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Assault: The Albatross of LASUTH Healthcare Workers

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LASUTH Healthcare Workers

By Olutayo Irantiola

The spate of physical violence in our society has increased tremendously, daily; the media is inundated with the news of all forms of assaults. It seems as if people have not taken lessons from all this reportage as it keeps rising astronomically. Unfortunately, this ugly trend has not spared healthcare workers and this is a dangerous position that must be discouraged.

The World Health Organization (WHO) defines workplace violence as, “Incidents where staff are abused, threatened, or assaulted in circumstances related to their work, including commuting to and from work, involving an explicit or implicit challenge to their safety, well-being, or health.”

WHO considers both physical and psychological harm, including attacks, verbal abuse, bullying, and both sexual and racial harassment, to be workplace violence.

In a study conducted by the New England Journal of Medicine, there are 4 types of violence that can occur in the workplace. The first type is by perpetrators who have no association with the workplace or employee.

In the second type, the assailant is a customer or a patient of the workplace or employee. The second type of violence, usually committed by the patient, their families, or their friends, is most prevalent against healthcare workers.

A third type is when the attacker is a current or former employee of the workplace. The fourth type occurs when the perpetrator has a personal relationship with the employee but not with the workplace.

Also, in an article published by BMC Health Services Research titled Manifestations of verbal and physical violence towards doctors: a comparison between hospital and community doctors by Tamar Nevo et al, doctors often are a target for workplace violence.

About a quarter of emergency room doctors reported that they were the victims of physical abuse over the previous year. In a study conducted at Michigan University, 89% of the violent incidents were by patients, 9% by family members, and 2% by friends of the patient.

The primary reasons for violence directed at the medical staff are long waiting times, dissatisfaction with treatment, a hurtful comment by a staff member, or the influence of drugs and alcohol on the attacker.

According to the US Department of Labour, 12% of the injuries sustained by registered nurses are from violent acts. These injuries can be deadly.

Last year in Nigeria, the former National President of Nigerian Association of Resident Doctors (NARD), Dr Aliyu Sokomba, Secretary-General, Dr Bilqis Muhammed, and Publicity and Social Secretary, Dr Egbogu Stanley, the association condemned the recent attack on members who were performing their legitimate duties in Maitama District Hospital, Abuja and Nnamdi Azikiwe University Teaching Hospital, Nnewi.

The recent happening at the Lagos State University Teaching Hospital (LASUTH) wherein the relative of a patient, who was presented with a gunshot injury, assaulted the staff has brought the discourse to the fore again.

In the process of trying to resuscitate the patient, the relative attacked 3 nurses and a doctor in the line of work. In fact, one of the nurses had a deep cut on the head, while one was almost stripped naked. However, the security personnel of the hospital later got him apprehended and arrested.

With the significant rise in the population of Lagos, both in numbers and in age, the waiting time to see a doctor gets longer in both the emergency room and the wards. These frequent acts of violence against employees can have on their morale over time.

“Emergency care is one of the specialties that do have a high burnout rate. How many other places do you go to work, and it’s commonplace and almost accepted that people are going to swear and scream at you? Eighty per cent of the emergency physicians say that patients threaten them or threaten to return to the emergency department to harm them. The cumulative effect of both kinds of violence does wear and it creates burnout. I think it’s contributing to nurses leaving the profession.”

Although the hospital has put up “zero tolerance” signs, patients and their relatives do not adhere to this instruction. With the various ways of escalating the pain of patients and their relatives to the hospital management, people still find it easier to be violent rather than engage with the management team. Every day across the country, people are verbally and physically abusing staff.

The apprehended relative of the patient has been taken to court and the law would take its due course. All hands are on deck waiting for the verdict. It is wise to state that everyone needs to be calm even in the face of utmost provocation and seek other methods of dispute resolution rather than resorting to violence.

According to the Chief Medical Director of the hospital, Professor Adetokunbo Fabamwo, with the level of innovative solutions that LASUTH is bringing to Lagosians through its dedicated healthcare workers, it can only be done in an atmosphere free of chaos and agitation.

Violence against healthcare workers is unacceptable. It harms the psychological and physical well-being of the staff but also affects their job motivation.

“The management of the hospital, under any circumstances, would not tolerate any assault against her staff going forward. The hospital provides for checks and balances within the hospital which is available to treat situations if they occur, and the hospital on several occasions appealed to aggrieved members of the public to seek redress through various channels.

“The hospital is committed to providing quality healthcare services to our patients and their relatives and we urge everyone to cooperate with our staff to facilitate their care,” he added.

As a responsible workplace, LASUTH has continued to investigate workplace violence incidents, risks, or hazards; provide training and education to employees who may be exposed to workplace violence hazards and risks; meet record-keeping requirements; and prohibit acts of discrimination or retaliation against employees for reporting workplace violence incidents, threats, or concerns.

It has become expedient, therefore, for policymakers, hospital managers, and supervisors should work collaboratively to minimize workplace violence and ensure the safety and psychophysical stability of all healthcare workers in Lagos and the nation at large.

Olutayo Irantiola is an astute PR Consultant and Public Affairs Analyst. He can be reached via peodavies@hotmail.com and he blogs on www.peodavies.com

Health

Oloriegbe Urges Governors to Establish Health Insurance Agencies

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health insurance agencies

By Adedapo Adesanya

Senator Ibrahim Oloriegbe has called on state governments to, as a matter of urgency, establish health insurance agencies to enable residents of their respective states to benefit from the new law.

He made the call at a media briefing in Abuja as part of calls to drive the spread of the National Health Insurance Authority (NHIA) Act recently signed into law by President Muhammadu Buhari.

“The signing of the health insurance Act makes it mandatory for all Nigerians to benefit from health insurance. It is now left for states to establish state health insurance schemes for their citizens to benefit from the service,” he said.

Mr Oloriegbe, who is the Chairman of the Senate Committee on Health, said that apart from reducing to the barest minimum avoidable high rate of morbidity and mortality in the country, the law will also halt out-of-pocket health expenditure by Nigerians and its attendant consequences.

He said that the new regulation will enable Nigerians to have access to qualitative and affordable health care as health insurance has become mandatory in Nigeria.

Enumerating the benefits of the new Act, the lawmaker said that it will help Nigeria in attaining Universal Health Coverage (UHC).

“So, the motivation is your best able to ensure that Nigeria attains Universal Health Coverage. But why do we have to do that? The financing of the health sector now is from two main sources, the public and private sectors. By private, we mean individuals.

“Then, it was about 65 per cent of out-of-pocket but now it is about 70.5 per cent based on the last National Health accounts studies.

“What it means is that out of every N100 that is spent on health, N70 is from individual pockets and that is not possible, not sustainable and not feasible in the long term. The resultant of that is that people die from curable and treatable illnesses because of lack of money,” the federal lawmaker said.

Mr Oloriegbe, who sponsored the bill and followed it through until it became a law, applauded the World Health Organisation (WHO) for being instrumental in its passage.

“Because we have the structure in place, the World Health Organisation (WHO) provided support for us to have leadership,” he stressed.

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Health

Health Insurance for all Nigerians by 2030 Now Realistic—NHIA

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health insurance for all Nigerians

By Adedapo Adesanya

The National Health Insurance Authority (NHIA) has commended President Muhammadu Buhari for signing into law the NHIA Act, saying health insurance for all Nigerians by 2030 is now more realisable.

The NHIS Deputy General Manager, Mr Emmanuel Ononokpono, in a statement said, “For over two decades, industry professionals had sustained the call for an amendment to the health insurance law, being a major impediment to the attainment of Universal Health Coverage (UHC).

“By this development, efforts to tackle the high incidence of poverty caused by out-of-pocket expenses for health care, through health insurance for all categories of Nigerians by 2030, is now more realisable than ever before.”

Mr Ononokpono also said that the management was also grateful to the Senate and the House of Representatives for their roles in the lead up to the enactment of the law.

He acknowledged the roles played by different stakeholders in the course of the legislative work on the law.

According to him, the Act establishes and empowers the NHIA to ensure the provision of health insurance for all Nigerians through a mandatory mechanism, in collaboration with state health insurance agencies.

He said that sections 25 and 26 of the Act established the Vulnerable Group Fund (VGF), indicating the various sources from which funding would be drawn.

Mr Ononokpono said that the legislation strengthened the NHIA to discharge a wide range of regulatory and promotion functions, to ultimately ensure that every Nigerian received access to quality and affordable health care.

He said that the legislation Mr Buhari assented to did not make provision for a telecommunications tax as a source of funding in the law, contrary to reports in some national media.

Mr Ononokpono also urged stakeholders and industry players, including the media to wait for a formal unveiling of the document.

President Buhari signed the National Health Insurance Authority Bill 2021 last week.

The newly signed law by the President repeals the National Health Insurance Scheme Act 2004.

Under the previous Act, states were required to pay a 50 per cent counterpart fund to access the total fund for the Basic Healthcare Provision Fund (BHCPF).

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Health

Explainer: What is Monkeypox Virus?

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Monkeypox virus

By Adedapo Adesanya

In a world where the coronavirus is still around, attention may shift to the Monkeypox virus – which has been found in Australia, the United States, and some top countries in Europe.

What is the Monkeypox Virus?

According to a World Health Organisation (WHO) research, the Monkeypox virus is a virus that is transmitted to humans from animals. The first case was discovered back in a small child back in 1970 in the Democratic Republic of the Congo.

It is a rare disease caused by the monkeypox virus, part of the same family as smallpox, though typically less severe. The incubation period of the newly spreading Monkeypox virus ranges from 6 to 13 days. However, it might be from 5 to 21 days.

Symptoms

Symptoms such as fever, intense headache, lymphadenopathy, back pain, myalgia (muscle aches), and an intense asthenia (lack of energy) usually appear in the patients who test positive for the Monkeypox virus. On the other hand, skin eruption usually starts within 1-3 days of the appearance of fever. The rash appears mostly on the face and extremities rather than on the chest.

History in Nigeria

There have since been sporadic cases reported across 10 African countries, including Nigeria, which in 2017 experienced the largest documented outbreak, with 172 suspected and 61 confirmed cases. In terms of age, 75 per cent of those affected were males aged 21 to 40 years old.

Cases outside of Africa have historically been less common and typically linked to international travel or imported animals.

How Can One Catch Monkeypox?

Monkeypox spreads when someone comes into close contact with another person, animal or material infected with the virus. The virus can enter the body through broken skin, the respiratory tract or through the eyes, nose and mouth. Human to human transmission most commonly occurs through respiratory droplets, though usually requires prolonged face-to-face contact.

Animal to human transmission meanwhile may occur via a bite or scratch but the disease is not generally considered a sexually transmitted disease, though it can be passed on during sex.

Available Treatment

There are currently no proven, safe treatments for monkeypox, though most cases are mild. In the past, researchers said that vaccination against smallpox with the vaccinia vaccine was proved through several observational studies to be about 85 per cent effective in preventing the Monkeypox virus.

A newer vaccinia-based vaccine was approved for the prevention of smallpox and monkeypox in 2019 and is also not yet widely available in the public sector. Countries including the United Kingdom and Spain are now offering the vaccine to those who have been exposed to infections to help reduce symptoms and limit the spread.

Can it Kill?

Monkeypox cases can occasionally be more severe, with some deaths having been reported in West Africa. However, health authorities stress that we are not on the brink of a serious outbreak and the risks to the general public remain very low.

What are Health Regulators Saying?

WHO says it continues to closely monitor as the situation is evolving rapidly. It is supporting member states with surveillance, preparedness, and outbreak response activities for monkeypox in affected countries.

Health authorities in the United Kingdom, the United States, and Canada urged people who experience new rashes or are concerned about monkeypox to contact their healthcare provider.

WHO also clarified that does it not recommend any restrictions for travel based on available information at this time.

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