By Chioma Obinna

Prof David Adewale Oke, the Chief Medical Director of the Lagos University Teaching Hospital, LASUTH, a renowned professor of cardiology, in an interview with Saturday Vanguard, maintained that LASUTH is the most busiest hospital in Lagos and the hospital is again disadvantaged due to its location.   He said although the emergency departments are overwhelmed on a daily basis, it will not only be irresponsible for the hospital to treat patients on bare floor but worst to turn patients back without resuscitation before referral.

His words: “LASUTH is the busiest hospital in Lagos and it is worst when there is industrial action going on in Federal hospitals like Lagos University Teaching Hospital, LUTH and Orthopaedic Hospital, Igbobi.   And right now, we are suffering the same fate because these hospitals are currently on strike. There is no way we can turn patients back even if we can’t admit them.   It is the responsibility of the doctors to resuscitate them and that explains why you saw some patients sitting in wheel chairs.

•Prof David Adewale Oke

Sometimes, when we identify patients that we feel cannot get to where we are referring them to, we tried to scout all the wards to find a bed to move a patient who is fairly stable so that we can take the new patient in. It is unfortunate that this hospital is probably the busiest hospital and the state owes a lot of obligation to the people in terms of free health.

A lot of those who come here cannot even afford to go elsewhere. So as harsh as I have been that nobody should be on the floor, sometimes we buy time to look for a place to put a patient. Otherwise if a patient comes and you send him or her back without resuscitation, the patient may die before he or she gets to the next centre.

Lack of bed syndrome

“We have about 600 bed space in the whole of LASUTH. In the medical emergency we have four wards with 25 beds and in surgical emergency we have three wards and an extension in BT wards.  In each ward, we have typical specialist for each ward, like ophthalmologists for eye, and neuro-surgeons that serve patients with neurological problems. In case of dire emergency we admit on any bed. However,

we cannot really move a patient if he or she is not stable and this leaves doctors in these areas with a lot of challenges on how to decide which patient should be moved to the main hospital wards.

Patient’s relations attitude

“Relatives have not made our jobs easy.   For instance, two days ago there was a drama in paediatrics emergency. A patient was brought in and the patient needed oxygen to be resuscitated. We did all of these and arrangement was made to transfer patient to Mercy Street Children Hospital in Lagos because there was no bed. The father was informed that this patient can go there since there was no bed space. He went bizarre, broke glasses and some hospital’s properties.

And this happens often here.   In a system that works, there should be communication between all hospitals. When you go abroad, once the bed is full it is full. But because you have communication with all hospitals you can easily phone and the ambulance can easily divert to another hospital. It is even worst when you have an industrial action like now.

The issue of bed space is not a problem that can easily be solved by LASUTH except the bed capacity is increased. That is really a capital project. What the State Ministry of Health is doing is to improve communication link between all the hospitals in the state. In LASUTH, we have a monitoring group comprising of senior nurses trained to solve problems.

Each hospital has and the state is trying to engage a system that will put us on. We now have Central phone lines. Like in LASUTH we have 0805, provided by GLO and most people working here have it.

Sometimes we have problems of sincerity of patients because this is a Tertiary institution. Sometimes the patient is so bad that their problem may only be solved here. And when that happens, it becomes a problem. You have to resuscitate and to see if you can get the patient in. As much as possible you want to save the patient’s life. Another challenge is the fact that there are only a few hospitals that can offer same services like LASUTH in Lagos.

We are close to the airport. Patients come in from everywhere. It is a problem we have to solve but as much as possible except it is essential we tried not to admit a patient if there is no bed but that rule cannot be followed every time.

Holding areas

“We do not allow relations inside the Accident and Emergency but we have holding areas where relations are allowed to stay. The patients holding area of Surgical Emergency is being moved because of the heliport the government is building. In an ideal situation, relations should not stay in the hospital but we have a peculiar situation in Nigeria even if the relation does not need to do anything for a patient they still feel it is necessary and it helps sometimes because you may need something extra which the relation will get but they are supposed to stay within the holding areas and come in from time to time.

Quality of nurses in emergency areas

“Nurses are very essential in making sure a patient gets out of hospital. We have enough nurses but no hospital will claim to have enough. We want as much as possible to replace the number of nurses that have left. We had an interview last week to replace them. In emergency departments, we run shifts. We are managing the number we have effectively.

Heliport

“The new heliport under construction will open up our operations. We have a critical care unit, an ultra modern centre that will soon be opened. Again, Ayinke House which is almost completed will be ready by December. Equipments are already on ground but we may have issues with the equipments when they are finally installed because they have been lying unused for a while but that will be sorted out.

We are also looking at expanding the hospital to meet the needs of our people and the only way is to move it. There are plans to build a 10-storey building for resident doctors and house officers so that our doctors will be on ground to easily see patients.