Vital equipment shortage hits public teaching hospitals
Published April 23, 2019
Dayo Ojerinde, Chima Azubuike, Bola Bamigbola, Ademola Babalola, Adeniyi Olugbemi and Ogbonna Casmir
Patients with serious ailments in the country are facing hard times as many of the country’s teaching hospitals have been hit by acute shortage of vital medical equipment to treat them.
Investigations by our correspondents reveal that public hospitals are battling with obsolete equipment in some hospitals while some medical facilities have none.
Consequently, patients with cancer and terminal ailments are being subjected to needless wait before treatment could get to them.
In fact, the Nigerian Medical Association said the dearth of vital equipment would not only worsen health care delivery in the country, it would also promote medical tourism.
Investigations by The PUNCH showed that the teaching hospitals, which normally should boast state-of-the-art medical machines, lacked equipment which had become basic in other parts of the world.
It was learnt that while only four teaching hospitals had functioning radiotherapy machines, there were dearth of equipment such as catheterisation laboratory, C-arm, dialysis machines, mechanical ventilators, intra-operative imaging and CT scanners in the tertiary health institutions.
Only four cancer treatment centres functional in Nigeria – NMA president
Confirming the dearth of vital equipment, the President of the NMA, Dr Francis Faduyile, in an interview with one of our correspondents, said Nigeria’s public hospitals had just eight radiotherapy centres, where cancer treatment could be done, but only four of them were functioning as of Monday (yesterday).
He stated, “We have eight teaching hospitals in Nigeria with radiotherapy centres – Lagos University Teaching Hospital, Idi-Araba; University College Hospital, Ibadan; National Hospital Abuja, Ahmadu Bello University Teaching Hospital, Zaria; University of Nigeria Teaching Hospital, Enugu; University of Benin Teaching Hospital, Benin; Usman Danfodiyo Teaching Hospital, Sokoto; and the Federal Teaching Hospital, Gombe – but about four of them are not in a functional state currently.
“The cancer treatment centre in the University College Hospital, Ibadan; Federal Teaching Hospital, Gombe; the University of Benin Teaching Hospital, Benin and that of the Lagos University Teaching Hospital, Idi-Araba, are not functioning at the moment,” Faduyile said.
The PUNCH had on April 3 reported that the LUTH Chief Medical Director, Prof Chris Bode, said the Nigeria Sovereign Investment Authority/ LUTH cancer centre that was inaugurated by President Muhammadu Buhari, on February 9, 2019, would open for patients on May 1, 2019.
Asked to comment on the consequence of dearth of radiotherapy machines on patients, the NMA president said, “It is obvious that anybody who has cancer in Nigeria currently is doomed to die because some of them have to go to Ghana, some of them have to go to India, but those who cannot afford to travel abroad will have a long wait and by the time it is their turn it must have gone beyond redemption, most of them die miserable deaths.”
Faduyile said radiotherapy service shortage had increased morbidity and mortality and hiked medical tourism.
He also said the country had 143 kidney dialysis centres in both public and private hospitals, adding that there were 53 centres in both teaching hospitals and federal medical centres.
Kogi public, private hospitals have no CT scanner – NMA
The NMA President said, “Most public facilities have obsolete equipment. Many of them have none at all and this leads to frustration and lack of workplace satisfaction. In Kogi State with about four million population, for instance, there is no CT (computerised tomography) scanning machine in both public and private hospitals, patient travels three hours to Abuja to have this investigation done. Non-lucky critically patients may die on transit before investigation or treatment.”
Our MRI has broken down, says OAUTH CMD
Also, the Chief Medical Director of the OAUTH, Ile Ife, Prof Victor Adetiloye, in an interview with The PUNCH, said the hospital lacked even medical equipment that could be considered basic.
Adetiloye said the OAUTH’s magnetic resonance imaging machine had broken down. According to him, no teaching hospital in Nigeria has positron emission tomography–computed tomography (PET/CT), which is also essential in the treatment of cancer.
According to medicalnewstoday.com, “MRI uses strong magnetic field and radio waves to create detailed images of the organs and tissues within the body.”
Adetiloye said, “I am from the radiology department. Medicine has gone to the level that what few years ago were considered as big machines are becoming basic machines. Citing the radiology department as an example, the CT is considered as basic equipment, but how many hospitals have it?
“The MRI cannot be said to be basic equipment, but for quality teaching hospitals, it is becoming like basic equipment now. There are certain investigations that only the MRI can give you perfect results. We have the MRI but it has broken down. There is a lot of equipment that we need that we don’t have. It is not peculiar to us.
“For instance, there is a machine, PET/CT. No teaching hospital in Nigeria has it. I am not sure we even have one in West Africa. Egypt has 10 of the machines. South Africa too, but I don’t know the number they have. The machine is used to check cancer patients after treating them to know if there are still residue hiding somewhere in the body.”
UNTH needs MRI, SC scanners, dialysis machine – CMD
At the UNTH, the Chief Medical Director, Dr Christopher Amah, said for the hospital to compete globally it would need the MRI and CT scanners, microscope, dialysis machine and a catheterisation laboratory.
On his part, the Enugu State Chairman of the NMA, Dr Ike Okwesili, told The PUNCH that the lack of adequate equipment was the cause of job dissatisfaction among clinicians.
Okwesili, who is a consultant physician at the orthopaedic pediatric department of the hospital, said the UNTH required an image intensifier to be able to carry out general orthopaedic practices.
“The hospital requires an MRI, catheterisation laboratory, C-arm and dialysis machines,” he added.
Although he said UNTH had functional theatres, which he said were equipped by VAMED years back under former President Olusegun Obasanjo’s government, the theatres needed to be upgraded.
“The theatre needs C-arm (image intensifier), operating microscopes and instrumentation sets for various surgical procedures,” he added.
Wikipedia.org defines a catheterisation laboratory as “an examination room in a hospital or clinic with diagnostic imaging equipment used to visualise the arteries of the heart and the chambers of the heart and treat any stenosis or abnormality found.”
Also, Medical-dictionary says C-arm “is used primarily for fluoroscopic imaging during surgical, orthopaedic, critical care, and emergency care procedures.”
We need more anesthetic machines, dialysis machines – FTH Gombe
The story remains the same in Gombe where the Secretary of Resident Doctors Association the Federal Teaching Hospital, Gombe, Dr Emmanuel Richard, in an interview with The PUNCH, listed basic equipment the hospital lacked as a stabilisation centre for severely malnourished patients and paediatric mechanical ventilator.”
But the CMD of the hospital, Dr Yahaya Alkali, said, “We don’t lack basic equipment because basic equipment includes a kidney dish and stethoscopes. What we lack is advanced equipment.”
Alkali, however, admitted that to compete with other hospitals in the world, FTH Gombe “needs monitors on every bed in the wards, incubators, ventilators, more anaesthetic machines, dialysis machines, CT scanner and a resuscitaire.”
A resuscitaire is defined by an online platform, jnciltd.com/products/drager, as a device needed “during labour and delivery procedures. It combines an effective warming therapy platform along with the components you need for clinical emergency and resuscitation.”
‘Dialysis centre not functioning’
Also, a kidney patient in the hospital, Mr Mohammed Sadiq, in an interview with one of our correspondents, lamented that the hospital’s dialysis centre was not functioning.
He said, “The government should come to the aid of those of us suffering from kidney related cases. We need a functional dialysis centre in the Gombe Federal Teaching Hospital.”
UCH has become a shadow of its former self – MDCN chair
In the same vein, the Chairman of Medical and Dental Council of Nigeria in the UCH, Dr Dare Olulana, in an interview with The PUNCH, lamented that the hospital, which was founded in 1957 and was rated the fourth best in the Commonwealth within its first 25years of its establishment, had become a shadow of its former self.
“After the glory of the 1960s and 1970s, the ugly reality now is that the UCH has been challenged in direction, perception and reception, using the words of one of the elders in the medical profession,” he stated.
Olulana added, “The several decades old physical structures (of the UCH) have become too ancient for the often scarce maintenance.”
He recalled that there were attempts by the Federal Government “to replace the obsolete equipment in the 2000s with VAMED projects but several (of the machines) have broken down because of the workload on the equipment. Having one phototherapy machine for example is as good as not having any.”
He, however, said the hospital had at least 16 theatre suites in various departments including the labour ward, the accident and emergency, ophthalmology and the main multi-purpose theatre suites.
Olulana added that UCH had a cardiac operation unit/catheterisation laboratory.
“But the machines and their functionalities, which are the most essential, are less than adequate. For example, C-arm for intra-operative imaging has been out of function for years. Again, one piece of equipment to serve many is as good as not having any. Others like mechanical ventilators to help babies that are less than 5kg to breathe are not available,” he lamented.
According to him, the hospital needs some higher technology anaesthetic machines with better modern respiratory delivery.
“Though what is on the ground can cope with many of the cases that are treated daily, these higher level machines are necessary in certain situations, after all, the expertise are available,” he stated.
According to Olulana, to compete with other teaching hospitals in the world, the UCH, among others, needs “ adequately equipped and seamlessly running intensive care units”
UDUTH Sokoto’s medical equipment epileptic, says CMD
The story was the same at the UDUTH in Sokoto where the hospital’s CMD, Dr Anas Sabir, said the health facility was facing the problem of obsolete equipment.
Anas said, “While some (of the machines) are not operating optimally, quite a number of them are obsolete as well.
“Some of our equipment such as the CT scan machine, the MRI machine, which is very important for neurosurgery, cancer machines and dialysis machines are epileptic.
“It is not all our anesthetic machines in the theatre that are working. We still have machines that are there since inception and when they get faulty, we repair them.”
‘No oxygen plant, standard labs in LASUTH’
Also, at the Lagos State University Teaching Hospital, the ARD President, Dr Fatai Balogun, lamented the state of equipment in the hospital.
He stated, “We have heard stories that there was no oxygen in the wards. It is embarrassing that a teaching hospital like LASUTH doesn’t have oxygen in the wards. We used to have an oxygen plant but now we buy. LASUTH ought to have a central oxygen source such that every ward is connected and served but that is far from the case.
“Our laboratories are far from being standard, blood is recurrently not available. It is as if there are interested forces making things difficult there. Many times we have had to go out of the hospital to get blood for use.”
Attempts to speak with the CMD of LASUTH, Prof Adetokunbo Fabanwo, was futile as he said he was barely five months old as the CMD and as such would not be able to provide answers to questions one of our correspondents sent to him earlier through the public relations unit of the hospital.
However, the Chairman of the Medical Advisory Committee of LASUTH, Dr Olufemi Fasanmade, told The PUNCH that although the hospital had most equipment, the machines should be constantly replaced.
He stated, “We have an ultrasound machine, CT scan machine. We have ventilators. We have virtually all the equipment that a patient will require and that is why when treatment fails in other hospitals, the patients are sent to LASUTH.
“The problem is that where a surgeon is doing 12-hour surgery, if 10 people need that surgery there will be a delay. We do have most of these machines, what we need is for them to be constantly replaced and for the number to be increased.”
But the Chairman, Medical Guild, Lagos, Dr Babajide Saheed, in a telephone interview with one of our correspondents on Monday said LASUTH did not have radiotherapy equipment.
He said, “They have cancer clinic centre where they offer chemotherapy to patients but they do not have radiotherapy equipment. They also have oncologists who attend to cancer patients as well.”
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