When bed space is gold in Lagos hospitals -By Wale Adepoju

Many lives have been lost in hospitals, not for want of doctors or equipment for treatment , but due to lack of bed spaces. WALE ADEPOJU writes on the travails of patients/casualties in this precarious situation.

ARMED with a referral from the Public Health Centre (PHC) in his council area, an employee of one of the Local Council Development Areas (LCDA) in Lagos had arrived at a specialist’s office at the Lagos State University Teaching Hospital (LASUTH) as early as 6am. His dream of securing audience with the doctor was dashed upon discovery  that he was the 70th patient to register that same day with such referrals.

At the end of the day, he went home disappointed as the specialist could not attend to him. Such is the situation at all the tertiary health institutions in the Centre of Excellence, where available facilities can no longer cope with the influx of patients.

Often, many patients, especially the not-so-rich ones, are seen on sofas and mats, receiving drips.  Those deserving special attention get such on special arrangements.  John (surname withheld) was taken to a teaching hospital in Lagos after sustaining a head injury in an auto crash. He could not be admitted at the Accident and Emergency (A&E) Ward of the hospital due to the non-availability of a bed space. After a brief moment, John died and his family was devastated.

Anita, a two-year-old girl had pneumonia.  She was rushed to the emergency ward of a teaching hospital. But, before the doctors could get her a bed space for admission, she passed on.

The late John and the late Anita joined the list of deaths recorded in the hospitals due to non-availability of bed spaces. Some experts, who spoke on the critical situation, agreed that something urgent must be done to reverse the trend. Prof. Akin Osibogun, the Chief Medical Director (CMD) of Lagos University Teaching Hospital (LUTH), spoke opn the development. He said: “We need to enlighten the people that teaching hospitals are not for headache, fever or malaria, but for serious medical issues that cannot be handled at the PHCs and secondary healthcare centres.”

The President, National Association of Resident Doctors (NARD), Dr. Olarenwaju Ekunjimi warned that non-availability of bed spaces in hospitals could spell doom for patients under emergency situations. He flayed the influx of patients to institutions that ordinarily, should serve as research and referral centres.

Sometimes ago, the Paediatric Ward of LUTH was forced to admit children, despite over-shooting its facility with an upsurge of patients at the ward. By the following day, the gesture had become the subject of debate. The hospital came under severe criticism in the media for delving into the provision of  primary healthcare. In its defence, the LUTH management had to call a press conference to enlighten the public on why it took such action.

Osibogun, who is of the Community Health Department, knew that drastic actions needed to be taken and therefore urged workers to save as many lives as possible, based on a standing order from the Federal Government that no patient should be denied healthcare. The CMD had the backing of the Health Minister, Prof. Onyebuchi Christian Chukwu, who flew into Lagos from Abuja to help shed light on the situation. According to him, admitting the sick children was done in good faith.

But the problem of over-crowding in the hospital cannot be solved overnight, as not many institutions can boast of adequate bed spaces.  Some hospitals have even extended their A & E and Paediatric Wards to accommodate more patients. But the influx of patients from neighbouring states continues to swell the number at the teaching and referral hospitals.
To worsen the situation, rural dwellers prefer to patronise teaching hospitals even for the slightest sickness.  They have lost faith in the (PHCs) built across the 774 local government areas.

Facilities at LUTH and other teaching hospitals that are either referral or research centres have become the first port of call for patients, who have not received the desired attention at the PHC. The secondary institutions have also been underutilised, despite adequately kitted to take care of the medical needs of patients with complicated cases. But some patients say the A & E wards are not spacious enough to accommodate many patients at a time. They urged the government to expand such facilities to accommodate more in-patients.

The CMD of LASUTH, Prof. Adewale Oke, attributed the influx of patients to the free health policy of the Lagos Government. In the state, health is free for children under 12 and the aged above 60.  “We do not turn patients back.  It is the instruction given to us by the Lagos State Government which is to ensure that the citizens enjoy maximum healthcare irrespective of their status, age, gender and creed”, he said.

Oke said that LASUTH, being a general hospital before its upgrade to a teaching hospital, continues to attract patients because of the provision of primary, secondary and tertiary services before the transformation.  “It would take a while before this is changed”, he added. Besides, he said the availability of the state-of-the art equipment and experienced manpower in the hospital are attractions for patients across the country.

Apex Nursing Officer, LASUTH, Mrs. Modupe Jokotade Shode, said the hospital receives between 3,000 and 5,000 patients daily.  She attributed the traffic to the liberal policy of the state on healthcare services. The Secretary of the state branch of Medical Women Association of Nigeria (MWAN), Dr. Ime Okon said the inclement environment in the hinterlands is encouraging rural-urban drift, a development she noted, has contributed to the over-stretching of facilities at the secondary and tertiary hospitals. 

“The rural areas are not developed enough for community health physicians to live in,”  she said. For instance, Dr Okon said the rural areas lack social facilities like good schools, potable water and stable electricity to attract resident doctors. The are also no modern houses to attract doctors from the cities.  “What of power? Usually, most rural areas don’t have electricity,” she said.

Proffering a solution, she said: “The government should give some incentives to motivate doctors posted to rural areas.  It may be a rural posting allowance. And rural posting should be rotational. “For instance, the University College Hospital (UCH), Ibadan, has a centre at Igboora where doctors are deployed to attend to the rural dwellers.  LUTH also has an annex at Pakoto, a rural community in Ogun State and doctors are posted there to provide medical service to the people.”