…It’s unethical to reject patients – FG
For so many people, it has been tales of sorrow over the refusal of health care providers to attend to their patients. ELEOJO IDACHABA reports that the situation portends national catastrophe.
Victims’ ordeals
If the experiences of the family of Mr. Joel Amedu Akor who died in Lagos on June 29, 2020, is anything to go by, then Nigerians especially patients and families of the dead are in for hard times as long as the Covid-19 pandemic lasts. This is because since the advent of the global disease, most hospitals in the country not only reject patients from being admitted to their facilities for fear of the virus, many patients lose their lives. Also, in extreme situations, corpses of patients who did not die in such facilities are being denied mortuary services.
In the case of the late Akor, Blueprint Weekend learnt that his corpse had to be transported from Lagos to his native Obagu community in Ofu local government area of Kogi state as soon as he died because all the government hospitals around Isolo and Mushin areas of Lagos, where he lived before his demise, refused to accept the corpse. Hence, his relations in Lagos had to travel all night and day to get the corpse to the Kogi state Teaching Hospital morgue in Anyigba before the body was buried a few days after.
George Ojogbane, a nephew to the deceased who was among those that brought the corpse home, told this reporter in Obagu last week that, “It wasn’t a pleasant experience coping with the stress of getting a space in a Lagos hospital to deposit the corpse as he died at home from a sickness unrelated to Covid-19. All the hospitals we approached simply refused on the excuse that there was no space. Some even told us to produce a certificate indicating that he did not die as a result of Covid-19. Now, here was a corpse that should either be kept in a morgue or buried in less than 24 hours. We had no other choice than to travel with the corpse from that morning all through the day until we got to the Kogi state Teaching Hospital morgue in Anyigba, nearly 12 hours after.”
“We also had to contend with police check points in and around Ondo, Ekiti, and Osun states who simply told us that we could not enter the state because of the ban on inter-states travels. Eventually, they allowed us to pass seeing that we were carrying a corpse.
If the Akors think theirs is an isolated case that of a business woman who suddenly took ill in a hotel facility located in Gwarimpa area of the Federal Capital Territory (FCT) where she had lodged was heart-wrenching. She had been rushed by the management of the hotel to almost all the hospitals in the city, but couldn’t get help.
In a viral video shot by the director of the hotel from the premises of Gwarimpa General Hospital showing clearly the woman lying helplessly in an ambulance with no help in sight, the director said, “The time now is 8:15pm and we have been on this matter since 7:00am today. This is what we face in this country. I am here at Gwarimpa General Hospital with two of my staff. We run a hospitality industry. We had a guest who suddenly took ill in her room, but we took it upon ourselves to get her medical attention because she couldn’t stand, speak or do anything.”
In an emotion-laden voice, he continued, “However, this is the fifth hospital we have visited today – from the Federal Medical Centre opposite Setraco in Gwarimpa to the National Hospital before we got here. In fact, it was at the National Hospital that I lost my patience because in all of these movements, we had to pay for everything because we cannot fathom how we could just abandon this woman in her late 50s to her fate and the hospitals that should take up the responsibility simply feel otherwise.
“In all the hospitals we visited, they checked her and confirmed that all her vital organs were working; therefore, her case is not synonymous with Covid-19, but they simply refused to accept her. Meanwhile, she cannot stand or talk as you can see – she has been lying in this ambulance all day. Painfully, we can’t take her back to the hotel for any reason and we cannot also abandon her here. This is a crazy time to take ill in Nigeria. If you take ill by this time in this country, you are simply in your own.”
Blueprint Weekend could not, at the time of filing in this report, confirm if the woman was eventually admitted to any hospital, abandoned to die or recovered on her own.
That is not all, in June, a middle-aged woman, simply called Ogochukwu who lives in Kadokuchi, a community within Gwarimpa Estate in Abuja, lost her mother that month because she could not access a bed space in any hospital within the city. Narrating the woman’s ordeal to this reporter, a neighbour who goes by the name Ifeyinwa said the old woman who was brought to Abuja from Ebonyi state in February 2020, in order to recuperate from an illness took ill again in April. Ifeyinwa said, “That was a month into the lockdown. The Wuse General Hospital where they were initially receiving treatment suddenly became overwhelmed by many cases, so the old woman could not be admitted when she developed a serious crisis. While all these lasted, the woman finally died in June.”
Experts’ take
Premium Times Centre for Investigative Report has it that by May 2020, at least 90,000 health care workers have been infected with Covid-19 globally, going by the International Council of Nurses (ICN), although this figure is believed to be underestimated across different countries.”
Quoting the president of the National Association of Nigerian Nurses and Midwives (NANNM), Mr. AbdulRafiu Adeniji, in the report, it noted that the rates of Covid-19 spread and fatality are enough to trigger anybody, thereby leading to the seemingly shift in giving attention away from non-communicable and communicable diseases.
According to Adeniji, “Although it’s not ideal for medical professionals to ignore any patient, the reality in Nigeria is a true reflection of not only lack of PPEs for health care workers treating Covid-19 patients, but also that of the shortage of manpower, infrastructure and the lack of motivation for the health care professionals.
Speaking further, he said, “Besides, our primary health care centres are almost not functional. Unfortunately, when all these happen, something would certainly suffer.”
Adeniji noted further that Nigeria has less than 200,000 nurses to a population of 800,000 people against the advice of the World Health Organisation (WHO).
“WHO recommended that PHC should be made to attend to 70 per cent of frequently-occurring illnesses, secondary health care centres to handle 15 per cent to 20 per cent, while teaching hospitals handle five to 10 per cent of people with chronic illnesses alongside research and training, but the reverse is the case in Nigeria?
“Our PHCs are suffering because public health nurses, midwives, and other related-health workers are not allowed to do what they are basically trained to do which includes providing health care to most of these patients at that local level and referral to see specialist doctors for critical cases.
“This brings to spotlight the current administration’s low commitment to the health care of its citizens as is contained in the proposed allocation for the Basic Health Care Fund (BHCF) for the 2020 budget. A check on the budget item for BHCF in the health budget indicates that N25.560 billion is allocated. This does not reflect the expected 1 per cent stipulated in the National Health Act (2014).
“This is because the National Health Act (2014) stated that at least, one per cent of the Consolidated Revenue Fund (CRF) shall be allocated to Basic Health Care Fund (BHCF). The goal of the fund is to substantially increase revenue and improve Primary Health Care (PHC). Based on the 2020 budget revised in June 2020, the Consolidated Revenue Fund (CRF) is N10.805 trillion, which means that the one per cent allocation to BHCF should be N108.5 billion and not N25.560 billion.”
The struggle
In Nigeria, it is a basic fact that access to decent health care is a daily struggle for the sick due to many factors like a seriously underfunded and dysfunctional national health insurance systems, the lack of basic infrastructure to provide clean water and electricity and a serious shortage of health care workers. The Ebola outbreak, for instance, which ought to be a wake-up call, exposed the soft underbelly of Nigeria’s flawed health systems.
The World Health Organisation (WHO) reckons that Africa bears a quarter of the global burden of diseases, but has access to only three per cent of health workers and less than one per cent of the world’s financial resources. The global body also states that barely a handful of African countries have met their pledges made to the African Union to pump at least 15 per cent of their national budgets into health care.
In the meantime, the Health Watch Magazine report notes that, “Any government looking to successfully bridge the gaps in Nigeria’s health sector must focus on improving health services and facilities for rural dwellers. Working with community leaders would enable the people to take ownership, leading to improved health-seeking behaviours. The community influencers and leaders would help debunk erroneous misconceptions that some illnesses cannot be treated in health centres.
“Again, the need to populate existing primary health centres with well-trained health professionals and adding new ones would encourage repeat visits to the health facilities as trust is being developed between health workers and their patients.”
FG’s reaction
In its reaction, the federal government advised medical facilities in the country to stop rejecting patients, especially emergency cases. The Minister of Health, Dr. Osagie Ehanire, gave the advice against the backdrop of complains that most hospital turn patients away from their facilities. He spoke recently at the Presidential Taskforce (PTF) briefing on Covid-19.
He said it was unethical not to attend to persons in distress, adding that any infected health worker puts a strain on the system. “It is unethical to reject patients who come to the hospital for treatment; such offenders should be reported.
“I also want to call on all health care facilities not to reject persons seeking medical help, especially in an emergency situation. It is unethical to reject such persons in distress.
“I also urge citizens to go to the hospitals when not feeling well and to cooperate with medical personnel by giving accurate information, especially with regard to their travel history.”
