When wife of the ex-Head of State, late General Sani Abacha, Maryam, founded the National Hospital, Abuja, unlike the French mystic, Nostradamus, she did not envisage how the medical facility would turn out to be what it is today; overstretched to its limit.
The supposedly world class facility, initially meant for women and children, was formally established under Decree 36 of 1999 (Act 36 of 1999). Former Head of State, General Abdusalami Abubakar, commissioned the magnificent edifice on May 22, 1999. Until the administration of former President Olusegun Obasanjo changed the name on May 10, 2000, it was originally called National Hospital For Women And Children.
Like other tertiary medical facilities in the country, the hospital is primarily designed to cater for special and specific challenges. It is also designed to referrals from providers of primary care and secondary care. Over time, pressure and increased demand for expanded quality health care services, forced the hospital to open its doors to other ailments.
While the expansion of healthcare services in the hospital was being done, little attention was paid to the expansion of the building, the wards, car parks and other services. The 850-bed space is now overstretched and the centre may not hold for too long if urgent remedial measures are not taken by government to halt the looming Tsunami.
Cases that ordinarily should be handled by primary and secondary healthcare centres now find their way to the hospital. Headaches, fevers and malaria, which, ordinarily should be handled by pharmacists or general hospitals are being treated by the hospital.
Patients from neighbouring states, who should ordinarily resort to state-owned primary and secondary healthcare centres, throng the hospital on daily basis. This further places additional burden on the already overwhelmed facility.
Few weeks ago, a team of medical professionals successfully separated co-joined twins, Goodness and Mercy. The team of 78 led by the lead surgeon, Prof Emmanuel Ameh, in an over 12-hour surgery, separated the co-joined twins on November 14, 2019. The feat attracted unprecedented global attention and outpour of commendations from Nigerians.
Despite this glaring feat, the worrisome level of unprofessionalism and poor health care services and human relations in the “self-proclaimed” best public hospital in Nigeria, need to be checked and quickly too. Some of the perceived ills and unprofessionalism could easily be seen while some happen behind the scene.
It is rare for a patient to visit the hospital and come out without some silent murmurs or open complaints which most times, receive no attention from the management. Understandably, the challenge may not totally be the fault of the hospital, its workers or management. It is also a clear evidence of the deplorable state of public healthcare system in Nigeria.
Nigerians, obviously, have limited choices when it comes to public healthcare services. The most affected are people with low financial strength who cannot afford quality healthcare services at private hospitals in Nigeria or abroad. They are forced to endure the bad situation, while they pray and hope for an improved healthcare service system.
In 2019, the Federal Government began the implementation of the Basic Health Care Provision Fund (BHCPF), starting with Osun State. The objective, then Minister of Health, Prof Isaac Adewole, said was to revitalise and re-equip Primary Healthcare Centres (PHCs) for use at local communities. From Osun, it moved to other states that met the criteria as at then.
They included Niger, Delta and Abia states in that order. Some designated PHCs in the states were revitalised and re-equipped for use at different local communities. But patients are still sceptical and lack the confidence in the primary healthcare system hence they prefer to visit tertiary health institutions for health care needs.
The consequences are there for all the see. Patients receive poor medical attention from “unmotivated” health workers, inadequate health professionals, limited services and bed space, among several others. Some patients at different units of the hospital expressed mixed feelings on the kind of medical services being received.
At Radiotherapy Unit, the queue to get attention was intimidating. Some patients complained about lack of attention and hostility from health workers in charge, which they assumed may be associated with stress due to the large number of patients and volume of work therein.
A septuagenarian, Agnes Ocheme, who is a retired teacher, accompanied her sick husband to the hospital: “We have repeatedly been booked to see the doctor. But we are forced to wait for hours on each of the days before getting access to the doctor.
“The condition in this place is not favourable for people especially some of us, the elderly persons. We have been here since morning, and it is already 1pm. We have not seen the doctor and we don’t even know our fate. There are so many people ahead of us also waiting to see the same doctor.
“As you can see, we have left the waiting room for outside. We are very tired and my sick husband cannot sit any longer. I had to look for a place for him to stretch his body. I think it is time the government looked into the issues of the aged people in Nigeria.
“In an ideal situation, we are not physically strong not to talk of when we have health challenges. We are not supposed to pass through the same process like the younger ones who still have energy and strength. It is not fair because an elderly person that does not have someone to help him or her through the processes involved in this hospital may die before even getting to the stage of seeing a doctor.”
Another patient, Miriam Yusuf, at the same unit, said: “The environment is so crowded. I think the volume of work in the hospital is even affecting the workers. They do not have enough time for the patients irrespective of their condition or illness.
“It has not been easy seeing a doctor in this hospital. Any day I am booked to see a doctor it takes me like a whole today before I could get the needed attention. I left my house as early as 7am. It is already 2pm I have not seen the doctor and do not even know when I will see him.
“It is only when you visit a place like this that you know the importance of being healthy. Imagine people with their money seeking health care services but to no avail. The government needs to take a critical look at what is happening in this hospital. Most people who cannot withstand stress are losing their lives on daily basis.”
Amina Dauda said: “It is not that we like lying on the floor but there is no free bed space. This is the only hospital that can attend to our challenges.”
A patient, Bayo, said he came from Nasarawa State to seek the attention of radiographers regarding his bad leg: “I have heard a lot of things about how patients suffer in this hospital. But I was a bit lucky with my case. I have been receiving prompt attention from health workers in different units that I have been referred to. And that has helped my speedy healing.
“I have spent over a month here and there is never a day dead bodies do not pass by. At a point, I became scared but a friend of mine and some family members have been helpful. Nevertheless, there is urgent need for government to look into health care system in Nigeria. Masses are dying of neglect long hours are spent at the hospitals and poor health care facilities. It is a horrible and a shameful situation.”
Workers at the Family Health Department are overwhelmed just like some other units by huge number of people awaiting medical attention. While patients are on queue, emergency cases are being received. Once any emergency case arrives, key workers suspend all services to attend and stabilise the patients involved.
That, perhaps, was responsible for the accumulated work and the inability of patients to get the expected health care services as quickly as needed after spending several hours on queue.
Cynthia, a parent said: “My brother, I am tired of this country and its system. I came here as early as 7am because I needed to get an urgent medical attention and possibly travel back home. But from all indications, it will not be possible because nobody is telling us anything.
“An emergency just arrived and all the medical officials have been mobilised to attend to the patient. I am very sure that once they come out of the room, they would close for the day. These are public health workers who work like ministry workers at Federal Secretariat.
“Howbeit, workers here are extremely overworked. They are overwhelmed by the number of patients visiting the hospital. I pity them sometimes but because patients are in pains and distabilised conditions, they do not appreciate the enormity of work/task being done by few workers. Government should please increase the workforce.”
Another patient, Amina Gwarzo, said: “My case is a different one. I came in from Kano some days back. I had visited hospitals in the past to get proper medical attention to my problem but could not. All fingers pointed at the National Hospital, Abuja.
“I was intimidated by the crowd when I came the first time last year. But I had to patiently wait till I got the required attention. It took me four days to get doctor’s attention the first time I came last year. Luckily to me, the doctor I met is from my local government. We became friends and he always facilitates anything I want in the hospital.
“But the issue is that many people who are not privileged like me are dying in pains. Someone slumped before me the last time I was here. The man, apparently, has been on the waiting queue to receive medical attention for several hours. Many other patients with different kinds of pains were also on the queue. The man could not hold the pain and slumped. Luckily, he did not die as he was quickly resuscitated through the help of workers in the hospital.
“It is good for people, particularly those who murmur and complain about this and that, to visit hospitals once in a while. Then, they will appreciate God for the gift of good health.”
At the Trauma centre, the case was different. The centre appears to be better organised than other units. Investigations reveal that the centre basically serves the interest of very important personalities and other specialised cases.
A former patient, Udukhokhai Uduozemhe, a public servant, said between 2014 and 2015, he had a blood discharge from the anus known as anal fistula. He was referred to the National Hospital.
He said: “Before the operation was eventually carried out, I used to go to the hospital in the morning at 7 so that I could be one of the early callers. But in spite of that, I never saw a doctor earlier than between 1:30pm and 3:00pm. A lot of people used to cue, waiting to see the doctors.
“Sometimes, due to the unpalatable situation, I used to question myself why I even fell ill in the first place. As the days went by, the hospital began a new process of scheduling appointments for patients through short message service, maybe to reduce the numbers of patients intending to meet doctors in a day. The process did not in any way reduce the number of hours one had to wait to see a doctor.”
He also recalled that when the operation date was fixed, the issue of bed space became problematic, but was later solved through the assistance of a good Samaritan nurse: “The hospital should be repositioned to meet the yearnings of Nigerians and the primary objectives for which it was established.”
An aggrieved mother, who did not want to be named, narrated: “My son had ear infection during the festive period. The doctor at our family hospital had ordered for a full blood count to be carried out because she was not comfortable with what she saw.
“The test was done twice outside the hospital. Still not satisfied, she referred us to the National Hospital for haematology tests. She wanted us to get an expert opinion on the abnormality she noticed in the two previous test results.
“The blood was drawn on a Friday and we were asked to return on a Monday for the result. Unfortunately, it was not ready as promised. I continued going back daily for the result when it was still not ready by Thursday, I decided to find out why.
“One of the haematologists on duty insisted the result was ready, but that I was in the wrong office looking for it. I asked why the result was not posted online since the request was made online, she said I was in the wrong department and directed me to the Haematology Department.
“Determined not to leave the hospital without the result, I had to practically trace the person that was behind posting of the result to one office in the Haematology Department. I insisted I would not leave until I got my son’s test result.
“It was only when I saw the result that I brought my son to see the doctor on a Friday and thankfully, the result was fine. It is important to note that while I was going for my son’s result, I saw others ready to engage in fisticuffs because their results were not ready despite the samples of the blood being taken in December.”
Spokesman of the hospital, Dr Tayo Hasstrup, dismissed the concerns raised by patients, insisting that the hospital facilities are open for use to all Nigerians irrespective of social and political status.
He said the level of pressure from health seekers in the hospital is extremely high, as people visit from different parts of Nigeria to access quality healthcare in the hospital: “Our health professionals are obviously overwhelmed by work load. Many of them go off their ways to work extra hours to meet the health needs of the people.”
He said the successful separation of the co-joined twins, Goodness and Mercy, further boosted the confidence of people in the hospital, resulting in unprecedented upsurge in patients’ attendance. Hence, the challenge of limited bed spaces in the hospital:
“We render varieties of world class medical services and people have attested to the level of professionalism and human relations with our patients. We are, however, unhappy that patients who ought to visit PHCs choose to come to the National Hospital. Such cases added pressure to our already ‘overstretched’ facilities.
“However, they are Nigerians who are entitled to quality health care services. We would continue to provide the services to the best of our ability.”