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The Lagos University Teaching Hospital, Idi-
Araba, a supposed centre of excellence in
health care in the country, is now a ghost enclave. For the 45th day running, paramedical workers have taken on the management of the hospital one on one on issues bothering on their welfare.
But the story is bigger than that LUTH is a rot, indeed a big disappointment to the country: Suffice to say that the call off of the strike will simply mark the closing of the preliminary pages of the story of this referral centre and begin its main chapters.
Last Sunday, the entire hospital wards were under lock and key. They included the physiotherapy, radio diagnosis, the ever-busy accident and emergency, obstetrics and gynaecoIogy, paediatrics, pharmacy, staff medical service, admission centre, medicine and surgery, etceteras. In all, the hospital has 650 bed spaces. The striking workers have refused to budge on their demands, which bother essentially on their welfare.
Mr. Kehinde Akinola just about 51 years old had a brain surgery on May 6 due to a head injury, which he sustained in an accident and was admitted at the hospital. According to his son, Joseph Olatunji Akinola, an Economics student of the Obafemi Awolowo University (OAU), IIe-Ife, “Baba has remained in this condition since that day, he has not opened his eyes but is breathing hence, we know that he is still alive. He was first placed on drips but now, we feed him through this ‘NG’ feeding pipe,’ which is passed through his nose. He takes fluids water, Milo, milk, custard and pap.”
Another patient also said to be in his 50s appeared a bad case. He was gasping for breath, and he has to pass urine via a tube. His son, Samuel, who was with him however said no ailment had been diagnosed. His abdominal region was swollen, which Samuel said began only the previous day and he had to exert pressure on the stomach for urine to trickle out in drops. As bad as these two cases appeared, there were no medical personnel around to attend to them.
Except for those two relatives of the patients, the only other person in sight was 19-year old Chidinma Sunday who had been abandoned in the hospital since he was six. He described himself, as “a nurse, a doctor and a patient.” Chidinma is confined to a wheel chair. The rest of the ward, indeed the entire hospital community was a deserted village.
The crisis has resulted in the death of several patients. For instance, when The Guardian returned to the hospital on Monday; the second patient who perhaps had a renal problem had bowed out. He was said to have died at about 3 a.m.
22-year old Raji Busari-Ishau , also an accident case was admitted into the surgical ward of LUTH on April 23, 2004, before the strike commenced. His case note read that he suffered ‘supracondylar and tibio fibula injuries and that ‘procedure ORIF is planned. He would require a token of N44, 500 for the surgery. Unfortunately, since he did not have the money he said: “No doctor has attended to me, they asked the students of the College of Medicine, University of Lagos, (CMUL) to be attending to me.” Today, Raji is on a wheel chair, even as one of his legs is fast deteriorating.
Except for one kind-spirited Dr. Bankole whom these few patients said has been coming in from time to time to attend to them, nothing else is coming in terms of medical aid. There is a limit to what help he can offer where the drugs and necessary medical equipment are unavailable.
It was for this alleged neglect of the institution as well as the hospital’s indifference to the plight of the workers that they called out a strike on June 15. Said the chairman of National Association of Nigerian Nurses and Midwives (NANNM) LUTH branch, Mr. Voa Vifowani: “We have come to this inevitable situation due to the insensitivity, of the LUTH management led by the Chief Medical Director Prof. Onatolu Odukoya to the plight of nurses on the one hand and the worrisome worsening conditions of LUTH, which today is in a terrible state of emergency.
The nurses were especially vexed by CMD, Odukoya’s alleged statement that “doctors own patients” and that they could carry on without the former. This they described as “an open disregard for the nursing profession.”
Other demands by the workers include:
- Non-payment of arrears of the Federal Government’s Harmonised Salary Package (HATISS IV);
- delay in salary payments; and
- removal of the GMD.
LUTH, a referral hospital was established in 1962. People are particularly sad that the one-time centre of medical excellence in West Africa has degenerated. The picture is pathetic. Samples:
- modular theatre down for three months running;
- no functional scanning machine;
- no functional x-ray machine;
- the Ear, Nose and Throat (ENT) accreditation given to the health institution, the only one so accredited in West Africa has since been withdrawn due to lack of efficiency;
- not one functional ambulance;
- no staff bus;
on water, bed sheets, pillows, etc in the hospital.
There are no nets on the windows hence patients have to battle all night long with mosquitoes in the now filthy environment. Recently, residents around the Mushin/ldi-Araba location of the hospital raised alarm over the health, hazard, which the stench coming from the hospital poses to them.
There are arguments that the problem of ageing may have set in on some of the hospital’s equipment. “But another school of thought dismissed the claim, questioning: “What about all the money voted on a yearly basis for maintenance, refurbishing and rehabilitation?” For instance N1.08 billion was voted to modernise LUTH through the Vamed Hospital Modernisation Project, huge sums of money, are allegedly being paid to First Foundation, the company that maintains the hospital’s CT scan machines yet patients have had to do these tests in private laboratories.
A joke shared by a senior nursing officer of LUTH is rather apt. She said: “... if you are brought to LUTH on a wheel chair, you would go back on a stretcher. And if you are brought on a stretcher, you would end up in the mortuary.”
The LUTH CMD’s defence has always been hinged on insufficient funds to run the hospital. For instance, the CMD was quoted as saying that in April this year, salary subvention to the hospital experienced a shortfall of NI0 million, which he claimed management augmented from the ‘cumulative slightly monthly excess.’
The workers, however, maintained that “but for poor management, the hospital has the capacity to generate enough resources to pay salaries and resuscitate decaying infrastructure, even without subventions.” This position corroborates that of Lady Elizabeth Uche Okonkwo. Okonkwo who is the secretary/registrar of the Medical Laboratory Science Council of Nigeria (MLSCN). She advised that government should, put ‘’in place modalities to make the health institutions self-sustaining. This she noted would minimise leakage, waste and at
the same time, enhance efficiency and improved health care delivery.
For the president, Confederation of African Medical Associations and Societies (CAMAS) Dr Boniface Oye-Adeniran, the CMDs across the country should not be held responsible for the poor states of the teaching hospitals. If workers are asking for the refurbishment of the hospitals, then the appeal should go to the Federal Government. He said, “in fairness to all the Chief Medical Directors, what they receive monthly is barely sufficient to pay salaries. The meagre resources they get cannot be used to perform wonders; they can only operate within what they have.
“Most of the teaching hospitals record deficits every month after paying workers’ salaries. What they are given does not cover their running cost.”
The gynaecologist called on the government to increase the level of funding to the teaching hospitals.
He cited two instances involving a senior government functionary who fell from a horse while playing polo and was brought to LUTH: “He needed an EED which the hospital did not have but one was brought within 72 hours. Today, other people are benefiting from it.
“Another top government official also brought his wife for delivery. The baby needed an incubator, as the child was a premature. LUTH did not have any, the man donated six incubators to the hospital which are the only ones in the hospital today.”
On another note, Oye-Adeniran observed that if half of what was given, in terms of funding to the National Hospital, Abuja had gone to the teaching hospitals they would do better. It would be recalled that a British concern, the International Hospital Group (IHP) secured a 10-year contract to manage the National Hospital. The group which took over on October 7, 2002 was given NI.39 billion for the first two years of the deal. The seven Britons allegedly earned N650 - million per annum.
There is also the supposition that if the National Health Insurance Scheme were implemented, the problem of funding of government hospitals would be reduced. The scheme, which was first introduced in Nigeria over 40 years ago was launched in the mid-90s and was established by Act 35 of 1999.
Meanwhile, LUTH workers are adamant, saying they would not go back to work until their demands are met. As the CMDs of teaching hospitals meet with government today, it is only hoped that all the pending issues will be addressed and succour brought to the suffering, masses. The situation on ground calls for emergency actions.
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