Staying alive in Nigeria
A saturday a few months ago at about 10am, I rushed my sister to the hospital. She was in the back seat of the car screaming in pain, vomiting into a plastic bag, all while shouting that she needed to use the toilet. It started an hour earlier with her complaining that her stomach hurt and had quickly escalated to her vomiting 5 times while simultaneously using the toilet.
I contemplated taking her to the private hospital on the other side of town. I looked back at my sick sister, she was gasping at the pain in her stomach I told the driver to take us to a Federal Medical Clinic – it was closer to our house and we knew one of the head doctors there.
I called Dr. A. and told him about my sister’s case. He informed me that he was not on duty, but that I should call him once we got to the emergency room and he would speak to the nurse.I did not understand why this was necessary, but said okay and ended the call.
My sister and I finally made it to the clinic. I hopped out of the car to take my sister into the emergency room.The emergency room was a bare room with a small waiting area. There were about 5-7 patients waiting and 1 head matron nurse, 3 orderlies and 2 doctors on duty. The first thing I noticed was that there was no electricity in the hospital.
As I helped my sister into the waiting area, she insisted on using the toilet.I made eye contact with the nurse and asked her quickly where the toilet was. She looked at me with indifference and pointed, “There.” I looked to the right, three doors and a hallway with no signs on any of the doors.
I asked her again, “Please, where is it?”
From her chair behind the desk, still seated, she said, “there.” Again, she pointed in an ambiguous direction.Confused, I guided my sister down a small hallway poked into a few doors and finally located the toilet.I settled my sister in and went back outside to meet the nurse that would soon be known as Nurse L.
Nurse L. reminded me of the nurse you avoided in boarding house sickbay. The one who would shout at you for screaming out in pain during your period or if you had been playing during prep time and cut your knee. I knew her type and knew how best to relate with her – appear timid and “respectful.”
I approached her timidly and told her that my sister was in pain and had been throwing up and stooling non-stop for the last thirty minutes. She looked at me with a nonchalant expression and said, “Where is she?” I replied, “In the toilet.” Nurse L. eyes fixed on her phone replied, “She has to come out now. Abi will I attend to her there?”
I rushed back in to check on my sister and told her she needed to come out so the doctors could attend to her.We walked back to the emergency room and Nurse L. looked at us and said nothing.Then I recalled Dr. A’s words. “Call me when you get there.”
I now understood the reasoning behind his request.I called him and handed the phone over to Nurse L. , I told her “Doctor A” wants to speak to you. She eyed the phone and took it begrudgingly.
“Yes? “She said, her tone was harsh but there was a playful banter between the two “What is it? I am here now. Why are you disturbing me? …Hmm okay oo.”
She gave me back the phone and said told me to open a hospital card.I left my sister on the bed and rushed to open a hospital card. This took some time as the attendant on duty who opens the hospital cards was off seat and I had to wait.
Once the attendant returned she proceeded to begin opening the hospital card. I attempted to collect it, but she told me I still needed to pay for the card. I handed her the money and she shook her head, and said “No, you need to pay at the other building.”
I was so annoyed. The driver who brought us was sitting outside, so I asked him to help me find the bursary and make the payment.
I rushed back to my sister’s side. She was still in pain and squirming. I looked around at Nurse L. hoping that someone would come and attend to her. As I was about to petition for her to help my sister a man in black shirt and glasses approached us. He was the on-duty doctor.
He walked over to my sister and began searching for a vein to open up a drip line for her. He joked with her to liven up the situation and told her it would not hurt. He was the first friendly face in the centre – Doctor N.
Once the drip started my sister began to ease up and the pain subsided. I felt relief wash over me.
As I waited by my sister’s side I began to observe the clinic properly. It was a well-staffed clinic and very obvious that the doctors and nurse were technically well trained. However, it was obvious that the logistics, equipment and management of the hospital were struggling. .
The logistics of getting things done were horrendous, from opening the card to making payments for treatments. One was running around like a headless chicken trying to get treatment. I imagined it impossible to come to the hospital alone if you were sick, as you needed someone to get things done for you.
I jolted back to reality when I heard Nurse L. raise her voice. She was attending to a patient who had cut her hand on a toilet bowl in her house while washing it and the girl appeared to be in a lot of pain. As Nurse L. attempted to clean the deep cut the girl jerked and Nurse L. shouted at her to keep still. What is wrong with her that she would “flog her”? I stood in shock at her lack of compassion.
My sister was now stable and almost done with the first pint of drip. Fortunately for us, they had some supplies in the centre that they used to administer treatment to my sister when we got there, but we needed to replace it. Nurse L. began to barrage us that we needed to pay for all the supplies we had used. Everything – the gloves worn by the nurse when setting up the drip, the needle use to inject the medicine for the pain and the pints of drip, they all had to be replaced. Thankfully, my other sister had arrived at this point and began working out the logistics of paying for the treatment.
All of a sudden, a young woman hobbled into the hospital with an elderly man, she was gasping for air saying she could not breathe. Another nurse, a young man, began to attend to her. They sat her down in the waiting room. Next thing, a pregnant woman was carried into the emergency care- she was lifeless. They dropped her on a stretcher and left her there. The hospital staff insisted that they open a card for her before her treatment. My sisters and I looked at each other. Tired and confused. So much pain and loom of death all around us.
My sister was almost done with her third round of drip she began to insist that she was feeling better and wanted to leave. She recommended we go to the hospital we were more familiar with because the atmosphere at the clinic was hostile and uncomfortable. The bed she was laying was an iron frame with a skeleton of a mattress.
As we were contemplating what to do, Doctor N began to shout in a state of panic. He was addressing the family members of the women with the pregnant woman. “This woman needs attention. Please go and buy her meds so I can treat her!”
Apparently she had been vomiting all night, and her family members did not have any money for her treatment and were still attempting to open a hospital card before they treated her.Doctor N began to panic and said, “abeg, I will go and get the meds if not, this lady will not make it.” He ran off to the pharmacy to get the medicine came back and began treating her.All of a sudden I hear yelling outside the centre. Nurse L. rushes out and began shouting “Leave them, leave them.”
I rushed outside confused and I see a young male nurse and a young man physically fighting. Apparently, the male nurse had slapped the young man who was a brother to a patient at the clinic.The slap, was the male nurse’s response to the young man telling him he doesn’t know his work.
It was absolute chaos.My sister’s drip was done and it was our cue to leave the clinic. I spoke with a doctor there and told him that we were not comfortable staying any longer as the environment was hostile. He apologized on their behalf and said, “Sorry, they tend to be like that”, in reference to the nurse and orderlies.
My experience at the Federal clinic was very disturbing. Classism played a huge role in the medical treatment received. We were only able to see a doctor quickly because we knew a head doctor at the hospital; we were only able to be seen because we had the financial ability to pay for all of our medical care. However, a significant amount of Nigerians do not have these same options and only have access to clinics like this where medical staff and patient relations is non-existent, medical supplies are a challenge to retrieve and there is a bureaucracy before you can receive treatment.
It is quite common knowledge that there is a major flaw and mismanagement in the health care system in Nigeria. This is a major reason why medical tourism to other countries is so prevalent. The question is when will there be a change?
A fundamental human right is the right to life, the right to know that if you are sick, you have access to adequate health care regardless of your socioeconomic status. Our government owes us this. As a Federal Medical Centre, I expected more and hope that this prompts a discussion, which leads to action to create a re-haul in the management of clinics such as this. Getting access to adequate medical treatment is a right. It should not be dependent on access to money or who you know especially in federal and state facilities that are supported by the government. Life is a right.
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