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A tale of two health systems

By Francis Ewherido

Citizen Adebayo Akinwunmi, 41, a Nigerian, was shot by armed robbers in his house, in Ogun State, near Lagos. He specifically requested his elder brother, Babatunde Akunwunmi, to take him to Reddington Hospital, where his company had a retainership. He probably took that decision to get prompt medical attention.

• a General Hospital.

At the hospital, the family claimed that the nurses on duty asked for a police report before he could be attended to, even though there has been an Act for Compulsory Treatment and Care of Victims of Gunshot since last year. The act simply says save life first and report to police thereafter. But the hospital has come out to say no, it treats gunshot victims, but that a hospital of Reddington magnitude did not have a single doctor on duty at the time the victim got there! [Even the small clinic that my family patronises has a doctor on duty at all time]. Reddington then referred him to the nearby Lagos State University Teaching Hospital (LASUTH). Long and short, the man died, he was pronounced dead on arrival at LASUTH.

Meanwhile, Citizen Isaac Sederbaum, 31, a United States citizen, went mountain biking in Washington State, US, when he was attacked by a cougar (mountain lion). After the attack, which killed his biking partner, Sederbaum put a call through to 911. He was airlifted to a hospital where he was promptly attended to. In spite of the fact that the cougar bit him in the head and shook him violently, citizen Sederbaum survived and is in stable condition. Where Sederbaum to suffer this violent attack in Nigeria, he would be cooling in the morgue by now.

Two emergencies, one fatality and one survivor; what is the critical difference here? Medical facilities? No, not in this case. The critical difference was the attitude of the medical personnel. One set of medical personnel have value for life, human life, while for the other group, patients are just numbers and death means nothing. What are mortuaries for after all?

We lost our sanctity for life a while ago. As I was writing, I saw the headline, “Again, herdsmen invade Benue community, kill five.” Tomorrow, fresh people will probably be killed and the killings continue. But for the fact that Nigeria’s population is growing in geometric progression, the number of killings in Nigeria would have put our population on the reverse by now.

By the way, gun wielding maniacs have also turned mass killings into a past time in the US. But have the people also lost their sanctity for life? Capital NO, because if you kill, they will hunt you down and bring you to justice, but that is a matter for another day.

My worry here is our health care professionals. Even if the rest of the society has lost its sanctity for human life, should these professionals who are trained, and, in addition, take an oath to save lives, also lose theirs. Many families in Nigeria have tales of family members who died because of the nonchalant attitude of health care professionals. They have no sense of urgency during emergencies; no iota of feeling for fellow humans or the plight and agony of relatives.

Predictably, Reddington has come out with a statement and all they are interested in is preserving their reputation. I have a strong feeling the personnel on duty actually told the Akinwunmis to get a police report for an emergency case in the early hours of the morning. Even if they did not, why will a hospital of Reddington’s stature not have a single doctor on duty at their Ikeja facility?

I was among the early patrons of Reddington when they started. I used to take my mother there. They were in a big bungalow then at their current Idowu Martins main facility, where a multi-storey building now stands. Standard of care was high then. Now they have grown in size and even have a branch, what happened to a commensurate growth in standard of care?

Even as at those early years, Reddington did not come cheap. So, you can imagine what their bills are now. Yet it cannot render premium services at all times. Abroad, expensive hospitals are like five-star hotels. They give you quality hospital environment, quality health care and quality standard of care. Everybody is courteous and treats you specially. I was at a medical facility abroad sometime ago. One of the staff was rude to my wife; she focused on the colour of our skin and forgot that patients’ money pay her salary. She was queried and redeployed, but not before she had apologized.

How come in this part of the world, the standard of care is always inversely related to the growth of medical facilities? Many of the federal health facilities are eyesores. The facilities are either dilapidated or not properly maintained. Most times it is very convenient for the personnel to blame the government, how about the poor standard of care? Is government responsible for that too? Why should somebody within the system not assign subordinates responsibilities and hold them accountable for the consequences of their actions and inactions?

Currently, members of the Joint Health Sector Union (JOHESU) are on strike for over a month now to press the government to implement the adjusted Consolidated Health Salary Structure. I have no issues with anybody asking for better pay, but JOSEHU should also begin to impress it on its members to raise their standard of services to Nigerians, the people whose taxes pay their salaries. If JOSEHU were to ask patrons of government hospitals to rate the performance of many of their members, they will be shocked with the outcome.

Many people feel health workers cannot justify even the little they are paid, not because of the size of their salaries, but because of their lackadaisical attitude to otherwise very essential services they render. The Nigerian health sector does have many challenges, but many are also self-inflicted and there are some we do not need money to solve. Change of values and attitude are all we need.

Meanwhile, the Lagos State Police Command should carry out a thorough investigation into the unfortunate death of Akinwunmi. If the hospital members of staff are found to be culpable, they should be used as example for others to sit up. Enough of these avoidable deaths; we are talking about human beings, not ants.

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