The Paediatric ward at LUTH: A simple story of our collective failure

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We have often been critical of some of the health reporting in our mainstream newspapers in Nigeria but this morning I have found a well researched piece, simply and explicit that brings to life the horrific conditions in our tertiary care centres in 2010 Nigeria. We have always wondered why Nigerians are not angry enough at the state of their health care system, why our colleagues in the profession seem to be in denial about the prioritisation of their demands of government and why the the government itself chooses to focus on everything but the quality of care. I invite you to read this piece by TOYOSI OGUNSEYE in the Punch of Sunday May 9. I then invite you to send it to every Nigerian you know. It s the story of how OUR children are cared for in the Lagos University teaching Hospital Lagos, one of the country’s premier public tertiary health care facilities.

Below are some excerpts…read each one slowly. None of these will require millions of dollars to solve. None of these should be insurmountable in 2010 Nigeria, as we approach 50 years of independence. But be strong as you read, as if you do have children yourself it will be hard to hold back the tears. Each of these excerpts has one simple element that is solvable with a bit of will and leadership. 


Common Nigerians…. don’t let this keep happening to YOUR children.

“While weary looking mothers sit on the wooden chairs in the reception area, the frequent shrieks from babies in the clinic unsettle everyone in the environment, which is a far cry from being clean. There are a few men around in this section of the hospital, which has only two dirty toilets, already flooded by water. There is no bathroom…”

“After a few minutes, his mother comes out of the hospital and screams profanities at the medical personnel on duty. She feels that they did not do enough to save her five-day-old baby. The doctors and nurses ignore her and continue attending to other babies who are in critical condition…” 

 

Each bed in the emergency ward, which was opened by former Health Minister, Prof. Olikoye Ransome-Kuti, in Aug. 22, 2001, has a minimum of two babies that are between a day and one-month-old occupying it…”

“It is important that their mothers hold their babies all the time because the beds in the hospital do not have side bars that can prevent the babies from falling off. Even when the drip is removed, I can‘t sleep because my baby may fall down…”

Since I gave birth to my child, I have not slept. Even if they allowed us to sleep in the ward, I doubt if I will do that because the mosquitoes there are too many. We use mosquito nets at night to protect our children. I have also not had my bath because there is no bathroom here…”


”When they admitted my child, I was asked to pay some fees and buy some drugs. Where I paid for the drugs was different from where I collected them; which was also different from where I was given a receipt.


”The pharmacy is a 10-minute walk from the bank where I paid the money and the office issuing the receipt is another 10-minute walk back to the hospital. I have had to make this journey several times because my baby needs new medication almost every day. I realised that if I did not device a means of sleeping, I will collapse.”


That scenario was what the mothers in the room needed to express their reservations about the doctor on duty. ”I don‘t know what is wrong with him. He behaves as if he is doing us a favour, but he is not. We are all paying; nobody is treated free of charge here and that is how the doctor gets paid. He acts as if he doesn‘t care about our babies, doesn‘t he have children?” one of the women says.


Last week, a baby died because the nurse did not remove the drip in its hand early enough. Its mother called the attention of the nurses on duty to the drip, which had finished. She kept calling the nurses when she noticed that her baby‘s blood was flowing back into the drip. By the time the nurses attended to the baby and removed the needle, it was already very weak. The baby died.”


So, why do people stick to the hospital despite its shortcomings? Some of the mothers explain that they do not have a choice. They say, ”This is a federal hospital that has specialist doctors. Most of the private hospitals don‘t have specialists or equipment so we have to come here when our babies are in danger.

The hospital’s response: 

”We have to keep three babies in one bed because we don‘t have enough beds. Is that not better than turning them back and allowing them to die? They say that babies die here but this happens because the mothers will watch the health of their babies deteriorate before bringing them to us. But we are not magicians. No one talks about the lives that we save.

Read the full story here.

We have a long
way but we can start somewhere. We can….

http://www.nigeriahealthwatch.com/

Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead

Chikwe Ihekweazu is an epidemiologist and consultant public health physician. He is the Editor of Nigeria Health Watch, and the Managing Partner of EpiAfric (www.epiafric.com), which provides expertise in public health research and advisory services, health communication and professional development. He previously held leadership roles at the South African National Institute for Communicable Diseases and the UK's Health Protection Agency. Chikwe has undertaken several short term consultancies for the World Health Organisation, mainly in response to major outbreaks. He is a TED Fellow and co-curator of TEDxEuston.

Discussion5 Comments

  1. Chikwe,
    Thanks for forwarding this piece and for the ‘caution’ before one reads it. For me it is de javu, unfortunately and that is why we embarked on ‘Whole System Change of Failing Health Systems’ in 2004. We did not reverse all the poor attitude and behaviour by the time my tenure ended in 2008, but as the book with the same title shows the green shoots of real progress were clearly obvious by then.
    You know how ‘class action suit forced Pfizer to come clean and pay some price for its negligence in Kano’, maybe patients in Nigeria need to do the same. Perhaps the only reason such avoidable and preventable poor service are not so common place in the West, is because patients have recourse to Justice if necessary and practitioners are constantly careful because they know that negligence, bad practice and incompetence carry heavy costs including losing a license. Deaths and complications can happen in any institution any where in the world, but Bolam’s Law ensures that practitioners who do the right thing have nothing to fear. I say so because when you try to enforce clinical governance, quality and safety in Nigeria, health practitioners tell you that it will lead to selection and defensive medical practice which will harm patients generally. My response is that Bolam’s law or its equivalent in other countries ensures that society at large recognises ‘accidents’ from ‘bad practice’. Health Practitioners do not get punished for accidents which by definition is beyond their control to prevent or avoid.

    Joseph Ana.
    Former Commissioner of Health
    Cross Rivers State

  2. In response to the former commissioner, I think it is better to take the best bits out of the west and leave out its downside like suing those doing their best out of a bad situation. Nigeria and words like service are worlds apart. Perhaps I should begin with those we elected to serve us. The treat us like dirt and steal from us, and as such, there is no baseline with which to compare.

    The BBC program “Welcome to Lagos” has many in arms over how the premier state of excellence was portrayed. Again, those baying for blood including Prof Soyinka appeared to miss the point. “The Paediatric ward at LUTH: A simple story of our collective failure” should be seen as a benchmarking tool in order for us to move forward faster. Its such a shame that our best is still not good enough.

  3. In response to the former commissioner, I think it is better to take the best bits out of the west and leave out its downside like suing those doing their best out of a bad situation. Nigeria and words like service are worlds apart. Perhaps I should begin with those we elected to serve us. They treat us like dirt and steal from us, and as such, there is no baseline with which to compare.

    The BBC program “Welcome to Lagos” has many in arms over how the premier state of excellence was portrayed. Again, those baying for blood including Prof Soyinka appeared to miss the point. “The Paediatric ward at LUTH: A simple story of our collective failure” should be seen as a benchmarking tool in order for us to move forward faster. Its such a shame that our best is still not good enough.

  4. To me, comparing hospital facilities in Nigeria to those in the developed world is far from it and may not achieve the desire result as we may as well give up. I suggest NHW should embark on peer comparison between states or hospitals that are doing well and those that are doing badly and publish them. This should include rating of the teaching hospitals using various criteria. Health comparison among africa states would also help.
    I however insist that not everything in Nigeria/Luth is bad as the bloggers in NHW wants us to believe. Recognising some bits of the achievement recorded maybe good as well. Maybe you guys should visit home more.

    Adesunloye Tope, Abuja, FCT, Nigeria

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