LASUTH Without Ayinke House, Six Years After

AYINKE House, maternal and child centre located at the premises of the Lagos State University Teaching Hospital (LASUTH), Ikeja means different things to different people.

For health care professionals in the teaching hospital, the centre is the best centre for care of pregnant women, new mothers and women’s health. And for patients, the centre is the best place for pre and post-natal services and women’s reproductive health care.

But in the last six years, things have changed in face of the standstill that the centre has been experiencing. The standstill is neither the fault of LASUTH medical doctors nor that of patients. The Lagos State Government, in a bid to modernize the centre, contracted a construction company to reconstruct it. But six years after, the dream has remained in the pipeline, as the re-construction is yet to be completed.

While some of the patients see themselves as the greatest losers in the delay, healthcare professionals say they are also to be pitied.
Speaking on the matter, President of Lagos State University Teaching Hospital (LASUTH) Association of Resident of Doctors (ARD), Dr Gbenga Dad eMatthews, told The Guardian that the delayed re-construction has affected maternal care at the teaching hospital.

“The infrastructural project of Ayinke House has entered the sixth year running. We have to shut down significant part of our maternal services and obstetrics part of maternal care. We still run the gynaecological care – the care for diseases that affect women, excluding childbirth and pregnancy- related illnesses. It has been a very trying period for us particularly in the area of highest level healthcare delivery for the citizenry,” DadeMatthews said.

He explained that Ayinke House is very critical in the performance of LASUTH. “If you ask people on the streets of Lagos, ‘do you need Ayinke House?’, they would tell you yes. But if you ask them ‘do you know LASUTH’, they would ask you, ‘where is that?’ That tells you how important that aspect of the teaching hospital is. In fact, some people have labeled the whole complex of LASUTH as Ayinke House. But it is just a department in the teaching hospital setting. It has been a birthplace for many Lagosians. There are few Lagos homes which don’t have a child that was born in Ayinke House. It has been the bedrock of obstetric practice in Lagos and in extension, in the nation.

“It is a very pivotal aspect of the teaching hospital and a very pivotal aspect of the training arm of medical students both at the undergraduate level and at the residency level for doctors who over the past six years have been deprived of the opportunity to have highly specialised obstetric training under one roof, as we used to have when Ayinke House was fully operational.”

The LASUTH ARD President continued: “As it is with many government projects, there are several bottlenecks. But this particular one has been placed at the feet of the contractor. It has been a significant cog in the wheel of the training of resident doctors, particularly in the field of obstetrics and gynaecology and other allied fields, because it must be said that it is not only obstetrics and gynaecology resident doctors that are being affected; those that are training in allied specialties like family medicine and who by necessity have to rotate and have some trainings in obstetrics and gynaecology, are being deprived of having this training under one roof.

“I keep on citing one roof because the makeshift structure in place now ensures that all our resident doctors are shared into two of the major secondary health centres: General Hospital, Isolo and General Hospital, Ifako-Ijaiye where obstetrics services are being rendered by consultants and resident doctors. This form of training cannot be optimal because the form of training one gets for specialist care at a secondary centre cannot be compared to what one will obtain at tertiary health institution, and which Ayinke House provided. We must also remember that the reason that it was closed down was to upgrade the facility; it has been there for donkey years and the facility needed to be upgraded. It is a good step, but the upgrading has taken too long.”

DadeMatthews added that delay in the re-construction project might have started threatening LASUTH Postgraduate Medical College’s accreditation, accreditation that determines whether the institution has the capacity to train resident doctors who are to become consultants in various medical fields.

“As regards accreditation for the various colleges, it is actually being challenged because there is no postgraduate medical college (whether the National Postgraduate Medical College or West African Postgraduate Medical College) that would give us accreditation, if we continue to train our resident doctors in secondary health institutions. Our current accreditations are being threatened. That is another reason this project needs to be completed soon to avoid us losing our high ranking status and our accreditation in the various postgraduate medical colleges.

“In those two regards, it has been a major setback. We are due for re-accreditation this year. It is important the structure is complete before the end of the year because we cannot push accreditation beyond the end of the year. Otherwise, our resident doctors will not be eligible to sit for examinations to become consultants. We won’t be able to produce new fellows of the various colleges if we do not have valid and current accreditations,” he said.

The resident doctor appealed to the Lagos State Government to complete the project. “I know that there are little challenges with the contract and construction process. I believe that with the new administration of Gov.Akinwunmi Ambode, the completion of the project is in sight. I want to believe so, if the challenge with the contractor and the contract can be resolved as quickly as possible.”

Even nurses are not left out of the appeal. Nurses, under the aegis of the Lagos State University Teaching Hospital Nurses, have urged the Lagos State Government to complete the Ayinke House as soon as possible.

Speaking in her welcome address at the yearly conference of the nurses recently in Lagos, Assistant Director, Nursing Services (ADNS), Mrs. Modupe Shode, called on Ambode to complete the centre.

“We plead with our Hon. Commissioner and the Lagos State Governor that the completion of Ayinke House should not exceed 2016. Since the closure of the facility in 2010 for refurbishment, pregnant women had been agitating for its reopening; nurses and mothers in Lagos are waiting anxiously for the re-opening of Ayinke House which is known to be one of the major birthing facilities in the state,” Shode said.

Former governor Babatunde Fashola had in March 2010 shut down Ayinke House after it became obvious that the structure and facilities in it could not withstand the demands from the public.

Understanding the importance of the project, the previous administration awarded the contract to rebuild the facility to a contractor. According to the State Tenders Board (STB), the government issued a mandate to the initial contractor to complete the project in 18 months.

The contractor commenced work on the project in 2011, an action which made people in need of medical care, particularly women in the state, to heave a sigh of relief. Also, in a bid to ensure prompt completion of the project, the state government on November 27, 2013 raised bond under the Lagos State fixed rate bond (series 2), to execute some strategic projects, including Ayinke House.

In spite of the amount that has been spent on the project, Ayinke House is yet to become operational six years after. When The Guardian visited the site on Thursday, there were no worker there.

When contacted, Lagos Health Commissioner, Dr Jide Idris, told The Guardian: “What happened was that the initial contractor messed up; he could not complete it. They were financially constrained. This present government of Akinwunmi Ambode, even before we came in, had to terminate the contract and re-awarded it”.

He disclosed that the new contractor gave a time frame of 12 months, starting from January, for the project to be completed.