• Tuesday, June 18, 2024
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LAUTECH Teaching Hospital suffers critical staff shortage as doctors leave for better pay, working conditions

Brain drain in Lautech teaching hospital

Health workers at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital are facing a multitude of challenges, including gruelling workloads, stagnant salaries, and a low hazard allowance. This situation has led to a concerning exodus of staff, jeopardising the quality of care provided at the facility and leading to a situation where 70 resident doctors, 10 house officers are doing the work of 238 individuals, BusinessDay Investigation can authoritatively report.

LAUTECH teaching hospital has 13 departments comprising of Medicine, Surgery, Obstetrics and Gynaecology, Radiology, Community Medicine and Family Medicine, Paediatrics, Nursing, Chemical pathology, Histopathology, Haematology, Orthopaedics and Psychiatry.

According to information on its website, the hospital has been making considerable progress with improvement in the number and quality of staff, acquiring modern equipment and providing international standard training for medical students and resident doctors, in the last 12 years.

It further stated to have an adequate number of consultants and resident doctors to cater for its patients.

“The hospital is well-equipped with state-of-the-art facilities,” information on its website read, with its vision to become the leading tertiary healthcare institution in the West Africa sub-region, renowned for world-class training, cutting-edge research, and superior services.

“Our goal is to be the preferred destination for specialised healthcare in a welcoming environment, distinguished by a culture of continuous and compassionate care,” it stated.

Reality differs

But Dr. Timothy, a house officer who joined the hospital for his internship in 2023, described his experience as a far cry from what he heard and expected before joining the institution. As of the time he spoke with our correspondent in late April 2024, he had been at the teaching hospital for seven months.

“What we heard was that the pay was good. Though not as high as what federal centres offer,” he said.

According to him, he, along with several colleagues, have been burdened by excessive work hours unlike healthcare professionals in other hospitals who take one call a week or a maximum of three calls in two weeks. This situation, he said, has led to burnout. He recounted instances of working 56 hours straight without rest during weekend call shifts.

He described his experience in the last seven months at the teaching hospital as very bad, explaining that when he and four others arrived at the LAUTECH teaching hospital, there were 16 other house officers working at the facility; their arrival, he added, increased the total number of house officers to 21.

“At least when I was coming here, we spoke to some of our seniors who were here already. They were like the working hours are good and everything. Even though we knew that the pay was not as high as what other centres pay. But since the working hours are okay, we came here solely to discover that even less than a month after we resumed work, a lot of those guys started completing the house job,” he said.

Long work hours 

Speaking on the number of working hours, he disclosed there’s no specific number of hours stipulated for doctors to work saying, “As a doctor, you have to take calls…”

Unlike their colleagues in other places who take one call in a week and a maximum of three calls in two weeks, he lamented the frequency of calls they take at the LAUTECH teaching hospital as one of the major challenges for them.

“They (colleagues in other hospitals) have a lot of time to themselves and everything. They are well-rested,” he added.

Timothy told this reporter he had done an alternate-day call for three consecutive months.

“At some point, some house officers got sick, which means that you work 36 hours out of every 48 hours,” he said.

Buildings of the Pharmacy department and ElectroEncephaloGram (EEG)/ElectroCardioGram (ECG). Photo credit: Damilola Olufemi.

Buildings of the Pharmacy department and ElectroEncephaloGram (EEG)/ElectroCardioGram (ECG). Photo credit: Damilola Olufemi.

These long hours, coupled with a shortage of workers, have created a stressful environment. Since Dr. Timothy and his colleagues arrived, many have already left after completing their house jobs. The hospital’s attempts to replace them haven’t been successful, as potential hires are drawn to better-paying opportunities elsewhere.

“Since we resumed, people we met have started finishing their house job. Now the issue has been to replace those people. So, they (LAUTECH teaching hospital management) have not been replacing them.”

He added that existing workers had submitted some applications as recommendations but the management of the hospital did not call those recommended for an interview.

“We submitted those applications. We talked to our guys about coming to LAUTECH Teaching Hospital. The hospital did not call those people for an interview. They did not give them any dates to resume. That’s not even an issue of them not seeing people apply. Now, those people have gone to other centres where they are now getting better pay,” he said.

Exhausting work schedules

Timothy explained that when one is on a weekend call, such an individual resume work on Saturday at 8 am and goes home on Monday at 4 pm while the break (rest period) is from Monday 4 pm to Tuesday 8 am.

“So, if you’re on a weekend call and you work from Saturday 8 am to Monday 4 pm, you’ve spent 56 hours at work without rest. Any patient that comes within that period, you are expected to see. No excuse. Nothing,” he said.

Amidst the busyness and working hours, Timothy disclosed they still get abused by some of the patients.

Despite the challenges, one of the things he noticed is that the workers at the teaching hospital love their job.

“It’s just that people have a passion for the job. I still don’t see doctors here arguing with patients. They still see patients to the best of their ability.”

He told our correspondent the average range of salary he gets is N170,000 to N175,000, adding that salaries have been increased in other centres and every time they complain, they don’t get a reaction anymore.

When workers of the centre complained about their pay, it was at this point the management of the hospital attempted to double how much should be paid for the quarters.

“They want to double the amount we are paying to the hospital at the same time we are crying that the salary is not being increased,” Timothy said.

The low wages at LAUTECH Teaching Hospital are another major source of discontent. While other hospitals have implemented salary increases, LAUTECH staff have seen no such improvement. This lack of financial incentive, combined with the demanding workload, has led to low morale among workers.

Dr. Timothy, for instance, has had little time for personal pursuits outside of work. He disclosed that as a sportsman who likes to have fun, since he got to Ogbomosho, he has not had time to do any of these things.

Some days from 4 pm to the next morning of his rest period, he had planned to go play football, but he could not use the little time he had to rest to go play ball.

“I struggle to watch football. Three to four months in a row I have not played ball. I have not done anything fun. I’ve not had the time to go out or do anything,” he said.

One house officer for A&E

A house officer, Jayeola, who joined the teaching hospital in February disclosed she had resigned from the centre since April 28, some two months after joining the hospital.

Aside from the overworking, Jayeola said there hasn’t been time for her family.

“When one person is doing the work of more than three people the stress would be much. It’s so stressful. A single house officer covering Accident and Emergency (A and E) and ward, also takes care of all the patients in the ward, and all the emergencies,” she said. “Since I have moved here (LAUTECH teaching hospital), I rarely call my family.”

She added that even when her family decided to reach out to via her mobile phone, she would either be in theatre or on ward rounds or seeing patients at the emergency.

The house officer also gave low payment as the reason for her exit. She said the management has been promising for a long time with no positive changes.

“I have submitted my resignation letter. The pay here is so small. I don’t think anything will be done in the next one month because they’ve been promising before now,” she said with a look that she had made up her mind not to go back on her decision.

Also, Adeyemo Deborah who joined LAUTECH teaching hospital in March 2024 spent less than three months before she resigned.

The medical officer who described the relationships with my colleagues as fantastic expressed sadness over the level of workload in the facility and the stress that was beyond what she could explain.

“In terms of workload, it was not palatable at all. It was so stressful. A unit that was supposed to have six house officers, had two. When I joined, I was the only house officer in the whole surgery department,” she said.

Stating the reason for her exit, she explained that she had gotten a better option in pay and other benefits.

She noted she finds it impossible to come back to the facility should the issues affecting it be resolved because it would be a waste of her time again. She expressed that she had spent two months before she left and had to start all over again from somewhere else.

“Immediately I left, I resumed to my new place of work. I have started my internship again,” she said.

‘Our mental health is at stake’

Dr Iwalewa Tosin, a resident doctor, also referred to as a registrar, has been working in the centre for over a year.

Speaking on the welfare of the teaching hospital, he said he is still being owed a two-and-a-half months’ salary for March, April, and May 2023.

“Till now, I’m yet to be paid,” he said.

He further confirmed workers in the teaching hospital are not enough. Rather than having more than 200 registrars, the teaching hospital barely boasts of 70. An indication that that a single individual is doing the work meant for more than three to four doctors.

Tosin said the salary is nothing to write home about and nothing has been done about it but it has been a continuous promise.

The registrar, sharing one of the hurdles he encounters said they work extra hard which eventually affects their mental health.

“We improvise a lot. This is a teaching hospital without medical officers. No casualty officer would take care of an emergency,” he said.

He said the discrepancy in pay compared to other centres is too obvious and the margin is too wide.

He confirmed the payment of N5,000 as a hazard allowance.

He said there was a time when the management did an audit in 2023 and discovered that they were paying them an additional N5,000 as COVID-19 palliative which raised the hazard allowance to N10,000, but in that same month it was detected, the COVID-19 payment was stopped because the nation was no longer in pandemic.

“If they could stop the payment that same month it was discovered, why is it taking them months to implement what they should do?” he questioned.

When asked if the patients are not affected by the lack of equipment in the facility, he said the health workers try to improvise as much as they can to ensure patients aren’t directly affected by the subpar facilities. However, the lack of resources and staff inevitably takes a toll.

“No matter what, no doctor is happy to find a patient coming in with pain or with a sickness and go back the same. Because of that, we will try our best to put some smiles on the faces of our patients,” he said.

LAUTECHTH in the doldrums

LAUTECH Teaching Hospital’s website boasts of being a well-equipped facility with a highly qualified staff. However, a medical officer paints a different picture. The family medicine department, for example, lacks accreditation, and the surgical theatre is in need of upgrades.

“If you’ve been to the theatre, you would know,” he told BusinessDay Investigations.

He added that the family medicine department for example is not accredited.

“So, if you are doing a residency in family medicine, there’s no accreditation. But these things are not obvious to the public. So, people probably think they are doing surgery and everything. But no. The environment they are doing the surgery is not suitable.

“We see these things compared to where we are coming from. It is no match for a hospital of this standard,” he explained.

He urged authorities of the LAUTECH teaching hospital to increase their pay “because we are the least paid in the country. I don’t know of any other centres that pay less than what they pay in LAUTECH teaching hospital.”

He also called for the employment of more hands in the centre and an upgrade of the theatre, intensive care unit, and emergency.

“Even if they increase the pay, there will still be agitations to increase the number of people working. No matter how much they want to pay you, when you’re almost dying at work, you still cry,” he said.

N5,000 hazard allowance

Dr Kayode Paul, who shared similar views as Dr Timothy, described his seven months in the teaching hospital as stressful. The house officer stressed the need for salaries that are competitive with other hospitals to attract and retain qualified staff.

According to the doctor, their salary is almost N100,000 less compared to their counterparts in other states. According to him, that is too wide to start a career with.

The amount of hazard allowance, which doctors said was a meagre N5,000, is also not encouraging to the workers spoken with. Paul maintained that this could not be compared to health risks and exposures they face.

He labelled the work-life balance in the hospital as horrible as there is no time for leisure activities and they could not keep relationships with their family members.

“We just have to keep it at the back of our mind that we need to give the best care possible. But I wouldn’t call what we are doing now coping because it is just a matter of time before we break down. We are just trying our best,” he said in a low and exhausted tone.

Paul, who would in a few months be done with his internship suggested that the renumeration of the teaching hospital be made comparable with other centres. “That way, it would be able to attract more people,” he said.

No to LAUTECHTH

A medical student, who is about to graduate from the teaching hospital, while speaking with our correspondent, said she would never take the LAUTECH teaching hospital as an option, citing low pay as one of the reasons for her decision.

“The difference between here and other centres is wide. I learnt they’ve not been paying the Medical Resident Training Fund (MRTF) here,” she said, adding that it is not worth working in the facility.

“How will someone be working tirelessly and the pay is like peanut compared to what other centres get,” she questioned.

The MRTF is a programme created to provide financial support to cover various expenses associated with residency training—examination fees, update fees, research projects, and other related costs—by the federal government.

Speaking with Dr David Olaniyan, President of the Association of Resident Doctors (ARD) in LAUTECH teaching hospital, BusinessDay Investigation gathered that the money helps the resident doctors to facilitate any training they get.

He disclosed that LAUTECH teaching hospital is yet to begin the payment.

“It is something we are begging the governor to please for the sake of the community and resident doctors who are also sacrificing their time and lives to follow the oath they’ve taken, to make life easy for them and to make the community have access to adequate health care,” he said.

Doctors’ exodus

Dr Adetokunbo Stephen, the general secretary of ARD in LAUTECH teaching hospital, stressed that low pay in the facility compared to other federal and state institutions has made it difficult to attract and retain qualified staff.

This, he added, has led to a decrease in the number of resident doctors, with many leaving for better-paying opportunities at other hospitals.

“People no longer want to come because everybody wants a good place. So, it is difficult to attract and tame residents in most departments of the hospital. Even those that have been here for over two years had to leave. The funniest part is that institutions around us have been calling our members. There is a lot of pressure and tension,” he said. “Due to the financial constraint, the number of its members has reduced and other centres are still pulling out the ones on ground.”

Speaking on steps taken by the association with the management to resolve the matter, Dr Stephen said, “We had made several moves in-house, several agitations, several discussions with management and we’ve escalated the issues to the government through several channels.

“There are a lot of challenges across the board. The fact that we don’t have the full complement of equipment and staff across the board affects the productivity and how well we manage patients.”

He exclusively told this reporter that two registrars had left the hospital. While one left in February 2024 for the University Teaching Hospital, Ilorin, the other left late last year; amongst others.

He appealed to the Oyo State government, particularly the governor, Seyi Makinde, who has in the past been favourable to the institution, to do more to attract people to the hospital.

“It wouldn’t be good for people to leave our centre to other centres,” he said.

80 tasked with work of 238 individuals

Dr Olaniyan while expressing his concern on the number of resident doctors and house officers in the facility disclosed there were about 70 resident doctors as against 270 that it used to be and the house officers are about 10 against 48, they used to be.

“The staff is reducing and it is not but the fact that aside from the national japa that most doctors are leaving the country, people are leaving our centres to other centres that they are being paid more than LAUTECH teaching hospital,” he said.

He added that due to the economic meltdown, the national body medical professionals belong to—Nigeria Medical Association–had decided to increase all our salaries by 25 to 35 per cent.

The federal government is said to have started the implementation and arrears payment.

Confirming the MRTF and 35 per cent salary increment has begun in other states, he said, “Yes, some other states are paying. Even in this state (Oyo), other health workers are enjoying it but none of it has been paid in LAUTECH teaching hospital.”

SOS to Makinde

The ARD president appealed to Makinde to implement the increase and payment to health workers.

“It will go a long way by attracting more health workers to come to the facility to work rather than the situation we are presently in,” he appealed.

He lauded the governor for his efforts in the resuscitation of the facility and payment of monies owed by the previous administration.

“We were here receiving a half salary for 22 months but when Seyi Makinde came, he paid up all our money to date and he did so many other things,” he added.

He called the attention of the state governor to the suffering staff of the LAUTECH teaching hospital and appealed to Makinde to save the lives of the workers in the facility.

“Please help us and save our lives. We have families and children. We have parents who have laboured on us that we need to take care of and patients we need to take care of too so that our minds can be in what we are doing because if we are not mentally right, we cannot treat them,” he said.

Dr Olaniyan, while shielding an insight on the N5,000 hazard allowance said such has been the amount in the last 10 years.

“Since I started work and my bosses have been here, it has always been N5,000. I have been in LAUTECH teaching hospital for the past 10 years.”

He added that there was a time it was buffered to N10,000 but it was reversed back to N5,000.

“During Covid-19, we were paid an extra N5,000 for the Covid-19 allowance. After COVID, it was removed back to N5,000,” he clarified.

‘I’m depressed’

Expressing his concern about the situation of LAUTECH teaching hospital, the ARD president disclosed has not been able to embark on some personal goals which saddens him.

“Mentally, I’m not happy. I’m depressed. There are personal achievements somebody is supposed to embark on because things are now expensive, you cannot embark on them. It’s depressing that you are doing so much and seeing very little to bank on,” he explained.

He further appealed to Makinde to look into LAUTECH teaching hospital matters and help restore every benefit that they are supposed to have.

“And we promised him, as we’ve always not let him down, we wouldn’t let him down. We believe in his mandate and he has been fulfilling it. He has done it before, we know he can do it again,” Dr. Olaniyan said.

Commissioner, perm sec, hospital mum

All efforts to speak with Oluwaserimi Ajetunmobi, the state commissioner of health approved abortive as she did not pick up his calls or reply to messages sent to her line.

Also, Akintunde Ayinde, the state Ministry of Health permanent secretary, while replying to a text disclosed he was in a meeting in the state and would call back. However, he did not get back as of the time of publishing this report.

Meanwhile, Omotayo Ogunleye, the Public Relations Officer of LAUTECH teaching hospital advised our correspondent to meet with the management before it can express any reaction on the issue.

“If you need any reaction, I will advise you to come over to meet with the management. You will get all the information you need. Come over to the teaching hospital, you will get every information you need,” he said.

Editor’s note: Some names in this report have been changed due to interviewees’ fear of intimidation.