Wednesday 3 June 2009

Walking Wednesday 3rd




Woke up thinking how can I make today more memorable, nothing was planned, it feels like the trip is ending in an anti-climax. So I thought to my self either I would get on an Okada or at least I would walk to the medical centre, easy enough I thought. I put on my face book status that this was what I was thinking of doing and soon the replies came back. Someone said ‘walk ACCOMPANIED’, and I replied OK I get the message.

Great I could walk along and take a few photos of my daily journey, I rang down to reception to ask if someone was able to chaperone me. At this point I again wondered if I was speaking a foreign language. ‘I would like to walk can someone walk with me please’ I repeated. 5 minutes later the phone rang ‘Madam your driver is ready’, I so nearly said OK and agree to just except the lift, which I often do when I haven’t got what I asked for.

In the end Mr Solomon the hotel manager rang me and said he would come and walk with me. When he eventually arrived he said was I sure I didn’t want him to drive me, I explained how I wanted to walk so I could see more and take photos. So we walked the 30 minutes or so in the baking heat of the by this time midday sun. He pointed out different things on the way, the shopping plaza, factories, what the work being done was, and we just chatted generally. On the way people called out Oylibo and when I turned, they all say welcome, a phase commonly used here. It felt good to be walking and taking in all that I will shortly miss.

He insisted on walking me to the door of the centre, by the time we arrived the sweat was pouring. I think the humidity must be even higher than the UK here as although it’s often reported to be between 30-35 degrees it always feels much hotter. Mr Solomon made his way back, probably on an Okada (which I am still tempted to try). As I entered the centre Femi informed me that there had been a power surge and the electric had shorted and caught alight. The ‘electrician’ was coming back to sort it out (hopefully as he had been paid up front). This also meant no fans, so the sweat continued to pour, with no relief.

We sat and chatted for a while and I expressed my disappointment that the trip to a general hospital had not materialised. Femi although did not feel it was something I needed to do agreed to take me to Ikeja General training hospital. Femi explained the history of the hospital, which had a mixture of very old and new looking buildings.

We entered and were advised to go to the Professor, we entered his room and Femi introduced us and why we were here. He generously gave up his time to speak to us and discussed the problems he faces and the politics behind a lot of these issues. He said that maternal death rate in Lagos was 650 per 100,000. He says that people don’t get antenatal care and that many birth at home or in churches with non qualified people looking after them, the figures are probably higher than this. People are not educated to know better, health education is not very well achieved here.

He then rang his Matron and asked us to be shown around. I had heard people say what to expect, birthing rooms etc. I can’t deny that I was shocked by what I saw. In a small centre like a Mafoluku I expected there to be lack of equipment and poor conditions. This was a teaching hospital, it was at best out of the dark ages. Women in threes in labour rooms, it appeared that little or no pain relief was being used, monitored with pinnards, they said they had sonic aids but I couldn’t see any evidence of them. There was a CTG machine (to monitor the fetal heart) but it wasn’t in use (maybe they were all low risk!). The walls were peeling, the beds were bare and tatty, the rooms were hot, and hygiene didn’t appear to be this big issue it is in the UK, no birthing partners to be seen.

When they are about to deliver they are taken across the corridor to a birthing room. In here was a couch with stirrups and a very old resuscitaire unit. The rooms were ugly, harsh and not clean looking in comparison to what I am used to they looked barbaric. The Midwives I spoken to said that they knew that things were not as they’d like and know they could learn a lot from people in the UK, the matron said they would benefit greatly by doing some kind of exchange with their UK counterparts. This would be a great idea, but what when they return the equipment is so dated and it would have been condemned in the UK.

We were then taken to the ante/postnatal wing; these again were very basic poor conditions. We were told that women that who can not pay or who turn up with out having had antenatal care are put into another area, which was more basic (can’t quite imagine getting more basic). The matrons that I spoke to were all concerned about maternal mortality and I have great respect for them and the work they do in the surrounding that they have to endure. I work in a relatively new hospital, it’s clean and equipment is generally modern and or well maintained. Women generally receive one to one care, there is choice of pain relief, partners can give support, and everything is at hand and no one is given a second class service on matter what they wealth or social standing.

I came away saddened at what women in this area have to endure and others hospitals may be different. Some may be more modern and have better décor and more up-to-date equipment. I would imagine that this isn’t too different to many others, when I’ve taught Doctors how to use a sonic aid because they have never seem one, when a nurse/midwife from another hospital wasn’t even aware what one was. I walked out of this hospital and said to Femi that I had assumed that his centre was basic and not the most cleanest of places, (no water, no sewage etc) but after seeing this teaching Hospital, I felt that the centres standards were certainly no worse than this and in some things better.

In a country that has only five radiotherapy units in it (the whole of Nigeria not just Lagos), Abuja the capital city has only 2 defibulators, Lagos only has three mammogram machines. There are many people dying prematurely due to lack of equipment, drugs etc, immediate medical care (ambulance service) is reportedly almost non-existent The average male lives to be 45 years of age. Health care is a vital need that should be available or accessible by all. Primary health care, health education and screening should be a priority.

This is not a poor country; this is a country that appears to not be managing its finances efficiently. A country that produces oil but doesn’t then refine its oil, it sells it and then purchases it back. This country has fantastic beaches, but where is the tourism? I could go but I won’t! Nigerians deserve better, there is a need for changes, there is a need for Nigerians that have seen the grass is greener to return and sow the seeds of change, to demand better, to expect better and to put in what ever they can to improve and to excel.

4 comments:

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  2. Well said Jo.A lot need to be done to improve quality of patient care in Nigeria.It is not like UK where people can go to hospital and expect to get free treatment because they have already paid for it through tax. A lot really need to be done.Nigeria definitely needs people with vision to move things forward.Hopefully, one day, we might get an Obama in Nigerian politics.It is even very ironically that healthcare is not even in the seven point agenda of the current Government.I wonder what they were thinking about when they drafted the agenda.A healthy nation they say is a wealthy nation.Health is wealth. However, we need politicians with vision and mission to rescue Nigeria from its current dungeon.When will that happen? That's the big question

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  3. I am glad you have the courage to tell what you see, but also you write with passion and compassion too, we have no idea how lucky we are in the UK and its unbelievable the lack of equipment in Nigeria, which must be like tieing the hands of the medical staff who are trying to work there! Pray for courage and vision and compassion for those with influence in Nigeria. And...... dont go on an okada! I'll give you a ride on my bike when you're back if you want!!!

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  4. The tide is turning... improvements are slowly happening, it is a vast job and many years of problems to be put right. This can happen with people like Femi who has a passion for his country and is not out just to make money but to make a change.
    People need to care about others and not just worry about whats in it for themselves, then change will really happen.

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