Nigerians have continued to lament their rejection by hospitals and clinics for fear of admitting coronavirus (Covid-19) patients, inadvertently.
Some of the affected people that spoke with our correspondents said that in some of the clinics they visited, although the doctors were willing to receive them as there was low patronage and the clinics needed money, they were still held back by the fear that they could be at risk.
“I was at a clinic for Typhoid treatment, but the doctor pointedly told me to check other places. He complained that there were no nurses around to take care of me. I knew that was just an alibi to send me out,” a young man in his 30’s said, craving anonymity.
Godwin (not real name) told BDSUNDAY: “My uncle’s wife was sick and went for her routine check. But she was not attended to when she got to the hospital. The hospitals are treating everyone like Covid-19 patient.”
“The only people they attend to now are pregnant women. I’ve taken an elderly person to a hospital in Alimosho LGA, and after two days, they discharged him, they said they could not keep patients for more than two days,” Godwin further recounts.
A young man simply identified as Joel was said to have died recently after he was allegedly refused treatment at a government health facility in Lagos for the fear that he could be a Covid-19 patient.
The nurses on duty allegedly said they were not attending to him because “their hands were full”.
The young man, Joel, was said to have slumped while playing football with his friends and was rushed to the hospital. His relations complained that had Joel been attended to when they got to the hospital, he would not have died. But the chief medical director of the health facility insisted that the young man was brought-in-dead (BID).
But private clinic owners said lack of personal protective equipment (PPE) is the reason for turning back patients for fear of contracting the virus while administering care, especially in instances where the ailment is uncertain.
“No one is giving us palliatives like personal protective equipment (PPEs) to be bold to even attend to those who brave it and come. No testing kits. So, we are exposed and patients are turned back when you are not sure of what they are suffering from. Asthmatic patients are dying because nobody wants to get close and administer nebulisers since it presents like Covid-19 respiratory symptoms,” a medical practitioner said.
Jide Ofor Akunne, an Optometrist at Ocuville Eye Clinic confirmed that a few patients were turned back by the security after their temperatures were screened and confirmed to be abnormal.
“Yes,” Akunne replied, “but not here directly, but from the gate,” he quickly added.
He further said: “We’re taking precaution from the gate also. So, the security downstairs checks your temperature when the pandemic was really high. So, they checked the temperature of one or two people that it was really high, so they were sent back. They were not happy, but they were just following instructions.
“They were asked to go to the hospital and come back after confirming it was not coronavirus. We’ve sent someone back just ones.”
Generally, it is business unusual within the walls of some private hospitals. This is despite economic activities gradually returning to normalcy, following the announcement of a gradual easing of restrictions put in place to reduce the spread of the virus.
Private hospitals in Lagos are yet to fully bounce back from the impact of the outbreak as poor patient inflow still persists.
Undoubtedly, the unexpected outbreak of the pandemic took the economy aback, reducing cash inflows of companies and leading to job losses. Sources in some private hospitals and clinics recount bitter impact of COVID-19 on their businesses, stating that patients are also afraid of visiting hospitals and clinics over fears of contracting the virus.
There has been a reduction in “outpatients and inpatients due to fear of Covid-19. Even some antenatal visits and delivery also minimally dropped,” a source at Inland Specialist Hospital said.
Speaking anonymously, the source explained that outpatients are people that visit the hospital; probably run tests, see doctors, collect drugs, and leave; while inpatients are those with severe cases that need admission in the hospital.
Asked what the policy for engaging patients, especially expatriates, was, she said: “The policy or rule is that you clerk the patient with a structured yes or no answer. This will give you a history to arrive at a diagnosis of whether to treat or refer to NCDC.
Earlier, prior to speaking with the source, another source (a male) at the hospital, had confirmed that some patients were turned back. “Yes,” he said, “especially all those “Egypt people,” he adds, referring to expatriates.
Visiting Nimbus Medical Centre in Ogudu, BDSUNDAY found that the hospital is not in operation currently. The premises were empty, except for the security personnel and three other non-medical staff (two women and a man) found at the waiting room at the time of visit.
“We’re not the doctors, nurses, nor management. The hospital has been shut down for a while,” one of the women said when the reporter asked to see the management.
It was later found, in a memo dated 12/03/2020 pasted by the entrance, that the hospital has been non-operational since 30 April “for comprehensive overhaul and repairs.”
In another memo, the management said it made arrangements with another hospital in Ogudu to accommodate its patients.
“Sequel to our letter dated 12th March 2020, on the above; we have made arrangements with Med-In-Specialist Hospital…to accommodate our patients. They have promised to provide adequate care to the patients that would be so transferred,” the memo reads.
While no physical repairs or renovations were seen at the time of visit, the reporter called one of the numbers provided in the memo and the responder confirmed that the hospital is undergoing renovations and currently not in operation.
Though no COVID-19-related reason was given for the shutdown of Nimbus, at Peach Care Medical Centre, the pandemic is taking a toll on their patient load which has dwindled over time and increased the hospital’s expenditure.
“Patients are afraid of coming to the hospital,” said Onayemi Oluwadare, manager, Peach Care Medical Centre. “It (the virus) has increased our expenses due to safety precautions. We purchase hand sanitizers and facemasks at higher rates and we don’t see patients that much.”
Oluwadare said, however, that their services have not depreciated and that they have not relaxed in their efforts to make the environment safe for patients, adding that additional staff has been employed to help with disinfecting the hospital’s environment.
Apart from increasing hygiene, general cleaning and cleaning after every patient, Jide Ofor Akunne told BDSUNDAY that most people are usually scared of coming to the clinic and it affected their inflow of patients.
“We had a reduction in patients because of the fear of coming to the clinic. Income went down, but we had patients we already had a personal relationship with and follow up on regular basis and we try to convince them that we’re up to par in terms of cleanliness and that they have nothing to fear,” he said.
On a normal day at Ocuville Eye Clinic, they have a patient load of about 10 on an average from the time of resumption and closure which is from 8: 30 a.m. to 5 p.m. But during the lockdown, work hours were reduced to three hours from 10 a.m. to 12 p.m.
Akunne said sometimes they do not see any patient. Sometimes, they only get one, and at other times, two.
He further explained that most of the patients that visited were those who come for routine checks. “The people we see are the people on routine who come to check their pressure for glaucoma. They have a calendar. If you don’t come, their pressure might be affected. So, they usually come. But for new patients, coming up for new problems, we hardly got that,” he said.
Both doctors agree that private hospitals need government intervention this period especially in the area of “instruments” that will assist in keeping their staff safe and environment safe for patients as well, because, according to the Optometrist, most of the transmission happens in labs, and hospitals because that is where people who are sick go to.
“The health sector pays taxes and remits our adequate revenue. I believe they can also come in to assist because taxes are meant for basic amenities for the citizens. The government can come in to provide PPE. Though we get our own PPE from the company’s personal funds, if the government comes in to support, it would be a great idea,” said Oluwadare, of Peach Care Medical Centre.
A case for partnership and what is involved
With the increasing number of cases continuing to rattle government at all levels, and thus, exuding a feeling of ineffective and insufficient response among Nigerians, a hand-in-glove work against the virus should not hurt anyone.
Lagos State is already which has the highest number of recorded cases is making the first by accrediting three private hospitals COVID-19 cases in the state.
Sharing insights on such partnerships, Felix Abraham Obi, senior program officer/health financing engagement officer at Results for Development said it’s imperative for government and private sector to collaborate in dealing with the surge, given that bed spaces in the isolation centres in Lagos and other states are getting filled up due to the rising numbers that outweigh the discharged cases of Covid19.
However, Obi stated that there are strict protocols and biosafety measures that must be observed in all Covid19 isolation and treatment centres.
“In addition to meeting these standards, setting up treatment centres require investments in addressing gaps and upgrading existing facilities and procurement of requisite equipment needed and we can’t assume that most private hospitals will readily meet these standards,” he said.
Further in his submissions, in addition to having the right facilities and equipment that meet the minimum standards, the private health facilities need to have the right number and mix of qualified personnel to treat and care for Covid19 patients.
These staff, Obi suggests, need to be trained on the case definition, treatment protocols, infection prevention and control measures among others by the respective State Ministries of Health in collaboration with NCDC. These trainings require resources and time to be planned and implemented before the private facilities can be assessed for accreditation.
With Lagos State making the first move, he expects that the Federal Ministry of Health (FMoH) and the Nigerian Centre for Disease Control (NCDC) and the States’ ministries of health must be thinking about, and possibly working on accrediting more private facilities to manage some cases.
But the private facilities must first, express some interest and willingness to participate considering the trade-off—a chance that their regular patients might avoid those fatalities due to risks and fear over their safety, which is inevitable.
“Covid19 era has shown how government and private sector can seamlessly collaborate to achieve common goals and I know there are existing frameworks and policies by the FMOH to incentivise investments in the health sector and foster stronger public-private partnerships in health. Moreover, there are examples of PPPs in healthcare that have worked even before CACOVID.
“There’s Health Care Federation of Nigeria (HFN) and Private Sector Health Alliance of Nigeria which have been at the fore of advancing PPPs with the public sector in Nigeria. These platforms can help leverage the resources of the private sector for health to increase the number of treatment centres and build additional capacity for treating Covid19 patients in collaboration with health authorities at federal and state level,” Obi said.
