Nigerian doctors and patients’ rights

Doctors on graduation swear to an oath. The oath demands they should seek to protect lives and that with care. Aside from this, patient’s everywhere around the world have rights which are sacrosanct and need to be protected. Unfortunately in this part of the world, ninety nine percent of the patients do not know they have a right.

The Nigeria Medical Association in itself does nothing to either protect or promote this. The aftermath of this is that patients’ rights are flagrantly abused in many instances and no one shows any concern.

Yoruba has an adage which literally means ‘when one is facing big challenge, lesser ones do have a field day slapping one’s face’. It is no news Nigeria (ns) are faced with myriads of problems. As we try to solve one, other problems manifest without prior notice or warning.

I have lived in Nigeria for the better part of my forty something years and I had watched with concern how our health workers especially in public and teaching hospitals treat patients as dogs. This may have exception. Generalising the issue may be prejudice.

Since my teenage years, going to the hospitals for consultation or whatever reasons mean spending the whole day. Our doctors and nurses present a front they are gods. Not many of them realise amongst the patients are qualified professionals like them. The difference is just in the choice of profession  each one made.If the level of professionalism displayed in the health sector in 1970s and 80s were considered not to be in the top notched, what we have witnessed in 2000 and beyond  called for a lot of concern. Though we must acknowledge the depreciation cut across all the fields of human endeavour.

Despite this, we keep making noise against Nigerians who could afford it travelling abroad at the slightest sign of headache. Who will blame anyone taking seriously his/her own life. We all have only one without a duplicate. In no means does one says doctors abroad are absolutely perfect, this is far from the truth. But because they know patients right will be enforced they are more careful.

The writer despite his previous experiences began to think seriously about this issue again as he witnessed what seemed like theatre of absurd. An Assistant Professor or a reader at the Obafemi Awolowo University was in a critical situation and he needed urgent and immediate attention. He went to his school’s teaching hospital but got a date in March.

Because he was in constant pain he went back to the university Teaching Hospital. He was turned down on flimsy excuses. At a point he was referred to the Emergency unit where for God knows what his case file kept on missing and each time he appears a new file has to be opened. While the wife pleads for help, few doctors who came around to pick something would walk by and said we are sorry we could not do anything now.

I remembered when I had an ear Infection about one and a half years ago. My initial thought was it must be something that would go away.  I went to a Pharmacy Shop and discussed with a Pharmacist on duty, she gave some pain relief amongst other but the pain continued the following day. By the evening of the third day it became unbearable and I went straight to Federal Medical Centre in Ebutte Metta Emergency clinic around seven in the evening.

The attitude of the staff on ground was something else. Then came the question ‘when did this start’ and I said three days ago. The next verdict was ‘we would not attend to you’, Emergency units are for serious cases. To them, mine was not an emergency otherwise I would not have waited for three day.

I was asked to return home and come for regular clinic the following morning. Because of the pain, I yelled and created scene. This produced no result until I remembered I knew someone in the top position in the hospital. It took a call to that person before I got attention that night.

How many of these will I share. In 2005, I was close to entering my office when a reckless driver hit me from behind. I became unconscious for a while and later discovered my femur had been broken. Good Samarithan took me to General Hospital in Ikeja around ten in the morning.

Despite the fact that I was in pain, I did not get any attention until four In the evening.  That was after two friends helped called a senior Matron who came to practically begged the people in the Emergency unit. According to them, all the doctors were busy and there was no bed space.I said what about first aid. What if I had sustained internal injury, would I have survived? The Nurse said I should thank my star the injury I sustained was not more than that as  people from accident scenes across Lagos that day were dead on arrival or badly injured and died within few hours. What followed the initial treatment was another story entirely. But that story was not funny.

In 1997, I had a surgery on my face in a Public hospital in Lagos. Apparently,  the doctor though renowned, lacked necessary equipment to do the surgery but because of the name of my sponsor, he wanted to score a cheap point. He did a trial and error thing where I almost lost my life. Whether intentionally or in error, he  damaged my facial nerve and kept quiet about this.

I got to know this when I was re-examined and had to undergo another surgery abroad. There I knew what medicine was. Any possible damage that may arise in the course of the surgery would have been discussed with the patient before the surgery. Patient would have agreed to this. Even at that every effort would be made to preserve what is preservable.  After the surgery abroad, patient would also be briefed about what was done.

In overseas’ hospitals, at least the ones I  went to,  doctors there don’t want to score cheap popularity. They will rather invite other experts who could help in case there are complication rather than wait till that occurred.  The one I had in Nigeria was selfish.

What about issue of case file and letter of referral.  In Nigeria, this is like asking for the nose of a lion. Few times I had  corrective surgeries done abroad, I was given my case files and at the end of each surgery a medical note/letter  was given without me asking for them. Each of these note/letter contains all the details of what was done from the day of admission till I was discharged:  drugs, examination, surgery process and the next step envisaged, the profile of the doctors that attended to me  and the next stage planned etc. They made the process easy  if a patient chose not go come back to them. Openness and transparency.

The first time I requested for referral letter/medical report here in Nigeria, it was a different story. Approval process was long and tedious. It took a month plus. In 2004, I lost a huge sum of money to a business deal. I lost hope and my heart started palpitations.  May be because of too much pressure and thinking. A friend referred me to a cardiologist in a private practice here in Lagos.  An old man for that matter who should be putting his house in order.

When I remembered what I went through in this doctor’s hand I shed tears. He suggested an xray which I did. From then on,  it was one drug recommendation or the other. He would not allow me  buy the drugs, he would collect money and claimed he ordered them from abroad.

when the drugs ‘arrived’ he would removed the packet and put the tablets inside drug dispensing nylon. I would asked for the name of the drug but he usually get angry saying I was querying his expertise. I was naive then but would you blame someone who wanted to hold on to life?

After three months of spending fortune, I changed to University College Teaching Hospital(UCH) Ibadan. one or two xrays,  the doctor slammed me with congestive heart disease. Another story began.

Eventually I changed hospital to Obafemi Awolowo Teaching Hospital, which is In question now, and met a real cardiologist who knew his job(Dr.Ogunyemi). Eletrocardiography (ECG) and Echocardiography (Echo) done and nothing was shown. The cardiologist had a deep conversation with me, he discovered I was thinking too much and had lost hope because of the money I lost. Just a few vitamin C and two months of constant conversation on shift of attention from my loss, I bounced back.

To be honest, it is not all Nigerian doctors that are guilty,  it was just the percentage.

In 1982, I was at UCH for a corrective surgery and met a very renowned doctor who trained abroad and had all the good qualities. He did not do the surgery I went for because he lack necessary equipment. As such he did not want to gamble with a precious life. He told me this. The only Magnetic Resonance Imaging (MRI) in the country bought for the hospital then had been damaged or stolen (?)

According to him he needed to get that done first plus few other equipment that were absent. The first time our daughter had a chest infection as a child around 2004, we met a paediatrician, Dr.(Mrs) Obadeyi. Professionals like her raised my hope of what medicine can be in Nigeria.

Honesty and respect for others are hallmark of  true professionals. But should I also shared my experience  in the hand of a private dentist? That will be a long story I will like to spare you. Yes we know doctors in public hospitals are overwhelmed with duties and are not paid well but these should not  be an excuse. Nigeria Medical Association must wake up to its duty.