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Regulatory failure, quackery trigger avoidable deaths in Lagos health facilities

By Gbenga Salau
08 May 2022   |   4:13 am
Last April, two persons lost their lives in two private health facilities in Lagos state because they were handled in an unapproved facility and by unqualified professionals.

One of the health facilities in Lagos State

Last April, two persons lost their lives in two private health facilities in Lagos state because they were handled in an unapproved facility and by unqualified professionals. After the damage had been done, the news filtered in, principally from relatives of the victims. As a result, the state government, through its regulatory agency stepped in, leading to the closure of the two health facilities. Government’s investigation of the activities that led to the deaths revealed some sharp practices.

In the first incident, which involved an health facility, Medville Global Health Centre in Okota area of the state, a pregnant woman died during operation. Though her baby survived. The state government’s investigation of the incident revealed that the alleged hospital was not registered with Lagos State Health Facility Monitoring and Accreditation Agency (HEFAMAA). It was also revealed that the facility inadequate personnel. The incident came to light when a Twitter user, Triplem Mchaty, in his tweet, alleged how the ‘incompetence’ of the hospital led to the death of his wife after she gave birth to a baby boy.

Narrating what happened, he said: “After hours of trying to push, my wife already got so weak and tired, my sister called me around 11 pm that they want to carry out caesarean section on her.”

“I was like something they supposed to have done since, instead of suffering her. Around 2am they called me on phone that she needs blood, mind you I was in Enugu while all these were happening. Unfortunately, she couldn’t make it. She died, they removed the baby boy, but the baby didn’t cry due to prolonged labour, he drank lots of water and blood.

“I rushed down to Enugu Airport and boarded a flight down to Lagos. On getting to the hospital, I found my wife lifeless in one old looking operation room.

“I was so heartbroken, they gave me an exorbitant bill of over N500,000 to pay before I could take her remains away,” he alleged.

The second episode also involved a woman, who went through surgery in the hands of unqualified health personnel at Felobam Alpha Convalescent Home. Government’s investigation into the matter after complaint by the victim’s family revealed that the health facility was not accredited to perform surgeries, just as the hospital was not adequately staffed.

The Executive Secretary of HEFAMAA, Dr. Abiola Idowu said the facility operated beyond schedule, because as a convalescent and nursing home, it was not permitted by the state Health Law to perform surgeries. She stated that the team sent to investigate the issue also found out that the facility had no qualified personnel as an auxiliary nurse was met at the time the monitors visited.

Commenting, a Lagos resident, Philip Akinsola, maintained that there are many health facilities operating without approval while those with accreditation have issues of inadequate staff or unqualified personnel manning some of their units and departments.

Providing insight from a recent experience, he said a church member had an accident and was taken to a place purported to be an hospital in Ajegunle, but when he visited the facility, it was a rundown bungalow of residential rooms competing with a three-room hospital wards.

“I was alarmed by the environment. Having such a building as a residential apartment is an eyesore, let alone a place to get medical attention from. There was just one ‘doctor’ attending to the patients and he was not trained to provide the service he was rendering as I found after some interrogation. Yet, he was called a doctor. It is a pity that our people are yoked by poverty and ignorance. And the government compounds the crisis by failing in its duty of providing supervisory and regulatory role diligently.”

Although the two persons that died from the recent incidents have paid the supreme price, there is need to have measures in place to completely eradicate incidences like this.

Speaking on the measures government can put in place to avert a recurrence, a public health specialist, Omotayo Olojede, said improved routine monitoring of accredited facilities by HEFAMAA as well as better surveillance mechanism to identify and shut down rogue/unregistered health facilities were necessary.

On how patients could know that a facility is not approved to operate as a health facility or carry out some health services, Olojede suggested that relevant government agencies such as HEFAMAA, Ministry of Health, and the Primary Healthcare Board should educate the populace better on the different categories of health facilities and their operational limits.

Olojode added that health facilities having inadequate staff and unqualified personnel is a serious menace. “Even in many big private hospitals, there are trainees and cadres that are not recognised by any law. In my opinion, I do not believe that we are ready to rid the health systems of quacks. When we are; when our lives truly matter to the government and other decision makers in the health sector, we will address this, starting with the doctors that train these quacks.”

He noted that in most hospitals and clinics where quacks are found, there is at least a qualified practitioner there; may be the owner or an employee that oversees the quacks. “Qualified practitioners have a responsibility to help in educating the populace and some are doing this already, especially nurses who are mostly victims. Most quacks are referred to as ‘nurses.’”

He was nonetheless optimistic that residents, if enlightened, may be a source of intelligence for relevant government agency to identify and apprehend owners of rogue health facilities. “The government may consider a whistleblower approach as well.”

On if government negligence contributed to the crisis, Olojede said laying the blame solely at the feet of the government may be a disservice, though the government needs to do better, but the people also have a role to play.

“I have seen cases where people would prefer going to quacks once referred from a Primary Healthcare Centre (PHC). As long as people see these quacks as options, there will be more and more of them,” he maintained.

For Dr Olaniyi Afolabi, another public health practitioner, noted that it is unfortunate such incidents are happening in this age of global technological advancement. “I believe that this is a common occurrence in a scenario where corruption thrives. Whichever way we look at it, the government is to be blamed at the end of the day. There are no two ways about it, there is a dearth of human resources and maintenance due to lack of political will and determination of government to face the situations headlong and fix things. These things have been with us a long time and things have not changed for the better.”

Afolabi stated that after appropriate sanctions and levies are imposed on the two health facilities that were shut, they may stage a comeback in no time and resume full fledged activities as soon as someone in the regulatory agency has been settled.

He noted: “Unqualified or even low cadre health workers can readily chew beyond what they are expected to bite as they are referred to in the society as “doctors” and this gives them a false sense of hope and expectation, which they want to strive to meet up with. Unfortunately, this happens at the detriment of innocent victims. One of the ways that the patients could know that such facilities are not approved to carry out such task is to have them well enlightened at all levels.

“Another way is for them to be able to access a portal, where the list of registered practitioners, their current status and license updates and all other vital statistics are domiciled. It is actually not only about any special role that qualified practitioners and enlightened residents can offer but there is need to be knowledgeable enough to be able to differentiate a qualified professional from one that’s not and address them the way they are.”

Afolabi believes that associations in the health sector can play a big role in curbing incidents like this by having regular campaigns on radio, television programmes and other media platforms to communicate the right messages on good health seeking behaviours, ways to identify and avoid patronizing quacks and patient fundamental rights.

Executive Secretary of HEFAMAA called on members of the public to continue supporting and cooperating with the state government in its fight against quackery and illegal operation of facilities by reporting those behind such acts to the agency to safeguard the health and well-being of the citizenry.

“We do monitor twice a year, but even when there are laws, people still flout them. Even when people know that there are standards and laws in place, they still flout them. The important thing is that, when they flout it, they do not get away with it. And we are working very well with professional bodies so that when people flout the law, we do what we can do by closing their facilities. We thereafter forward the matter to their professional bodies so that they can be penalised. And we are glad that the relationship between us and the professional bodies is working well, because once we pass anything to them, they treat it speedily and not wave it aside since they know the important job we do in Lagos.”

Idowu disclosed that as part of efforts to improve its monitoring activities and coverage, it has selected eight private organisations that are reputable to complement its monitoring exercise. “We are going to cede our monitoring activities because they will be in the locality for repeated monitoring and report to us. That does not mean we are going to stop our job, but just to increase the coverage of the agency.”

On how the public could be better aware of approved and unapproved facilities, she stated that the responsibility lies with the public because sometimes in trying to cut corners and not wanting to go to approved facilities due to cost and time, they visit poor health facilities.

“So, we constantly engage people that if you do not see our logo in a health facility, do not patronise it. It means that Lagos State government cannot vouch for such facilities. And if they patronise any with our logo and they are not satisfied with the treatment that they get, we would now see to it that such health facility is penalised. In some cases, we prosecute or report to professional associations, who will penalised the person.

“We also encourage the residents to ask questions, use your intuition to decide if the person can actually offer the healthcare service that is being sought. Outside all of that, some people are criminal, as some would still impersonate and call themselves doctors when they are not. For those who do that, when caught, we report them to the professional body, if the person is an healthcare worker for prosecution because it is criminal.”