-By: MI SPY
“I SOLEMNLY PLEDGE to consecrate my life to the service of humanity… I WILL PRACTISE my profession with conscience and dignity.” – PHYSICIANS’ OATH
Maybe like president Buhari’s “Nobody can say that we haven’t done well in terms of security, we have done our best, but the way this situation is now, we can only pray,” we would have to hear something akin to that someday in relation to our first and the best clinic. And then, we go before God and suspend all sense of rationality in us and begin to pray, seeking miracle where we are the obstacle. When I give a boy what to eat (foodstuffs); provide the utensils and every other things needed; as well as teaching him how to cook, I don’t expect him to ever come back to me crying of hunger. He has all that is needed. Mix the right mixtures, in the right quantities, cook and you have your food. And not to disturb me with your cries of hunger again. That, is God – Jah. The sense of reasoning he gave us, the ability he gave us to think wasn’t for anything else but to solve our own problems. God never descended from Heaven to develop science; didn’t come down to transform crude oil into petrol et al; and we didn’t pray to him for that. If we can develop these necessities on our own, why can’t we face our own problems, and develop solutions to them on our own? After all, these developments brought about alongside positives, the negatives. While of course it is appalling that the reaction to crises in most cases tilts towards the supernatural even when the disaster is not natural; today’s episode addresses complaints from residents of Unibadan about the state of health in Jaja clinic where WELFARE has bided its FAREWELL, leaving us not to FAIR-WELL.
June 15, 2018 – following the fifth episode of this weekly publication; someone, a whatsapp user (name withdrawn) reacted to the publication, “OF JAJA CLINIC UNIBADAN: IN A STATE OF EMERGENCY, AND THE EMERGENCY UNIT THAT NEEDS EMERGENCY.” He said, “…as sugar-coated this article is, I think it’s just a misunderstanding; 1) your friend’s case wasn’t an emergency 2) you people only want to be cared for, do you care at all about those doctors?… but trust me the bulk of the problem is that health sector in Nigeria is way understaffed.” In less than 8 seconds, it was revealed who he is – a medical student. Not committing Ad – Hominem and while the piece as well is not a reply to his assertions, it kicked off from where he stopped. If someone in pain and needed to be supported on both sides is not an emergency case, what about an asthmatic patient under attack? Oh! A final year resident of Alexander Brown Hall (ABH) responded to the question quoted verbatim – “An asthmatic patient, is it an emergency or not?” He responded swiftly saying, “It is bro, especially during the attack” and when quizzed on his opinion on a medical practitioner that refuses to respond to an asthmatic patient, he was firm too. “That’s bad. She wants to kill the patient.”
As much as I thought we had closed the chapter on Jaja…. Of course, a copy of it was published on the Official Group of University of Ibadan Students’ Union where all (some members of the management inclusive) could see it; of course, they are there if you don’t know. This just concluded week, six close friends from their various faculties buzzed me via whatsapp. One even called thrice early at around 7am, claiming I was unreachable the night before. Several as well claimed to have called. They all had similar but diverse issues. They all unite in one voice against Jaja but the offense of Jaja though most similar are different peculiarly.
While there are complaints, not all can I be allowed to pen here. Of the early morning caller, he was on his way to the hall to watch the Nigeria vs. Argentina match at about 6:50pm on Tuesday when he met two friends at the Faculty of Arts on their way to Jaja, greeted and proceeded towards his destination following promises from the ladies to meet later at night. By 8:30pm, he left the match to check on the ladies to discover Jaja receptionist area was filled up, yet there was none with the exception of a man in his early old age going about with files having collated their names. By 9:30, they were called to the doctor waiting room and they sat by his office. By 10pm, having called no one in, the doctor came out, declared he has an emergency and left. By 10:10pm, a woman who was even all the more rude to them according to him came and close the doors and that was it for them. This begs the question – what was the doctor doing inside before and during the thirty minutes of waiting? They all grudgingly left by 10:30pm realizing no one else is available to attend to them. They were mostly ladies all looking unwell and swearing Jaja would be their last option when ill. For some, it was 4hours wasted, they were even with their school bag, having went there straight from their respective classes.
Wait! That reminds me of the friend that had to go home for over three days resulting to self-medication to get better having waited at Jaja almost 3hours prior to that (going home) from 6pm to 9pm only for the doctor to come out and declare he’s going on a break and would only attend to emergency cases alone when he’s back. He wasn’t even back at 15mins and all had to leave. These particular friend’s crises worsened at home and they had to rely on a pharmacy store in the hood.
The movies hitherto projected in black and white must have to you, been normal, of course in the insane clime we are in; your much awaited tale is here. The emergency situation that nails the coffin for Jaja’s need for an emergency is that of an Asthmatic patient. It is pertinent to note that the Asthma patient young lady while recounting her woes said she has had similar cases with the very same doctor in the past. Her peculiarity in the recounting of her story is that as much as there are empathetic doctors there, there are those who frustrate patients and hence making more and more rubbishing the clinic.
In 2017 first semester, she had an attack and she rushed down to Jaja where she was nebulized. But being unfamiliar with it (but for once), she was choking and had to be adjusting it at intervals – removing and returning it. Therein, a drama ensued as a man she perceived to be an Abefele officer was brought in for a snake bite. A doctor whom I am going to christen Dr. Mrs. Empathy was in charge of the case. She (patient) witnessed her (Doc) insistence on the nurses passing of Saline solution through his body even though the nurses informed her they have anti-venom. She returned to her and shouted at her for removing the Nebulizer, claiming she wouldn’t treat her any further but refer her to UCH if she would not get well. She returned the next day, met different doctors and was treated well.
Though subject to investigation, malaria has turned into a terminal illness in UI. During the second semester, last year 2017 – clothed in heavy cardigans during the hot weather, she got to Jaja with a high body temperature. Having waited for hours as is the norm and it was her turn, she entered and sat down. For another 10minutes minimum, she was non-existing as the doctor – Mrs. Empathy was the doctor. She was engrossed with her friend on the discussion of “Abula” a traditional Yoruba food. According to her, from what she could make from their discussion, the doctor’s friend is the wife to a relative (brother, uncle or cousin) of Akeredolu of Ondo state, the patient herself from Ondo state. Following her departure, her temperature was checked and she wrote her to get a test, the result of which won’t be ready till after 4hours. Feeling surging pains, she requested anything that could alleviate the pains but was rudely told she can’t be given any. When she returned in the evening, she met a young doctor who gave her injections and showed concerns she shouldn’t have been released without care at first.
THE MAIN DEAL – ASTHMA IS NO EMERGENCY
On June 22, at around past 6, she went from the laboratory to the power crusade of IVCU (Ibadan Varsity Christian Union) amidst Asthma attacks. Of course, she had had it two days prior and was on drugs (prednisolone, loratidine, PCM) and not eager to say “hi” to Jaja so soon again decided to rely on her Ventocin R inhaler which only gave her ten minutes relieve before attacking her again, consistently. She then went to Jaja around 7pm to meet the emergency overcrowded. She wrote down her name and waited. Following 45mins, it had worsened and her wheezing was becoming audible. The emergency room had become freer and then she went. The nurse who had attended to her two days prior seeing her called on the doctor that there’s an emergency case of Asthma, that which was first downplayed by the doctor. Providence or coincidence, it was Dr. (Mrs.) Empathy again. At this point, the attack had worsened (with labour breathes), drawing sympathy from those around. At the “Duty Sister” room, having listened to her chest, the doctor told her to go and tell the attendants/messengers to get her case file as against the very first precaution they were supposed to take with her (without even her file – emergency ought to be treated as one) and not stress her around again. The only man he met angrily told her he does not have time, even after making it known she’s an asthmatic patient; he was obviously on errand and must have been frustrated. After about fifteen minutes of her return to the emergency waiting room, the nurse returned to request for her prescription paper. The patient responded in a believed-to-be characteristic manner of a frustrated patient that ‘she has been there since morning unattended too’ as her case keep worsening with her inhaler keep her in shape. “Which since morning have you been here? What nonsense are you telling me?” she had quizzed rhetorically and angrily at her. This made her as well to come to the conclusion her welfare that night cannot be entrusted in their care and thus angrily left, taking a bike to Awo Hall to inform her senior colleague and friend that she would be missing a meeting. However, seeing her and her wheezing state got everyone scared, an assertion confirmed by this colleague who happens to be a colleague and friend of mine as well. She then decided to call her mum and relatives around in Ibadan for help. They went to her hostel in CMF where she put the call through requesting her mum help call relatives nearby to come and get her out of school for private Medicare. However, the porter nearest to her took the phone from her pleading her mum prevail on her to return to Jaja as the case doesn’t look too nice; that Jaja is capable of treating her which her mother did. Returning to Jaja was another drama.
The doctor flared up, it was recounted by both parties separately saying, “Is that the nonsense you are meant to say? Are you not supposed to apologize to me (for keeping me waiting) on her behalf? Even is she not supposed to apologize?” Just not to delay further, the colleague apologized reiterating that the patient needs to be attended to (as she had hitherto said). And again according to both parties, the doctor sent the pleading colleague out of her office claiming her sight is irritating and annoying her, though one of them while recounting this wasn’t too sure of the exact words used, she asserted they were derogatory. She then came outside, gave her prescription and she obtained from the pharmacy the drugs needed after being scolded there she shouldn’t have left no matter the ill-treatment she received. She ought to have placed her health’s interest first. She took the drugs to the nurse who demanded an apology of her own too, which she gave grudgingly with a clause she said the nurse mustn’t have heard – “even though I didn’t know what I did wrong, I am sorry.” She then gave the Nebuse she (the patient) had obtained from the pharmacy and gave it to a young student nurse who administered it (10mg) on her plus hydrocortisone injection. It is worthy of note to that the patient in question attested that doctor Empathy wrote 5mg of Nebuse for her which clearly would have been ineffective as a result of the extent of the crises. Of course after about ten to fifteen minutes, she was stabilized as her wheezing subsided.
Rule 11 – CLINIC ETIQUETTE under the General Principles of the Ethics of Medical and Dental practices in Nigeria states explicitly that medical practitioners (D) must always give unconditional positive regard to their patient and express empathy… (E) must at all times and under all circumstances , show appropriate courtesy to patient. It is worthy of note that not only was the patient in a life threatening emergency disregarded and delayed, she was punished unprofessionally. According to her, the usual practice at Jaja with the good doctors has always been that she is made to wait while they fetch a doctor who checks her heartbeat and then prescribe verbally i.e. “nebulize her 5mg.” The nurses always have nebules at the emergency for emergency purposes. And when she is certified stable, she is then prescribed the nebules she has used to get it back from the pharmacy and return it to the emergency. So it is never short on it. However, making her go through the stress of getting her file herself and also getting her drugs herself when one exists at the emergency unit while under attack leaves so much to be desired and can’t be said to be a professional conduct. And Rule 28 – Professional Negligence categorizes (A) failure to attend promptly to patient requiring urgent attention as one. This piece will not be complete without another passionate plea on the powers concerned – the Medical clinic as well as the school management to look into these growing rate of delays, and unprofessionalism among health care workers.