A few months ago, a newspaper reported the suffering that an elderly woman and hundreds of other patients pass through while accessing care at the general hospitals in Lagos.
According to the story, the elderly patient, Abeke Bello, 83, arrived at the hospital at 5.30a.m. one cold morning to find that her number was 62.
Having met less than 10 other patients who were physically present, Bello said she was surprised that many people had picked numbers before her.
She said, “I took a taxi from where I live to get here on time, but I was shocked that I was number 62. I had expected to pick a number that was not up to 10. There were less than 10 people here, so where were all the people that picked the numbers?
“I tried to get here earlier, but it was not possible. The last time I came by 5am for my last appointment in January, I left around 2.30pm. So, I wonder when I would leave the hospital now that I came at 5.30am and picked number 62.”
A second story was the case of a 10-year-old hernia patient awaiting surgery in a public hospital in Lagos. In 2012, reports indicated that he had been on the waiting list since 2009. After a series of postponements, Ibrahim’s surgery was fixed for 2013.
The scandalous thing is that Ibrahim first visited the hospital when he was five years old, but now, he is nine.
These two stories depict the suffering the masses pass through on a daily basis while seeking health care at our secondary public hospitals.
A combination of refusal of patients to use the primary healthcare centres, overstretched public secondary and tertiary hospitals, dearth of bed spaces and acute staff shortage in the face of overwhelming patient traffic are factors militating against the efforts of the state government to deliver quality health care to the citizenry.
Primary healthcare centres
Globally, PHCs provide easy access to health care services to people at the grassroots. But the reverse appears to be the case in Nigeria. Primary healthcare centres are dedicated to improving the health status of patients and the community at large by providing accessible, affordable, quality health care services to everyone, regardless of their ability to pay.
The nation has continued to witness a breakdown of service delivery at primary healthcare centres, leading to unnecessary congestion at the secondary and tertiary levels.
I have seen some patients in our general hospitals who did not come for treatment, but they had come to be educated on health issues such as symptoms of pregnancy, proper breastfeeding, the type of food that is healthy for hypertensive and diabetic patients, etc.
Health education is, first, a primary health centre service, though it must be done at all levels of health care. General hospitals are not built for immunisation and other minor cases. It is when PHCs cannot handle a case that they refer the patient to secondary hospital such as the general hospital.
A revitalisation process for the primary health care system has led to the development of a template that is now being used as a yardstick in establishing flagship primary health centres in the 57 local council development areas in Lagos.
A former special adviser to Lagos State governor on public health, Dr. Yewande Adesina, once said this about flagship primary health centres: “Anytime you come here, there would be a doctor, there would be a nurse and the laboratory would open where you can do your tests. There would be people to open cards for you. The services would be available on a 24-hour basis.
“Let me explain that all of the things that you go for at the general hospitals are substantially here – HIV screening, diabetes, hypertension, malaria treatment, tuberculosis, immunisation of children, antenatal care, normal and uncomplicated pregnancies, child delivery, malaria, upper respiratory tract infections, pneumonia, typhoid fever, etc., all can be done here at little or no cost.”
I was at one of the flagship centres to see things firsthand. I met two medical doctors, some nurses, and an optometrist who I learnt consult thrice a week; a pharmacy technician, a record officer, an ambulance driver, among others, who were all on duty. It was an organised setting with a total of six medical doctors.
Other care on offer include primary eye care, primary dental care, and treatment of minor injuries, life-saving services, stabilisation before referring patients, ambulance system, emergency response and preparedness.
The model has succeeded in every part of the world and needs to be replicated in Lagos to make health care a local success and alleviate the suffering of hundreds of patients who are having difficulties accessing care at the secondary level.
A patient had come to one of the general hospitals where I once worked as a casualty officer for his blood pressure check around midnight, thereby denying critically ill patients the opportunity to be given utmost attention. His blood pressure was checked and he was advised to subsequently check it at any nearby health centre.
Do you live in Lagos? Are you a known diabetic or hypertensive patient? Kindly visit a flagship primary health centre in your council area for medical screenings, check-ups and continued care. I can say boldly that you don’t need to travel far anymore to access qualitative health care. Prevention is better than cure!
Kindly visit my blog: www.doctoradesanya.blogspot.com for other health issues.