Enyeribe Ejiogu, Noah Ebije (Kaduna) and Abdullahi Hassan (Zaria), Bamigbola Gbolagunte (Akure), Rose Ejembi (Makurdi), Timothy Olanrewaju (Maiduguri), Raphael Ede (Enugu), Paul Osuyi (Asaba), Tony Osauzo and Ighomuaye Lucky (Benin), Emmanuel Adeyemi (Lokoja), Laide Raheem (Abeokuta), Layi Olanrewaju (Ilorin), Judex Okoro (Calabar)
Across the country, most tertiary and secondary health facilities (teaching hospitals and federal medical centres) are nothing to write home about. In most of these institutions, the situation is so bad that patients are required to provide their own medicaments such as hand-gloves, syringes, bandages, among others. This is just as many have to purchase drugs from pharmacies outside the hospitals before they could get the attention of the ostensibly overwhelmed doctors.
Hospital structures in many instances are dilapidated just as many vital diagnostic equipment have either broken down, outdated or simply not available. In the face of these daunting challenges, several doctors, motivated by their Chief Medical Directors (CMD) still strive to give their best in the face of the bad situation.
In this report, our reporters in the various state present a picture of the state of Federal Government hospitals, which the present administration promised in 2015 to bring to world class standard before 2019. As the nation awaits the inauguration of the second term of the President Muhammadu Buhari administration, many say this is the time for the various teaching hospitals and FMCs to receive the attention of the government? For the people, Buhari having done relatively well in his fight against corruption and insurgency, as well as chanelling good efforts in revamping the economy, he should now focus attention on health facilities in the country, saying that a heathy nation is a wealthy nation.
At the University of Benin Teaching Hospital, UBTH, Benin, Edo State, healthcare professionals are making the best of a bad situation as they struggle to use the available equipment to render services to patients.
One major diagnostic equipment procured by the institution, Magnetic Resonance Imaging (MRI), broke down a long time ago. Ever since then, the hospital has had to refer patients to private facilities that have the equipment for MRI tests.
However, the chairman of the UBTH chapter of the National Association of Nigerian Nurses and Midwives, Mr. Augustine Osigbeme, is full of praise for the management of the tertiary health institution, for its efforts to keep some of the available equipment marginally functional. Osigbeme’s earnest desire is that the Federal Government would assist the university to fix the existing one, as well as acquire a new one. This would end the era of referring patients to neighbouring states for tests that could have been easily handled at the hospital, if the requisite machines were available, he said.
“With regard to the state of diagnostic equipment in UBTH, and considering the efforts of the current management, I would say that our equipment are working. It is common knowledge that diagnostic machines may break down for one reason or the other, but they would be given prompt attention. However, there are some equipment that would have been helpful if we had them like the Magnetic Resonance Imaging (MRI), but the issue is that we do not have MRI in UBTH.
“When some doctors want to perform simple surgery, they have to send the patient to Ondo or Asaba in Delta State. I know one or two centres in Benin have these machines, but they are not available at the Federal Government hospital.
“So, it will not be bad if the Federal Government can buy these machines because we know how much they budgeted for Aso Rock Clinic, which serves less than one thousand persons compared to how much they budgeted for the public hospitals.
“So government should give adequate funds to the teaching hospitals and federal medical centres to acquire vital modern equipment for the sake of the people. When you send these people to a private facility, the bill will be too high,” he said.
Osigbeme also called for improved welfare package for the healthcare providers to curtail brain drain in the country’s health sector.
“Do you know why they are leaving? They are leaving because salaries are poor, welfare of the people is also poor. It is the fault of the government. So, when you are talking of machines, you should talk about the human beings that operate the machines because the machine cannot run itself.
“So, we are asking the Federal Government to employ appropriate staff and to also make conditions in Nigeria conducive for the workers, especially these in the health sector so that the people can enjoy the facilities and good health”, he said.
A medical doctor who spoke on condition of anonymity, disclosed that basic things such as oxygen cylinders are sometimes not available for treatment of patients requiring them.
“There is no difference between now and the past,” the doctor said in reference to the state of equipment and services in the hospital.
Also commenting on the services rendered by the health workers at UBTH, a patient who preferred anonymity said the hospital renders one of the best services in the country. She said the hospital places premium on the wellbeing of its patients.
The Chief Medical Director of the hospital, Dr. Darlignton Obaseki, was away when our correspondent visited. And no other official was mandated to speak on his behalf while the chairman of the Association of Resident Doctors, UBTH, Dr. Ese Eseigbe did not respond to several calls made to his mobile phone.
Lokoja General Hospital was converted to a Federal Medical Centre (FMC) few years after Kogi State was created in August 21, 1991. A visit to the FMC, revealed that the hospital is the largest hospital in the state with about 6,000 staff. It also has the highest concentration of medical doctors, consultants, pharmacists, laboratory scientists, nurses and other medical personnel, among others.
Investigation revealed that most of complex health issues are referred to the centre from the 21 local government areas in the state because of the facilities on ground and the capable hands available, even far better than the state specialist hospital located a short distance from it.
However, a visit to the FMC revealed that some of the equipment/ facilities in the hospital are now obsolete with some of them in bad shape while others have stopped working.
For instance, patients that need to undergo endoscopy are referred to other private hospitals, where they pay as much as N60,000 instead of the normal N30,000. Similarly, it was observed that only one of the five x-ray machines available in the hospital is modern. The older ones are in very bad shape and indeed hazardous to use now. Also, at the medical science laboratory, it was learnt that some equipment that could aid accurate analysis are now in bad shape and need replacement.
Although, the in-patient wards are essentially neat, there is clear and present need for more beds and beddings. However, drugs are in short supply. The National Health Insurance Scheme introduced by the Federal Government to aid some categories of patients is non-existent in the hospital as patients would often be told that the drugs prescribed for them were out of stock.
Also, Sunday Sun investigations showed that morticians at the mortuary department lacked requisite chemicals for embalmment of corpses. Hence, bereaved families are compelled to pay for the purchase of the relevant chemicals from outside. One other challenge confronting the mortuary is the growing number of unclaimed corpses of accident and kidnapping victims, robbery attacks and such other dead bodies deposited by officers of the Federal Road Safety Commission
It was learnt that some of these corpses could be held up to 10-12 months in the mortuary, thereby blocking spaces and causing offensive odour to pollute the environment.
The Accident and Emergency Unit suffers a severe lack of staff, resulting in the available staff to be overstretched and overwhelmed by the deluge of cases. This often leads to loss of lives of patients before they could receive attention.
A natural outcome of the daunting situation at FMC Lokoja is that commitment and morale have gone down with the attendant effect that most of the medical doctors run private clinics/ hospitals outside.
Investigation revealed that some of them hardly stay long enough at the hospital before closing for the day and resuming at their private clinics, where they refer patients from the FMC to regularly. This practice is said to be so rampant in the hospital that even in-house pharmacists also operate their own pharmacies outside, where they sell drugs to patients.
A patient, Abdullahi Eneojo, complained to Sunday Sun that his young son, who was operated on for hernia was left on the bed and nobody attended to him for three days.
“The worst thing is the uncaring attitude of the medical personnel to patients and show of outright wickedness by the FMC staff, especially the nurses who are so arrogant and saucy,” Eneojo said.
Curiously the effort made to speak with the Chief Medical Director was not successful at the appointment was cancelled after Sunday Sun reporter had waited for three hours. The Public Relations Officer, Blessing Anthony Sule, who had previously arranged the botched interview with the CMD declined to comment on the challenges confronting the hospital on ground that she was not authorised to speak on behalf of the CMD.
When the then General Hospital Abeokuta was taken over by the Federal Government and converted into a Federal Medical Centre, Idi-Aba, Abeokuta, to serve as a tertiary medical facility to provide specialist healthcare to the people of Ogun State, it was thought that healthcare service would improve. Unfortunately, FMC-Abeokuta has not been spared from the challenges confronting similar facilities across the country. It also has to contend with obsolete equipment, dilapidated infrastructure and insufficient staff, among others.
Notwithstanding the pitiable situation of the hospital, the appointment of the incumbent Chief Medical Director, Prof. Adewale Musa-Olowu in 2017, has seen the hospital witnessed considerable improvement.
Several structures are being built and the Accident and Emergency Section has been given a facelift.
Before now, the medical centre was embroiled in crisis emanating from agitations and strikes by the Joint Health Sector Unions (JOHESU). But the situation has significantly improved under the leadership of Musa-Olowu.
Sunday Sun learnt from the Public Relations Officer of Joint Health Sector Unions (JOHESU), FMC Abeokuta chapter, Taiwo Tiamiyu, that in addition to other personnel shortages, the hospital needs a well-equipped medical laboratory that can meet the demands of the high number of patients that troop to the health facility daily.
Although the hospital has about 75 consultants, many resident doctors are needed to support the consultants. He, however, commended the CMD for facilitating about eight new structures, including the pharmacy department and a four-wing medical complex for physiotherapy, gynaecology, ENT and social workers.
Interestingly, the hospital has taken delivery of a modular theatre equipment and also has a new ICT centre that currently provides free WiFi service. Notwithstanding, the hospital desperately needs to repair the second X-ray machine in the radiography unit.
As at the time of filing this report, the CMD was unavailable to speak with Sunday Sun as he was said to be away on official engagement at Joga Orile in Abeokuta North Local Government Area of the state, to supervise the establishment of an annex of the hospital to cater for the medical needs of the rural community and its environs.
Ahmadu Bello University Teaching Hospital (ABUTH), Shika, Zaria is located on a massive expanse of land in an isolated area dotted with old and modern structures, and hamstrung by scanty number of medical personnel operating with obsolete equipment. Many wards are idle without patients. A number of the hospital buildings are dilapidated and in grave need of complete renovation.
As at the time of filing this report, Sunday Sun learnt from the Acting Chief Medical Director and Chairman, Medical Advisory Council, Prof Adamu Ahmed, that the dilapidated state of the structures in the hospital could be attributed to the fact that they were built about 40 years ago, but were not occupied and put to use until 2004, by which time the structures had started to show signs of deterioration and disrepair.
“You can see some leakages in the building and we have not rehabilitated these buildings since we came in 2005; there is need to rehabilitate them, to have a befitting status,” he said.
Lamenting over the problem of lack of equipment, he said: “As at today, one of the major problems in the hospital is that most of our important equipment, which should aid our operations, are not functioning optimally. The X-ray department is the typical example where major equipment are not working. It is really embarrassing that a tertiary health facility like this which is a teaching hospital does not have CT (computed tomography) scanning machine.
“Today, if a patient needs to undergo CT scanning, we have to send him or her to a hospital outside this place to obtain such services. CT scan is mandatory and absolutely necessary for most patients. The same situation exists in radiology and oncology departments; we have some equipment that are not working.
“Ahmadu Bello University Teaching Hospital is the centre of excellence for oncology in Nigeria. It is one of the hospitals chosen for the treatment of cancer, but as at today, we have well trained and specialized doctors and medical personnel who have acquired experience in the treatment of any cancer disease. But unfortunately, basic facilities for radiotherapy, which is a vital component of cancer treatment, are lacking. Our only functional equipment in the department has broken down for more than one year now.”
On state of the laboratories in the hospital, Ahmed said: “We have well functional laboratories in the hospital, for medical microbiology, chemical pathology and anatomy. These laboratories have basic equipment that are working very well and we have well-trained personnel to manage these places. All the same, we need to acquire some sophisticated equipment for the laboratories to enhance their operations.”
Speaking about the hospital wards, he said ABUTH has capacity for 750 beds for patients which are shared and distributed among the departments depending on the specialty.
“The basic requirement in every ward is that there should be facilities and personnel to run those places. But unfortunately, we have shortage of manpower at the moment. For quite some time, we have not recruited healthcare personnel; so we have shortage of doctors, nurses, other professional healthcare personnel and even cleaners.
“Now that government has contracted out the services of cleaners, the hospital is not allowed to employ cleaners, security officers or gardeners. The companies handling these jobs are paid directly by the Federal Ministry of Health.
“For the past two years, these companies have not received any amount from the ministry. So, we had to find ways to manage their services otherwise the hospital would have been hygienically disastrous.
“At present, the morale of gardeners and cleaners is low because of their predicament as they only receive stipends from us instead of salary. You see, we have to do a lot to keep them working, but for how long will this continue? Any time you come to this hospital you find not less than 350 patients on admission. Few days ago, we had 398 patients on admission.
“These patients came with their relatives; so we have to clean, sweep and even wash the wards every day, we have to provide doctors and nurses to look after the patients. We are seriously under-staffed and we are working very hard to ensure that we recruit more medical and paramedical staff,’’ he said.
Regarding funding, the Acting Medical Director said: “The funding of ABUTH is grossly inadequate because as we speak, we get only about N5 million to N6.3 million monthly as overhead cost, and it does not come every month.
“In the past, the hospital spent seven months without receiving overhead cost. Out of this N5 million, we have to pay for electricity which hits N10 to N12 million every month. So, you can see that the money coming as overhead cost is not enough to cover our electricity bill alone, not to talk of other expenses. Besides this payment, we have to buy diesel for our generators.
“Though we are lucky to have received our capital expenditure for 2018 from the national budget in time, the internally generated revenue usually comes from the services we offer. We have a drug revolving fund programme which enables us purchase drugs directly from manufacturers and sell at low price to patients, our drugs are of best quality and affordable.
“We offer paid services in our laboratories, from which we raise some money to keep us functioning. We also generate some money from the NHIS programme and collaborations with donor agencies. We have also approached philanthropists in the community, but this has not yielded any positive result.’’
The current situation at the Federal Medical Centre, Owo in Ondo State, is a source of worry for stakeholders in the health sector, especially those working in the hospital. This is because of the poor working condition and lack of vital medical facilities in the hospital occasioned by alleged maladministration on the part of the management of the hospital.
Sunday Sun gathered that basic medical facilities needed for the treatment of some ailments are not available in the hospital, a situation which oftentimes necessitate the transfer of patients to other hospitals.
Also, it was learnt that many medical experts in the hospital have no opportunity for further training like their counterparts in other tertiary health centres in the country.
A visit to the hospital showed that many outpatients undergo some basic medical tests at private centres while many patients on admission in the hospital also have some tests done outside the hospital. This is even as patients were asked to buy drugs and other necessary medical items needed by them from private medical stores as such items were not available in the hospital.
The hospital which is the only tertiary health institution located in the state is always flooded with patients, especially accident victims, who are most times referred to other health centres due to paucity of medical facilities.
A staff of the hospital who spoke on condition of anonymity hinted that the welfare of the workers of the hospital was not given priority, hence the strike often embarked upon by various categories of workers in the hospital.
He also blamed the management of the hospital for not putting in place necessary facilities for the medical care of patients, and thereby called on the Minister of Health, Prof. Isaac Adewole to embark on an unscheduled visit to the hospital.
He lamented the high level of insecurity in the town, recalling that some members of staff of the hospital had been victims of kidnapping and killing on their way to work.
As at today, the Federal Medical Center (FMC), Makurdi, is the only health facility owned by the Federal Government in Benue State.
Although management of the health institution has continued to try its best to ensure maintenance of facilities in the hospital, some of the patients believe that the efforts of the management was like using a spoon to fetch water from an ocean.
Patients and their families who confided in Sunday Sun lamented that the hospital is gradually becoming a mere prescription centre as they have to virtually purchase all drugs from outside the hospital.
The Medical Director, Dr. Peteru Inunduh, who expressed worry over the infrastructural deficiencies in the hospital as a result of inadequate funding, however, noted that no hospital in Nigeria is self-sufficient in all areas.
“Healthcare delivery is very wide. I don’t think there is any hospital in this country that is self-sufficient or has all the equipment it needs to carry out service delivery because medicine is a very wide subject.
“In the hospital, we are offering close to 20 different specialities. And I want to tell you that every specialty has its own needs. So, when you conduct a needs assessment survey, you will discover that in every department of the hospital, there is a gap in terms of infrastructure and equipment,” he said.
Inunduh disclosed that the hospital, which was built in 1927, attended to 135,000 patients in 2016 and 165,000 patients in 2017 respectively.
He explained that the facilities in the wards are hardly enough for the increasing number of patients that throng the health facility daily.
“Now, we are limited because even the number of beds are not enough. Sometimes, patients come in and there are no beds because our patient turnover is very huge. Sometimes, we see as much 165,000 patients in a year. That is way beyond the capacity of the hospital. We are doing our best, but our patient load is much,” he said.
He also lamented that because of the low budgetary provision for the health facility, outsourced staff of the hospital such as security and cleaners have not been paid in the last four years.
He identified poor funding as the major challenge of the health facility, which has hampered the management in carrying out some critical developmental projects.
The University of Maiduguri Teaching Hospital, continues to strive to render healthcare service in the face of the huge challenge posed by Boko Haram insurgency.
“Fate has put the University of Maiduguri Teaching Hospital (UMTH) at its present position otherwise Borno and the Northeast would have suffered greatly and probably too many victims of the Boko Haram insurgency,” said the Borno State governor, Kashim Shettima, when he reviewed the services provided by the hospital in the heat of the violence.
For nearly two decades, UMTH which was established in July 1983, has remained the only tertiary hospital in the six Northeast states, providing medical services for referral cases from other secondary hospitals.
“It was established to provide clinical services, training medical personnel and conduct research in health issues,” Chief Medical Director, Prof Ahmed Ahidjo, said.
He explained that the hospital has not fared badly in carrying out its role. Until few years ago, it was the only referral point for patients from Adamawa, Gombe, Yobe and Bauchi states.
Over the years, the hospital has developed and its site witnessed erection of more structures and facilities. The accident and emergency unit of the hospital is the centre of activities receiving scores of victims of insurgency.
Chairman, Medical Advisory Committee (CMAC), Dr Mala Bukar Sandabe, said that the hospital received huge numbers of victims of bomb blasts and Boko Haram attacks, among others.
He said that the Gen. Theophilus Danjuma-led Presidential Victims Support Fund has been providing drugs and other medicaments specifically for victims of insurgency.
He also said that the hospital entered into agreement with the National Emergency Management Agency (NEMA) to provide over N70 million for the treatment of victims of insurgency since 2003, but said more than half of the money was yet to be released to the hospital.
“We are left with no other alternative than to use our scarce resources to handle the treatment,”he said, adding that the situation has been affecting the hospital’s finances.
The General Outpatient Department (GOPD) believed to be the eye of the hospital due to its strategic position as the first contact clinic receives over 73 per cent of total patients who come to the hospital, the Chief Medical Director, Dr Ahmad Abba, explained.
With 28 medical doctors, including those in administrative cadre, the hospital has only six consulting rooms for medical personnel to attend to over 200 out-patients who come to the hospital daily. Worse still, these medical personnel have to contend with inadequate equipment. For instance, the doctors share only one BP apparatus for patients.
“This means that we have to wait for ourselves to have access to the tool. This slows down work and takes more time especially on busy days,” Abba disclosed.
But the CMD said personnel were not deterred by these odds as they were more concerned with giving medical attention to patients. “The hospital should be a place of succour and that is what we strive to give to our patients,” he said.
The radiology department which provides diagnosis for other medical cases in the hospital has witnessed a lot of transformation especially with the introduction of the VAMED intervention by the Federal Government in 2005. The VAMED intervention was a special project that saw the contractors providing medical equipment, which they maintained for a period of five years. We got some of them that time and after five years, the contract wound up,” the Head of Radiology Department, Dr Muhammad Ahmadu said.
He said that the department started having challenges with the radiography machines after the expiration of VAMED contract. “We needed periodic and preventive maintenance, but these were not done. Most parts of the equipment are unavailable in the country. They are very costly, very expensive.”
Although the CT scan machine is functioning, it ought to be upgraded from 16 slides to over 600. Aside, the magnetic resonance imaging, MRI, the only machine being used in the radiology department is of low magnetic strength compared to what operates in other climes. “Even the X-Ray machine should be upgraded to digital radiography,” he stated.
Despite these challenges, the radiologist said that the hospital has been playing vital role in the diagnosis and treatment of renal cases.
At the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, patients complain of lack of water in the hospital and power supply. They said patients provide water for themselves. They also buy hand-gloves for doctors or nurses to attend to them.
UNTH was setup as a centre of excellence in research and training of high manpower in health sector as well as providing health services to Nigerians. However, due to poor funding, the management has been struggling to do what it can to keep the facility running.
When Sunday Sun visited the hospital patients complained that before a sick person would be attended to, relations would be required to procure some items such as, JIK bleach, Dettol disinfectant, Morning Fresh dishwashing liquid and a packet of hand gloves
A patient who gave his name as Hycinth Dugwu told Sunday Sun that he had been in the hospital for over two weeks and for that period of time he had to spend more than N350 every day to buy water. “I buy 10 liters of water for N60 in this hospital.”
He lamented that patients were required to buy everything including drugs, syringe and hand-gloves before doctors would even attend to them. “You can imagine if someone is rushed to hospital under an emergency, for instance, accident victims; the person would be required to procure hand glove before a doctor could attend to the person. That is the situation. I don’t blame the management because if the government provided adequate funds those things would be available for emergency cases at least.
Dugwu said that the hospital does not provide food to even patients in the ward. “For two weeks I have been here, my family has been buying food for me.”
Another patient, Mr Okenwa Michael, told Sunday Sun that his father was left on a stretcher at the casualty ward because there was no bed space.
Some staff who spoke to Sunday Sun on condition of anonymity said that the major challenges of the hospital are lack of power supply and water. “Several scheduled surgical operations have been cancelled due to non-availability of power supply. The hospital depends largely on a generator and when it breaks down, any surgery set for that day would be cancelled,” a source revealed.
Speaking in an interview, the Chief Medical Director, CMD, Dr. Christopher Amah, acknowledged the fact that power and water have been major challenges of the hospital.
According to him, the hospital spends N15 to N18 million every month to provide energy to the hospital, but receives only N5.5 million as overhead to run the entire hospital including the old site, three rural comprehensive health centres and the federal secretariat.
Amah who said that if not for the collaboration of the hospital with foreign donors from US, UK, Italia, among who have provided some level of infrastructure the hospital would have been in a sorry state.
“As you know, the mandate of the hospital first and foremost is research, training of high level manpower in the health sector and then rendering service. In terms of infrastructural facilities, it is not adequate and we can do better if there is fund. The assistance we get from number of foreign collaborators from US, UK, Italia and other countries have helped to improve our infrastructure. We get a lot of support from them and that is what has been helping us, especially in the cardiac programme.”
Prior to the commencement of the treasury single account (TSA) scheme, the CMD said that their internally generated revenue was used to replace some of the ageing equipment and refurbishing some wards.
On the power challenges, he said the hospital has generators to power the hospital, but stated that funds to fuel them adequately has been a major challenge. “We run generators here as the primary source of power instead of the public power. For instance, in the cardiac center when we are operating we don’t talk about public power, we switch on to generator. We have two 350KVA generators to run the cardiac centre because you cannot trust the public power supply.
“Cancellation of operations is largely due to power. When the backup generator for any reason is faulty or lack of diesel we cancel operations for that day. It is unfortunate, but we cannot help it. In 2018 we received the money for seven months out of 12 months.”
On water, he said that the water challenge is being addressed. At the Orthopedic Hospital, Enugu, the story is the same. Most of the wards have their widows broken down.
The story at the Federal Neuro-Psychiatric Hospital, Enugu the story is no different from others. Lack of funding has resulted in so many projects being abandoned.
The Federal Medical Centre (FMC), Asaba, Delta State is a tertiary health institution with about 350 bed spaces, the health facility is often overwhelmed by a deluge of patients seeking medical services.
As a tertiary health institution, Asaba FMC is supposed to handle referrals from primary and secondary healthcare facilities. But that is not the case as the place witnesses an influx of patients with various ailments including malaria.
The rush at the Asaba FMC, it was gathered, is partly due to the inadequacies at the primary and secondary healthcare centres across the oil-rich state. Besides, the FMC boasts of medical facilities that are non-existent even in some private healthcare centres in the state.
However, not all equipment in the hospital are fully functional while some need to be upgraded to conform to modern standards. Besides, some equipment breakdown without being fixed immediately, thereby necessitating the procurement of such services from outside the hospital.
In the radiology department, for instance, there are about four ultrasound machines, but the facilities are often over stretched by the huge number of patients seeking X-Ray services. At times when it breaks down, patients are referred to private facilities to carry out X-Ray.
Medical Director of the hospital, Dr. Victor Azubuike Osiatumah, a radiologist, admits that not all the ultrasound scan machines were functional when our correspondent confronted him with the reality.
“All four are not functional right now, but at least two are working. In this year’s budget there is a provision for acquisition of two additional X-ray machines, we have given letters of award,” he disclosed.
Osiatumah adds: “You know, when a machine breaks down and you are servicing it, at that point in time, it would not be available for use, and people would say that they came and it was not available.
“For the greater part of the year, the services are available, and if for one month that it was being serviced and, therefore, not available, it is not enough to generalize that there are no equipment. But again, it is possible that there are one or two staff playing some pranks which we will find out and apply sanction.
“If there is any staff deliberately sending patients out for such services for pecuniary gains, we will sanction because there is no laboratory anywhere in this state that can compare to what we have here. So, there is no better laboratory.”
The outpatient department is located in a one-storey building, which has the basic facilities to attend to any patient before referrals are made to other relevant departments. But for patients seeking admission, the hospital sometimes runs out of space due to the influx of patients, an obvious indication that the structures are inadequate to cope with the number of people, irrespective of the fact the FMC is supposed to be a referral centre.
For patients requesting surgical services, there are six theatre suites at the hospital with two of the suites at the obstetrics and gynecology unit, three in the main theatre while one is at the accident and emergency unit.
In addition to six functional theatre suites, Osiatumah said another being built for the accident and emergency unit would bring the number to seven, when completed.
He said that management has taken steps to develop other sub-specialties in medical practice at the hospital in order to reflect its tertiary status.
University of Ilorin Teaching Hospital (UITH), Ilorin, Kwara State, belongs to the second generation of teaching hospitals established by law on the May 2 1980. It took off in July 1980 and started operation from its temporary site located at the General Hospital and Maternity Hospital, both owned by the Kwara State Government.
In May 2007, former President Olusegun Obasanjo commissioned the permanent site while complete movement took place three years later in April 2010. The university is credited with starting the Community Based Experience and Service (COBES), which was its own unique expression of community medicine which gave its medical students opportunity for practical, hands-on learning.
Typical of other teaching hospitals owned and funded by the federal government, evidence of infrastructural deficiency dogs the health institution. Take one simple case: the laundry building, which is vital to the process of patient care, in terms of surgery and admission in the wards, is not up to standard. More importantly, the machines are obsolete.
Again the teaching hospital does not have a standard mortuary and the internal road network is bad. There is no water in the hospital and no electricity supply. The hospital relies on generators most of the time. In addition, most of the equipment in the hospital are obsolete. Drugs are either not available or priced out of reach of patients, thereby leaving the relations of the patients to patronize pharmacy shops outside the hospital. The wards are in a fair state but the beds need to upgraded and new beddings provided.
The hospital has two X-ray machines which are not modern. Two are available but marginally functional. Other diagnostic imaging machines for CT scan, MRI and mammography were not working as at the time of filing this report. Sunday Sun gathered from a source that “lack of spare parts and competent engineers to service the machines are the two major problems of the diagnostic machines.”
“The former chief medical director was more interested in brick and mortar projects; he preferred building houses, which have not yet been put to use,” the source said.
The surgical theatre staff disclosed it is one vital facility said to be relatively good state as staff who work there did not complain much about it. The laboratory rooms were found not to be spacious as would befit a standard medical laboratory science facility. Some of the machines in the laboratory have outlived their usefulness and need to be discarded.
At the hospital, patients are compelled to provide gloves, syringes and needles as well as detergents for cleaning.
A patient, Wosilat Ajetunmobi, who was on admission at the hospital said she had to provide gloves, syringe and soap before the nurses on duty would attend to her. Another patient, 67-year-old Amosa Abdullahi, commended the staff for treatment he received at the hospital.
He added: “But it takes long before many patients are attended to because the hospital is under-staffed. I want to appeal to the government to employ more hands to reduce the time people spend before getting treatment.
The chairman of JOHESU at the UITH, Comrade Olatunde Oluwawumi, who spoke with Sunday Sun on the state of affairs at the teaching hospital acknowledged and commended the efforts of the new CMD to improve the standard of the hospital generally, and noted that only so little could be done with available resources.
“The issues of health should not be toyed with. We are concerned with the health of Nigerians but we cannot continue to groan in pains even as we work to save people’s lives,” Oluwawumi said.
Despite the unsavoury deficiencies observed, there appears to be a silver lining in the horizon given the onerous efforts of the new Chief Medical Director, Professor A. D. Yussuf, who has made infrastructural upgrading as the focal point of his administration. Under his leadership, replacement of basic things like beddings has commenced; broken down equipment have either been replaced or repaired.
Under the present setting, the twin theatres of the hospital can now handle complex simultaneous surgeries as power supply has been boosted.
However, the health facility is still hamstrung by the daily gridlock on the road that leads into the hospital, due primarily to the construction work being done on the road.
The University of Calabar Teaching Hospital, UCTH, like the other tertiary health institutions has been contending with infrastructural problems. The bad situation has driven patients into the waiting arms of private clinics for medical attention.
As in other teaching hospitals adequate power supply has resulted in dismal services being rendered to patients. On several occasions, doctors were compelled to cancel scheduled surgical operations. In some critical situations, they resort to using rechargeable lamps to carry out surgeries, especially at night.
The state of wards is bad. When Sunday Sun visited some of the wards including the male and female surgical wards, neonatal wards, etc, are infested with mosquitoes as the mesh on the windows have been torn.
To aid themselves, patients are forced to provide some of the medicaments required and other items such as rechargeable lamps, disinfectants and to purchase water. Sometimes, they could be required to buy electric bulbs to replace the ones that have burnt out.
However, the management has embarked on some developmental projects, among which are rehabilitation of the nurses’ hostel, construction of Ebola centre and the establishment of a well-equipped ophthalmology unit.
Some of the staff, who didn’t want their names in print, blamed nurses, consultants, resident doctors and management for the poor state of affairs at the hospital.
A union leader, who pleaded anonymity, said: “The hospital is not functioning at optimum capacity because of lack of power supply and lack no materials for staff to work with and the facilities at the wards are in poor state. I think everything boils down to the attitude of the healthcare professionals. Everybody -nurses, doctors, management and medical health workers – should change their attitude towards work, bearing in mind always that we managing human beings with critical health issues.”
Reaction of Prof Thomas Agan, CMD UCTH
Four years ago, University of Calabar Teaching Hospital (UCTH) relocated to its permanent site, which was for long not put into use after completion. The Chief Medical Director, Prof Thomas Agan, said the hospital lost a lot when the facilities at the permanent site were vandalised.
He noted that progressively dwindling funding from the government has created some infrastructural deficiencies and made it difficult to provide standard amenities in the wards, standard visitors car pack, cafeteria, utility vehicles just as the hospital suffers from equipment gaps. Moreover, the replacement of broken down patient beds, mattresses and beddings as well as other items needed in the wards was hampered.
Agan, who doubles as the chairman, Committee of Chief Medical Directors and Medical Directors of Federal Tertiary Hospitals, said: “The state of the wards when compared to what obtains in other parts of the world cannot be described as good as the initial concept for these wards cannot match the modern day concept due to poor funding and low level of internally generated revenue.”
With regard to outpatient clinics, he said: “We have most basic facilities for patient care. However, it is not possible to provide every need at all times. For example, you may enter the clinic sometimes and discover that the blood pressure equipment, ECG, echocardiogram or any other equipment is malfunctioning.
“We have two digital x-ray and a mobile x-ray machines. Unfortunately, as a result of power fluctuation they have been damaged. These machines were temporarily shot down. We have now acquired a generator dedicated to the building housing the vital equipment.”
Continuing, he said: “The hospital has adequate operating theatres for all the specialties. These theatres may not be optimally equipped as compared to what obtains elsewhere but they have all the basic needs and we have constructed new four operating rooms for gynecological cases to reduce the syndrome of cancelling operations as a result of space to operate.
“Unfortunately, the medical laboratories for some time did not function maximally because of the crisis between the laboratory scientists and the pathologists. The board of our hospital waded into the crisis to resolve the issues.”
He lamented over the unfortunate situation where patients were sometimes asked to provide certain consumables that the hospital ordinarily should provide, and that such happens only times of acute shortages or at weekends. The crisis in the medical laboratories compelled patients to run some tests in private laboratories. He blamed the negative attitude of health care givers towards patients, and urged them to have a change of heart and bear the biblical golden rule in mind at all times.