The precarious situation in our health institutions continues to be a source of worry to all. Before now, stakeholders in the health sector had cried out over the deplorable conditions that had taken a heavy toll on the people seeking medical attention. It is worrisome that virtually all aspects of our national life suffer from one problem or another. If there is a sector that deserves more attention, the health sector should be topmost in such classification. For it is when the citizens are healthy that the nation can prosper. A sickening citizen cannot contribute meaningfully towards national advancement.
Apart from the several bright minds that the country has lost to brain-drain, the dilapidated health infrastructure has continued to encourage medical tourism in which colossal sums of money are lost to other foreign countries, which the Nigerian Medical Association puts at about $1bn annually and for optimal healthcare delivery to take root, the World Health Organisation recommends a doctor-patient ratio of 1:600 for every country. Painting a gory picture, the NMA warns that if Nigeria decides to graduate 3,000 doctors every year without the doctors leaving the country, it will still take another 25 years to meet the WHO estimate!
What do we witness today in our health institutions? Sad experiences are reported in the media almost on a daily basis. Recently, firsthand accounts were given of a colleague, who lost his wife a few days ago. While the services provided by private clinics and hospitals are fairer, those provided by government clinics, hospitals, and institutions are generally poor. The reason for this can be attributed to the same problems that have marred the management of public facilities and infrastructure in the country. The situations in teaching hospitals tend to be more grievous because specialist hospitals are expected to be properly established, funded, equipped, and staffed with a wide range of consultants and personnel.
Ordinarily, patients are referred to teaching hospitals when their health conditions are not given the required attention by smaller hospitals. Hence, patients are helpless when asked or taken to teaching hospitals where they are made to suffer untold hardship and neglect. As I mentioned earlier, a colleague lost his wife at the University College Hospital, Ibadan, Oyo State after being admitted for childbirth. The excellence that the UCH and other leading teaching hospitals across Nigeria are known for appears to be fading off and becoming something else. In the end, the woman died but the child narrowly survived. Narrating his ordeal, the friend complained that most of the medical workers that attended to them were hostile and treated them with disdain. Not only that, when her sick wife was brought in as an emergency case on a Friday, she was also not given appropriate attention till Sunday. When it was time for payment, he lamented that the hospital insisted that payment must be by cash despite the government’s regulations encouraging cashless transactions.
The bereaved man recalled that after payments, people were made to go to another section whereby receipts were issued wondering why payments and issuance of receipts cannot be done simultaneously. The other harrowing encounter was that potable water was not readily available, the buildings are dilapidated, many of the wards looked unkempt, and mosquitoes had a field day biting them. As it is, people are frightened to go to hospitals for the fear of contracting new diseases. It was further learned that some sections of public hospitals are designated as special wards. Why such a discrimination in a public institution? In many public hospitals, patients wait endlessly in queues to see a doctor irrespective of the nature of their illness, and bed spaces are insufficient that the sick are made to sleep on the bare floor.
The dire situation of our health facilities can be zeroed down to human factors such as graft, inadequate funding, poor administration, non-adherence to medical ethics, lack of enforcement of punitive measures against gross misconduct, and weak supervision by regulatory bodies. Corruption by medical workers allows them to make fortune from the misfortune of others. The decline in statutory allocations to health has equally impaired many public hospitals from performing to expectations. Funds are not released on time and if at all, they are grossly insufficient. For instance, the total combined budgetary allocation by the Federal Government to its teaching hospitals was a meagre N475.37 billion comprising N176.45bn in 2019, N158.24bn in 2018, and N140.68bn in 2017.
Failure to adhere to professional codes such as a subscription to the Hippocratic Oath and other medical ethics would continue to embolden erring health workers to act with impunity. Appropriate disciplinary measures should be meted out to medical practitioners whose professional negligence is a source of embarrassment to the council as was done in the case of Dr. (Mrs.) FCL Olaye v Chairman Medical and Dental Practitioner Investigating Panel ORS [1992] 5 NWLR 553. The truth is that as long as we continue to admit, and enrol persons without human feeling, conscience and calling into medicine, nursing, laboratory technology, and the like, quality healthcare will remain a mirage.
Adewale Kupoluyi, Federal University of Agriculture, Abeokuta, Ogun State @AdewaleKupoluyi
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