Tag: SERAP

The socio-Economic Rights and Accountability Project (SERAP) has con-tended that health is a justiciable right of every Nigerian.

It said the government must treat health as an enforceable right.

SERAP said in a report: “It is only when government ensures that health is regarded as a justiciable right for all citizens, regardless of status or situation in life, that public healthcare system will assume minimum threshold of a developed healthcare system.”

The 53-page report alleges ”humanitarian crisis, manifestations of corruption and how unhygienic conditions, severe shortages of medicines and medical supplies in the three hospitals made it extremely difficult for many Nigerians to obtain essential medical care”.

The report, launched at the Citi-Height Hotels, Lagos is entitled: Failing healthcare: How Federal hospitals are letting down the poor and making healthcare a privilege rather than a right.

It was presented to the media by pioneer Dean, School of Law, American University of Nigeria, Yola, Professor Dejo Olowu.

It was part of the highlights of the public hearing held by SERAP to provide a forum for people to provide testimonies and submit complaints/petitions on allegations of corruption they encounter while accessing public services particularly in the health, education and water sectors.

Olowu asked the civil societies to mobilise and support members of the community to use the rights-based approach to demand improved healthcare in the country.

He advised them to activate remedial processes at national, regional and international courts and tribunals as appropriate and to expose the impunity in the public healthcare sector.

He contended that civil society organisations have a responsibility to utilise their reporting mechanisms to showcase violations against the right to health under regional and international human rights treaties.

The report reveals that healthcare delivery was failing at the Lagos University Teaching Hospital, (LUTH) Idi Araba, National Orthopaedic Hospital, Igbobi (NOHIL), and the Federal Medical Centre, Ebute Meta (FMC).

The study by SERAP sought to analyse evidence-based information on the causes of the failure in healthcare service delivery in Nigeria, using three of the frontline institutions of public healthcare delivery, namely, LUTH, NOHIL and FMC, all in Lagos State.

It focused on healthcare service delivery at LUTH, NOHIL and FMC as representatives of the experiences in their counterparts across the country.

The report, conducted between April and June, this year, showed a deterioration in the quality and safety of care in these hospitals.

It claimed, for instance, that LUTH, NOHIL and FMC do not have enough cancer treatment machines, that Linear accelerator (LINAC), magnetic resonance imaging (MRI) and CT scan machines are not working optimally due to erratic electricity even as the hospitals do not have back-up plans.

According to the report, “a LINAC costs about US$5 million and the six that the Federal Government procured for six teaching hospitals have packed up. The dialysis machine at LUTH is outdated and its functionality at the time of study was zilch. LUTH recently lost its accreditation to teach dentistry because all its five dental chairs had packed up and there is no functional dental engine available.”

It further disclosed that “vital medical supplies such as oxygen, diagnostic machines, dental chairs, sterilising units, burns apparatuses, were in pronounced shortage. Overcrowded waiting rooms and wards were noticeable.

The organisation claimed its researchers reported that some wards have no mosquito nets and that there is no waiting area for mothers with sick babies. There is the Gynaecology ward, at which entrance a small bench that could seat about four persons, was placed. The bench was occupied by patients’ relatives, presumably.

“At the end of the corridor where the neonatal ward is, there is a similar four-seater bench, fully occupied. The bench, having been occupied, a group of people were standing. At the neonatal ward, a waiting room for mothers whose babies are on admission was not part of the hospital’s plan. The mothers have improvised.

“A woman lay on the bare pavement under the staircase, taking a rest. Nearby was an area where waiting mothers had carved out as waiting area. A number of women, whose babies were on admission, were seen sitting or lying down on a mat or on the pavement.  With the laid mats, sacks of clothes, plates, buckets etc stacked against the wall and a woman washing clothes, it was clear that many a mother stay for days in this state.”

According to SERAP: “The infant incubator or neonatal incubator is a rigid box-like enclosure in which an infant can be kept in a controlled environment for observation and care. Some of the incubators in LUTH are not working. It is either the heater is bad, or the monitoring mechanisms are not working. The incubators available in LUTH have been in use for over 15 years.”

SERAP claimed that a nurse, who has worked for some years in LUTH, spoke to its researchers and revealed that “some beds in different wards are too old, but LUTH knows how to manage. Some of the available beds have become dilapidated. Some beds can cause acci– dents. They have beds from which patients can fall. It has really happened, and I’ve seen it happen. But they keep managing”.

Another medical staff said, “Even bed sheets are in short supply. Patients use their wrapper for bed sheets sometimes. And when they use LUTH bed sheets, they are usually old and torn most of the time”.

SERAP also quoted a senior doctor as saying that there is poor water supply in LUTH and water is supposed to be an essential commodity, especially in a hospital. It’s deplorable to the extent that water does not run in the taps. You are seeing LUTH’s flowers and wall paints, but it is rotten inside. I will be right to say things are not working optimally in LUTH.

“Another senior medical officer at LUTH said, ‘LUTH is like a dumping ground for health care in Lagos. It’s usually the extreme cases that are brought to LUTH after treatment elsewhere has failed. Even if you’re rushed in as an emergency case, it’s not guaranteed that you’ll be attended to. Sometimes they’ll tell you there are no available beds unless you can afford the VIP section.

“At all the three study sites, derelict and obsolete equipment were commonplace. Most wheelchairs in LUTH are stiff and old. They are not in optimal condition. There is a poor maintenance culture. Not even the lifts are working well. One can easily get stuck in an elevator; so it is better to use the staircases. The lift in E Block is bad to the extent that they got a man to manually operate the lift when people enter and are in transit. It doesn’t even have doors anymore.

“LUTH has its own laboratories but the doctors their prefer to refer patients to the private laboratory because private lab are considered to be more efficient and delivered results quicker.”

”Another nurse at LUTH said: ‘The facilities are overstretched. To see a specialist on clinic days you have to leave your home by 4am or 5am to be at LUTH by 6.30am to join the queue early. Even at that, there are no guarantees you will be attended to’’.

“Nurses are forced to pick and choose patients to attend to. The ideal World Health Organisation (WHO) standard is five nurses to one patient. In LUTH it’s two nurses to 30 patients. In each ward, there are about 30 patients, and there are only about four nurses for each shift. In the afternoon, there’ll be two nurses, and in the night, there’ll be two nurses.

“Another nurse said sometimes, in the night, there is no light in the wards. Nurses sometimes use torchlight to attend to patients. LUTH electricity just recently improved, still electricity supply is epileptic. It’s still bad but it was worse. Before, there was no electricity at all day and night.’”

“At Igbobi, no money, no treatment. Admission at Igbobi’s casualty ward is N5,000 per day. After the preliminary examination, tests and eventual diagnosis, patients must pay before they could be admitted into the appropriate ward for their conditions.

“Patients get their syringes and needles, gloves, without it the doctor will not touch the patient. If they ask you for it and you don’t have it, they just walk away, they don’t have time. Privatisation of laboratories is another ill that the National Orthopaedic Hospital, Igbobi, has in common with LUTH.”

To reverse the situation, the report advised the leadership in each of the hospitals on need to back up their commitment to enable data collection as well as performance tracking and reporting, increase the transparency in the execution of the budget planning process by publishing income and expenditure reports, ensuring the release of assigned budgets to the health sector and projects implemented.

It said information on funded projects, on renovation and reconstruction will be vital to regaining the confidence of health workers and the public.

It also counselled the board of these hospitals to live up to their responsibility by monitoring standard procedures and compliance in daily management, administration and the delivery of services, adding that where there are established cases of failures as we found during the study, there should be responses to ensure accountability.

“The study in addition recommended that the federal government should allocate adequate resources for improving the quality of equipment and human resources in the public hospitals under its patronage” it stated.