Crisis in Care: Lagos hospitals risk more death due to bed space crunch

•Shocking sordid details of the state of Lagos hospitals

By Newton-Ray Ukwuoma

She sat on the wheelchair the entire time,” the bereaved husband told me during a private chat, “Because there was no space at the emergency ward.

“Since she was on medication, I asked for ambulance or personnel to follow us to the hospital she was referred to. They did not show any concern.”

Weeks ago – amidst the frenzy of appointing a new Chief Medical Director for the Lagos State University Teaching Hospital (LASUTH) by the Governor, Mr Akinwumi Ambode – a video surfaced online about the death of one Mrs. Omolara Kalejaiye, 45, the beloved wife of the Baale of Otumara II in the Apapa Road of Ebute Metta.

Mrs. Omolara Kalejaiye died, according to the bitter account of her husband, High Chief Kehinde Kalejaiye, who filmed and posted the video, not because she slumped while taking her bath in her sister’s home in Ikeja, but because she was denied admission and treatment in LASUTH, where she was first taken to, due to a bed space crunch at the Bola Tinubu Emergency Medical Ward.

“One of the nurses told us that once she had been given a referral letter, they could not treat her. That was when they removed the oxygen and drip, and that was when I called the Assistant Chief Medical Director to assist us get a bed space for my wife,” he continued.

“The Assistant CMD told me that it was late that I should wait till dawn. Hearing that from him infuriated me. It was a matter of life and death and all he could say was that I should wait till morning. He didn’t show any concern as well. We had to wait.

“We took her there around 11.30pm, but when it was around 4.30 am her legs became very stiff without any medication and oxygen, we took her to the Yaba Federal Medical Centre. When we got there, there was also no bed space. It wasn’t long after that, that she gave up the ghost.”

The LASUTH management said it had set up a committee to investigate the matter.

But it has been over three weeks since. Even the High Chief has expressed doubt that the outcome of the investigation would come to any good.

Meanwhile, when I checked during the week, no new bed space or alternative measure has been put in place by the hospital to ensure patients who flock the hospital’s emergency wards are admitted and have access to medical care. This means that more and more helpless patients, who are denied access to emergency medical care due to insufficient beds, will continue to risk death.

Should Lagos residents continue to lose loved ones, relatives, friends and colleagues daily due to this bed-space crisis?

I decided to dig deep into the issue of shortage of bed space in Lagos hospitals. 

The Shortage

Masked as a resident whose diabetic mother was lapsing into a coma, I visited the Lagos State University Teaching Hospital (LASUTH). The mission was to request for an ambulance.

In the beginning, it didn’t seem like a great idea. Normally, an ambulance should simply be a phone call away. But there was an air about the hospital that Tuesday afternoon that seemed to say ‘normal’ was out and something else was in.

It was past 2.30pm. The sun was in its full strength on the landscape. The road leading to the main entrance of the hospital was occupied. People and cars struggled along its chink.  LASUTH is located at the centre of traffic, centre of Lagos. The three major roads that lead to the hospital come from the Murtala Muhammed International Airport on the right, the busy Computer Village at the centre and Maryland on the left, and with its neighbours being the High Court, the police training academy among other government-owned establishments.

On this day, the two sides of the main gates –entrance and exist – were permanently open to ease the traffic. At the administrative block right after the first three storied ward on the right, a nurse in sky blue jumpsuit emerged from an office.

“If you want to request an ambulance go to the Nursing Department upstairs,” she told this reporter very care freely as she paced towards a red Toyota Camry, bag in hand and a look of indifference to match.

The entire Nursing Department was made up of two small rooms – one for the receptionist, visitors, and the other for the nurses – about six tables circled around the room with a corner for nursing paraphernalia. Three nurses were seated when the correspondent walked in.

“I said there is no space at all,” one of the elderly nurses in her early fifties stabbed. “Somebody even called earlier. Everywhere is filled up.”

“Do you work here?” another nurse interjected.

“No. Someone directed me to come here,” the reporter answered.

“Who is the patient to you?” the first nurse resumed.

“She is my mum.”

“There is no space,” she repeated.

“Both in the emergency and in the wards?”

“Yes (she meant ‘No’),” the first nurse retorted.

“Is she stable? Why didn’t you bring her to the hospital since morning?” The second nurse pressed.

“If the patient is stable, if she can walk you can bring her to see the complainant doctor. She doesn’t necessarily need to be admitted. It is only when her condition is beyond control that we can admit her.”

“Why isn’t there space for admission?”

The first nurse laughed heartily. The question amused her. “I cannot answer that question,” she said in-between chuckles then continued. “This is Lagos. This is Nigeria. Everybody wants to bring their sick relations here.”

“The hospital is congested”, the third nurse, who had been looking on and wasn’t going to take it anymore joined in.

“As a matter of fact, if you get to the ward now there is no space to even walk free. The wards are jam-packed. People come from every part of the country and around the world to this hospital. Most of our patients are not Lagosians. People from neighbouring states and other parts of the world come here. We have a lot of patients in our hands.

“What we do is when a new patient is brought here, we stabilise them and then refer them to other hospitals. We do not keep them any more in our custody because there is no space to keep them. We are battling with space.”

It was as though her response had been bottled up inside her for a long time, suffocating her and the question just saved her life – from choking.

At the CMD’s office, as soon as I gave his true identity, the receptionist said, “CMD doesn’t want to see any journalist at this time”.

Shortage of Everything 

Ifako-Ijaiye General Hospital is the closest institution to LASUTH. The sight of patients lying on the bare floor, pregnant women and mothers of new born babies littering the hospital and seeking the attention of medical workers was enough credence to the degeneration in the public hospitals due to congestion.

It was the same conclusion as LASUTH, except that there was the shortage of almost everything: shortage of bed spaces, of medical personnel and of fresh air.

A mother, who gave her name as Florence, 33, and whose new born was referred to the hospital from the Isolo General Hospital, told the reporter she had been on the queue with her sickly baby since 12noon.

It was 2.45pm. I, camouflaging as the woman’s husband, took mother and baby to the nearest medical staff.

“Sir, she came late. Most of the women who came here before 9am have been attended to,” he told me.

“And I have asked her to wait. You can see the queue.” Indeed a snaky chain of benches was arranged at the Maternity ward. Tens of women sat and waited their turns.

At the Maternity Ward no one is admitted a day after childbirth. “I came here last night. After the safe delivery of my baby I was discharged this morning,” Mrs. Ugbaji told me.

The Emergency ward was the smallest of all the wards in this hospital. About three doctors worked on the sick. The beds could be counted, about ten of them that ringed the room were all booked. Everyone else was attended to outside.

When Saturday Tribune approached the Medical Director and Chief Executive Officer, Dr. A. A. Kaka, for his response on the situation, he declined, saying, “I am a civil servant before I can respond to you, you have to seek permission from my boss, the Minister of Health”.

The same sentiment was rehashed by the Chief Medical Director at the Gbagada General Hospital as well as the Yaba Federal Medical Centre, where Mrs. Omolara Kalejaiye was referred to.

All attempts to reach the federal authorities and the Commissioner for Health, Dr Idris Jide were not successful at the time of filing this report.

According to the Public Relations Officer (PRO) of the Lagos State Ministry of Health, Mrs. Salako Adeola, Dr Idris, had travelled outside the country on an official engagement.

Meanwhile at the Lagos University Teaching Hospital (LUTH), the over 100-bed capacity Emergency Ward continued to accept patients from different general hospitals. At the time, the reporter visited the teaching hospital, ambulances from Ibeju-Lekki General Hospital and the Apapa General Hospitals were unloading critical patients into the hospital.

Population explosion

Touted as one of the fastest growing cities in the world, Lagos boosts of a population of 23 million residents with an immigration rate of 123,840 visitors per day. That approximates to 44.6million visitors annually. There are about 26 secondary health institutions and over 300 Primary Health Centres under the Lagos State Health Service Commission. The question remains whether these facilities are actually enough to take care of the over 23 million residents and its increasing population of visitors?

“It is obvious they are not enough,” argued Wale Adetona, who had once tasted the ‘bitter pill’ at LASUTH, where he was once referred to after a domestic accident.

“It was so bad that my wound was only stitched at the hospital and I was told to go, despite the excruciating pains that would have needed some days to observe,” he stated.

Curiously, despite the shoddy treatment, he still believes his case was better than those of others, who were not even allowed to alight from the vehicles that brought them before they were ejected from the hospital.

“They were treated in their vehicles and discharged for lack of bed space, not minding the gravity of the cases that brought them there,” Adetona added.

Beyond Shortage

Beyond the shortage of bed space in the hospital, High Chief Kalejaiye argued that a combination of unprofessional conducts such as negligence, negative attitude of medical workers made him a widower.

Speaking he said, “The lackadaisical attitude of doctors and nurses in our hospitals exists chiefly because the doctors and nurses know that no one is monitoring them. But if they know that someone is watching and that they could be fired with evidence, they will change their attitude towards patients.

“This is why I want to suggest to them to install surveillance cameras in all our hospitals, especially in the emergency wards, so that government can monitor the activities of their workers.

“I have been told that they are investigating what happened to my wife, but the question is, how can they know what exactly happened when there is no camera at the emergency ward? What is the evidence to prove that the doctor and nurse unplugged the oxygen mask from my wife? If the government care about protecting the life of the common man, this should be their priority.

“Bed space is an issue we should not be talking about at this age and time,” he told me.

“Bed space should not the problem of a hospital like LASUTH. I actually counted, they do not have up to 30 bed spaces in the Emergency ward.

“This is very ridiculous.

“The painful part of this is that people are dying every day because of this bed space problem. The day my wife was brought to the emergency ward, I saw how the doctors were treating people in their cars, outside on the wheelchair. I think these cases always happen at night, not in the day. I believe that the CMDs should have written the government about this.

“As far as Lagos State is concerned bed space should not be the problem in our hospitals. How much does expanding the emergency