BY OUR CORRESPONDENTS
Without any serious expansion since they were set up, public hospitals across Nigeria no longer have enough bed spaces to cope with the increasing number of patients due for admission.
Consequently, such patients, including those in emergency situations, are being turned back to seek treatment elsewhere.
Those who have no means to seek medical attention in the more expensive private hospitals spend hours and sometimes a whole day waiting for the next available bed spaces.
Some distressed family members narrated their ordeal while waiting for their ailing siblings or parents secure bed spaces, especially in the accident and emergency wards.
Some hospital officials confirmed to LEADERSHIP Friday that the situation is mostly pronounced in accident and emergency wards, orthopaedic and paediatrics sections, because of terrorists and bandits’ attacks, rising road crashes and pregnant women due for delivery as well as children who are sick.
They added that the outbreak of the COVID-19 pandemic compounded the situation as some wards were converted to isolation centres.
One of health workers in Maiduguri, Borno State, said the Boko Haram insurgency and the coronavirus pandemic contributed largely to the current dearth of bed spaces in most of the state and federal hospitals in the state.
The official who works at the State Specialist Hospital, Maiduguri l, said sometimes patients do queue up for their turn to be admitted.
He said the situation had been on for a long time in the state’s hospitals, adding that patients are being turned back for lack of bed spaces.
The chairman, Medical Advisory Committee (CMAC), University of Maiduguri Teaching Hospital (UMTH ) chapter, Prof Mala Bukar Sandabe, said because of the COVID-19 pandemic related issues, UMTH had to reduce the size of the medical ward to give space to COVID-19 patients.
Sandabe said from available statistics, the hospital has a duration of admission and discharge, so that they do not allow beds to be filled up at any time.
He stated: “Second, because of insurgency, sometimes you have unexpectedly large numbers of patients from gunshot wounds and all sorts of incidents. Those ones, we take care of them at the accident and emergency section and then, if we don’t have enough space in the unit, we take them to the wards.
“Our major challenge now is the medical ward, the bed space is not adequate for the patients. Among the patients that occupy bed spaces are those with chronic kidney diseases particularly, the female ward is always filled up. They occupy most spaces in the accident and emergency unit and that is why it is always filled up.
“But recently, we have commissioned a trauma centre and we have started deploying personnel there. So we are hoping that soon, we will start receiving patients there so that the accident and emergency unit can be decongested.”
In Lagos state, there are 320 Primary Healthcare Centres (PHCs), 26 secondary health facilities and two tertiary hospitals. Yet, most of these health facilities have challenges ranging from bed space, poor attitude of healthcare workers to poor infrastructure.
In the dawn of COVID-19 pandemic however, these fragile health systems have been overwhelmed as there are not enough bed spaces, manpower, among other challenges to adequately cater for the health needs of the residents of Lagos.
When LEADERSHIP Friday visited the Lagos University Teaching Hospital (LUTH), several patients were at the emergency room, waiting to be attended to, due to lack of bed space.
Mrs Charissa Adams, one of the patients who spoke with LEADERSHIP Friday, said while she was rushed to the hospital around 5:00am, Wednesday last week, the doctors were yet to attend to her after several hours because there was no bed space for her at the emergency ward.
Her worried husband said she is fighting for her life, “but there is no bed space for her.
“When I pleaded with a nurse to attend to her at the passage where my wife was lying down, she told me that the hospital’s policy forbids that. She said they are not allowed to treat a patient on the floor,” he said
The story was the same at the Lagos State University Teaching Hospital (LASUTH), as patients were seen unattended due to lack of bed spaces.
One of the patients said he had been waiting for four hours due to lack of bed space and doctors on ground to attend to him.
The director, Clinical Services and Training, LASUTH, Dr. Ibrahim Mustafa, told LEADERSHIP Friday that the state government is in constant recognition of the fact that there is a need to expand the public health facilities and employ more doctors and it is pumping a lot of funds into that.
“We may be faced with some challenges, but with time, we will get it right,” he said
Mustapa said, “The population of Lagos State is more than 20 million, meanwhile, our hospital was 700 bedded, but because the state government takes the health of its populace very seriously, the old Ayinke House, a clinic built to cater for maternal and under five children’s health was refurbished with additional 200 beds, making the total bed space in the Lagos State University Teaching Hospital to be 900.
“The state government is in constant recognition of the fact that there is a need to expand the facilities that are currently available in the state. Right now, LASUTH is the-go-to teaching hospital in the state. The general populace of Lagos State and people from neighbouring states want to be treated at LASUTH, mainly because of the facilities that are made available, and the manpower that we have available in LASUTH.”.
He listed some of the things they have done to ensure availability of bed spaces as working on the turn over. “Turn over in terms of admission and discharges. For instance, we are making it a point of duty that patients in the emergency room cannot stay there for more than 48 hours and when they are moved to the wards, our doctors try to make sure they get well on time, so as to free more bed spaces. So, as long as we have moved patients out from the emergency room, there will be available space to treat more emergency cases.
“We cannot run from the fact that we still need to expand our facilities, especially in terms of bed space, and I can tell you that the state government is actively looking at that, so that LASUTH will be a purpose built hospital that will have more bed space and be efficiency-centered,” he said.
On strengthening the Primary Health care (PHC) centres in the state, Mustapa said the state government has over the years tried to strengthen the PHC centres, by building maternal and child health centres across the state, all in a bid to take the pressure off LASUTH.
In Osun State, LEADERSHIP Friday gathered that most of the public hospitals owned by the local, state and federal governments cannot boast of bed spaces for their patients who deserve admittance at any point in time.
Though almost every ward is affected at the Obafemi Awolowo University Teaching Hospital, Ile-Ife and Osun State Teaching Hospital, (OAUTH) Osogbo, the worst hit is the orthopedic ward.
This, according to Mrs Awodeji A. O. of OAUTH is due to duration of residence by patients and spike in the number of those from accidents caused by cyclists on a daily basis.
She noted that if all the bed spaces in the hospital were allocated to orthopaedic patients, the hospital will still require more bed spaces.
Also commenting on the development, the acting chief medical director of Osun State University, Professor Peter Olaitan, said the hospital management is making efforts to increase the bed spaces to accommodate deserving patients
According to him, having patients admitted in hospitals helps in monitoring the progress being made in the healing process, adding that the danger involved in having patients that are supposed to be under intensive care is enormous.
Recounting his experience, Mr Adeolu Olabisi said he lost his wife to the cold hands of death a few years back due to non-availability of a bed space at the State Hospital, Osogbo.
According to him, if his wife had been admitted, the complications that led to her death would have been treated accordingly.
At the Federal Medical Centre (FMC) Owerri, the medical director, Dr Kingsley Achigbu, said the hospital is doing its best to provide adequate beds for its patients.
He said the influx of patients to the centre had increased the intake of patients, resulting in patients struggling to take up available spaces within the hospital.
He said FMC is expanding and this will enable more beds spaces to be provided for patients.
His words: “We are erecting more structures, so as to accommodate more patients and as soon as we complete the structures, the issue of bed space will be a thing of the past”.
A health Worker in the state, Loveth Okoro said the state government is paying lip service to the health needs of the people.
According to her, apart from the issue of bed space, the facilities in the state owned hospitals should be upgraded, so as to compete favourably with private hospitals in the state.
Dr Ihekuba Justin of the state Ministry of Health said the issue of lack of bed space is of great concern to the present administration and claimed that the state government had put mechanisms in place to deal with the challenge in the general hospitals in the state.
In Niger State, the Federal Medical Centre Bida, Is the only tertiary referral centre thus, the hospital is always filled up while other less severe patients are taken to the general hospitals.
LEADERSHIP Friday observed that the hospital was filled to capacity with those on admission and others seeking out-patient services.
As at the time LEADERSHIP Friday visited on Wednesday the bed spaces were filled. Attempts to see the chief medical director proved abortive but many consultants were seen attending to the patients.
The patients who spoke on condition of anonymity alleged that because of lack of bed spaces they had restricted some of them to outdoor services and made visits.
At the state-owned IBB Specialist Hospital, there are only two wards one for male and female with limited bed spaces whereas over 100 patients requiring bed spaces beseech the hospital on a daily basis.
Also in most general hospitals in the urban centres visited, our correspondent was confronted with cases of no bed spaces while the situation in the 22 general hospitals was the same.
It was learned that some doctors operating in the hospitals often refer the patients to their private clinics.
A consultant at the Federal Medical Centre FMC, Asaba who prefers anonymity, attributed the dearth of bed spaces in the hospital to the high number of patients who thronged into the hospital in search of quality services provided at the hospital.
He said, “The reasons for lack of bed spaces in FMC, Asaba is not farfetched. This is because the hospital caters for patients from three States of Delta, Anambra, Edo and Imo and so many people from different places.
“The level of manpower in the FMC, Asaba is high, as at now, we have over 80 consultants in different fields handling specialized cases hence referrers from different places.
“Ideally, the FMC, Asaba is supposed to handle special cases but at present, we handle primary and secondary health care services, this is another reason why many patients thronged here.
“So, the solution is to establish more equipped hospitals that can handle primary and secondary medical services at different places.”
In Rivers State, the issue of dearth of bed spaces seems to be common in most state government-owned hospitals.
A visit by LEADERSHIP Friday to most hospitals in Port Harcourt, including the Rivers State University Teaching Hospital, revealed that most of the patients, especially those with less life-threatening issues are advised to come from home in order to create space for patients in critical conditions.
A resident of Port Harcourt, who pleaded for anonymity, narrated how authorities of the hospital told them that there was no bed space for her dying husband who was rushed to the hospital from Imo State.
However, speaking with LEADERSHIP, a medical doctor attached to the University of Port Harcourt Teaching Hospital, Ameh Samuel Ameh, said bed space had never been a problem in the hospital.
Ameh stated that the structures in the hospital were built to create space for patients as the need arises.
CMD, NMA Chairman Differ On Adequate Bed Space In Hospitals
There is no problem with bed spaces for the sick at the University of Ilorin Teaching Hospital (UITH).
The chief medical director of the hospital, Prof Abdullah Yusuf disclosed this during an interview with our correspondent in Ilorin, Kwara State.
Yusuf added: UITH like many other hospitals is up and doing especially in the area of bed spaces. No patient qualified for admission had ever been rejected due to absence of space.
“At the heat of lockdown occasioned by COVID-19, a national agency christened Emeka Offor Foundation and Savannah Centre donated over 500 mattresses to the hospital. Besides, since its movement to the permanent site, the hospital had unparalleled space to accommodate any category of patients, even at the emergency wing.
“The health workers are up and moving stabilised patients into the relevant wards with promptness.”
Also, in an interview, the Chairman of the Nigeria Medical Association (NMA), Kwara State chapter, Prof Issa Baba, said: Bed occupancy rate (BOR) is a measure of utilization of the available bed capacity in the hospital, and it indicates the percentage of beds occupied by patients in a given period of time, usually one year. It reflects efficiency in the use of hospital beds. And hospitals can be said to be operating efficiently at BOR of 80–90%”.
He added: “The hospitals’ mean bed occupancy rate was, according to a study in Nigeria, as low as 42.14%, far below standard benchmark. That as it appears very low in Nigeria, it is not generalisable for all fields of medicine and subspecialties or ward divisions within the hospitals. For example the bed occupancy rate for paediatrics and adult emergencies as well as intensive care are extremely high and in most cases there are inadequate bed spaces for these acute treatment areas of medical and surgical care. Same can be said of psychiatric care in most of our teaching hospitals and medical centres where some don’t even have dedicated bed spaces for mental and behavioural disorders or substance use disorders.
No Hospital Can Admit Patients After Exceeding Its Capacity – CMDs
Meanwhile, hospital chiefs have debunked the claim that ailing Nigerians are increasingly finding it difficult to get bed spaces in public hospitals.
A visit by our correspondent to some of the public hospitals including Benue State University Teaching Hospital (BSUTH) Màkurdi, it was observed that all the patients were on their beds.
However, our correspondent who spoke to the Chief Medical Director of BSUTH Professor Terrumun Swende to explain that the Hospital which comprised 350 beddings has never exceeded the beddings.
According to him, since he assumed office as the CMD of the hospital, they have not exceeded all the beddings at once; it was only in 2019 the hospital admitted people up to 180 at once.
Corroborating what the BSUTH boss said, the chief medical director, (CMD) Federal Medical Centre Màkurdi, Dr Peteru Inunduh, said the hospital is a 500- bed facility that has never admitted patients after exceeding its capacity.
Population Explosion, Land For Expansion Responsible For Mess – NMA
In the Federal Capital Territory (FCT) for instance, this situation compels patients to patronise private hospitals even when they don’t have health insurance.
A civil servant in Nyanya, a suburb in the FCT, Mr. Martins Josaiah, whose wife was recently delivered of a baby in a private hospital, told our correspondent that he had initially taken his wife to Asokoro district hospital but was told there was no bed.
Martins said even though he lives in Nyanya, he didn’t bother taking his wife there because of fear of no bed space.
He said he had to take his wife to a private hospital that night even though he didn’t have enough money at that moment.
Also, a teacher in Karu, Dorcas Abu, said her son was very ill and she rushed him to Nyanya General Hospital but was told that there was no bed in the children’s ward to admit the boy, she was referred to Asokoro District Hospital, on reaching there, she was told the same thing and was referred to Maitama general hospital.
The chairman, Nigerian Medical Association (NMA), FCT, Dr Enema Amodu, said there was a need for the government to provide more beds and space to be able to accommodate more patients.
He said, “If there are only ten beds in hospital and there are emergencies and the beds are filled up, you can’t put a patient on the floor, so it’s a government problem not the doctor but it’s just that the anxiety that surrounds the patient at that time, all eyes will be on the doctor.
“So it’s the government that should provide more beds and more space. They are doing their best but they should do more.”
Also, the immediate past president, Nigerian Association of Resident Doctors (NARD), FCT, Dr. Roland Aigbovo, said the problem of no bed space is as a result of population explosion with no room for expansion of hospitals, saying it is not as if there are no enough beds but no space for expansion.
He said the various general hospitals in the FCT were built to cater for the districts that they are. “For instance, Wuse hospital caters for people in Wuse and Maitama for people in that district but over time, there has been a population explosion and with the explosion, most facilities do not have the room for expansion.
“You are meant to cater for the growing population with no room for expansion. That is basically what is responsible for no bed space. For instance, the hospital that is supposed to be a cottage hospitalis now operating as a general hospital.
“Just go round many of the hospitals, you will see that there are not even spaces for expansion. For instance, in Asokoro, there is an estate close to the hospital, of which you cannot encroach into that estate, if you go to Maitama, the same thing. If you go to Wuse, there is a police station on the right so all of the hospitals are just somewhere that there is no room for expansion.
“If you keep breaking the buildings in trying to expand, you are also weakening the structural strength of the building so that is basically what is responsible.”
On the way out, Dr. Aigbovo said more hospitals have to be built in the various districts. “For instance, Asokoro now practically caters for Asokoro, Nyanya and Karu. Nyanya hospital is a general hospital but it is basically more like for women and children. So, most of their surgical cases come to Asokoro.
“Karu hospital is more like a behavioral medicine unit so if more health workers are employed to expand the services in those hospitals, one way or the other it will reduce the burden in Asokoro. So also most of these new districts that are coming up, there should be more hospitals so that it will reduce the pressure on those other existing facilities,” he urged.
Efforts to get reaction from the Federal Ministry of Health proved abortive as the director, Hospital Services, Dr. Adebinkpe Adebiyi, referred our correspondent to the FCT health authorities, even when told that the same scenario plays out in teaching hospitals in the country.