Monday, 10 June 2013

ADEOLA AKINREMI: Help! LUTH Needs Beds for the Sick


Adeola Akinremi writes that patients at Lagos University Teaching Hospital are being turned down for shortage of bed space

The speed was unusual.  In a moment it arrived at the gate and then headed straight to the emergency ward. Inside the ambulance, a man wrapped in white cloth lay on the stretcher with two nurses at the back of the ambulance with him. After it had meandered through the roads within, it pulled to a final stop at the Accident and Emergency (A and E) ward, and without delay one of the nurses rushed inside the emergency ward. She later emerged from the ward looking dejected.  “The patient would not be allowed in, because there is no space,” she said in an angry tone.


In a ward nearby, another woman let out a rage, “This is a rotten place. I can’t take this anymore.  Her shout attracted attention.  She claimed to have been visiting the hospital for nearly one month without access to a bed space to enable her child to go through a surgical operation, in spite of the fact that her son has been given admission card.  And though she cried, there was no one to wipe off her tears.


At Lagos University Teaching Hopistal (LUTH), Idi Araba, Lagos, mothers who are supporting their children that are patients in the hospital are telling tales of anguish, just as adult patients in the hospital are facing same harsh condition too.


A woman who pleaded, anonymity said: “I first came here at the beginning of the month and this is the third week since I have been coming because my child would need to go through surgery. We haven’t had a bed space allocated to us, yet we have paid for admission. I have the admission card as a proof.  What is going on here is strange. You see people taking drips sitting on a chair because there is no bed space. I have also seen people inside the ambulance outside the emergency ward area being attended to with the doors and windows of the ambulance opened for ventilation just because there is no bed space.”


Another patient corroborated her story. She said: “I just think LUTH is over stretched and the government seems not care a hoot. It is a misnormal for patients to be waiting for bed space after paying for admission.  I personally went through many of the wards to see things for myself and you will always see people waiting in a cubicle praying to God to get a bed space. I saw a particular pathetic case of a woman who claimed to have been sitting down in the visitors’ area waiting to get bed space for three days, because a nurse told her if she leaves and someone is discharged, she would lose the opportunity of getting a bed space to commence her child’s treatment.”


A doctor at the Ears, Nose and Throat (ENT) clinic of the hospital confirmed what others said. He claimed that LUTH is a referrer centre and the hospital receives a lot of patients on daily basis, but the infrastructure is not there to contain them.
For instance, he claimed that at the ENT clinic, doctors there can only perform surgery on just two people per day because there are just two surgical trays available for surgical operation and it would take about 24 hours for trays to be sterilised after use. The surgical tray costs less than $200.


“We are constrained and you can’t blame the doctors for it. We can only work with what we have. It’s true that LUTH definitely needs support to achieve maximum impact. In fact when you come here now as a patient and you need to do laboratory tests we would advise you to go outside if you have the means and especially if it is required urgently, because when you want to wait in line for the one here, the crowd will scare you and of course the delay you will experience,” said a doctor at LUTH’s ENT clinic.


In May 2010, the Minister of Health, Prof. Onyebuchi Chukwu during his official tour of the facilities at LUTH said, unless it gets immediate help, the hospital may be forced to turn back patients, especially children. And two years after his visit to the hospital nothing concrete has been done to reverse the trend. So his prediction has now taken a foothold, patients, especially children are being turned back for lack of bed space at LUTH.


In 2002, the federal government under the former President Olusegun Obasanjo entered into a contract with Helmut Dietrich for Vamed Engineering GMBH & Co. KG, to refurbish eight hospitals in the first phase of the project worth N17 billon. LUTH was listed under the first phase. The terms of contract of the project covered rehabilitation, design, procurement, supply and installation, training of health personnel, and five years maintenance of the equipment.


Under the terms of the contract according to reports, the project was to be completed over a period of five years and the core clinical areas to be refurbished included radiology (diagnostics and therapeutic), surgery (theatres), intensive care, the laboratories, accident and emergency and special clinical departments.


But those familiar with the project said the impact has not been felt by patients at LUTH. According to sources, the project may have encountered some bureaucracy that has frustrated its delivery according to details.


However in a recent interview with Daily Independent, the  Chief Medical Director (CMD) of  LUTH, professor, Akin Osibogun was quoted as saying, “Our medical equipment are working. Though they can breakdown sometimes but we have biomedical engineering department that takes care of them. Every hospital has its own peculiar challenge but we are doing our best within the circumstance.
“We are daily besieged by patients that do not have any reason to be here. LUTH is supposed to be a referral hospital taking care of tertiary health care but daily we are made to take care of cases that should have been handled at the primary and secondary health facilities. These make our workers overwhelmed and stressed.

“Do not forget that we have only 800 beds for a population of more than 150 million or even more that may have reasons to come here. Also, because we offer the cheapest and most sophisticated healthcare, most people come here. Another thing is that we do not turn back patients. LUTH is more like the last bus stop for most people. This is why we must all support the National Health Insurance Scheme (NHIS) to work. It is the way to go. LUTH alone cannot carter for millions of Nigerians that is why the Federal Government is encouraging private sector participation.”


While responding to THISDAY questions in a correspondence, Osibogun said: “Permit me to say that it cannot be expected that one hospital, no matter how big, can be in a position to admit all patients requiring admission in a large population such as Lagos State. Hospital beds are therefore available in Federal, and State Government hospitals as well as several private hospitals in Lagos State.
On the part of the Federal Government, it maintains the Federal Medical Centre Ebute Metta, the National Orthopaedic Hospital Igbobi and the Federal Neuropsychiatry Hospital in Yaba in addition to the Lagos University Teaching Hospital. All the hospitals mentioned have admission facilities.


As far as paediatric beds are concerned at the Lagos University Teaching Hospital, the Federal Government is supporting the Hospital to put up a new Children Emergency building with additional 100 pediatric bed spaces. On completion before the end of this year, it is expected to bring the total number of pediatric bed spaces in LUTH to 250. That number is the size of some other hospitals and we must commend the government for its efforts.”


THISDAY also observed that most of wards at LUTH does not have mosquito net in a country known to have one of the highest malaria record in the world.
A patient, Mrs. Ukpe said: “It is just unbelievable, but it is true that as patients you are likely to leave this hospital with a malaria case after your initial sickness has been treated. Our ward has no netting. The windows are opened 24 hours for ventilation and mosquitoes find their way in through the windows. I can show you spots on my body from mosquito bites, they were not there when we were admitted. The government must do something about it.”


The same can be said of its administrative process which is not yet automated, especially when a patient is discharge.
Mrs. Ukpe claimed that a woman whose son was discharged a day earlier couldn’t go home until 10 pm because she had to take receipts round for clearance. “Imagine a situation where there is no one to stay with you baby and you need to keep going from one place after the other. How can you cope?” she queried.


And now that LUTH is 50, expectations are high for accelerated service by the patients, but the hospital spokesperson, Mrs. Hope Nwawolo said, “the number of patients is increasing and we cannot do much about it. We hope that when the new child centre is completed, it would help provide more space for the children. Another issue is that people are leaving the primary health care centres to come to LUTH which is tertiary. So the problem will always be there.”



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