The Nigerian healthcare system is in a state of crisis. Hospitals are understaffed, underfunded, and overcrowded. In this blog post, we’ll explore fifteen shocking trends in Nigerian hospitals that you need to know. There are lots of shocking facts and information you need to know about.
People who have experienced some of these trends would tell you a lot of stories and that makes people wonder whether these things are true or false. A lot of Nigerian hospitals are understaffed and the medical staff is often not properly trained. As a result, patients are at a higher risk of misdiagnosis and suffering from complications. From fraud to health worker harassment, we will cover them in this article.
Using Nurses To Consult As Doctors
This happens more often than you would think.it is a shocking trend in Nigerian hospitals that goes almost unchecked. In a bid to either reduce costs or just plain medical negligence. A lot of MDs in private hospitals use male nurses and pass them off as doctors. Regulations here in Nigeria are very lax, so they tend to get away with this nefarious practice. These MDs usually use male nurses.
The male nurse usually would have spent a lot of time beside the MD or other doctors in the hospital, observing, and learning. When Md sees that the male nurse has garnered the required knowledge to treat basic illnesses. They usually appoint that nurse as a doctor. Most of the time these MDs do not pay nearly as much salary to the nurse as they would a doctor. Health monitoring organizations should do more to regulate and monitor what goes on in hospitals.
Fraud Amongst Healthcare Workers
This usually happens in different instances. One of the most common is price inflation when purchasing drugs or medical equipment. The person in charge of purchasing drugs and the drug supplier. They inflate purchase prices, forge the receipts and share the profits.
Another one involves companies that have retainers with hospitals, The doctor in charge or the HR admin or both. They inflate the prices of treatments and procedures for company employees; they remit the excess cash to their contact in the company.
This particular fraud involves HMOs and their liaison or HR personnel responsible for the HMO contract. The HMO usually sends gifts and other benefits, monetary and kind to the person responsible for maintaining the contract with the HMO. Sometimes even when the HMO obviously does not give optimal service, you still find that personnel still vouching for heaven and earth for the HMO. All this in a bid to retain that company’s agreement.
Harassment of Doctors/Nurses
Every Nigerian doctor/nurse has experienced this kind of harassment. A patient will be brought in, and the doctor and nurses on call would try to attend to the patient. Maybe due to stress and grief, a relative starts harassing and assaulting the doctor, saying things like if the doctor does not save the patient/relative that they will beat up the doctor and or burn down the hospital. Let’s not even talk about the threat to nurses.
I have been a victim and a witness to this. Sometimes a patient would be brought in BID (brought in dead). The relatives did not want to believe or accept that their relative was dead. This led to the relative threatening hell and brimstone. They promised to burn down the hospital. I had to ask the nurses to prepare the surgical theatre and we had to fake an operation. WE ended up bringing out most of the shotgun pellets and we also had one of the relatives in the theatre with us but the man was already dead.
They had already calmed down when they saw how active we were pretending to be. One of the men later told me that we were extremely lucky. Only God knows what would have happened if we had not improvised.
Inaccessibility to Laboratory Results
I know this one sounds hard to believe but it happens. This bears more on patient education. A lot of patients in the Nigerian healthcare system do not have access to their lab test results. Why? You ask. Well, I have no idea either. The patients sometimes state that the doctors at their hospitals refuse to give them the results. They go ahead to explain how the doctor told them that it belongs to the hospital. Hospitals in Nigeria are slow in adapting EMR (emergency medical records) and this in turn stagnates the transfer of medical records across different health care providers.
Falsifying Laboratory Results To Extend Patient’s Hospital Stay
Some hospitals deliberately forge patient results to paint a worse picture of suggested illness just to extend the hospital stay and charge more money. I know this is an extremely shocking trend in some Nigerian hospitals You may do a EUCR (Electrolytes, Urea, and Creatinine) and the results would show an increased level of urea, creatinine, or some of the other electrolytes involved.
Meanwhile, the patient may be very fine and ready for discharge. Once this result is presented and a grim picture is painted, the patient obliges then stays and sometimes is just given i.v fluids with Vit B Complex and Soluble vitamin C.
Patient Trust Is At An All-Time Low
Patients have shared inappropriate reports about unprofessional conduct from doctors. I have been told on multiple occasions how a patient would come in with a certain complaint, maybe discharge from breasts or maybe vaginal discharge or itching. As it should go, a doctor should always have a female chaperon in the consulting room when it comes to complaints that may lead to physical examination, e.g. undressing, etc. But you find a lot of doctors inappropriately touching a lady all in the name of physical examination.
You even find some doctors performing vaginal exams, and inserting their fingers in the vagina when there is absolutely no reason for that kind of examination at all.
There was this story back then about a male obstetrician who would always try to fondle his female clients.
We heard then that while performing examinations, the lady’s leg is in stirrups elevated while her genitals are exposed. He would then try to finger and play with their genitals. Most of the women thought it was normal procedure, others against it who were against it refused to speak up because they were scared that he would ruin their chances at IVF or other assisted reproductive techniques.
Women looking for children tend to be very desperate and overlook a lot of things. This also sheds light on the helplessness of women in certain situations. This kind of molestation destroys trust, even if the woman goes along with the procedure.
Pay Before Service
This is why you need to get health insurance. This allows you to get service without having to worry about funds. How many times have patients died because they were refused treatment because they could not afford it? Before you start blaming doctors and all, remember doctors have families and bills to pay too.
The nurses, porters, cleaners, security guards, and lab attendants all have families. The drugs, I.V fluids, light, diesel, etc all cost money and we all know how hard it is to run a business comfortably in Nigeria. There may be emergency cases that you cannot pay for out of pocket, or even if you can, your bank may have network issues at the Point of transfer, the atm may not dispense money, etc.
Having an affordable health insurance plan solves all these problems. Get your health insurance today.
Cutting Corners When It Comes To Medication
This comes from personal experience. In a lot of Nigerian Hospitals. You see the administration of either cheap or adulterated drugs, all in a bid to cut costs. You see someone treated for malaria and in less than two weeks, he/ she is back again in less than 2 weeks for treatment of the same ailment. Although this particular problem may boil down to drug suppliers supplying cheap alternatives (Chinese-produced medicine). Some hospitals use the same antibiotic used for malaria or furuncle to treat a case of severe sepsis. Cutting corners endangers the patient’s recovery. It can lead to slow recovery, severe wound breakdown, and sepsis.
Every Illness Is Not Malaria And Typhoid
Yes, I said it. It Is not everyone that comes in with intermittent fever, joint pain, loss of appetite, weakness that has malaria, and typhoid. If a malaria test is done on almost anyone that lives in the tropical regions, it will be positive for malaria at least (+). A complete blood count should be done and also a thick and thin film for malaria parasites. A Widal test used for diagnosing typhoid is obsolete and redundant. The truth is you cannot diagnose typhoid simply from a Widal test. You would have to do a full blood culture for diagnosis. Most of the typhoid cases treated are a result of misdiagnosis. But you dare not tell a Nigerian that he/she does not have typhoid, if you do, just know you have reduced your medical value in that patient’s eyes. This is especially true for a lot of Nigerians.
Injections Work Better Than Pills
While there may be some truth in this, it has to do more with the rate of absorption rather than efficacy. The prescription of tablets or administration of injection should be based on the decision of your healthcare provider. Tablets/pills are absorbed in the stomach and passed through the liver before entering the bloodstream. Injections enter the bloodstream directly. There may also be situations where the patient has to stick to injections e.g.
- Acid reflux
- In cases of dehydration
- Pre-surgery and post-surgery
- Giving blood or blood products
- Administering iron in iron-deficient patients
- During chemotherapy
The only difference between injections and tablets is the faster rate of action.
Types of Injection Routes
- Intravenous- in the vein
- Intramuscular- in the muscle
- Subcutaneous -Fatty Tissue
- Intraosseous – into the bone
- Intradermal- below the surface of the skin
Sneaking In Local/Alternative Medicine Into The Hospital
If you have ever worked in a hospital situated around Ajegunle, Oshodi, Ketu, Orile, and other low-income environs, you must have experienced this. You would be treating a patient in the hospital, then a relative, a friend who feels he/she knows better, or the person who feels that treatment is not going as fast as they hoped. They would sneak in different local concoctions (without the knowledge of any hospital staff) and start administering them to the patient. Without any regard for the treatment, the person is already on. You see mothers-in-law, grandmothers, and old aunties come with all sorts of concoctions. They do this and when the patient does not recover, or some complications arise, they will never mention the nonsense they were giving the patient. They will pour all the blame on the hospital staff. This practice is just a recipe for disaster.
Understaffed Hospitals And Overworked Doctors And Nurses
This is all too common. Young doctors and nurses just starting out usually feel the brunt of this form of abuse by hospital owners and administrators.
Some Nigerian workers feel that there is glory in suffering, that’s why they brag about how many patients they handled alone back in the day.
What they will never tell you is how many patients were misdiagnosed, administered the wrong medications or wrong dosage, or even died under their thorough care. The mortality rate of the patients in that hospital at that time would be very high.
A lot of Nigerian medical professionals tend to overlook the mental health aspect of tortuous work. They forget that their well-being is paramount to delivering optimal service and care to patients.
Physician burnout and mental health issues are real.
You find doctors working 2 or 3 different shifts at different hospitals. In a private hospital in Nigeria, you can find one doctor attending to over 40 patients daily in a 30-bed hospital. While the employees do all this slavery, in the name of making ends meet, you will see the MD or CEO take his entire family on vacation while refusing to adequately staff the hospital. If you should complain or even make a suggestion, You will be reprimanded, and threatened with the loss of your job.
Sometimes they go as far as withholding your salary or even deducting your salary. The government knows about a lot of these kinds of malpractice and just doesn’t care. Do you know what happens when a doctor is too tired to function and still tries to function? Thank God for Coca-Cola and caffeine.
Terrible Salary And Little or No Benefits
A lot of hospitals are guilty of this. New doctors are paid a horrible starting salary. I must confess, in a place like Nigeria, the salary of a medical doctor is actually better than that of a lawyer, policeman, or engineer but it is still abysmal pay. In a lot of private and family-owned hospitals in Nigeria, you will see a lot of the above-listed trends. In some hospitals where the wife of the owner is either the matron or HR personnel, you will witness a lot of non-charlance and terrible attitude towards employees. All this thrives because Nigeria is a lawless country. A country where once you have a little money, you can get away with almost anything.
In Nigeria, during the Ebola pandemic, the hazard allowance was #5000 (five thousand Naira) which is 12 dollars, yes, I said 12 dollars. If you think they changed it during COVID 19, you would be so wrong. This is why you find a lot of doctors working at 2 or 3 establishments just to make ends meet.
Bed Shortage/ Lack of Equipment and Experience To Handle Certain Cases.
A lot of relatives have lost their loved ones due to this annoying chronic issue of no bed space. Let me paint a scenario for you.
You have a relative that was involved in a road traffic accident and manage to find someone willing enough to take you to a federal or state-owned hospital.
You arrive at the hospital, adrenal pumping, emotions all over the place, nerves all racked up. Meanwhile, you are secretly praying that Nigeria does not happen to the person that you rushed to the hospital.
Just then a young doctor in his scrubs comes out, looks at the patient, and what you hear is “No bed space”. You stand there looking, angry, sad, hurt, and horrified.
In the panic of it all, you rush out to another government hospital only to hear the same three annoying words “NO BED SPACE”. With tears in your eyes and you already expecting the worst outcome, you direct the person, or the driver who has been taking you all around, to take you to a private hospital. When you arrive the doctor comes out, sees the patient, assuming he/she is still alive, and tells you that they are not equipped to handle this kind of case, you go around to some other private hospitals, and you hear the same thing. When you finally get a hospital that will attend to you, it is either the victim is already dead or the hospital costs are too expensive. This is a very common occurrence in the Nigerian Healthcare setting.
Inaccessibility To A Doctor/ Brain Drain
According to the WHO, for every 10,000 patients, there are only 4 doctors available to treat them. Also, the women and men report in 2021 revealed that as of 2018. T
here were 44,021 doctors in Nigeria but by 2019 it reduced to 24,640. That is an astounding 19,381 doctors that left the shores of Nigeria.
This puts the doctor/patient ratio at an abysmal 1:600. Guardian newspaper reports that at least 2000 doctors leave the shores of Nigeria every year. During the onset of the COVID 19 pandemic, countries like Oman, Emirates, and Saudi Arabia saw an uptake in Nigerian medical Doctors.
Nigeria currently has the 3rd highest number of doctors working in the United Kingdom behind India and Pakistan respectively. All these statistics point to one thing if no dramatic action is taken “ SERIOUS WAHALA DEY OOH”. One last statistic according to the Nursing and Midwifery Council of Nigeria, 7000 nurses left the shores of Nigeria in 2021. This is roughly 600 nurses leaving per month.
Conclusion
It is alarming to see the state of some Nigerian hospitals, with issues such as lack of equipment, bed shortages, poor hygiene, etc. However, these are not problems that are unique to Nigeria. Hospitals around the world are struggling with these same issues. It’s just that as a Nigerian, these issues affect me too and a spotlight should be aimed at the Nigerian Healthcare System. If you are interested in witnessing a change, then Like, Comment, and Share this article.
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