How lack of a ventilator killed my daughter

Just the other day, I drove by Bourdillon road in Ikoyi, Lagos Nigeria and saw change. The former Gold Cross hospital located on that road has now transformed into Lagoon hospital. It may be recalled that my 18 years old daughter who was a law undergraduate of University of Birmingham, England, Kikaose Ebiye-Onyibe (on track to graduate this summer) died there on the 12th of April last year.

That’s one year ago that my family and I were plunged into a vortex of grief and anguish that we are yet to pull out of as we are still searching for answers to why: a vibrant young girl who flew into Lagos from school and walked into Gold Cross hospital less than 12 hours after; and having been diagnosed with ruptured appendix through CT scan in a private laboratory in Lagos (a procedure the doctors in Bournebrook Varsity hospital, Birmingham failed to carry out), before being admitted for surgery after which she passed away from massive loss of blood.

Till this moment, l cannot forget the day that has become the worst in my life because I watched my smart, God fearing and goal getting Kikaose fighting for and losing her life in the Intensive Care Unit, ICU of Gold Cross hospital. Believe me.

The sudden passage of a teenage child is not like the death of aged parents or other relatives.

There is nothing worse.

After the surgery that commenced at about midnight of 11th April and lasted for nearly three hours, Kikaose was wheeled out of the theatre into my waiting arms as my heart literally leaped for joy that the surgery was successful.

She spent the rest of the night in her hospital bed till the morning with her mum praying by her side. At about 10am on April 12th which was the fateful day, Kikaose was rushed into the ICU because doctors reckoned that she was loosing her pulse due to blood loss and they needed to infuse her with more blood.

Blood? I was shocked to hear that because from what l have been reading up on appendicitis, high loss of blood is never expected in an appendix surgery. How come Kikaose had lost so much blood? My wife and l were not allowed inside the theatre when the surgery was being performed, so we don’t know what might have gone wrong. While the blood infusion was going on, we were further informed that Kikaose would be transferred by ambulance to Lagoon hospital, Apapa where she can be put in a ventilator – a breathing mechanism that would enable the highly distressed girl who was at that point gasping badly for breathe, sustain her heart beat.

Why were we not informed that Gold Cross hospital had no ventilator which is a vital equipment for sustaining patients heartbeat should have been available in such hospital in a high brow neighborhood?

In the midst of doctors and other medics running back and forth in search of oxygen to support her breathing, l inquired from one of the personnel about how Kikaose was doing. She tried to reassure me by informing me that Kikaose would be okay as she was a sharp and brave girl.

She then disclosed how the team of doctors in the ICU were discussing the possibility of opening up a patient to correct what might have been done wrongly and Kikaose even in her pains had enough presence of mind to interject by asking if they wanted to open her up again.

A question which the doctors responded to by saying that they were not talking about her but another patient.

With the benefit of hindsight, something must have gone wrong to warrant that dialogue and l have no doubt that Kikaose was the subject of that discussion because the medical team could not have been discussing another patient in the ICU with a gravely ill patient.

With her other vital organs badly damaged due to the toxins from her ruptured appendix oozing into her body cavities and in the process poisoning her, Kikaose gave up the ghost before she could be taken to Lagoon hospital where she could have been put in a ventilator.

Regrettably, immediately the CT scan report revealed at about 6pm that Kikaose’s appendix had ruptured, we should have put her on a return fight to England from where she had arrived earlier that morning with Virgin Atlantic airways of which she had a return ticket. But we were advised that there was little or no risky conducting the surgery in Nigeria.

Sadly, our confidence in Nigerian medical system has turned out to be our gravest mistake.

Obviously, we were it thinking right otherwise we could realized that President Muhammadu Buhari does not have such confidence in Nigeria’s medical system hence he has consistently been seeking and obtaining medical attention in the UK.

To be fair, he is not the only or first head of state to seek medical care abroad.

Former military president, general lbrahim Babangida had also sort medical care abroad and so did his late wife Mariam. Similarly, late Umar Yar’Adua went overseas to seek medical remedy and Stella-the late wife of Olusegun Obasanjo did so too, as well as Patience, the wife of the immediate past president, Goodluck Jonathan, embarked on a long medical tourism that was subject of speculations.

The narrative above demonstrates a long trend of lack of trust trust in the quality of health care delivery in Nigeria by our leaders over the past 30 years hence the sector is in shambles.

Ironically after about one year of Kikaose’s untimely passage, Gold Cross where she passed away largely due to lack of a ventilator, has been transformed into Lagoon hospital, the medical facility that she was to be taken to, if she had made it out of the ICU.

Before we departed the hospital on April 12th where her mum, other family members and sympathizers held Kikaose’s remains ‘hostage’ for hours in fervent prayers and in defiance of doctors pronouncement that she had given up the ghost , the question on my mind was and has been, what did the doctors do wrongly when they opened up Kikaose inside the theatre on that fateful midnight of April 11th?

In a country where transparency is an anathema so people hardly have good conscience and where for the excuse of esprit de Corp, professional colleagues who should be exposed for their incompetence to prevent them from injuring others are protected , the actions or inactions that led to Kikaose’s untimely death are shrouded in secrecy.

Hopefully, one day, somehow, somewhere, a nurse, matron or doctor involved in Kikaose’s care or lack there off, would make a confession as to why she suffered massive blood loss during a routine surgery for a ruptured appendix.

Not that it would bring her back to life, but other potential victims may be protected from being attended to by incompetent medical personnel and poorly equipped hospitals with exterior glitter and glitz but whose interior is bereft of life saving equipment and expertise.

Each time, on my drive home, when I see Gold Cross which has now been rebranded Lagoon hospital that symbolizes sorrow and tears to me and my family, I can’t help but wonder if the transformation is only cosmetic or it also covers the equipment and personnel. I said it before and l’m saying it again. It’s about time that the authorities started ranking and categorizing our hospitals into grades as banks are ranked into tiers.

Hospitals also have to be compelled to display in a visible location (as restaurants display their menu and price list abroad) the list of doctors on duty and their qualifications to enable a client have an idea of the quality of care to expect.

It’s unacceptable for a hospital smack in the heart of Ikoyi, Lagos (presumably a tier 1) that demanded a deposit of half a million Naira before a simple appendicitis surgery can be carried out, would lack a vital equipment like a ventilator to sustain the heart beat of a patient.

To be clear. I’m not being bellicose by sharing the most devastating experience of my life, but l’m only trying to ensure that after the unfortunate loss of Kikaose, things change for the better in our hospitals.

I’m not ignorant of the alarming number of young people from both affluent and poor homes that have died in Nigeria in the past one year under strange circumstances. Just as I’m also abreast of the anguish being suffered by the parents of victims of Boko Haram terrorist attacks including Chibok and Dapchi girls killed or still in captivity.

Nether am l unmindful of the mindless and dastardly killing of students in Parkway school in Florida, USA as well as the appalling wave of gang killings of youths in London, England which has assumed alarming proportions of up forty victims since the beginning of this year. I share the grief and agony of those who have lost loved ones.

However, the difference between the tragic events in the Western world is that while the tragedies occurred as a result of criminal activities, Nigerians are dying as result of lack of adequate medical care. Unfortunately, all the victims of the aforementioned incidents in the USA and UK are teenagers like Kikaose who were potential leaders of tomorrow.

Justifiably, in the USA and UK, there are currently intensive campaigns for more control on access to guns and knives. And the campaign especially in the USA is being led by the youths who have been the victims through a march by the youths to Washington, putting law makers on notice that they won’t receive the votes of youths if they continue to play politics with gun control.

In Nigeria, we are now hearing that Govt is planning to declare a state of emergency in the health sector.
Would they really do so without their hands being forced through public pressure and other legitimate actions?

Unfortunately, until the wake up call through the recent presentation of the abysmal poor health care situation in Nigeria by Bill Gates, the founder of Microsoft and co-Chairman of Bill and Millinda Gates foundation, health care was a non issue in our country as nothing was being done to bring it to the front burner.

It’s a crying shame that in the past ten years, only a paltry sum of N3.9 trillion was allocated to the Heath care sector out of the N55.19 trillion budgeted by the federal government. According to Vanguard newspaper report, that figure represents only 7.07% and that’s by far below the World Health Organization, WHO recommendation of at least 13%.

Hopefully, the forthcoming THISDAY newspaper promoted summit on Universal Health Coverage would be a timely intervention that would nudge authorities into giving nurturing, protecting and saving of lives from cradle the attention that it deserves.

Perhaps it would facilitate the life expectancy of Nigerians notching up from the current miserable low of 53 years to the biblically recommended and respectable age of 70.

Countries like Japan, Germany and Sweden as well as Norway etc have life expectancy of between 80-9O years and such longevity is not a product of good genes, but consistent investment in healthcare from dawn to twilight of life or cradle to grave.

Magnus Onyibe, a development strategist, alumnus of Fletcher School of Law and Diplomacy, Tufts university, Massachusetts, USA and former commissioner in Delta state, sent this piece from Lagos.