Our Public Hospitals Are Sick And Our Senior Doctors Are Aloof -By Ugoji Egbujo

The tragic case of Dr Vwaere Diaso doesn’t even tell the story. The rot is malignant. After the cheap elevator collapsed, the young lady couldn’t be extracted for almost an hour. This accident happened in the heart of Lagos, the country’s centre of excellence. When the fractured doctor arrived at the surgical table, the monitors didn’t work. The colleagues of the deceased young doctor have been through a nightmare. That was a tertiary hospital, but there was no functional monitor anywhere around that place that day in 2023. Yet Lagos might even be better than most other states

The senior doctors are patriots. They stayed while others left. But they have become wimps. The tertiary hospitals are run by doctors yet standards are dead. In one of the teaching hospitals in Lagos, there are practically no residents. Residents abandon their programs and jump to greener pastures abroad, but they are not replaced. The senior doctors are unperturbed. While the junior residents work themselves to death at the expense of poor patients, the senior doctors carry on like they took no oath to stand up for their colleagues and the integrity of the system.

An overworked doctor is an accident waiting to happen, but who cares? Sometimes young doctors are placed on call duty every other day and are compelled to resume work the morning after a call. Some of these doctors are mothers, but nobody cares. The medical residency program can be intense, but it shouldn’t be crushing. When a doctor is handed four times the patient load he can cope with and gets no rest in between, the patients bear the brunt. Rather than provide good working environments for residents and help them resist the allure of foreign medical practice, these hospitals, in lacking basic amenities, justify the brain drain.

At the level of a teaching hospital, there should be basic minimum requirements; otherwise, the facility should be downgraded and depopulated. If a hospital can’t find residents, the management must close down some of the wards. If a teaching hospital doesn’t have functional tertiary facilities, then that teaching hospital must be downgraded to a primary health care facility. The status of a hospital is neither a function of the size of the buildings nor the ego of the supervising senior doctors who march around it with big titles.

A tertiary hospital must maintain a certain quantity and quality of staff and a measurable level of sophistication in equipment. Staff welfare and clinic services must be the priority. But in Nigeria, a medical professor administers a teaching hospital and allows the residents to use a ramshackle space as a shared call duty room. The professor doesn’t recognize that young doctors must be treated with dignity. All the senior doctors who manage these hospitals, care about is their job and its perks. To protect the job given to him by politicians who wouldn’t fund health care adequately, he engages in the unconscionable coercion of the young doctors to work like young donkeys.

The professor knows that outpatient clinics in a referral centre must be properly kitted. But he lets it run on like a bolekaja. There are no Sphygmomanometers in consulting rooms. Gynaecology consulting rooms have no mobile ultrasounds. These are cheap instruments that have become basic medical tools everywhere else. But senior doctors are more interested in keeping their administrative jobs than offering ethical leadership. Fortunately for these folks, the governor and his wife will never come around because they have subscribed to an air ambulance service.

The governments joke with healthcare, but the senior doctors are complicit. Tertiary hospitals are like airlines. Once an airline can’t keep up, its license is withdrawn. I aviation, the regulators are strict. In medicine the regulators are lousy. Nobody can overwork pilots. The rules are strict. So why are doctors overworked by senior doctors. Once the hospital can’t meet basic standards, it must be downgraded or decommissioned. All medical accreditations are done by senior doctors. So why can’t they withdraw accreditations at the first sight of inadequacy? Why do they collude with corrupt politicians to seduce the public into a false sense of safety by passing off large buildings, colourful and decrepit, as serious hospitals?

In January 2017, I rushed my father to the Federal Medical Center in Owerri. He had suffered a stroke. In the emergency department, there was no stretcher. It was 5.30 am. We were stranded in an abject referral hospital. There was no way to bring out the comatose patient from the car without risking more injuries. Someone graciously pointed at a wheelchair with a broken leg. The nurses were too busy to lend us any sustained attention. We lost precious minutes in that hospital before we decided to run away. It was a hopeless situation. The deep is sustained by the criminal complicity of senior doctors mandated to regulate healthcare facilities to wield the stick. That Federal Medical Centre has now been promoted to a teaching hospital.

The senior doctors must find the courage. Ill-equipped and poorly staffed hospitals must be downgraded. That’s the only message the prodigal politicians will understand. Strikes haven’t worked. Politicians are medical tourists, but the downgrading of facilities will harm their ego and prevent them from fooling the public. Hospitals must be run like airlines. Senior doctors must rise and cure the hospitals.