Established as referral health facilities, with adequate and qualified health professionals, most teaching hospitals in Nigeria have fallen short of the expectations of those that are in need of healthcare services.
The teaching hospitals are burdened by unreliable and high costs of electricity supply to power diagnostic equipment. Medical equipment in most of the facilities are either obsolete, malfunctioning or lack maintenance where they exist. The hospitals are poorly funded, resulting in health workers leaving the country in search of alternative means of living. Their patients groan in pain; and in most cases, the doctors and nurses watch helplessly.
In this special report, our correspondents across the country x-ray the state of the tertiary institutions and present facts that point to urgent need to save the hospitals.
University College Hospital, Ibadan
For decades, the University College Hospital (UCH) in Ibadan has been a beacon of hope and a symbol of medical excellence in Nigeria. The premier medical facility in West Africa has played a pivotal role in providing advanced healthcare services. That is no longer the situation.
The hospital is currently facing so many challenges including inadequate medical equipment, staff, and unreliable electricity supply. The hospital is also burdened by unfulfilled government promises, leaving patients to battle for their lives with uncertainties. Some of the medical equipment that require urgent attention include pediatric devices, Magnetic Resonance Imaging (MRI) and CT scanner. Critical wards, such as the Paediatric Intensive Care Unit (PICU), suffer from inadequate space, beds, and ventilators, limiting the treatment capacity.
The hospital had occasionally fallen back on philanthropic gestures of some Nigerians, as well as local and international organizations that have been complementing the government’s efforts over the years.
The UCH operates under immense strain due to staff shortages. There is a dearth of doctors, nurses, and support staff. Doctors often work long hours, leading to fatigue and increased chances of medical errors. Nurses find it challenging to provide personalized care when attending to a high number of patients simultaneously. The hospital administration constantly grapples with an imbalance between the growing number of patients and the limited number of healthcare professionals. The state of electricity supply is an enduring challenge for UCH. Frequent power outages can disrupt critical procedures and surgeries, posing a severe risk to patients. For 17 days in March and April 2024, IBEDC disconnected the hospital for owing the utility company a cumulative debt of N495 million.
The hospital runs on a monthly electricity bill ranging from N45 million to N71 million, yet, it has about 75 generators in different locations within the premises, according to its Chief Medical Director, Abiodun Otegbayo.
Despite the challenging situation, many patients praise the dedication and expertise of the medical staff at the hospital. On the flip side, they express frustration and anxiety over waiting for a long time to get medical attention, inadequate facilities, and difficulty in accessing water within the facility.
University of Port Harcourt Teaching Hospital
A recent investigation into the state of medical equipment at the University of Port Harcourt Teaching Hospital (UPTH) has revealed alarming shortcomings, putting patient care at risk.
The hospital’s sole MRI machine, which was installed in 2018 frequently goes out of order due to maintenance issues and a lack of qualified technicians. This has resulted in delayed diagnoses and treatments for patients in need.
Furthermore, the hospital’s mammography machines are in a deplorable state. One of the two machines in the hospital is outdated; the other malfunctions, and lacks digital imaging capabilities. This hampers the hospital’s ability to detect breast cancer early, and poses a potential danger to lives. At the Intensive Care Unit (ICU), only four of the six monitors are functional, and those that are not functional are outdated, lacking modern features like real-time data analysis. This compromises the quality of care for critically ill patients.
The hospital’s 2D-Doppler Echocardiography machine, installed in 2020, is relatively new but often unavailable due to scheduling conflicts and staff shortages. Hospital authorities have acknowledged the challenges, citing funding constraints and maintenance issues. Medical professionals and patients’ families are calling for urgent action to address these shortcomings.
“It’s unacceptable that patients are suffering due to equipment failures and shortages. We need modern equipment and trained staff to provide quality care,” a physician at the UPTH told Saturday Sun. The hospital, which is supposed to be a leading healthcare provider in the Niger Delta region, is struggling with outdated equipment, inadequate staffing, and insufficient funding.
The doctor-patient ratio is quite high, and the hospital lacks sufficient nursing staff, specialists, and resident doctors. The shortages lead to increased workload for existing staff, potentially compromising patient care. There are instances where patients are referred to other hospitals due to lack of specialists.
University of Maiduguri Teaching Hospital
The University of Maiduguri Teaching Hospital (UMTH) is currently seen as a referral hospital burdened by Boko Haram insurgency.
Designed initially as a 600-bed capacity hospital, the institution remained a major medical centre for hundreds of people in the North-East and neighbouring countries like Niger and Chad until the outbreak of insurgency in 2009. The violence led to the destruction of many primary healthcare centres and facilities across Borno, Adamawa and Yobe, the three states affected by insurgency.
The Accident and Emergency (A &E) unit of the hospital receives more patients as victims of frequent bomb explosions and Boko Haram attacks are brought in for urgent medical attention.
Records in the hospital also show that the pediatric unit, surgery, kidney center and General Outpatient unit usually get a high number of patients.
Sources in the hospital, however, said the movement of some of the senior medical staff, especially doctors, to newly established federal hospitals and medical centres in some states in the North-East has depleted UMTH’s staff strength. This, according to some patients, makes the medical staff in the hospital overwhelmed with the number of people that seek medicare at UMTH daily.
Chief Medical Director, Ahmed Ahidjo, confirmed the increasing movement of medical staff has created a gap in manpower for delivery of services.
“While other tertiary hospitals are crying of brain drain externally, our challenge at UMTH is internal drain as many quality medical staff; doctors, lab technologists and pharmacists have moved to other hospitals in the North-East and Abuja,” he said.
Ahidjo said the major challenge UMTH faces is power supply. He said the hospital spends about N100 million monthly on diesel to power its generators in addition to payment of electricity bills to power distribution companies. He called for support from well-meaning individuals and private organisations to the hospital.
Despite these challenges, the CMD said the hospital has recorded some progress in terms of delivery of medical services to the people, provision of medical equipment and facilities. For instance, the establishment and building of a cancer and trauma center, which was commissioned by President Muhammadu Buhari in 2023.
He said the trauma centre has been providing rehabilitation service to people affected by the violence while the Orthopedic/Repairs and Rehabilitation Centre established in the hospital by the International Committee of the Red Crossover (ICRC) provides rehabilitation service to patients physically affected either by accidents or insurgency. Currently, the hospital bed capacity has been doubled to 1,205 from the 600 beds it had at inception
University of Benin Teaching Hospital
At the University of Benin Teaching Hospital (UBTH), electricity supply is also a major challenge. Medical equipment are in bad condition. And for these reasons, patients are often asked to go outside the teaching hospital to carry out their medical laboratory tests.
Even with available medical equipment, the hospital is burdened by inadequate manpower, occasioned by doctors, nurses and other categories of health workers leaving in droves for greener pastures. As at the time of this report, the dental unit of the hospital had its electricity supply cut off for over one week by the Benin Electricity Distribution Company (BEDC). It therefore had to rely on a power generating set.
It was gathered that payment of staff allowances and training is also an issue at the teaching hospital.
For inexplicable reasons, the hospital’s management is blamed for concentration of efforts on academic training above offering clinical services, which some stakeholders believe should be left for the University of Benin, the parent institution.
In another twist, a staff of the UBTH told our report that the cost of getting medical attention at a teaching hospital in the northern part of the country is far cheaper than what obtains in the south. “With N5,000 you can get a case note in the north whereas with N10,000 you can’t in the South,” she said. However, doctors at the hospitals get commendation from some patients for their level of efficiency.
Ahmadu Bello University Teaching Hospital, Zaria
Investigation reveals that the Ahmadu Bello University Teaching Hospital (ABUTH), Zaria in Kaduna State lacks modern and adequate medical equipment, enough qualified medical personnel to function optimally.
The hospital, which caters for patients from Kaduna and neighbouring states, is overstretched, especially in critical units such as the Accident and Emergency (A&E) section.
Now, a shadow of itself, ABUTH, which was widely reputed for excellence is currently in a deplorable state and may soon become moribund as most of the medical equipment are obsolete and non-functional. It was also gathered that a large number of patients at the hospital are unattended to, as a result of inadequate number of doctors and hospital equipment.
“ABUTH was established with three primary objectives: to provide specialized medical care to patients, to train medical personnel, and to conduct research for the advancement of medical knowledge. “The hospital is now in dire need of cardiovascular percussionists, anesthetists, and heart surgeons,” a staff told our correspondent.
Lagos University Teaching Hospital (LUTH)
Although the hospital is bedeviled with manpower and electricity supply challenges, Ayodeji Oluwole, Chairman Medical Advisory Committee at the hospital reported that the government has invested a lot in medical equipment and infrastructure in the hospital.
About seven years ago, the hospital got electricity supply from an Independent Power Plant (IPP) that is gas powered. This provided 24/7 uninterrupted power supply, but in the last one year, according to the management, the bills became ridiculously high.
“We started by paying N25 million every month (2017, 2018). In January this year, the hospital paid about N80 million. We paid two bills, one for the gas and one for the set power. From N80 million to N120 million; and then to N250 million. So in March when they brought the bill of N250 million, the CMO said that there is nothing we can do about it. We can’t afford it. Then we had to go back to Eko Discos. In the last few weeks they cut us off when we couldn’t pay the bill of over N180 million,” Oluwole lamented.
He applauded the government for fulfilling all promises made to the hospital over the years.
“Every promise they have given us they have fulfilled. The promises they have given us this year are two – Cath Lab and Nuclear Medicine. We felt they will complete them. It takes time to build them. Hopefully by this time next year they will be ready.
“That will help Nigerians who go to India and Egypt. It will be available locally and it will be cheaper for them. Even the government is building a geriatric medicine for old people.”
But some of the patients who spoke to our correspondent expressed mixed feelings. While some expressed satisfaction with the quality of healthcare they got from the hospital, others expressed the view that the services they got fell short of their expectations.
Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka
The Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Anambra State, has been in darkness for over four months, following the disconnection by the Enugu Electricity Distribution Company (EEDC).
Patients and health workers groan everyday even as Resident Doctors at the hospital are considering embarking on strike over non-payment of allowances and poor medical infrastructure in the facility.
The Association of Resident Doctors (ARD)-COOUTH said they would withdraw their services without further notice if the harsh and poor working conditions persist.
Onyebuchi Ichoku, president of the association, said the condition of doctors and other medical and health workers in the hospital is terrible, adding that there have been no payment of hazard allowance, Medical Residency Training Fund and implementation of 25 percent increase in basic salary since July 2023.
Ichoku also called for the restoration of electricity and provision of diagnostic equipment in the hospital for more effective service delivery.
He said the poor working conditions had resulted in the continued emigration of his colleagues to other countries and neighboring institutions, adding that it was putting so much pressure on the existing workforce in the hospital.
A patient at the hospital, Ngozi Moneme, lamented poor medical attention and blamed it on negligence on the part of the government.
“As we speak, there is no single oxygen machine here. What you see here is a mere empty cylinder. I have watched people struggle and die here even with the so-called oxygen device fastened on them because it’s not working. At times, doctors use rechargeable torch light to do ward rounds because there is no light.
She said in some cases when the generator is put on, it doesn’t stay beyond two hours, apparently because of the cost of diesel.
But Joe Akabuike, Chief Medical Director of the hospital, said the challenges facing both staff and patients in the hospital would be addressed by the state government.
Federal Medical Centre, Owerri
The Federal Medical Centre (FMC) Teaching Hospital, Owerri is presently yearning for health workers according to a doctor who works at the tertiary health facility. Like in other places, a large number of their health workers have traveled abroad in search of greener pastures.
Medical equipment at the facility are grossly inadequate. The hospital is in need of MRI machines, CT scanner, and several others to complement the efforts of the few doctors. The greatest of the challenges facing the hospital is power supply. The hospital spends a huge amount of money on diesel despite installing a new 33 KVA source of power supply recently.
Some patients who spoke to our correspondent on the state of the hospital expressed frustration.
“I don’t like coming to this hospital but for the few old doctors here. Their services are unpredictable. Sometimes it is good and at other times, you will regret coming to this place,” said one of the patients. Patients at the hospital also lament the bureaucratic process involved in attending to patients.
“Even when there is an emergency, you will be required to go from one department to another,” said another patient, who claimed that this situation had resulted in the death of some patients.
University of Nigeria Teaching Hospital, Enugu
The University of Nigeria Teaching Hospital (UNTH) does not have a single MRI machine, investigation revealed. However, a number of the CT and MRI machines in some public health institutions in Enugu including UNTH, are owned by individuals who partner with public hospitals. This arrangement results in higher costs for patients. For instance, while a brain CT scan might cost around N65,000 at a public facility, the same service could be cheaper at a private hospital.
Electricity supply at the hospital is unstable and many of these machines cannot be supported by solar energy. The teaching hospital relies on dedicated generators that often break down without warning. The cost of running these generators, combined with the risk of their failure, makes it extremely difficult to ensure uninterrupted health services. It was further discovered that UPS systems, which are meant to provide backup power, are often of poor quality and do not perform as expected. This creates a situation where, despite having the equipment, the hospital is constantly battling to keep them operational.
A former chairman of the Nigerian Medical Association in Enugu State, Celestine Ugwuoke, who is also a Consultant Radiologist at the UNTH said: “Our problem extends far beyond just acquiring equipment. It’s also about the maintenance and operational costs. Take MRI machines, for example. Enugu, which is the capital of the South East, has only one functional MRI machine.
On manpower challenges facing the hospital, Ugwuoke explained that there are vacancies in the hospital, but due to government-imposed restrictions, “we are unable to employ the necessary staff. Even those that are willing to work are often left without opportunities.” This leaves the current staff overworked and stretched beyond limit.
Ladoke Akintola University Teaching Hospital, Ogbomoso
The situation at Ladoke Akitola University Teaching Hospital in Ogbomoso is similar to that of UCH in terms of staffing, equipment, remuneration, as well as electricity supply and funding. The only difference between the two institutions is that Ladoke Akintola University Teaching Hospital is not as big as UCH.
The Chairman, Nigeria Medical Association (NMA), Oyo State, Happy Adedapo, explained that health workers at the hospital have not been enjoying some benefits like their counterparts in UCH. He mentioned hazard allowance, consolidated salary scheme, medical training funds, as well as some incentives, and allowances.
Rivers State University Teaching Hospital
The Rivers State University Teaching Hospital (RSUTH) Port Harcourt, metamorphosed from Braithwaite Memorial Hospital, which existed for several decades to a teaching hospital.
Some medical equipment there are outdated and in need of replacement or upgrade.
Also, there is a shortage of some essential medical equipment, such as ventilators, dialysis machines, and ultrasound machines. There is also inadequate sterilization equipment, which can compromise a patient’s safety. Being a hospital that is in the centre of the state capital and easily accessible, it gets an influx of patients daily.
Margaret Ngele, a woman who recently gave birth at the hospital said she was overwhelmed with joy, over the attention the nurses and other hospital staff gave her and her baby.
Ngele said: “My doctor and nurses explained everything and kept me updated on the progress. They made sure I was comfortable and empowered to make decisions.”
Much money is spent on power generation, making it difficult for the hospital to depend on Port Harcourt Electricity Distribution Company (PHEDC).
According to the management, the epileptic electricity supply is not what the hospital can depend on. “The state government is spending much on generating power for the hospital. Without light, it is difficult to operate,” a technical staff said.
Osun State University Teaching Hospital
Medical equipment at the Osun State University Teaching Hospital are in moribund state. Findings show that there is an exodus of doctors and nurses from the teaching hospital, apart from those who have retired while some equipment like CT Scan and MRI machines are not available at the hospital.
It was gathered that no recruitment has taken place in the teaching hospital in the last twelve years except replacement in some departments while some departments that required doctors still do not have.
Some patients who spoke to our correspondent lamented that some equipment that are expected to be available in the hospital are not there. When our correspondent visited the hospital, a patient lamented that the hospital could not conduct genotype and blood group test, saying: “They directed us to go and do it outside.”
Another patient also lamented that the hospital did not have reagents to do blood tests and patients were referred to other facilities outside the hospital for the tests.
President of Association of Resident Doctors, Ojo Oluwadamilola, declined to comment on the state of equipment in the hospital. But the state’s Commissioner for Health, Jola Akinola, told our correspondent that the process to recruit doctors and nurses is still ongoing and will be ready in due course.
He said, “Osun State University Teaching Hospital has one of the highest number of medical practitioners in all the teaching hospitals with over 200 and we have a standing order that whenever anybody leaves, whether a nurse or medical doctor, they should be replaced immediately. They don’t need any approval or wait for anybody,” Akintola added.
Sun
