By Livy Iwunze.

This is an article from the Guardian Newspaper Ocotber 22 2007

LET me begin with a full disclosure: I was recently a patient in the Lagos University Teaching Hospital (LUTH). I spent days on admission there. And this article is therefore, my personal experience.   I went to LUTH because it had a reputation. It is many things to many people. To the Federal Government, LUTH is one of the tertiary health institutions in the country that are classified as Centres of Excellence. Others in this category include UCH in Ibadan, UNTH in Enugu and ABUTH in Zaria. In the second tier of these Centers of Excellence we have JUTH in Jos, UBTH in Benin, OAUTH in Ife and NAUTH in Nnewi, UITH, Ilorin, UCTH in Calabar, among others. They are also referred to as Centres of Excellence for the training of doctors and other medical personnel.

To the general public, especially those who have not had any personal experience, LUTH is not only an apex health institution in Lagos where doctors and nurses are trained but also a place where the best medical services are supposed to be provided.    However, to those who have had a personal experience with LUTH, either as patients or relations of patients, the verdict is not exactly the same. In fact, my personal experience with LUTH is close to a grueling nightmare. No one should be deceived by the flamboyant billboards and radio jingles that followed when Chief Olusegun Obasanjo hurriedly commissioned “The New LUTH” on the eve of his handing over.

Apart from the billboard conspicuously displayed at the gate and the plaque strategically positioned at the entrance to the Out-Patients Department, there is not much to show for the millions of naira said to have been spent on the renovation of LUTH. Lest I forget, the outside of some of the buildings was also painted for effects. And that is about all.    You cannot go inside LUTH without asking: What did ex-President Chief Olusegun Obasanjo commission in LUTH? Was it the empty taps everywhere or the dilapidated beds and equipment in the wards or the archaic equipment in the labs that Obasanjo went to commission? Indeed, the whole exercise is seen by many people as a huge fraud calculated to deceive Nigerians, especially Lagosians. Pity the doctors, nurses and other medical personnel! They can only complain secretly because the civil service rules forbid them from complaining publicly.

So, they suffer in silence as they try to make the best of a horrible situation.    A visit to a Consulting room can make a sick man get ‘sicker’. They are so dirty with broken chairs and tables. In some, the electric tubes are gone. The window louvers are either cracked or gone. Of course no one talks of water in either the clinics or the toilets. In the wards, the nurses and cleaners try their best to keep the places clean but such things as beds, mattresses and pillows are so revoltingly old and dirty that even when patients put their own bed sheets, they still remain repulsive. Anyway, a sick man has no choice. Does he? Not in LUTH, anyway!    A closer look at the wards shows that time was when they boasted of such facilities as oxygen tubes, vacuums and bells. Water still remains a big luxury in the wards. The toilets can make a normal person throw up. Is it any wonder then that the wards stink and provide breeding grounds conducive for giant rats and mosquitoes? Of course, patients who can afford it, provide their own mosquito nets. Those who cannot, abandon themselves at the mercy of the giant mosquitoes.   

Today, most of the wards are no better than pens for animals. Patients have to buy the materials for their treatment – cotton wool, bandages, syringes, drips, all drugs, plasters, bottles for blood samples as well as gloves that the nurses and doctors use in attending to the patients. LUTH supplies none of these basic items. Who says LUTH is not a glorified consulting clinic? Or better still, a glorified primary health center.    The most scandalous area of LUTH is the theatre where surgeries are performed. It is shameful and incredible that for more than three weeks between the months of June and July surgery appointments had to be cancelled or rescheduled. Why? Lack of oxygen! The Management of LUTH just managed to release a few for emergency surgeries, especially for expectant mothers. When the problem of oxygen was later solved, surgeries could still not be done. Why? The air conditioning system had packed up! Somehow the technicians managed to put them in order after some weeks.   

I may not be a medical person but I have been informed by those who should know that oxygen does not cost a fortune and that it is not scarce in the Lagos Metropolis. I am reliably informed that a unit of gas costs less than two thousand naira from BOC Gases, a company that is located at Oshodi, a distance of less than four kilometers from LUTH. Investigations showed that BOC Gases was being owed about two million naira by LUTH. For this reason, BOC Gases decided to compel LUTH to clear the outstanding debt before getting fresh supplies. Yet LUTH’s charges are the highest of all public health institutions in the country. As a result of the shortage of oxygen, the public suffered. The result was many avoidable deaths.   

Emergency laboratory tests are done by private laboratories, many of which dominate the Idi Araba vicinity of LUTH. These lucky private laboratories make a fortune due to the inability of LUTH to provide such essential services in-house.   Patients requiring blood for their operations still have to pray to God after donating blood for their surgeries because the blood bank in LUTH may not be able to make such blood available. This often leads to cancellation of such surgery appointments. And it is mandatory for every surgery patient to donate three pints of blood before the operation.

Worse still, patients bear the cost of the extra days they spend because of the cancellations or postponements. What about refund of payments made for services not rendered? This is almost impossible because of extreme bureaucratic bottlenecks. In fact, most patients, out of frustration, eventually abandon the process.   In fact the present situation in LUTH calls for urgent investigation and adequate financial assistance from the Federal Government so as to save lives and save the nation the embarrassment caused by this human neglect as well as reduce the frustration that is the lot of the doctors and nurses.

This is, indeed, the immediate challenge facing the new Minister of Health, Adenike Grange, who is an accomplished medical professional. Incidentally, the new minister retired from LUTH as a Professor of Pediatrics. She would be expected to use her first-hand experience of LUTH to transform the institution. The last administration of Chief Olusegun Obasanjo politicized healthcare provision in the country. To continue the same way will spell doom for the already comatose health sector.    Ironically, when you confront the doctors and nurses about the unwholesome situation in LUTH, they would tell you that they are constrained by Civil Service Rules that forbid them to complain to the public. They are frustrated at seeing their patients suffer and die preventable deaths.    

Today LUTH has degenerated to the level of a mere Consulting Clinic. Yet, all of us would recall that Chief Olusegun Obasanjo, while he was president and was increasing fuel prices at will, told Nigerians that he would use the excess money to rehabilitate hospitals, schools, roads, etc. Perhaps one day someone would have the courage to invite ex-President Obasanjo to come and explain how he spent the billions derived from the removal of fuel subsidy and the oil proceeds for the eight years when he was both president and the substantive oil minister. 

Anyway, it is not all a tale of woe from LUTH. One must commend the attitude, disposition and temperament of the doctors and nurses. Indeed the doctors and nurses bend over backwards to ensure that they save the lives of their patients. Their condition is pitiable. Some of them are compelled by circumstances to work for twenty hours a day. Indeed it is the sentiment of utmost patriotism that has restrained many of the doctors in LUTH from seeking greener pastures elsewhere. But then, patriotism does not put bread on the dinning table nor does it pay bills. We must also remember that there is a limit to human sacrifice and improvisation. Beyond that limit the inescapable law of diminishing returns sets in.    

As professionals who can rub shoulders with their colleagues anywhere in the world, the doctors, nurses and other para-medics always empathize with the patients and their relations and treat them with utmost respect and compassion. You can’t but admire the enthusiasm these professionals exhibit in trying to make the best from the few equipment at their disposal.    Perhaps one cannot say this of the other ancillary staff, especially the admin, accounts and records personnel. This later group exhibits the odious non-chalance which is the hallmark of Nigerian bureaucracy. The tragedy is that this later group hardly realizes that they are dealing with sick people to whom one minute could make the difference between life and death. The word urgency is missing in their lexicon. 

After all said and done, the question still remains: who will halt the decay in LUTH? Indeed, the government of Umaru Yar’Adua must spare some time to take a second look at the Teaching Hospitals which ex-President Obasanjo claimed to have re-equipped and hurriedly commissioned before he reluctantly exited from Aso Rock. People still remember, with nostalgia, the tenure of late Olikoye Ransome Kuti as Health Minister. He transformed medical delivery in Nigeria. Dr. Adenike Grange should take a cue from the Kuti era and leave an enduring legacy by taking LUTH and other tertiary health institutions to the level of their counterparts elsewhere in the world.

Nigeria has the resources and the manpower to achieve this. What is now required is the political will.

• Iwunze lives in Lagos