Hundreds of medical doctors and other healthcare givers in public and private hospitals across Nigeria are literally dodging from having face-to-face interaction with patients because they don’t have Personal Protective Equipment (PPE) that will shield them from contracting the ravaging COVID-19. PPE comprised of face shields, gloves, goggles and glasses, gowns, head covers, masks, respirators (in some cases) and shoe covers.
Some doctors, nurses, lab technicians among others have moved to COVID-19 isolation centres after they tested positive, or locked themselves at home waiting for their results.
The development has created a wallowing gap in health care delivery, with some experts attributing the increased number of deaths not only to coronavirus but to other ailments that deserve constant attention.
The Nigeria Health Work Force Country Profile 2018, launched in February this year, revealed that the number of medical doctors registered with the Medical and Dental Council of Nigeria (MDCN) stands at 74,543, meaning there is only one doctor to 2,753 patients in the country.
The coronavirus caught many countries unawares, including Nigeria where federal and state government hospitals lack enough equipment to address large scale emergencies. Although there has been some progress at all levels in upgrading facilities to deal with COVID-19 and other diseases through special intervention by the federal government, support from local and international donors, Daily Trust reports that PPE remains grossly inadequate, subjecting health workers to infections while many patients lost their lives for lack of care.
While most teaching hospitals and Federal Medical Centres (FMCs) have been overwhelmed by patients suffering from various ailments amidst lockdown to contain the spread of COVID-19, medical personnel are battling to cope with the challenge and many contracted the deadly disease in the process.
There are 22 FMCs in the country and when approached to comment on equipping their staff to be in the right frame of mind to attend to patients, most of the officials said they provided enough PPE to their doctors, nurses and other workers. Spokesmen for teaching hospitals and FMCs in Ebonyi, Bayelsa, Lagos and others spoke in the same tone, saying they have enough PPE for their workers.
This is however in contrast to what the health workers in the states said. According to them, there was a need for a new approach to protecting them. One of the health workers at one of the hospital in Lagos, who pleaded anonymity, told our correspondent that they only get new N95 from the management when the old face mask is torn or damaged. She said some used theirs for weeks, adding, “no matter the quality of the mask, it is obvious it will be contaminated.”
“But the management said there is nothing wrong in using the mask again and again,” she lamented. Hospitals attending to emergencies only Findings reveal that many public hospitals only attend to “extremely emergency cases” while private clinics in some states have closed their doors for all categories of patients, all in an effort to protect their staff from contracting the coronavirus. Dr. Ali, a medical doctor who consults in public and private hospitals in Abuja and some states said this is the most trying moments for them.
“We all love our patients and we are passionate about treating them but not at the detriment of our welfare, our safety, and the security of our families,” he said. “We can only work when we are secured and honestly we are getting overwhelmed. “We took the decision of reducing the number of patients we attend to, and in some instances not attending to them at all because the PPE that we supposed to use all the time, which are mostly disposable, are not going round the way they should.
“Sometimes, very few health givers have access to the PPE and considering the rate at which community transmission is increasing, every patient is a potential carrier and you will not just go and attend to him without protection. “Of course, the federal government has done a lot in providing the PPE but they are not enough. Every hospital should have them irrespective of whether that facility has been designated to attend to COVID-19 patients or not.
So, yes, it is true that our colleagues are being circumspect; I don’t want to say they are avoiding patients but every one of us would love to stay away until we have protection garments,” he said.
‘Our fear in Kano is valid’
A doctor at the Aminu Kano Teaching Hospital (AKTH), who preferred anonymity, confirmed to Daily Trust that he and many of his colleagues stopped going to work due to lack of protective gears.
He said many of his colleagues tested positive for COVID-19, while the results of others are still pending, lamenting that “the worst part of the whole issue is that one of our colleagues who was infected by the disease has transmitted it to her mother.” “We decided to desert our place of work because we have complained severally to the management of the hospital regarding the shortage of working facilities, but no response. “In the last two weeks, we have lost 41 patients and most of us had to go for test…
We have to step back since last week Wednesday. “It is not a strike, but we will not resume work until all our demands are met by the management of the hospital,” he said. Another doctor said, “Our lives are at risk; so also that of our families and the patients we are attending to. We thank God the management of the hospital has started responding to our calls because we have started witnessing changes. “However, we will still not resume until the results of our colleagues are ready so that we will decide who is to resume work and who is to be isolated.
“The management of the hospital should provide a hotel where doctors would be kept for 14 days upon completion of their 2-week duty. “Any doctor that worked for two weeks should be isolated for two weeks before he even go to his family. “This has been the practice in Abuja and it works perfectly. “If you work for two weeks, you will be isolated for two weeks before you go to your home and later report to your duty post again,” he said. Another doctor said, “We are not admitting patients again because many of our colleagues have tested positive for coronavirus.
“It is the same thing at Dala Hospital. Out of the 25 doctors that underwent the test, 15 tested positive. We are sitting on a time bomb, wallahi”. He said AKTH had introduced telemedicine in which the mobile phone numbers of HODs of Specialist Departments have been released to the public for consultation for non-emergency conditions. “But we still continue attending to emergency cases. The medicine side of Accident and Emergency was closed for fumigation, but surgery and other departments in A and E are working.
We carried out an operation on a patient recently,” he said. Daily Trust reports that the Kano State chapter of the Nigerian Medical Association (NMA) said on Tuesday, May 5, that 34 doctors had tested positive to the novel coronavirus in the state while one of the confirmed cases died. The NMA Chairman, Sanusi Bala, explained that many of the victims were the doctors working at AKTH and other private clinics in the state. He said many of them were infected through normal clinical routines while attending to unsuspected COVID-19 cases and therefore appealed to authorities to provide more protection for doctors through the procurement of PPE.
Another doctor said there was a need to establish strong synergy between the Kano State government and the management of AKTH. When contacted on the doctors’ allegation, the Assistant Director Communication of AKTH, Hajiya Hauwa Muhammed Abdullahi, said that the management had done a lot in ensuring that not only the doctors but everyone that mattered is being protected. She added that the hospital had provided adequate PPE to its staff for their safety adding that management had made it mandatory to see that best PPE are being provided.
“You can check for yourself, the PPE we provided to our doctors are of world standard and we make sure that we provide them with the required numbers,” she said.
Lifeline for FMC Abuja
Our investigations at the Federal Medical Centre, Jabi, Abuja, revealed that until recently, the hospital had suffered from the shortage of PPE, a development that affected the work of the staff. It was gathered that the First Lady, Hajiya Aisha Buhari recently made donations of PPE to the hospital. A nurse at the hospital who craved anonymity said that they got a lifeline when the Chief Medical Director secured a donation from Mrs. Buhari.
Before the donation, she said the PPE available were normal face masks and hand sanitisers produced by their pharmacy department. She said the pharmacy department started producing for the hospital’s use when the cost of purchase became so high as a result of the COVID-19 outbreak. “We also have the infrared thermometer for screening as people come into the hospital, but there was shortage of other PPE for use by staff. Another staff blamed federal government agencies for not providing PPE for hospitals. A staff of the administrative department said there was no time the hospital did not have PPE, but admitted that they did not have enough until recently.
We’ll always make case for our members – NMA
The President of the Nigerian Medical Association (NMA), Dr. Francis A. Faduyile, said the association had said repeatedly that most hospitals across the country do not have enough protective equipment for health workers, but the problem has not abated. He said even COVID-19 isolation and treatment centres were now suffering from shortage of PPE. Asked if he was aware that doctors were absconding from duties at public and private hospitals on account of lack of PPE, he said he was not aware.
When our reporter asked for his advice for health workers who do not have PPE to work with, he said: “My advice for them is that they should follow what the minister of health has said several times that “health workers should get themselves protected, meaning they must be protected for them to treat patients.” On whether they have their own tally of members infected by COVID-19, Faduyile said he does not have the exact number of health workers infected as at press time, saying many doctors and other health workers tested positive.
He said that the 113 health workers mentioned by the minister do not include six doctors who tested positive in Lagos, and the 30 health workers that tested positive in Kano some days after the minister’s speech. It would be recalled that the Minister of Health, Dr. Osagie Ehanire, had said that about 113 health workers in Nigeria have so far tested positive for COVID-19. “Latest figure we have is that there are about 113 people in the health sector infected with COVID-19.
Although they are not all public health workers, there are good numbers from private hospitals,” he said. The Medical and Health Workers Union of Nigeria (MHWUN) said over 100 of their members in the country have been infected with COVID-19. The union in a statement signed by the National President and Secretary-General, of the union, Biobelemoye Josiah and Silas G. Adamu, called on the federal and state governments to provide large quantities of PPE and other consumables to health workers at all levels to enable them do their work professionally.
“This is important because the health worker is not on a “kamikaze” mission, hence must be alive and healthy before he/she can save other lives,” they said. They also advised their members to observe all known protocols to ensure that they stay safe. They should see every patient as a suspected COVID-19 carrier but be polite when dealing with such patients unless proved otherwise.