By Simon Kolawole
My wife lost her cousin last week. She suddenly started gasping for breath, so it was a clear case of medical emergency. The family rushed her to a private hospital. Unable to handle the emergency, the hospital referred her to the Lagos State University Teaching Hospital (LASUTH). At LASUTH, they were told there was “no bed space” and advised to proceed to the Lagos University Teaching Hospital (LUTH). Getting to LUTH, they were also told there was “no bed space”. Frustrated and traumatised, they headed back home waiting for the worst to happen. That, after all, is the fate of millions of Nigerians out there who are not lucky enough to be in government.
Somehow, somebody who knew somebody who knew somebody at LASUTH finally helped her secure a bed space and she was returned to the hospital. Unfortunately, she did not make it. I do not suggest, even slightly, that she would not have died if there was bed space in the first instance. I cannot prove that scientifically. Patients still die at hospitals that have bed space. In fact, people die at world’s best and most sophisticated hospitals. We have to get that clearly. What I am unable to absorb is the fact that emergency patients are being turned back at general hospitals for lack of “bed space”. I’m not even talking about the more complicated task of emergency care.
My driver had a similar experience years ago. His father was seriously ill. As his condition did not get better, I asked him to seek care at a general hospital. There was “no bed space” at Gbagada so they headed for LUTH, where they were also told there was “no bed space”. He started pleading with them to save his father’s life, and one of the nurses shouted at him: “Will I turn myself to bed?!” While they were at it, one woman rushed in her dying father. As the nurses started yelling “no bed space” at her, the man breathed his last. Nobody advised my driver to ferry his father elsewhere; this time we chose a very expensive private hospital. Unfortunately, the man still died.
“No bed space” is the story of healthcare in our dearly beloved country. A country that once sold crude oil for $147 per barrel. A country that once had $23 billion in “excess” revenue from crude oil sales. A country that buys convoys of armoured cars for public officers with billions of naira every year. A country that burns billions of naira on buying kola nuts and toothpicks for government houses. A country that pours billions of naira into the pockets of legislators — at federal and state levels — for “constituency projects”. A country that finances the libidos and egos of public officers with hundreds of billions every year. And a country that has “no bed space” in public hospitals.
“No bed space”, as far as I am concerned, is just a metaphor. It means more than it says. The healthcare system is terminally sick. It has been sick for decades, and getting sicker by the day. Even if there is no bed space, what about providing basic emergency care — a little oxygen, for instance — to save a life, even if on a bare floor? You need to see how poor people are treated like goats at our hospitals. What has overcome us in this country that we have been so drained of compassion? All over the world, health workers are care givers: they are the most compassionate people. In Nigeria, they rank among the most sadistic. The system is upside down.
There was “no bed space” during the military era. There is still “no bed space” in the democratic dispensation. From 1999 till today, we have had Presidents Olusegun Obasanjo, Umaru Musa Yar’Adua, Goodluck Jonathan and now Muhammadu Buhari — and there is still “no bed space”. We have had PDP and APC in power at different levels, national and sub-national, and there is still “no bed space”. We have spent billions on the health sector and there is still “no bed space”. But you know what? We have space for presidential jets and governors’ convoys. We have space for air ambulances for the rich and the powerful. But there is “no bed space” for the people.
The “space” problem is not limited to hospital beds. Do you know how many Nigerian students want to study medicine? Many start dreaming of it from their primary school days. They want to give care to people. They want to save lives. They meet all the basic requirements — credit pass in this subject, in that subject. They do very well in university entry exams. But you know the drill: there is “no space” in the public universities, clearly the better equipped institutions to train them. Some universities even boast about how they turn back “thousands” of applicants every year because there is no “space”. They force students to study something else.
You would be forgiven for thinking that aspiring medical students are being denied admission because Nigeria already has enough doctors. Well, you are wrong. Nigeria posts a doctor-patient ratio of 1:3500. This is way below the WHO-recommended 1:600. To put that in perspective, a doctor in a country that meets the WHO ratio will have attended to six patients before a Nigerian doctor attends to one. The Cuban ratio — reputed as the world’s best — is 1:250. To see a doctor, a Cuban has 14 times more chances than a Nigerian; that could mean a Nigerian patient waiting for two weeks longer than a Cuban. But we don’t have “space” to train more doctors.
Countries that lack enough medical doctors usually adopt emergency measures to address the problem. For instance, decades ago, the UK allowed in doctors from Pakistan, India and Nigeria — and at the same time revved its production line of British doctors. Today, they have produced well enough of their own doctors and have stopped renewing the contracts of foreign doctors. That is strategic planning. In my own country, we are discouraging people from studying medicine because there is no “space” — as if space would create itself without strategic thinking. Yet we are battling all kinds of treatable diseases as our population continues to explode. Where is common sense?
I am sorry to bore you this morning over the state of medical infrastructure in Nigeria. I know that is not what many Nigerians really want to read. The hottest topic in town is Senator Dino Melaye’s monster hit, “Ajekun Iya”. Pardon the distraction. Unfortunately, I am more passionate about the plight of hapless Nigerians than the politics of 2019 that is currently playing out in Abuja. Things are not exactly what you are watching on the TV screen. Forget the drama: the real game is not televised. It is 2019. Nigeria is one amazing country where intrigues and politicking for the next election always take priority over the welfare of the citizens.
When war broke out in the Nigeria Governors Forum (NGF) under President Goodluck Jonathan, I wrote “Fellow Nigerians, It Is All Politics!” (June 2, 2013), warning us that it was all about the 2015 elections and had nothing to do with healthcare, education, power and roads. I was thoroughly abused by those who said I was “sitting on the fence” rather than supporting one faction or the other. I stand by my story. And I say this again: all the huffing and puffing going on in Abuja is not about healthcare, education, power and roads. It is all proxy wars ahead of 2019. I stand to be abused again — and I will still stand by my story. My interest is governance, not politics.
But this party called APC is nothing but a disaster. The 2019 intrigues started even before Buhari was inaugurated as president in 2015. I have never seen anything like this in my life. It was not as if the PDP was any better, but at least it managed to pretend to be working for at least two years before an outbreak of full-blown war over the next election. Meanwhile, APC is the only ruling party I have seen that does not exist at the national level. It is only the state chapters that can lay some claim to relevance. I have lost count of the number of factions in APC, all of them jostling and positioning for 2019 — while there is no “space” at the hospitals and medical colleges.