LASUTH’s queue of sorrow and death

Oke and Abdulbaasit

BUKOLA ADEBAYO in this piece writes that some patients in need of life-saving surgeries at the Lagos State University Teaching Hospital queue endlessly for surgeons’ attention, with some dying in the process.

As it is in Samuel Beckett’s absurdist play, Waiting for Godot, where two characters, Vladimir and Estragon wait endlessly for an unknown relation called Godot, patients in need of surgery at the Lagos State University Teaching Hospital, Ikeja have been waiting for surgeons to deliver them from their pains. Some of the patients have been on the surgery queue since 2009. And because of the dearth of surgeons, patients have, like Vladimir and Estragon, been waiting continually for overworked surgeons to slice away their pains.

LASUTH is no doubt overwhelmed and its facilities overstretched. It is the only tertiary hospital owned by the Lagos State government for its over 18 million people. With less than 80 surgeons, and only four surgical theatres, the hospital cannot cope with the huge number of patients that need life-saving surgeries. Consequently, patients are put on queue. Some die before their turn while others who could afford it go abroad for their surgeries.

Patients who spoke to our correspondent at the hospital in Lagos at various times said it appeared the hospital’s facilities and manpower could no longer cope with their demands.

Investigations by our correspondent revealed that patients who need life-saving medical attention have to wait for years due to an acute shortage of doctors, manpower and facilities in addition to long months of strikes.

One of those on queue for hernia surgery, Abdul Bassit Ibrahim, 9, was said to have been waiting for his turn since 2009. He was admitted to the Paediatric Unit of LASUTH in 2009.

His mother, Mrs. Silifat Ibrahim, who spoke with our correspondent during a visit to the hospital, last month, said she brought Ibrahim to the hospital in 2009 when she noticed a swelling in his reproductive organ at age five. She said his doctor referred him to LASUTH for comprehensive care and investigations.

“We came to LASUTH in 2009 and after thorough examination, he was diagnosed with hernia. One of his testes was swollen and it was causing him a lot of discomfort and he could not play or move with it.

“We felt the surgery would be done as soon as possible but to our surprise, we were asked   to come back in March 2010 for the operation. When I complained, I was told that there were   hundreds of patients waiting for the same surgery at the unit,” she stated.

But to her dismay, Tawakalit said when they came back to the hospital on the day of the operation the following year, they were turned back again.

She said, “I was at the hospital in March 2010 to keep the date for the hernia surgery but to my dismay we were given another date for 2011.They said they still had a spill over of patients from 2010.They advised us to be coming for check-ups at the clinic.”

Tawakalit said when they returned for the operation in 2011, her son’s file was missing and they were turned back again.

“They had reassured me that my son’s operation would be done that day and we got there as early as 6am but the nurse told us again that the surgery would not take place because his file was missing. The nurse just said I should better go and start tests again, because without it there would be no surgery.

“I started crying and called my husband, who told me to threaten them that they would take the matter up in his office (a media house). It was not until I told them that, that they started running up and down and later told me to come back the next day.”

Her husband, Mr. Abdulfatai Ibrahim, who also narrated their ordeal to our correspondent, said he accompanied his wife to the hospital the next day in 2011 and also requested to transfer his son to a private hospital where the operation could be done.

Ibrahim said, “By the time we got there the next day, they had found  my son’s  file but I told them they should give me his records so I could do it somewhere  else, but  the consultant told me not to take my son to another hospital because of the delicate nature of his condition.

“But I was desperate because we noticed that the testis could get swollen this week and deflate the following week. He was always complaining of tummy aches and sometimes he would not sleep because of the pain. But I took to the doctor’s advice as I did not want anything to happen to his reproductive organ.”

They were subsequently given another date for November this year.

But the family received the shock of their lives when they took Basit to the hospital in November and they were told to come back in 2013, four years after he was initially billed for the surgery.

“When Ibrahim first visited the hospital, he was five years old and now he is nine. We see other patients lamenting that they have been coming even before 2009. My fear is that they may also postpone the surgery from 2013 to 2014.

“But why do they keep postponing the surgery date?” he asked no one in particular.

Ibrahim called on the management of the hospital to quickly expand its facilities and provide personnel to address this yearly wait for surgeries that should be treated with utmost urgency.

Another prominent health professional, who pleaded anonymity, disclosed that his in-laws were forced to take his mother in-law to Britain for a surgery when the old woman could no longer endure the pains of waiting.

 “They kept on shifting the surgery date and the old woman was dying. After the fourth postponement, the family just decided to take her to UK for the surgery. Only God knows how many patients have died while waiting for their turn.  Government at all levels should enhance welfare of medical personnel and invest heavily in medical equipment and training to eliminate brain drain in the health sector,” he said.

Another patient, who simply gave her name as Seun, also narrated her story to our correspondent at the Ear, Nose and Throat clinic of LASUTH. She said she had yet to get a conclusive treatment since she came to the hospital two years ago.

According to her, she is diagnosed with a swollen thyroid gland which has to be surgically removed.

Seun said, “I was told that I would have a goitre operation on January 2011. The date was later postponed to December because surgeons have not completed surgeries for those on queue since 2010.

“When I came back in December, there was a queue at the theatre, the doctors were working round the clock but we were too many. I was not surprised when it did not get to my turn. I was given another date for March this year, when I came, the doctors at the hospital were on strike. The surgery has been slated for another day this month, my hope is that it will be my turn or they won’t be on strike again.”

She called on the management of the hospital and the state government to quickly address this perennial accumulation of patients in need of surgeries.

Medical doctors in the hospital, who spoke to our correspondent on the trend, said they too were being overworked.

They complained that the hospital was facing an acute shortage of specialists, experts and resident doctors.

One of the doctors, who spoke on condition of anonymity because  he was not authorised to speak for the hospital, blamed the prolonged labour crises which led to the sack of over 788 senior and junior doctors by the state government in May for the mass exodus of doctors from the hospital.

He also stated that the prolonged strike this year had increased the backlog of patients from previous years.

The source said, “Many of the specialists and doctors have left the employ of the Lagos State because they do not want a repeat of what happened in May. They have gone to take up better offers in hospitals abroad but those of us that are left in the system are suffering because their patients have been transferred to us, thus adding to the burden on ground before they left.”

According to him, although the hospital has facilities and personnel, they are grossly inadequate compared to the population of patients.

He said, “LASUTH has just one urologist. We have just four operating theatres to cope with both emergencies and non-emergencies in the whole of Lagos. All the consultants have to use the same theatre. That should not be so.

“If there are more operating theatres, at least a surgeon can operate two or three times daily, but when operating suites are not enough, there will be accumulation of surgeries and disease burden will also increase.”

Another specialist who also spoke with our correspondent on condition of anonymity said this backlog of patients had informed many patients’ decision to travel out of the country for surgeries that could be done in the hospital or to seek the help of quacks.

The source said, “We are all lamenting that Nigerians are travelling out of the country for surgeries. They will have to, why should they wait for two years for a surgery that will be done within two days in India? For my patients who can afford it, I recommend that they should travel out so we can attend to those who cannot.

“Even the less-privileged patients have to wait for months, when they can no longer bear it they go back to quacks that are ever ready. Government must quickly address this issue by providing more hospitals. LASUTH alone cannot do it; we should have at least two more tertiary hospitals in Lagos.”

Asked to comment on the issue, the hospital’s Chief Medical Director, Prof. David Oke, admitted to the long wait for surgeries at the hospital.

This, he said, was because of huge population of patients, inadequate personnel and limited bed spaces to accommodate the sick.

He added that LASUTH as a tertiary hospital was also performing surgeries that should be done in general hospitals and primary health care centres.

Oke said, “We can only accommodate what we can. When our beds are full, they are full. The work before LASUTH is enormous, we have patients on referrals not just from hospitals within Lagos, patients also come from Osun, Oyo, Kaduna states, Abuja and as far as Benin Republic.

“LASUTH is a tertiary hospital, we should only be seeing complex cases but we perform most of the surgeries in the state here.”

Oke, however, stated that the state government was aware of the hospital’s predicament adding that was why more health workers and medical personnel were being recruited into its primary and secondary health facilities.

The CMD also disclosed that plans were underway to provide two extra operating theatres at the hospital to ease the backlog of patients waiting for surgeries at the hospital.

He stated, “We are going to have two or three additional operating suites so that our surgeons can have more facilities to work in the New Year. We are also looking at expanding our bed spaces.”