16 Nov 2005 |
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Our first son was delivered in a private clinic off our street in a quiet suburb in Port Harcourt. By virtue of this glorious event, the doctor instantly became a family friend and we felt safe in his hands. However, an occurrence in that clinic frightened me – earlier in the day, a woman had been delivered of a baby by nurses of questionable training – the kind one sees in most private clinics in Nigeria. You can always tell by the mediocrity of language and the crassness of manner. Frantic GSM calls by the woman’s husband revealed that the doctor was caught up in traffic! There was no back-up doctor and there was no vital resuscitation equipment on ground. Mercifully there were no complications and the baby survived. That was really a close shave. I should have heeded that early warning and run like hell from these ill managed, trial and error centers called private clinics but I didn’t. And I didn’t really have a better choice. Two years later, our second baby was ready to arrive. We shopped, dutifully attended antenatal clinic sessions, followed the doctor’s instructions with religious passion and prayed fervently for Gods mercies. The doctor carried out regular ultra-scans, supposedly to ascertain the baby’s well-being and readiness for birth. Labor turned out to be an excruciating 18-hour ordeal during which my wife pleaded for a Caesarian section – a request that was obstinately refused. After heavy maternal lacerations and a broken fetal arm, a baby boy weighing 4.2kg was born - half-dead. Nine days and 2 consultants later, his breathing improves but a condition called Erbs palsy is diagnosed - our baby cannot move his right hand! I was devastated. I voraciously read up anything I could find on Erbs palsy. I learnt that this condition is likely whenever babies weigh more than 3.5kg, or if labor is induced with drugs. I understood that this was an avoidable situation if the physician’s judgment was worth its weight in salt. Treatment could be successful with physiotherapy – a prolonged, painstaking regimen of exercises, nerve stimulation procedures and promises of possible full recovery…. I started asking pointed questions. What was the purpose of those sporadic UT scans for which I was made to pay heavily for? Couldn’t the weight of the baby be estimated from those scans? What was wrong with a Caesarian if the proper equipment and other requirements were ready and operational? We eventually paid close to eighty thousand naira before leaving the clinic with a deformed baby. We lost confidence in the money-thirsty doctor and his accursed clinic and vowed never to go back. Four months of physiotherapy (and its attendant costs and slow progress) have passed since this incident and we are yet to receive any follow-up call from that doctor on how the baby is faring. The stress of managing a two-year old boy and his four-month old brother with Erbs palsy finally takes its toll on my wife. She breaks down in a heap of fever, nausea and body aches - malaria has come visiting our home… The fear of Erbs palsy being the beginning of wisdom, as well as the genesis of a dogged resolve not to compromise on healthcare, I rush my wife to a top-echelon clinic in Port Harcourt - supposedly a ‘consortium’ of tried and tested ‘consultants’ operating a 24-hour cycle. The hospital building was as imposing as the car park was intimidating. Obviously this clinic enjoys the retainership of most of the big oil companies in Port Harcourt . The reception was tastefully furnished. One is treated to a view of well-dressed paramedics on elegant computer terminals. My wallet trembled at the thought of the check-in fees. They seemed fair considering the air-conditioned environment, the impeccable English and the soft classical music wafting through invisible speakers. My first wave of apprehension came when we were eventually ushered into one of the consulting rooms. Instead of a wizened, bespectacled consultant, a sleepy eyed young man, obviously in his late twenties sat on the other side of the desk. Since malaria shouldn’t be a complex case, I tried to relax as he went through a doctorly sequence of questions, grunts and scribbles with my wife. Eventually a retinue of drugs was prescribed and my wife was placed on admission for ‘close observation’. The lush private room to which my wife was admitted was on the second floor (which we graciously accessed via an electronic lift complete with soft music). As soon as she was tucked into bed, a new era gradually rears its head – the era of gross insensitivity and stifling impersonality on the part of nurse and doctor alike! Perhaps the over-staffed atmosphere aggravated this, or most probably, the fact that we were not company patients. There was a brand new young doctor accompanied by a sour team of uncouth ‘nurses’ for each work shift. The doctors were uncomfortably too distant. There was no continuity on the maze of prescriptions, I got a look of concealed disdain whenever I complained and the food was a sorry excuse served on expensive crockery…my wife only got sicker and sicker. The thought of fake drugs caressed my worried mind and I shuddered in the cold, air-conditioned Mozart-infused façade. Not a single consultant came to my wife’s bedside. Only one doctor was grudgingly able to see her up to twice. Six doctors, a lot of confusion/miscommunication, two laboratory tests, one ultra-scan, one referral for surgery and fifty-eight thousand naira later, we run from that hospital with our tails between our sorry legs, sicker than ever! As we ran, a curtain of realization falls in my embattled mind and I know I’ve been an unsuspecting victim! This place is a money-spinning front-office stage for oil-company patients (and pseudo-patients). It is not for plebeians like me! My doped wife eventually recovers from the drug-cocktails in the modest surroundings of our home. She is now hale and hearty, ready to commence on the truncated physiotherapy appointments at the teaching hospital with the baby. So long for the consulting consortium! I have been sampling opinions on the issue of crass capitalism in the healthcare sector and I have realised that the rot is now the order of the day. Whatever happened to the oath of Hippcrates? Has the mediocrity and corruption of the Nigerian psyche wormed its insipid way into the hearts and minds of Nigerian doctors? The arena is replete with worrisome cases of unwarranted prescriptions, suspicious surgeries, unnecessary hospitalization, exorbitant charges, selective billing, qualitative/quantitative understaffing, man-know-man, fake medication, class distinction and general exploitation mainly for profit maximization. The sadder note is that Nigerians do not have a culture of seeking redress on these issues, whether real or perceived. The government operated tertiary healthcare institutions have their own sorry side of the coin. One is faced with the annoying recalcitrant attitudes of government employees. Patients, especially the poor, are treated like criminals. The doctors within these institutions have their own private consulting clinics and the quiet message is : If you really need proper attention, and you can afford it, come to my private clinic. It was with a sense of relief that I learnt that an audit committee exists within the Nigerian Medical Association to address issues ranging from incompetence and non-professionalism to outright malpractice. Some of the sessions are even televised for public viewing. Unfortunately these issues only come up when really important patients are involved. The poor majority usually suffer in silence and ignorance. The Nigerian Medical Association in conjunction the ministry of health should facilitate a far reaching medium solely for the investigation of these issues. If the Healthcare sector finally crumbles, then the final part of our decline is here! In tribute to a sticker I saw on the back of a lorry in Onitsha , let us be proactive on these issues because, as the sticker says, many have gone ! By Chukwuma Ezeike Port Harcourt e-mail: pachoox@yahoo.com
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