Rescuing Enugu healthcare system from collapse

The efficiency of a country’s healthcare delivery system determines the state of wellbeing of its citizens. Therefore, the morbidity and mortality rate in any society definitely reflect the level of its medical services. DENNIS AGBO writes that the healthcare system in Enugu is in a parlous state as this is affecting the citizens, especially those in rural areas.

Despite yearly budgets and support from partners on healthcare system in the Enugu State, the health institutions have remained in shambles, compounded by the lack of cooperation from the staff that refuses to work in rural hospitals. The Ikem District Hospital is a case study and sad tale of how residents of Isi-Uzo Local Government die due to lack of medical attention.

There have been instances of emergencies where doctors, nurses and other medical staff were never at work and even functional ambulance available. The four medical doctors posted thereby the Enugu State Ministry of Health are irregular at work or even not at their duty posts. National Mirror investigation reveals that most of the workers, including doctors live in Enugu, which is 45 kilometres from the hospital and only come to work once a week.

A health worker and native of the community lamented that the work roster by the health ministry is not being adhered to by the doctors. This situation is made worse by none monitoring by the regulatory ministry. Efforts by the Ikem community to monitor the activities of the health workers have not yielded any result unlike the Enugu-Ezike District Hospital where the host community monitors workers attendance at the hospital.

The Ikem District Hospital, like six others in the state was built by the Jim Nwobodo administration in 1979, and has not received any attention in terms of facilities upgrading.

Many of buildings are overgrown by weeds and some have been destroyed by harmattan fires, while others have collapsed due to structural decay and age. It is this sorry state of facilities that has led to the current renovation of the General Out-Patient Department, GOPD, ward by PATHS 11, through the Millennium Development Goals, MDGs. Even when there are allegations that the contractor is not doing a good job, the building being renovated has remained at the foundation level.

When the hospital administration team visited, the officers were moved to plead for the posting of doctors who will become regular at work. The people now depend on quacks and drug retailers for their medical needs.

There are reports of some doctors running private hospitals in nearby communities. A hospital worker said “Ikem Hospital is the poorest and most neglected in present dispensation. Cabals from other parts of the state are trying to undermine it.

“There should be doctors and nurses quarters. The old quarters have collapsed. Bad roads are part of the problems facing the hospital because all of them are dilapidated, even though some are now receiving attention”.

A senior health ministry official said one major reason why workers are shunning rural hospitals is due to disparity in salaries and wages between them and their counterparts in places like Park lane specialist hospital in Enugu metropolis. He stated that healthcare partners usually supply drugs to city hospitals and the state wide free maternal care is also obtainable there, thereby making health workers to avoid posting to rural areas.

The Awgu District Hospital suffers the same fate. There, health workers lament the dilapidated infrastructure and lack of adequate personnel which is hampering health service delivery.

The staff made this known when the Commissioner of Health, Dr. George Ezeh, visited the hospital to inspect the facilities. They lamented that the hospital, established in 1954 by the natives and the British District Commissioner, D. R.Gibbs, to offer comprehensive health delivery service, has almost collapsed.

They pointed to the shortage of staff, obsolete medical equipment, perennial power outage and decayed infrastructure as major challenges facing the hospital.

The commissioner was conducted round the pharmacy department which roof was blown off by the winds some years ago, thereby forcing the hospital to store drugs in places not conducive for them. The District Health Officer for Awgu, Dr. Fred Chukwudi, said the hospital has three regular doctors, 11 nurses, one theatre nurse and one theatre anesthetist, but without theatre attendant. The matron, Mrs. Marcellina Njoku said nurses work two to three shifts at a time and that she also does the work of a cleaner.

“You can see a nurse working two to three shifts at a time and we lack ward orderly,” she said. At the medical records department, there is no ventilation, thereby putting the patients at risk of contracting airborne disease like tuberculosis. Ijezie said “The environment is not conducive. When you are attending to TB patients and they cough, there is no space for air to circulate.”

The files of patients are still kept in hard-copy since the operations are yet to be computerised, making the sorting of files of the 700 HIV and other patients an arduous task. The situation at the medical laboratory is not different as Ikemefuna Nwobodo is the only laboratory scientist at the facility.

He told the commissioner that he does the job of chemical pathologist, microbiologist and conducts comprehensive HIV tests on patients. Chukwudi, also stated that the hospital admits on average of 15 patients every month, saying the number could be higher but they prefer staying outside the hospital due to epileptic power supply.

Addressing the hospital staff, the commissioner, urged them to be dedicated and ensure that patients are given adequate attention. He said: “The poor people coming here should be made to feel like human beings.

When they are sick, let’s treat them with godliness.” Chief Medical Officer in the hospital, Dr. Peter Ezeh, reeled out challenges facing it, among which are shortage of staff, security, and lack of regular water and absence of a blood bank. But recently, the state government took some bold steps to approve the recruitment of 225 health workers for the seven district hospitals, three sub-district hospitals and 41 cottage hospitals.

The Commissioner for Information, Mr. Chuks Ugwoke, said the health workers to be employed include 20 medical officers, 150 nurses, pharmacists, radiographers, laboratory scientists, security guards and clerical officers.

He recalled that the government had already approved the renovation of the seven district hospitals in line with its commitment towards providing affordable qualitative healthcare services to the people.

In a related development stakeholders in the state health sector have expressed worry over the policy requiring pregnant women to produce evidence of tax payments by their husbands before accessing the Free Maternal and Child Health, FMCH, programme.

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