Health
Hospitals are Established to Admit Sick Patients, Not Turn Them Away: The LASUTH Perspective
By Oluwaseyi Adewale
With good intent, every generation has reasons for taking certain humanitarian decisions for the betterment of the society. This can also be said of the evolution of the Cottage Hospital located in Ikeja, Lagos, which has metamorphosed into the Lagos State University Teaching Hospital (LASUTH).
The hospital began operations in 1955 as a cottage hospital founded by the Old Western Regional Government to provide healthcare services for the people of Ikeja and its suburbs. A cottage hospital is a small rural hospital with a few beds. This cottage hospital concept is a type of hospital mostly located in the United Kingdom. As the need for quality medicare increased in Ikeja and environs, the hospital was transformed and became known as the Ikeja General Hospital before the administration of Asiwaju Bola Ahmed Tinubu who then transformed it into a tertiary healthcare institution now known as LASUTH.
As is typical of a tertiary institution that aims to become a quaternary healthcare institution in the nearest future, its utmost priority should be in the areas of advanced medicare.
This is supposed to be the core of the healthcare services provided by the institution but there are a lot of distractions because uncomplicated cases that could be handled by the many Primary Health Centres and the 27 General hospitals located across the state are usually brought to LASUTH. As such, this impedes the core activities of the institution. Eighty per cent of cases brought to LASUTH as emergencies are not tertiary cases.
It is very important to add that the management of LASUTH is poised to provide optimal care to all patients that come into its facilities. The ever-recurring tales of no bed space within the hospital have become disconcerting. Currently, LASUTH has a 750-bed capacity and with the bourgeoning cases of emergencies in the state, only 36 beds are available for medical and surgical emergency cases. Unfortunately, the demand for emergency beds is much more than what is available.
Under the leadership of the Chief Medical Director (CMD) of the hospital, Prof. Adetokunbo O. Fabamwo, the hospital has a policy of not turning any emergency back but in the event no available bed space, first aid is administered to the patient before any form of referral to any other reputable tertiary institution. Prof. Fabamwo noted that the hospital is established to admit patients and not turn them back but when all the beds are occupied, it is not feasible. In addition, it is unethical and unprofessional for patients to be admitted and treated on the floor.
With the strides of the current administration of Mr Babajide Sanwo-Olu in the health sector, the Lagos State Government has assiduously improved and empowered the primary and secondary healthcare facilities. A lot of infrastructural upgrades are ongoing. In addition, massive recruitment of health personnel was recently embarked upon at the three levels of health care.
As Lagosians keep thronging to LASUTH, the hospital keeps expending both human and material resources on primary healthcare cases rather than the serious and complicated cases that the hospital should be focused on delivering. Also, Lagos, as the most populous state in the country and with the influx of more people into the Centre of Excellence, massive strain is constantly on its healthcare resources.
In the 4th quarter of 2021, the total number of visits to the hospital was a total of 50,959, 3,861 were in-patients on admission, while 47,098 were out-patients. 2,658 patients admitted have been discharged. The percentage of bed occupancy averaged 98% approximately.
As an institution that is keen on improving its services, the hospital commenced the use of bed space managers who ensure speedy transfers of stable patients from the Emergency Units to the wards.
As of now, there is a construction of a 200-bed facility within the hospital in progress. In addition, the Lagos State Government has approved massive recruitment of relevant health workers. This process is ongoing.
We appeal to the general public to make use of Primary Healthcare Centres and General Hospitals to ease the burden on LASUTH.
Oluwaseyi Adewale is the Head of the Public Affairs Department of LASUTH
By Adedapo Adesanya
The World Health Organisation (WHO) and the Edo State government have intensified a coordinated response to contain the spread of the Monkeypox disease.
So far, Nigeria has reported 357 suspected cases with 133 confirmed monkeypox cases from 25 states – Lagos, Adamawa, Delta, Rivers, Edo, Bayelsa, Nasarawa Plateau FCT, Ondo, Anambra Cross River, Kwara, Borno, Taraba, Oyo, Imo, Kano, Katsina, Gombe, Niger Ogun, Kogi, Bauchi, Akwa Ibom and Abia.
Meanwhile, eight persons have so far tested positive for monkeypox in Edo state, and all the people diagnosed with the disease have recovered.
The Director, Public Health, Edo State Ministry of Health, Dr Ojeifo Stephenson, said it has become imperative to warn the residents of the state about the health risks that the virus poses and reiterate the need to be cautious and adhere to preventive measures.
He said the state Ministry of Health with support from the World Health Organization (WHO) and partners, has ramped up surveillance, diagnostics and other activities to curb the spread of infectious diseases.
“We have stepped up surveillance including prompt investigation of suspected cases, facilitating documentation of contacts, contact tracing and monitoring, as well as developed and disseminated public health advisory to raise awareness about the disease among residents of the state,” he said.
Additionally, Dr Benson Okwara, who works at UBTH, said WHO has been an invaluable partner in the response to monkeypox diagnosis and treatment in the facility.
Dr Okwara has five years of experience in managing patients with monkeypox.
He lamented that the disease spreads within the communities because of the poor health-seeking behaviour and late presentation of the case to the hospital.
“However, with WHO’s coordination, there is an early response following notification of suspected/confirmed cases with detailed case investigations using the monkeypox case investigation form (CIF) to collect data on patient contacts.
“There is a need for continuous risk messaging to educate people about infectious diseases and the importance of seeking medical care early and at appropriate health facilities to prevent the spread of diseases,” he said.
Across Nigeria, the Nigeria Centre for Disease Control (NCDC), supported by WHO, has activated Monkeypox Emergency Operations Centre to strengthen in-country preparedness and contribute to the global response to the outbreak.
Furthermore, WHO is supporting the coordination of technical assistance and operational support of partners, including the national One-health risk surveillance and information sharing (NOHRSIS) group, to facilitate timely information exchange on all prioritized zoonotic diseases.
Monkeypox is a zoonotic disease endemic in Nigeria and some parts of Africa.
However, there has been sporadic spread to other countries as more than 16,000 cases of monkeypox have been reported across more than 70 countries so far this year, and the number of confirmed infections rose 77 per cent from late June through early July.
The virus is being transmitted from animals to humans.
Recently, WHO activated its highest alert level for the growing monkeypox outbreak, declaring the virus a public health emergency of international concern.
By Adedapo Adesanya
The World Health Organization (WHO) has expressed its desire to support Nigeria in operationalising the National Health Insurance Authority (NHIA) Act 2022 signed by President Muhammadu Buhari in May 2022.
WHO’s Country Representative (WR), Dr Walter Kazadi Mulombo, made this pledge during a high-level meeting with the Secretary to the Government of the Federation (SGF), Mr Boss Mustapha, the Director General, National Health Insurance Authority (NHIA), Professor Mohammed Sambo, and a team of WHO Health Financing Mission delegates from the WHO Geneva, Africa Regional Office, and Nigeria.
The first ever high-level WHO Health Financing Mission to Nigeria, led by Dr Joseph Kutzin, was scheduled to provide sustainable health financing support to the country towards Universal Health Coverage (UHC) and health security while undertaking targeted advocacy to accelerate operationalization of the NHIA Act including the Vulnerable Group Fund (VGF).
This is in line with WHO’s goal of ensuring that all individuals and communities receive the quality health services they need without suffering financial hardship.
Dr Mulombo said President Buhari’s signing of the NHIA Bill into law will make health insurance mandatory for all legal residents in Nigeria and expands coverage to over 83 million poor and vulnerable people.
He expressed the optimism that government will prioritize immediate appropriation of the Special Intervention Fund in the Act to establish the Vulnerable Group Fund.
“Indeed, the task of ensuring that all citizens have access to the quality healthcare they need without falling into poverty is a deliberate political decision to achieve the cardinal objectives of population coverage, service coverage, and financial protection. I have no doubts that in a large federal nation like Nigeria, this milestone of appropriating the Special Intervention Fund will be achieved in the 2023 fiscal year”, he said.
In his remarks, Mr Mustapha appreciated WHO as the foremost development partner to Nigeria on health and lauded WHO’s invaluable guidance, particularly on the COVID-19 pandemic.
“WHO has demonstrated that it is an organization that cares for and caters for the health needs of the people. On the NHIA, let me commend the DG for his tenacity and determination to have this Act come to fruition. I want to thank WHO and other partners who supported in the drafting of the Bill. This modest attempt has provided basic health insurance coverage to the vulnerable, and making it mandatory will go a long way in assisting our people to manage their income and remain at work in terms of the depressed economy we are witnessing”.
The SGF further expressed the government’s commitment to appropriate the Special Intervention Fund (SIF) in the 2023 national budget for the establishment of the Vulnerable Group Fund (VGF).
“No family in Nigeria has economically survived catering for any of their own suffering from cancer. The health of our people is therefore topmost on our priorities despite competing demands”, he stated.
By Kestér Kenn Klomegâh
With rising cases of the monkeypox virus, Russians are back seeking again cheap health publicity in Africa. Just as Foreign Minister Sergey Lavrov completed his four African-nation tours, Russia plans to send monkeypox test kits to Egypt, Uganda, Ethiopia and Congo.
Russian consumer health watchdog Rospotrebnadzor said in a media statement that Russian test systems to diagnose monkeypox would be provided to Egypt, Uganda, Ethiopia, and the Republic of Congo at the end of July.
“Rospotrebnadzor is continuing to extend support to partner countries’ efforts to counter the spread of monkeypox. Test systems produced by Rospotrebnadzor’s Vector Research Center will be handed over to Egypt, Uganda, Ethiopia, and the Republic of Congo at the end of July,” the press service said.
“Furthermore, Rospotrebnadzor specialists are arranging special workshops for colleagues from partner countries that deal with laboratory methods to diagnose monkeypox,” it said.
Rospotrebnadzor said earlier that the Vector Research Center had produced monkeypox test kits, and such testing is currently available in all Russian regions.
Monkeypox is a rare infectious disease, most common in remote parts of Central and West Africa. Its symptoms include nausea, fever, rash, itch and muscle pain.
On July 12, Rospotrebnadzor announced the first national case of monkeypox: the patient had returned from Portugal. His symptoms were mild and did not endanger the patient’s life. Rospotrebnadzor said that all his contacts had been promptly identified and were under medical monitoring. The threat of spread has been contained.
Faced with a surge in monkeypox cases, the World Health Organization (WHO) has already declared the outbreak of monkeypox as a global health emergency — the highest alarm it sounded. Monkeypox has affected over 15,800 people in 72 countries, according to a tally by the US Centers for Disease Control and Prevention (CDC) published on July 20.
WHO, however, warned against discrimination. “A failure to act will have grave consequences for global health,” Lawrence Gostin, the director of the WHO Collaborating Center on National and Global Health Law, said on Twitter.
Some experts have asked why Russians have not chosen African countries such as Nigeria, or regions such as Central and West Africa where the virus is currently spreading most. But have listed as priority countries that Sergey Lavrov visited on 24-27 July: Egypt, Ethiopia, Uganda and the Republic of the Congo.
