The precarious situation in our health institutions became a source of worry going by the first experience of some relatives and friends in recent times. Before now, stakeholders in the health sectors have cried out over the deplorable conditions that have taken a heavy toll on the people seeking medical attention. A sickening citizen would be incapable of contributing meaningfully towards national advancement. Apart from the several brilliant brains that the country has lost to brain-drain, the dilapidated health infrastructure has continued to encourage medical tourism in which colossal sums of money are lost to foreign countries, which the Nigerian Medical Association (NMA) puts at about US $1 billion annually whereas, for optimal health care delivery, the World Health Organisation (WHO) recommends a doctor-patient ratio of 1:600 for every country.
Ordinarily, patients are referred to teaching hospitals when their health conditions are not given the required attention by smaller hospitals. Hence, patients are helpless when asked or taken to teaching hospitals. They are made to suffer untold hardship and neglect at the teaching hospitals. As I mentioned above, a friend lost his wife at the University College Hospital (UCH), Ibadan, Oyo State after being admitted for childbirth. The excellence that UCH was known for appears to be fading-off and becoming something else with how patients and their relatives are treated. The bereaved man further said that after payment, people were made to go to another section whereby receipts are issued wondering why payments and issuance of receipts cannot be done at the same time and simultaneously.
Other worrisome experience encountered by the bereaved man was that potable water was not readily available, the buildings were dilapidated and many of the wards looked unkempt whereby mosquitoes had a field day biting them. As it is, people are frightened to go to hospitals for the fear of contracting new diseases. It was learned that some sections of the hospital are even kept as special wards. Why such discrimination in a public institution? In many public hospitals, patients wait endlessly in queues to see a doctor irrespective of the nature of their illness, and bed spaces are so insufficient that the sick are made to sleep on the bare floor.
The dire situation of our health facilities can be zeroed down to factors such as graft by medical workers, inadequate funding, poor administration, non-adherence to medical professional ethics, lack of enforcement of punitive measures against misconduct, and weak supervision by regulatory bodies. Corruption by medical workers involves making fortune from the misfortune of others through exploitation. The decline in statutory allocations to health has impaired many public hospitals from performing to expectations. Funds are not released on time and if at all, they are grossly insufficient to cover capital and recurrent expenditure.
Poor administration allows such rot to take. Failure to adhere to professional codes such as a subscription to the Hippocratic Oath and other medical ethics would continue to embolden health workers to act with impunity such that violators of ethics are hardly apprehended and punished. This should not be going by the call for the Nigeria Medical Council to exercise discipline over the medical practitioners whose professional negligence is a source of embarrassment to the council as was done in the case of Dr. (Mrs.) FCL Olaye v Chairman Medical and Dental Practitioner Investigating Panel ORS [1992] 5 NWLR 553.
The truth is that as long as we continue to admit and enrol persons without conscience, calling and human feelings into medicine, nursing, laboratory technology and the like, the quality healthcare with a human face would be a mirage. Failure by professional associations, regulatory agencies, and government bodies to put a tab on the administration of public hospitals has largely also contributed to the problem. The government should ensure that statutory allocations are released promptly and adequately. The ministries of health at the federal and state levels should embark on regular supervision of hospitals from time to time.
Our legislature should intensify its oversight functions diligently to keep the institutions on their toes. No health worker should be spared for engaging in corrupt practices and misconduct in tandem with the extant laws. Hospital management should remove unnecessary bureaucracy that either delays medical attention or breeds corruption such as stealing of patients’ drugs and other belongings. State government should improve on the primary and secondary levels of healthcare delivery to reduce the undue pressure on teaching hospitals, which in the 1960s and 1970s, catering for many categories of patients.
More importantly, individuals and corporate organisations should invest and make donations to upgrade our health systems. The nation should train more doctors and other health professionals on current trends. For a more sustainable approach to management, the option of public-private partnerships should be explored. As long as health institutions are in bad shape, many people including top government functionaries and family members would continue to travel out for medical tourism; brain-drain would keep thriving while avoidable casualty would be a recurring decimal in our hospitals. This should stop.
