Thursday, 17 April 2014
Two Days At Nigeria’s Premier Teaching Hospital By ‘Sola Fagorusi
As a country, we are still far from it. We are eon years away from that point when to die would be hard! We are decades away from that age when Nigeria’s maternal health statistics would be the poster boy for other African nations. Recently, I spent the working hours of two days at the teaching hospital of Nigeria’s premier University – the University College Hospital, UCH, Ibadan. As much as I remember what I saw there; it is the things I did not see that I continue to recall.
I was an undergraduate when I read Aunty Tola Adenle’s now rested column in the Nation Newspaper. I will never forget her shared experience of the 70’s in the United States when she was being wheeled into the labour room and she expressed enormous unease. The nurse upon knowledge of her reason firmly reassured her - ‘no mother dies here at child birth.’ It was on an authoritative tone. I am not sure any hospital, private or public, in Nigeria can offer same today. It is always safe to push that in the hands of God. And of a truth, nothing is wrong with that.
Premised on a couple of flippant comments by some friends as to an asymmetrical but placid and painless cheek prominence, I thought it wise to do a proper check up and off to UCH I went. The Teaching Hospital which is closely associated with the University of Ibadan has recorded many local firsts in the past given its ground breaking activities. At UCH, it is rightly assumed that Nigeria’s best hands in the medical career abound. My visit there allowed me a closer look at this affirmation.
I got to the hospital at 7:42am in company of a friend, meeting 4 other people waiting for medical care. A woman had her son’s head gingerly rested on her laps. The boy turned frequently and written over him was the discomfort he was hoping would be assuaged at the clinic. The time ticked; I watched as the staff trickled in. As we engaged with the administrative staff on preliminary registration processes, I was again reminded of the typical civil service situation where the customer is not yet King! The contacts were awkward at best; failure to have clear information on what you really wanted was met by harsh reproach by some of the staff. On the grounds of culture, I did not like the tone, especially to the elderly ones who had cause to be at the hospital. The bill had just been raised and registration was now a monthly affair. It was not surprising to hear dissenting voices from those uninformed of the development. I watched a senior female staff address them on the new trend. I was impressed with her civility to people who asked her for clarification.
For a moment, I wished all were like her. I wished the account clerk kept a smile eternally on her face and did not add to the pain of the already pained even as they parted with their cash! I momentarily wondered if they had management trainings for them on at least annual basis. The administrative room was initially dark thanks to power failure, one that was later restored about an hour later.
While we waited in the lobby, I saw a deep use of development communication nuances by Dr. Ojelade. She had a session with us on how the teeth should be brushed and shared tips on how to keep the mouth healthy. Certain that all of us could communicate in Yoruba; she passed her information across in the language, engaging with us with a participatory approach at every turn. She did not facipulate; rather, she boldly facilitated. One point she made clearly was the volume of paste that was to be on the tooth brush. ‘It’s supposed to be small but you know that tooth paste companies want to sell and so they advertise with images showing that it should be throughout the stretch of the brush. It is wrong.’ In a flash, I wondered why the Medical and Dental Association could not call these advertisers to order - another regulatory failure in some form. With a smile permanently edged on her face, Dr. Ojelade ended her session with us after colourfully answering a couple of questions showing her own white teeth in the process. I look at the wall clock in the waiting room, it was 4:35! It apparently was not functioning. The television bracket was also blank.
It was finally my turn to see the doctor. I got my blood pressure and weight measured. I could not miss the good nurtured behaviour of the nurse. She apologised that she left briefly to attend to some other things. She enquired if I was fine. She wanted to know if I slept well - all these while she kept at her work. ‘What’s your name ma?’ I sought to know. ‘I am Olowokere, Mrs.’, she answered while looking straight into my eyes. The medical personnel who had earlier called my name came again and she apologised to me again for taking too much time. With a gay spirit, I walked into the oral diagnosis section of the hospital.
She was young but confident of what she was up to. She asked me to lie down and she began to throw questions at me. She wanted my dental medical history. She apparently was not familiar with a case like mine. She threw all her knowledge at it. She had fair theories on what could have been wrong.
Three of her friends later joined her to also take a look and examine the condition. Noticing that one of them was an Indian was a ray of hope that some form of glory still lies in the institution at a time when most medical referrals were ending in her country. Perceptibly, they were all dental students in training. One look in their eyes and I saw the raw obsession for knowledge. As I lay on the dental chair heads up, I noticed the fans revolve slowly. A row was clean and the other left dusty. Attempts to modernise the facility was obvious but it was inadequate. Having clerked me, it was time to have the doctor meet the patient. Two hours after, I had met two of the best minds at UCH. With limited equipments and stifling environment, I watched both of them who I guess had sworn under the Hippocratic Oath to do exactly what they were trained to do discuss back and forth on what the painless problem may be. By the second day, I met another two. Offering knowledge from their various specialties and training, they considered all there was to the case. It was literally painless and thrilling watching them do so. I was a happy Guinea Pig! Occasionally, I caught a thing or two about the terms they were using given my science background. Some students were assembled and for a couple of minutes, the lead doctor taught the students. Oh, it’s a teaching hospital I recalled. My mind again drifted to what would have been if government could provide all there was to have a world class dental facility.
By the second day, I had gone to a private clinic to get a digital dental x-ray done. The machine at UCH was non-functional. While at the main complex, I watched as people streamed in and out. I saw sad faces. I saw confused ones. I saw happy ones. I saw helpless ones. Of the 6 lifts in the hospital, only 2 functioned – one for general purpose and the other for patients. The queue on the general purpose end was heavy. This was the same hospital that former president Olusegun Obasanjo, had upgraded in 2005. I went through the information unit of the hospital. It was well put together but I am not sure it functions optimally. They have an internet and Facebook desk. My checks online later showed someone was not doing enough. The Servicom Desk number available to the public – 0705.589.4260 was predictably not functional like that of most public institutions.
I did not run into any senator at the hospital. I did not run into any of the commissioners of Oyo State at the hospital. Even if I could not identify them in person, the typical Nigerian paraphernalia of office would have helped me point them out in the crowd. I did not see any of their close dependants. It would perhaps have been an indication that the men of timber and calibre in the society, apologies to Kingsley Ozuomba Mbadiwe, frequent the place. The doctors upon seeing the digital scan I brought back were still a little handicapped. They needed more information. They wanted a proper diagnosis. An Orthopantogram, OPG Machine was it but, the UCH did not have a functioning one. The newly acquired one was yet to be fully installed. As I discussed further with one of the doctors, I was amazed at his ICT dexterity. Apparently, he understood why the machine was yet to become functional. It was a software compatibility problem. I pitied the stretch of his work and thinking. While bothering about advances in dentistry and medicine, he also had to think about the technical and electronic aspects. As he led me out of the X-Ray section of UCH and I later made my way through the main gate of the teaching hospital with Crown Continental Security manning the gate, I cast a long look at the hospital again and wondered our shared fate as a nation. As I write this, I await information on the availability of the machine in the hospital. I am convinced as to the availability of brilliant minds in our medical profession even though this has been vigorously questioned of late given some avoidable deaths. What they undoubtedly lack are the tools of this age to make the practise enjoyable and fruitful. But in a country where our leaders jet out to Germany, USA and of late, India for something as little as a stomach upset and lacerations, it should therefore not be startling that we are not yet there. I can only imagine what happens in our community hospitals; at least in places where they exist. The day you meet a Nigerian senator or minister on admission in our hospital, then, it is an indication that our medical triumph moment is near.
P.S - I decided to leave out the name of the doctors who tended to me to honour my own phony Hippocratic Oath!
@SolaFagro on twitter.