. If this happened, when will Nigerians reap the benefits of this programme in other health institutions across the country?

However, if the Federal Ministry of Health's plan to launch a new patient feedback platform, PFP, which will allow patients lodge complaints against hospitals is anything to go by, it would help push the country's health workers to deliver world class services.

The PFP is expected to enable patients and their relatives send their complaints or commendations about services direct to the health minister's office by SMS at no cost to the patient. Nigerians are waiting.

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