EDITORIAL: Is UCH Ibadan now a killing field?

Reports filtering into the public domain indicate that the emergency section of Nigeria’s premier university’s teaching hospital has deteriorated so badly that patients and their relations refer to it as a ‘killing field!

This is indeed a tragedy, a further reflection of the decadence which the nation’s public health institutions have suffered in the last thirty odd years.

The University College Hospital (UCH), Ibadan was Nigeria’s first teaching hospital, commissioned in 1957. For many years, the hospital was the leader in the field of tertiary medical training, research, and healthcare delivery in the West African subregion. It was among the best globally.

UCH pioneered open heart surgery in Nigeria in the late 70s and made history when it successfully performed surgery on the youngest cardiac patient ever operated on in any public health institution in Nigeria.

The beneficiary of this medical feat was a sevenmonth-old baby with a hole in the heart. Sadly, over the years, UCH has faded in its glory, as services and facilities have deteriorated.

The outbreak of the COVID-19 pandemic this year led to a further overstretching of the already inadequate facilities, resulting in a situation where several patients rushed to the hospital, in recent times, have died due to lack of urgent attention to their cases.

The focal point of complaints is the Emergency Services Unit – which has now been described by patients as a killing field!

Emergency services, as first responders, should attend to patients within the first few minutes of arrival. Recent incidents reveal a different reality in UCH.

One incident involved a sister of a Staff Lecturer who was on the admissions queue (in the car) within the premises of UCH from Saturday evening till Sunday afternoon before being placed on admission.

She eventually passed on. Another case involved a patient who came to the emergency unit on a Tuesday and was kept waiting for 17 hours, till the next day. These are two of many more recently cited examples.

The staff have complained that a shortage of facilities is one of the reasons for the tardy services; but the picture is clear – UCH’s emergency services are not keeping up with emergencies.

This situation is not unique to UCH, as similar stories exist in tertiary medical institutions across the country.

The Lagos University Teaching Hospital (LUTH), another strategic teaching hospital in Nigeria, once had a case where a former Chief Medical Director of the hospital was rushed to the emergency unit on account of a medical crisis and did not receive attention until he died.

The state of the Emergency unit in UCH and other hospitals in the country is a microcosm of our health sector in general.

Given the lack of required facilities, the generally unsatisfactory services, and the glaring absence of enough trained personnel in our public hospitals, the government should declare a state of emergency in the health sector and urgently devote more resources to the save the nation from a major health crisis!

This call for the declaration of a state of emergency is not new.

In March 2018, the Senate urged the federal government to declare a state of emergency and provide funding for the overhaul of at least one public medical facility in each geo-political zone in the country.

Almost three years on, patients are tagging emergency services units as killing fields. Is the Government waiting for the entire citizenry to be killed?

The governments at all levels – local, state, and federal, are all complicit in the health sector crisis. According to Professor Jesse Otegbayo, the Chief Medical Director (CMD) of UCH, “the problem with the teaching hospitals as it relates to ineffective healthcare delivery is the near-comatose state of state-owned general hospitals and primary health centres.

If they can wake up to their responsibility and equip their hospitals in terms of manpower, equipment, and facilities, there will be less burden on tertiary healthcare centres, and we can focus more on our primary duties”.

The private sector also has a vital role to play mostly in the provision of primary healthcare services.

The financial commitment required to address challenges like inadequate infrastructure and facilities is one that the private sector can source for or provide.

They would also need to infuse the discipline and goal-orientation needed to ensure quick and efficient service in healthcare facilities.

READ ALSO: Ibom specialist hospital records success in brain, spinal cord surgeries

For example, By the end of 2020, GBC Health’s ‘Adopt-A-Healthcare-Facility-Programme’ (ADHFP) has a goal to establish a chain of Primary Healthcare Centres (PHCs), across Nigeria’s 774 Local Government Areas and apply market-based reforms to provide low-cost health services at decent standards to the poor and vulnerable.

Fixing Nigeria’s deplorable health sector will have the dual effect of conserving the foreign exchange spent on medical tourism by Nigerians ($1billion according to Price Waterhouse Coopers (2016) report), and restore the sector to its former glory when royalty like the Saudi Monarch and other African leaders used to visit UCH for treatment.

Nigeria’s health sector is in a state of emergency! If this outcry seems overly alarmist, perhaps we should start by admitting the obvious: the fact that our healthcare emergency services units in Nigeria are unable to attend to emergencies appropriately is an emergency we cannot ignore. The time to act is now!