BY VICTORIA OJEME

Last week, we began an X-ray in Nigeria’s health sector and published some of the reports. This week, we bring the concluding part of the story.

Poor capacity and manpower shortage impact poorly on healthcare

The Federal Capital Territory, Abuja has 13 government hospitals, spread across the 6 area councils, namely, General hospitals, Abuja Area Municipal Council(AMAC) located in Nyanya, Abaji, Gwagwalada, Kwali, Kuje and Bwari, including those located in the federal capital city.

These are the Wuse General Hospital, Maitama General Hospital, Asokoro General Hospital, National Hospital Hospital and of course Gwagwalada Teaching Hospital, as well as Federal Staff hospital, airport road Jabi.

For a population of 6 million, the current population estimates for the Federal Capital, the number of government hospitals seems adequate on face value, but a closer look at some of the indices, including, doctor to patient ratio, expertise as well as quality of service clearly indicate that all is not well with health care delivery in the FCT, in spite of Abuja being the Federal capital.

An estimate of patients who go to seek medical care at government hospitals located within the city centre indicates a figure of between 300 to 400 daily, while the area council is estimated to be between 150 to 200 patients.

The National hospital daily patients attendance is put at between 400 to 500, apparently because it is one of the few referral hospitals for more serious ailments that would otherwise require treatment abroad.

The overall estimates of patients’ daily attendance at government owned hospitals in FCT are put at about 6,000, a number that has far outstripped available infrastructure and manpower.

In FCT, only the National hospital has the MIR Scan, an important requirement for successful diagnosis of ailments such as cancer related diseases as well as bone marrow and brain related injury and treatment.

The general hospitals located in the six area councils are worse hit, barely managing to render mundane primary health care services, such as maternal and ante-natal care, HIV/AIDS care and prevention, among others.

As far as bed spaces are concerned, the National Hospital has the highest number of bed spaces, with 350 bed spaces, while such hospitals as Wuse has 130, Maitama, 60 and Asokoro, 60 bed spaces, meaning that on the average, only about 800 bed spaces are available for  an estimated patient population of about 6,000, including estimated bed spaces of about 150 available at general hospitals located at the area councils.

The quality of service delivery, ranging from misdiagnosis, aswell as outright incompetence in the handling of patients and ethical issues related to poor capacity have continued to dogg health services in the Federal capital.

The death of a 26 years old pregnant woman, Mrs Nana Lasisi during labour at the University of Abuja Teaching Hospital, Gwagwalada not only opened the eyes of the public to the level of incompetence in government hospitals in FCT, but also highlighted the helplessness faced by government in taking far reaching punitive measures against such misconduct for fear of losing the scarcely available medical personnel.

The woman was said to have fallen from a theatre table during labour, which later led to injuries on her head , after which she was confirmed dead on August 4, 2011, leaving behind a new born baby boy.

Lasisi who was hospitalized on the 21st July, 2011 for the purpose of delivery was administered with drugs to induce labour, after she was past her due date by one week and two days, further complicating her situation.

Then Minister of State for Health, Dr Mohammed Pate, who visited the hospital on a fact finding mission condemned the incidence.

The Minster had promised to investigate the incidence and possibly take punitive measures against those responsible for the unfortunate death of the pregnant woman, but nothing has been heard about the matter till date.

Ministry sources had confided that, the Ministry could not afford to dismiss any doctor at the moment owing to severe shortage of man power in the nation’s health sector, particularly in the FCT.

The case of the plight of five years old Ferdinand Chukwuma, also easily lends credence to the growing level of incompetence in government hospitals in FCT.

His parents recently pleaded for support to take their child to India for surgery owing to the apparent inability of doctors at the Maraba general hospital and University of Abuja Teaching Hospital, both in the suburb of FCT to surgically correct intestinal obstruction.

Though Ferdinand’s intestines were removed by doctors at the University of Abuja Teaching Hospital, ostensibly to rectify the problem, but it did turn out that, the course of treatment was wrong.

The FederalStaffHospital, Jabi was recently embroiled in crisis, when pharmacists in the hospital downed tools over allegations that the Medical Director imposed a private pharmaceutical company as the sole dispenser of drugs in the hospital.

In what is clearly an ethical issue, known to be rampant practice in the medical profession in FCT, the crisis paralysed services in the hospital for days.

The Ministry of Health has since waded into the matter, leaving many to guess what might be the outcome of the Ministry’s intervention.

Only recently, a woman, who did not want her name mentioned was wrongly diagnosed with breast cancer and had two of her breast cut off, only to discover in far away America that she did not have cancer.

Minister of Health Professor Onyebuchi Chukwu had recently lamented poor service delivery in federal hospitals, including hospitals in the FCT.

The Minister expressed his concern at a meeting with  the Forum of Chairmen of Boards of Federal Tertiary Heath Institutions, in Abuja.

Insisting on the need for health professionals to adhere strictly to the World Health Organization(WHO) checklist on standards on surgical safety, he warned of dire consequences for doctors who become negligent .

The minister, in a statement signed by Special Assistant to the Minister on Media and Communication, Dan Nwomeh , Chukwu  recalled the dismissal of some consultants and resident doctors in some federal hospitals for negligence, saying that if the checklist is used as a standard procedure in hospitals, the unfortunate incidences that led to the sack of the doctors would have been avoided.

“The minister lamented that most of the criticisms against the Federal Ministry of Health arise from the situations in the hospitals, and mandated the forum to take necessary actions to ensure the realization of President Goodluck Jonathan’s vision for health”

“Prof. Chukwu listed critical areas of intervention such as environmental hygiene, out-of-stock syndrome in pharmacies, long waiting time and quality of services to patients” the statement added.

Manpower shortage is also a critical area that has continued to negatively impact on health care delivery in FCT.

For a daily patient population of about 6,000, the distributions of various categories of health care professionals grossly undermine any meaningful effort to improve service delivery.

Estimate of pharmacists available at any point in time in all government hospitals is put at about 120 in the whole of FCT, while doctors are slightly higher with an estimated number of 350.

With so many patients in FCT traveling out in droves for medical care, as well as unprecedented expansion in the number of daily patients attendance in private hospitals, inspite of the exorbitant charges, health care services in the FCT are clearly not meeting the needs and standards expected by residents.