Dr Biodun Ogungbo, MBBS, FRCS, FRCSEd, MSc
‘Better to remain silent and be thought a fool,
Than to speak out, removing all doubt’. Abraham Lincoln
Just managing
I was conducting a clinic recently when my patient related his ordeal in the hands of a surgeon. Apparently, my patient had undergone two botched operations for a broken bone in his arm. The operations were performed by the highest ranking medico: The Consultant! It seemed that the outcome of the operations was no better than would be achieved by the local traditional bone setter or nature.
To be fair, without the right atmosphere and proper management many hospitals are an embodiment of incompetence. The fact is that with poor funding, poor internal resource allocation and an abject state in most hospitals, medicine in Nigeria today is about 20 years behind what obtains in progressive communities. Perfect!
Health
For example, most of our National Orthopedic Hospitals can be proud of the lack of materials and equipments required to do their jobs. Patients are daily given a list to buy things required for surgery. Surgeons are performing operations long outdated and keeping patients for long periods in hospital for nature to heal them. Mostly, because they do not have the right equipment and just manage daily. Similarly, medics have to wait for patients to go and buy life saving drugs before treatment can be carried out. Relatives have to donate blood or you do not get any!
Sadly, when the Minister comes to visit, he is shown a window dressing: a smokescreen that hides the true situation on ground. Nobody will dare tell him the truth: that the health of our nation is in coma. Why do hospitals lie and pretend all is well during these visits?
Let us digress a little
Education
My patient, a lecturer, was lambasting doctors before I reminded him that teachers were no better. Our educational system has been run aground on their watch and no one is happy with the downturn in standards of education in Nigeria. University graduates are no better than primary school pupils in their readiness for the workplace!
Engineering
For example, I drove into a little village in the UK at night. On reflex, I looked down the street to see if the street lights were on! It took me only a few seconds to realise that I was not in Abuja and that ‘NEPA’ was not in control here. Still, you wonder. Why is it that not a single university has come up with a plan or proposal for the solution to our energy crisis? No bright sparks? No clue? Where are our engineers?
Customs and Immigration
Even closer to home is the issue with our customs and immigration services. Have you passed through the airports and noticed the lack of seriousness and professionalism? Rich -looking people, white faces and beautiful women simply stroll through the check points. Are these people actually protecting us illegal drugs, foreign agricultural pests, guns and dangerous ammunition? Do they look like they have the equipments to thwart the sophisticated efforts of drug barons and criminals who might want to do ‘business’ in Nigeria?
Police
Oh, pray you do not have to spend time in any of our police stations. Or end up behind the counter. When you talk about moral in the force and level of professionalism, you know both are at an all time low. Even the social and living conditions of our policemen and women leave a lot to be desired. We do not look after them yet expect a lot from them! Have you seen the Police conducting fingerprinting exercises or collecting DNA for investigations? Do they have their own forensic pathologist to assist their cases? The fact is that no one is happy with anybody as we are all in the same soup of mediocrity.
Okay, back to health
Health
Mediocrity is now the new excellence in Nigeria. You read in the news that some teaching hospital has performed its first open heart surgery or a kidney transplant in 2016. It is sad to read about this especially when kidney transplants have been performed for over 60 years. The first successful kidney transplant was performed in 1954 and thousands of kidney transplants are performed yearly in the USA alone.
In fact, even in Nigeria, St Nicholas hospital performed the first renal transplant surgery over 10 years ago. They were the first hospital to perform kidney transplants in Nigeria and the sub-region and since then have carried out over 150 successful transplants. The hospital has a dedicated renal transplant team and confessed to a high rate of success.
Talking of success
The problem with kidney transplants or open heart surgery is not whether the hospitals performed the operation or not. Not even whether they used indigenous teams or foreigners, but whether the patients are alive and well, in a month, 3 months or at 1 year. That is what we never hear about as the Commissioner for Health or the Chief Medical Director rushes out, inviting ‘paid’ journalists to a crummy press conference.
Who is keeping tabs on these pronouncements and looking after the interests of the patient? Who goes back 6 months later to see what progress if any, have been made? Not the Federal Ministry of Health, for sure! They have no clue what is going on in their back garden let alone in a hospital in Lagos State! Blame the budget.
So, for the discerning individual, there is nothing new to report in kidney transplantation. It has been done before, it is being done daily in other climes and performing your first transplant in 2016 is not worth bringing the drummers out. Not in my books, anyway.
Bottom line
Our public hospitals need to keep an eye on the little things instead of relishing in talks about stuff they cannot sustain. Boasting about renal transplants, open heart surgery and other ‘flash in the pan’ feats does their thousands of unhappy patients a massive disservice.
Instead, they should concentrate on improving patients’ outcomes following simple abdominal surgeries, pregnancy and delivery and the care of patients with back pain or broken bones. Ensure that patients do not leave their sick beds to go looking for Paracetamol!
That’s the meat in the soup.