Saturday, May 30, 2020

How we lost our loved ones rejected by hospitals amid COVID-19 pandemic–Bereaved families

He once assured me not to worry that God would soon bless his efforts but he never waited to enjoy the blessings.” These were the words of bereaved Mrs Joy Okereke-Nkemakolam as she shed uncontrollable tears while speaking with our correspondent.
Nkemakolam is the elder sister of 32-year-old Joel Aleke who  allegedly died recently due to the negligence of some hospital workers.  It was gathered that Joel slumped on Sunday while playing football and was rushed to the hospital, but was allegedly refused treatment for fear that he might be a COVID-19 patient.
She told our correspondent that the deceased being the first son acted as the father of the house and husband to their mother since their father passed on  10 years ago.
As she spoke, her words were halted by the tears that chocked her throat. It was an emotional moment as he recounted how her brother could have been saved if the medical workers had attended to him.
Nkemakolam said it was difficult for her family to break the news of Joel’s death to their mother as it would lead to double tragedy in the family.
“Breaking the news of my brother’s death to my mum will kill her. My brother Joel has been like a husband to her since our father passed on 10 years ago.  We don’t want to experience double tragedy,” she told our correspondent as she sank into a chair.
She noted that the 32-year-old was loved by people in his area and one could see how sad they were hearing about his death. “Joel was a good man, gentle and easy-going,” she added.
The sister further said Joel could give up anything to have peace and was a lover of football. She stated, “He was passionate about football. He started playing football when he was eight years. He could play football three or four times a week. He sometimes played football in the morning before going to the shop to sell.”
Talking about their relationship, Nkemakolam said after her brother clocked 32 last month, he confided in her of his plans to marry soon.
“He told me he would soon settle down with his fiancé who’s the only lady I knew with him. He sold beans in bags and was a serious young man,” she stated.
She added, “Joel was also  humble. At 32, he visited me to wash my clothes. He washed my husband’s car too. Whenever he came around, he would ask me what he could do in the house and the moment I sent him on an errand, he was up on his feet to do it.
“He would tell me, ‘mama don’t worry, God will soon bless my hustle.’ But my brother is gone. Wherever there was trouble, you wouldn’t see Joel. He loved children. He was a teacher before he resigned to learn a trade.”
She let out anguish as she stated that the country killed her brother. Nkemakolam said, “This country killed my brother. How could you allow a hospital to operate and they don’t have oxygen. The General Hospital didn’t even do anything to help the situation.
“It’s terrible when hospitals that ought to be saving lives are the ones killing people. They killed my Joel. If they rushed someone to the hospital that he slumped while playing football, they should have fought to save his life. He wasn’t a COVID-19 patient but he was killed because the hospitals were scared of attending to patients because of coronavirus scare. He never complained of heart or chest pain or anything. They should have treated him first at least to save his life.”
Needless deaths amid wobbling health system
There are many forgotten victims of the coronavirus pandemic beyond those infected with the virus. Ever since the ravaging pandemic started some hospitals  were accused of refusing to attend to patients for fear of contracting the virus especially since most hospitals weren’t equipped in treating victims of the virus.
Joel’s not the only one who suffered rejection by hospital for fear of the COVID-19 pandemic.
Mr Francis Ufford would have been 61 in a couple of months but he succumbed to high blood pressure. It’s almost the same narrative as few private hospitals that were open at the Alagbado area of Lagos were without oxygen.
His cousin, Gerald Ufford, who spoke with Saturday PUNCH said when he heard of Francis’ condition that night, the family did all they could to ensure he was taken to the best hospital. He accused the hospital of responsible for his death.
Ufford said, “He was diagnosed of high blood pressure some two years ago.  He lived at Alagbado and when he had the attack, due to the lockdown, his daughter got an airman to escort them and begged a neighbour to drive them to the hospital as they could not move freely because of the pandemic.
“In order to avoid drama, the daughter got the officer, so they could get to the hospital on time. Many hospitals in the neighbourhood didn’t have oxygen so the Lagos University Teaching Hospital was the best option, unfortunately they didn’t accommodate him.
“The hospital refused to admit him because they said their space was filled up and didn’t have bed to admit him. Then we took him to the Ikeja General Hospital and it was the same story. We continued to carry him about from one hospital to the other before we saw a private hospital willing to attend to him. But by the time they started to attend to him, it was late. He died in the process.  Due to the stress of carrying him around, his blood pressure was like 220. They tried to bring it down but by then it was already late. He succumbed to death.’’
Ufford described the late Francis as a good man willing to help whenever he could. “He was a good man. He loved to help people. He was a calm person who always minded his business; He was a family man, gentle and easygoing.”
As tales of rejections of non-COVID-19 patients by hospitals spread, the Presidential Task Force on COVID-19 advised hospitals not to reject such patients,, adding that doing so would lead to an increase in the number of deaths.
The Secretary to the Government of the Federation, Mr Boss Mustapha, had said that the there had been a spike in death being recorded in the country because hospitals were turning back non COVID-19 patients.
He said, “As at present, records show that we may be experiencing more unnecessary deaths because our hospitals are turning back non-COVID-19 related patients.”
The Minister of Health, Osagie Ehanire, also urged health institutions not to stop offering critical health services to patients requiring attention.
John Ademulegun is also another person who allegedly  died as a result of health workers refusing to attend to non-COVID-19 patients.
The aggrieved brother of the deceased, a lecturer, Dr Demian Ademulegun, said the issue should not be swept under the carpet.
He stated, “Our mother died shortly before the lockdown. She should have been buried if not for situation. Her remains are still in the mortuary. But the Nigeria health system has truncated my brother’s life. We now have to bury a mother and a child at the same time. What a sad country we live in.”
The lecturer narrated that the deceased complained of stomach pain and was finding it difficult to breathe. “We took him to a private hospital around midnight; they directed we should take him to the Infectious Disease Hospital. We did that night and IDH directed we should go to LUTH.
“We were not attended to. The female doctor on duty spoke  from afar and did told us to take him to IDH  without  any attention. She didn’t attend to us at all.
“ I told the doctor that we were just coming from IDH but she just walked away. Having no choice, we took him to IDH again. It was our second visit to the place. The time was getting to 2am. He was still agile but finding it more difficult to breathe. We got to IDH the second time. It was even my brother that answered all the questions from the doctor on duty. After the questioning, the doctor said he couldn’t admit him because the wards in IDH had been turned to COVID-19 wards and that it would be dangerous to admit him since he had not been tested positive. He advised we should return to LUTH.”
He said when they returned to LUTH the same female doctor bluntly refused to attend to them.
“She did not attend to everybody that brought in any one for emergency. She turned everyone back and advised that they should go to IDH,” he narrated.
He expressed that he watched his brother beg for oxygen around 3am as he continued to experience difficulty in breathing.
“At this point, my brother begged that he needed oxygen to breathe well. It was then getting to 3am,” Ademulegun stated.
He stated, “We decided to take him to LASUTH at Ikeja. It was then getting to around 4am. The doctor on duty at the emergency ward after a long time came out to check his temperature while in the car. It read 36 degrees. After a long while, he came out to meet us with a note that we should return to LUTH. We told him we had been to LUTH twice and they did not attend to us. He also left us in the car pack.”
“Doctors are supposed to be kind and humane. But the doctors who attended to us were wicked and callous. They killed my brother. If they have done the right thing, my brother wouldn’t have died.”
He said when they didn’t have a choice, they returned to LUTH the third time in the night and it was getting to 4.30 am and the lady doctor on duty still refused to attend to them.
“We pleaded in vain seeing our brother in agony. My brother pleaded that we should get him a chair to sit as he was getting increasingly uncomfortable in the car. We got him a seat in the car pack. We were there from 6 am, 7am until 10am,” he said.
Ademulegun stated that a doctor later came to attend to them and examined his brother, promising to hospitalise him.
He added, “My brother was the one that addressed the doctor that came around 10am. He begged him that he should not allow him to die, that he needed oxygen.
“It took another two to three hours before he was admitted in a single apartment and we were not allowed to be with him. We were outside.
“He died at around 9.45 pm on Friday but we were not informed until around 9am the next day.’’
He added that the deceased studied civil engineering at the University of Lagos, lamenting that the country’s health system shortened his life.
“He still has an elder sister and he died prematurely. Something must be done about the failure of Nigeria’s health system.”
For Sylvester Okey, suffering from collapsed intestine before the coronavirus pandemic, he was referred to the LUTH by a private facility managing his condition.
The sister, a musical artiste, Bethamary, told Saturday PUNCH  that her brother was rejected at the hospital for lack of bed space.
After the rejection, she quickly rushed him to LASUTH but he was also rejected there too. He was subsequently taken to several private facilities but was refused admission. Bethamary said her brother lost hope after the rejections and asked to be taken home where he died.
With hot tears, she explained “I drove to LUTH and when we got to the accident and emergency section, a doctor came out, took his information and checked him in my car. He went back inside. My brother fought for life but the nation’s health system failed him.
“Another doctor later came out to tell us that there was no bed space in the hospital. I begged him to name any amount for us to pay, but the doctor just said my brother needed intensive care but I  didn’t want to admit him in the hospital.
“I left LUTH for LASUTH and we met people outside the accident and emergency ward and asked for someone I could talk to. But I was asked for a referral letter from the hospital treating him and I produced it. The moment they saw the letter, we were told to go and do a COVID-19 test and I took Sylvester to the Ikota Primary School for the test. But the person we met there said he did not know when the result would be ready but he took his samples.”
She said that after they left there, she took him to some private hospitals, which also rejected him and those at the last place she took him to, didn’t treat him well. According to her, the doctor did not come down to check her brother but he told the medical director that he attended to them.
“On Monday, May 4, 2020, he started struggling for life and called me; when I got to his room, he was in pains and requested Holy Communion, which I blessed and gave to him and he was okay,” she added.
She said her brother died because the hospitals turned him back without attending to him. She stated, “He could not take it anymore. He died because of the failed health system.”
The bereaved  families who spoke with our correspondent also lamented what they described as lack of oxygen in most of the hospitals they took their ailing loved ones to.
For instance, Ademulegun said when the doctor wasn’t showing any concern to his sick brother, they opted for a private hospital. He added that as they kept moving from one hospital to the other, they discovered that lack of oxygen was common to them all.
He said, “We tried to look for some private hospitals around to find out whether they could administer oxygen on him. The two private hospitals we went to did not have oxygen.”
We don’t reject patients —Hospitals
Earlier, when The PUNCH contacted the Chief Medical Director,  Isolo General hospital, Dr Godwin Akhaboa, he said the facility was not in the habit of rejecting patients, adding that Joel was brought in dead.
Akhaboa said, “There are parameters to look at before certifying a patient dead and no doctor will say a patient is dead without checking those parameters. It’s never done; no nurse or doctor will do that. The patient had a cardiac arrest on a football field and he was brought in dead.”
Also, the Public Relations Officer, LUTH, Kelechi Otuneme, said the hospital wasn’t in the habit of  rejecting patients but rather it was limited by resources.
He said, “We exist because of patients. LUTH has three tripods; service delivery, research and training. There is no reason why we would not offer service delivery to the people.
“We are a tertiary hospital for that matter. The other hospital that complements us in that light is LASUTH in serving over 20 million population.  I think it’s not fair to say that we are rejecting patients.”
Otuneme explained that at the Accidents and Emergency ward, being the first ward where patients were admitted into, it was always difficult for them to control the number of patients at the ward and they couldn’t accommodate more than the hospital capacity.
He added, “At the Accidents and Emergency ward, there are usually occasions where there would be no space at least for the time being. You know the department is meant to stabilise people for a period of time before they are moved to other wards. When the ward is occupied, we have to tell them to wait till there are free bed spaces. It is not as though we deliberately say there is no bed space, and it’s like that all over the country.
“These things are beyond the hospital, we can’t control what happens to people, so there is no way we can stop accidents from happening to people.  Also in some cases, Primary Health Care Centres are not available or not open and people with malaria come to the hospital and have occupied the bed before others. We can’t possibly send them away from the beds.  These are the issues that needed to be attended to.”
On his part, Director of Clinical Services and Training,, LASUTH, Dr Ibrahim Mustapha, stated that the hospital didn’t reject patients as claimed by those who brought their sick ones to the hospital.
He said, “It is not true that we reject patients. Saying we reject patients is not true. Why are we then hospitals if we reject patients? I will encourage you to come to the office and see things for yourself. If that is the case, where do we get the people that fill our hospitals? Our hospital is oversubscribed. Many patients come here and there is no way we can attend to all patients that come. We don’t have the capacity. That is why we have other hospitals around.
“When patients come and the bed spaces are already filled up, we won’t be able to accommodate them. As I speak to you, I have the two emergency rooms filled up. Where are they from?”
Mustapha stated that the hospital didn’t reject suspected cases of COVID-19, noting that there was no way it would reject patients who didn’t even show symptoms of the virus.
He added, “ The practice in LASUTH is that when patients come in during this COVID-19 period, we ask them questions which we refer to as screening questions to know if it is a suspected COVID-19 case or not. Questions like “have you been having fever, cough, any respiratory distress,’
“Even in a situation where they are suspected COVID-19 cases, we keep them in our isolation ward at LASUTH, so they don’t get mixed up with others. After that, their samples are taken for a test and when the result comes out as positive, we refer the patients to any of the COVID-19 government-designated treatment centres around. And some staff members who have tested positive are receiving treatment at Agidingbi.
“If after the result the patient is negative, we move the patient out of the isolation ward to the general ward and continue treatment with such patients. That is our protocol at LASUTH.”
Mustapha stated that while taking measures to ensure that more patients were accommodated at LASUTH, there was an ongoing project at the hospital sponsored by a philanthropist.
He said, “We are building 20-bedded quarantine and triage self-contained room courtesy of a philanthropist. It is constructed in such a way that people will not mix with each other. Positive will not mix with negative.”
The director said that patients came with expectations usually, but doctors were trained to attend to the most critical issues.
He added, “Patients come in with their own expectations and such sometimes are not medically sound. We do a thing called Triage. It means sorting and attending to patients based on their medical needs. Treatment is not solely based on first come, first served, we prioritise patients based on how critical an issue is; we attend to those patients that are in dire need first.
“Our doctors have also been taught to attend to patients based on the triage. That is what they have been trained to do.  But most times, the patients don’t understand what the doctors are doing. And that is what we tell them to carry patients along. Many patients are not properly informed so they peddle misinformation around.”
Hospitals inability to accommodate patients not doctors’ fault – NMA
President, Nigerian Medical Association, Dr. Francis Faduyile, said that it was not the fault of the doctors or other medical practitioners if hospitals were unable to accommodate patients coming into hospitals.
He identified the major issues in the nation’s health sector as lack of adequate funding and poor utilisation of funds.
He said, “Many of the public hospitals employ doctors, nurses and other health workers. It is whatever the government provides that they work with. When you have a hospital that can only accommodate 30 people, there is nothing they can do about it than to admit the number of patients that the hospitals can accommodate.  It is beyond the workers there. It’s not like they like to reject patients. There is a limit to what they can do.
“It is the responsibility of the government to look for a way to provide more bed spaces and other infrastructures. Such roles are beyond the limit of medical practitioners.”
Faduyile said until hospitals were well projected and a sustainable plan employed, people might not be able to get the best of medical practice in Lagos.
He added, “If they have properly budgeted money for hospitals, during planning, they should know the number of hospitals that should be situated in a place based on the area’s population. But in a situation where there is no adequate planning, you might have one or two hospitals in an area which will not be able to cater to the needs of the people.”
Faduyile also linked the issue of poor funding to lack of oxygen in hospitals, noting that the issue wasn’t peculiar to private hospitals but also public ones.
He said, “ Talking about the issue of lack of oxygen, it is not only private hospitals that do not have a regular supply of oxygen. But there are also many public hospitals that do not have a regular supply of oxygen and this is due to the fact that many of them are poorly funded. It is the funding that will allow you to get what you want at the right time.
“If you don’t have adequate funding then you begin to prioritise, not knowing if the next patient will need that exact equipment that you didn’t put into consideration.”
The NMA President  said it was not right to blame owners of private hospitals as the financial situations of the people who patronise them would determine the types of equipment available at the hospital.
He said, “The best a private hospital can do depends on the buying power of the patients that visit the hospital. You can’t have consumables worth millions of naira and your patients can’t pay beyond N50, 000. You will certainly run at a loss and when you don’t have enough money to re-equip, then you will not have a supply in place. The buying power of the people around will also determine what type of services the hospitals offer. You can’t compare the services in highbrow areas to the one in an area where there are more low-class people. The differences will definitely show in the services they offer.”
He noted that the only sustainable health situation in the country was to have a health insurance scheme.
Faduyile noted, “The only way we can experience adequate minimum is when we have a health insurance scheme in place in such a way that everybody contributes to it and everybody is guaranteed a minimum level of care. Otherwise, people will continue to be denied a good healthcare system.”

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