Chris Ihidero Unedited: 26 hours in the emergency ward of a Government hospital

By Chris Ihidero

I arrived at the Federal Medical Centre, Abeokuta at about 4.30 on a Friday afternoon a couple of weeks ago. It had become expedient to transfer a relative there, as he wasn’t getting better after three days at one of the most popular private hospitals in Ikeja. On the Tuesday morning of that week, my relative, a long time cardiac and diabetes patient, had felt discomfort on the left side of his body and felt it wasn’t responding as it should. He was quickly rushed to this private hospital. We didn’t know it at that time but it was the onset of a stroke.

Going to a Nigerian government hospital is usually a traumatic experience for many, not so much because of the quality of care (it is generally believed that the best medical brains this country has to offer still work in General Hospitals), but because of the chaos that comes with a general hospital setting, especially in a place like Lagos. The emergency ward of any hospital, by its nature, is often a ‘chaotic’ place; the chaos rises to an altogether unbelievable level in a general hospital.

The doctors at the private hospital had concluded that the relative would need surgery for the scrotal swelling and a pacemaker inserted in his heart. They had concluded that his heart was so weak that it needed assistance to function properly; his pulse was extremely low. They were on the verge of calling in specialist consultants when it was decided by the relative’s family that he should be transferred to FMC, where he had been receiving bi-monthly medical care for the past 4 years, for a second opinion.

A shrill cry welcomed us as we wheeled the relative into the emergency ward. A young man was crying out incoherently; I couldn’t map out what he was saying or what language he was speaking, but his pain was as clear to see as a blue sky. On another bed, a man was covered in bandages, barely breathing and surrounded by relatives looking very worried. As the hours go by, I see a pastor who bent to carry a bucket of water, heard a snap and hasn’t walked since; I watch as the doctors fruitlessly fight for an old woman’s life.  I see a young man who had been involved in an accident and needed some form of brain surgery rushed in, only for them to see the telephone number of a neurosurgeon on the wall; the hospital didn’t have one in residence and the one whose number was on the wall was at least an hour away, in another state’s general hospital.

An emergency ward is never silent: consistent cries for help mingle with sobs from those who are losing the battle to stay alive, and those who have just lost someone.

A young doctor took my relative’s vitals and asked background questions. A report was written and sent to the medical and surgical teams on duty. Hours pass by and the teams are busy doing the rounds in other wards. The young doctor and I get talking. He looked pretty worn out to me and I asked him when last he caught some sleep. 72 hours ago, he informs me. I take in the environment; watch the doctors and nurses closely as they rush from one emergency patient to another.  Most of them had been on their feet for over 5 hours since I got there. The air is heavy with the smell of blood and urine and drugs and antiseptic cleaning liquid; it doesn’t seem as if they notice at all. They just keep trudging on.

Tales of uncaring doctors and uncivil nurses and matrons of general hospitals is Nigeria are legendary. The story we often fail to tell is the one concerning the conditions under which they work. The volume of cases they have to deal with must be killing for anybody. The often obsolete facilities they are provided which renders their skills and training almost worthless. Everyone that rushed a patient to that ward in my time there had to go purchase everything the patient would be treated with, including gloves, injections and drips. Space was a problem too, so overcrowding is an accepted norm.

It’s 6 hours since our arrival, and the medical team finally arrives.  A glance at the relative and a few questions, and the leader of the medical team is ready to take off the young doctor’s head. His assessment and report had been terribly exaggerated. Over the next two hours, the team leader will thoroughly examine the relative and dictate notes. Over 5 pages of notes were written. By the end of the examination, I was given a list of drugs to go and purchase at the hospital pharmacy and treatment commenced immediately. All my attempts to tell the doctor what the doctors at the private hospital had said failed: ‘We will carry out our own investigation and reach our own conclusions. Don’t worry’. That was all he was willing to tell me.

It’s past midnight now and the relative has been able to sleep at last. I’m in my car, as it was too late to go find a hotel in Abeokuta. The shrill cry of the patient continuously pierces the silence of the night.  As I try to find some sleep in the car, I wonder what it would be like if we actually paid proper attention to the demands of healthcare in this country; if we put the training and skills of our medical personnel to proper use; if we didn’t allow facilities to become obsolete; if we didn’t mismanage the process of healthcare delivery.

Dawn came with good tidings; because the relative’s heart was weak, his body had been retaining body fluid. An injection that cost N1300 (one a day) was all that was needed to get the body fluid out quickly. When I saw him that morning, I could see he was getting better already. When the surgical team saw him, the smiled and said he didn’t need any surgery for the scrotal swelling, he just needed to wear tighter pants!

I left the hospital that evening, a little reassured of the possibilities this country still holds, comforted by the feeling that all hope was not yet lost, and that my undying faith in Nigerians was not misplaced.

The relative was discharged a week later. He wouldn’t be needing a pacemaker. He wouldn’t be needing any surgery.

If anyone from Federal Medical Centre Abeokuta is reading this, thank you very much for the good job you are all doing; your rewards will be bountiful.

We don’t praise enough.