By Dr. Okeme Arome The deteriorating state of healthcare in Nigeria is alarming! It is a time bomb. We sit on a barrel of gunpowder and what's more, we are smoking our cigars nonchalantly and relishing in our sybaritism as though everything was fine. There was not as much as a foot space in most of the tertiary hospitals in Kaduna to receive a referred patient on the morning of 8th of October. The sight of the accident and emergency ward in Barau dikko almost brought tears to my eyes. The irreconcilable prodigious number of patients against the overstretched few number of health workers was a depressing sight. If Lizzy had come here alone, I bet at this sight she would have made back for the village, she would rather face her fate than have it brought closer to her by this despondent sight. We left for 44, Nigerian Defence Academy hospital. At 44 at about 2pm, after we had done some good waiting, I finally approached one of the doctors, had a conversation, elicited the information that they hadn't a hematologist and it dawned on me that Lizzy had to be taken to the almighty Ahmadu Bello university teaching hospital, shika. It was about 4pm and I had to return to work, I chartered a car for them, 3 of them, and paid for them to be taken to Zaria. At about 5 they had arrived and thankfully shika attended to them at the A&E and admitted them the following day. I was told the hematologist was her doctor and due to the dearth of space, she was admitted in the Nephrology unit of the female medical ward. One week later, just as most teaching hospital I know in Nigeria, Lizzy had being barely attended to. I called in that week and was told she needed two units of blood, we made that expressly available. I spoke with the intern doctor and he said they had written a consult some days back to the surgeons to take a biopsy to aid in perpetuating her care but they hadn't come. I enquired more and he said they had written a list of equipment they would need for the procedure and claimed the caregivers hadn't bought them, the caregivers in turn claimed they hadn't being given any list. Addled, I asked him to check back with them and ensured they had got the equipments. The following week was still the same drama, this time Lizzy was already complaining of severe pains and crying. She had even protested the setting of IV medications to her because she felt nothing tangible was being done only administration of Pain killers and fluid. She cried for me. She wanted to be taken back to my facility because she felt we were giving her better care than the supposed tertiary institutions were. Three days ago I called again and was told they were yet to take the biopsy, now I was mad. I called here and there and realized the hopelessness of my situation...and hers. What was keeping the surgeons? Who was erring in the discharge of their duties? Where is the malfeasance emanating from? Where is the social welfare people? Where is the CMAC? Why do we treat people differently even in the tertiary centres? If she was the daughter of a governor or some influential personage, would she had being left unattended to because of some flimsy excuses for this long? I am sure even the CMD would have being having sleepless nights by her bedside. I mean we weren't begging for money because Lizzy was the Nigerian people's property. They had pooled resources together to help diagnose and possibly commence treating her situation as the case might be. But alas, someone somewhere wasn't doing their duties effectively. ABU Zaria has demonstrated and showcased a practical example of the general picture of the typical Nigerian Tertiary healthcare centre characterized by social infrastructural decadence and human capital inefficiency. Like most typical failed institutions with perfunctory leaders, they will always come forth with a plausible and befitting excuse for their shortcomings- the stench of their evasion of duty that pervades the air. They can forge an excuse such as "someone inadvertently left ajar the door that sealed the offensive smell and caused the effluvial diffusion", admitting however that there is/was a malfeasance! The facade of dilapidation and near desolation of the healthcare centres that greeted the eyes is nothing compared to the decay, indolence and apathy to work of her working personnel within. Doctors are as responsible for the failure in the delivery of standard healthcare services as the leaders of the country. If a patient can stay in the hospital for over a week and no definitive diagnosis had being reached because of somebody's dereliction of duty or inefficiency then we have failed as doctors. Nothing stinks like the stupid pride displayed by some doctors in the residency program. It is nauseating! Little wonder Mr. President would rather travel out to get treatment for an ear infection on the backdrop of specialists in the field of ENT. Lizzy died 2days ago without a diagnosis in a tertiary hospital, ABU Zaria, Kaduna state, Nigeria. She was buried in her village surrounded by the peering eyes of her younger ones. This only gives credence to patients who regard referral to tertiary centres as a dead sentence, most of whose fears are confirmed in the end. Most would rather go home and die in the hands of their loved ones. Nigerians, you should be very proud of yourselves for being an instrument of hope to Lizzy. But for your assistance financially, Lizzy might have long died. The sheer depression the experience in shika had being for her would have brought in the grim reaper rather fast. Yet she should have lived longer if she had being attended to with the urgency that her case called for. Though in my last conversation with her she was in pains, I can assure you that she loved you all and prayed for you. My earnest prayer is for no poor man to get sicker that would require his being admitted in a Nigerian hospital, that place, sorry to say, is a junkyard.
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