Lagos State University Teaching Hospital (LASUTH) is moving to get state authorities to expand the capacity of secondary health facilities across the state to handle emergency issues and so reduce pressure on the state-owned tertiary facility.
This is coming after a two-part investigation by BusinessDay exposing the deplorable state of tackling emergency issues at both Lagos University Teaching Hospital (LUTH) and LASUTH.
To reduce the sad incidence of turning away helpless patients at LASUTH, Adetokunbo Fabamwo, chief medical director of the institution, said the hospital was in the process of enlisting stakeholders, including the Lagos State commissioner for health, to key into the expansion idea, educate the public and enforce a ‘no-referral letter, no-admission’ policy in the state tertiary hospital.
Within LASUTH, the director is considering conversion of both medical and surgical units from bungalows of slightly over 60-bed combined capacity to a storey building each in order to double the capacity of both units to over 120 beds. This is expected to enable the hospital to accommodate more needy patients than it currently does.
“I think the way forward is to expand our emergency units and my own prescription is that the spaces should be doubled. Our current surgical emergency unit should go up one floor with equal number of beds so that we have a total of 60 beds. Our current medical emergency will go up another floor and double the numbers of beds [from about 30 currently],” Fabamwo said in an exclusive interview with BusinessDay.
“Also lot of them [patients] in surgical unit, for instance, are neurosurgical cases. They are long-stay patients. What we really need is a spill-over ward where we can keep these kinds of cases which will be in for a long time but we don’t have that. So they clog up our emergency spaces and block ways for others and we can’t throw them out on the street because they still need some form of intensive care,” he said.
While lack of bed space is a core factor that leads to long, often traumatic wait by patients at emergency centres, other factors that complicate emergency response include over-subscription of available facilities, conditions requiring long stay, shortage of health professionals and poor adherence to protocols of easing patients’ flow from emergency units to main wards of speciality treatment, Fabamwo, a professor of Obstetrics and Gynaecology, explained.
As at 11am on January 2, all 37 beds in medical emergency unit were occupied with only one of 30 beds in surgical emergency vacant, according to data reeled out by the CMD.
In the midst of that, Nigeria’s medical brain drain has equally taken a toll on the quality of care available. Where a typical 30-bed ward should be overseen by five nurses, in the ratio of a nurse to six patients, LASUTH unfortunately grapples with a maximum of two during the day and one nurse at night.
“That is how bad the shortage is. For doctors, some months ago, we recruited 10 resident doctors in the department of surgery anew. As at five weeks ago, nine of them resigned en masse. Some travelled abroad, some went to LUTH, and others went to Federal Medical Centre Ebute-Metta because the federal institutions pay higher than the state. So there is this internal brain drain in which our doctors move to federal institutions when they get the opportunity,” Fabamwo explained.
But beginning from this first quarter of 2020, the teaching hospital plans to leverage Lagos State Governor Babajide Sanwo-Olu’s recent order for immediate replacement of health staff rather than the previous practice of quarterly replacement to tackle staff shortage.
The governor, reacting to the question on bed space in hospitals among other issues during a televised interview on TVC News last Tuesday, promised a renewed commitment to health, saying the budgetary provision to the sector would be doubled. He also promised that a central monitoring of all public health centres would be instituted to reduce pressure at the tertiary level.
“In the 2020 budget, we are doubling the health budget and this is the first time we are seeing that kind of numbers. A lot of things are happening and we are also trying to wrap up even the infrastructure in the health space,” Sanwo-Olu said.
“There is an automatic approval to replace health staff after exit. We are bringing all the PHCs under the same monitoring so that there is no pressure on the secondary and tertiary hospital that we have,” he said.
Temitayo Ayetoto
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