Recession: Nursing mothers, patients abscond from hospitals to avoid bills

THE PUNCH Newspaper

The current economic crisis rocking the country has been hitting the nation’s health sector hard, Saturday PUNCH has learnt.

Investigations by our correspondents during the week revealed that many patients, including pregnant women, have either been shunning or absconding from public hospitals because of the high cost of accessing effective medical care.

Some of the patients have therefore resorted to seeking help in traditional healing homes and places of worship.

The Chief Medical Director, University of Ilorin Teaching Hospital, Ilorin, Prof. Abdulwaheed Olatinwo, confirmed to one of our correspondents that many patients had been unable to pay their bills after treatments.

He said the problem might be connected with the current economic crisis in the country.

Olatinwo said, “The problem is that more people cannot pay. We now need to be looking for more funds to take care of the poor as we cannot turn down people, most especially, emergency cases. For those who cannot pay, it is either we write their bills off or we rely on some philanthropists assistance.”

The Director-General, Kwara State Hospital Management Bureau, Dr. Olubunmi Jetawo-Winter, also said new mothers and other patients had been absconding from the hospital without paying their medical bills.

Jetawo-Winter, who stated that the development was connected with the current economic challenges in the country, said, “We have a lot of patients who are unable to pay their bills. I believe it is because of the situation of the country.

“We have people who are admitted and when they are fairly okay, even when they had not been discharged yet, they abscond because they do not want to wait until they are discharged to avoid paying their bills.

“There have been cases where patients will pretend as if they are going to the bathroom or to the restroom and just abscond from there. They now understand that when it is an emergency, we must treat them before asking for money in accordance with the instruction given to all the hospitals.

“Some patients, especially expectant mothers, are a classical example. They only come to the hospitals when the heads of their babies are already sticking out and at that point, we do not have a choice but to deliver them of the babies and make sure that the baby and the mother are safe. The moment that happens, they abscond.”

The Chief Medical Director, Benue State University Teaching Hospital, Makurdi, Prof. Orkwuga Malu, explained the harrowing experience the hospital is going through in the discharge of its responsibilities.

Malu, who admitted that the number of patients, including expectant mothers, visiting the hospital for treatment had dropped due to economic hardship, said the situation might have led to the rise in the prices of drugs.

He said, “When we give orders for supply of drugs, the contractors will come back without supplying them because by the time they get to the market, the prices of the drugs would have gone up beyond what they had quoted for us.

“So, there is delay in the supply of drugs and sometimes, we have to cut down on the quantity of drugs we want to buy or source for extra funds elsewhere to be able to buy the drugs in order to keep the service going.”

The CMD also admitted that the poor power supply in the country and the high cost of running generators were affecting the services of the hospital.

The situation is not different in public hospitals in Ondo State.

Many sick people and expectant mothers in the state told one of our correspondents that the current economic crisis facing the country was negatively affecting them.

Initially, Mother and Child Hospitals in Akure and Ondo towns were offering free services, including caesarian sections to pregnant women, while children under five years of age were treated free of charge.

But it was learnt that this had changed because of the economic reality in the country as patients now have to buy drugs to be administered on them by the hospitals.

One of our correspondents gathered that the state government increased treatment bills in the health institutions as part of the efforts to boost its Internally Generated Revenue.

A source close to the Ondo State Hospital Management Board said the government’s funding of public hospitals had drastically reduced.

But the Ondo State Commissioner for Information, Kayode Akinmade, said medical services in the two hospitals were the best in the country.

Investigation, however, revealed a slight increase in the number of patients seeking treatment from traditional medical centres across the state.

In Enugu State, it was learnt that patients had been trooping to “spiritual healing homes” for treatment because of the higher cost of accessing medical care in public hospitals.

A source said though Enugu State University Teaching Hospital still attracts patients due to some specialist services it offers, there had been a marked reduction in the number of patients in recent times.

The source said, “Patients who come to the hospital complain of high cost of services.”

The CMD, Specialist Hospital, Bauchi, Dr. Zailani Isa, admitted that there was decrease in the number of patients, including expectant mothers being admitted in the 350-bed hospital, unlike before.

He said, “As of yesterday (Thursday), we had only 65 patients on admission. Before now, our usual patients on admission were between 100 and 120. There was a time when we were having up to 150 patients on admission. The decline in the number of patients on admission is because they cannot afford the bills, drugs and pay for surgeries.”

According to him, except children between 0 and five years of age who are given free drugs and treatments as directed by the state governor, others are to pay for their drugs and other medical services.

He said, “We have challenges. Like now, we are running on generator and it will be switched off by 2pm. This is based on the directive of the governor, so we always switch it off. We will put it on in the evening because we cannot afford to run on generator for 24 hours, it is not possible. So we put it on in the evening from 7.30 till 10pm.”

The collapse of the drug revolving scheme in Cross River State appears to have made the situation more pathetic in the state.

At the University of Calabar Teaching Hospital and the General Hospital in Calabar, one of our correspondents learnt that the pharmacy units at the two facilities merely existed because they lacked drugs to dispense to patients.

It was gathered that equipment in the gigantic laboratories at both institutions had been abandoned as medical personnel have formed the habit of referring patients to get examined in private diagnostic centres.

A top official from UCTH, who spoke on condition of anonymity, said 90 per cent of the drugs prescribed for outpatients and those on admission were bought from external pharmacies.

He said, “We have hospital revolving fund, where an amount is reserved for the purchase of drugs. Once the fund is made available, it is the duty of the pharmacy unit to purchase drugs and sell to the public. The idea is to ensure that the fund is always available. Unfortunately, money meant for that purpose is now being channelled to other areas.”

The Director-General, Cross River State Primary Healthcare Development Agency, Dr. Betta Edu, confirmed the source’s claim.

Edu said most public health institutions in the state had become prescription centres.

She, however, said that the newly introduced State Health Insurance Scheme tagged “Ayade Care” would seek to address the collapse in the health sector.

The financial challenge is also having its toll on the Osun State health care system.

Patients, especially those whose cases require surgeries at the State Hospital, Asubiaro in Osogbo, were being made to buy diesel to power the hospital’s generator to be used during the procedures.

An official at the hospital, who spoke on condition of anonymity, said, “Drugs are not available in our hospital. The only drugs available are paracetamol and Vitamin-C; you can’t get more than those two here.

“Patients who require surgeries are asked to bring diesel to power the generator. Some may be asked to bring 10 litres depending on how long the surgery will take.”

The situation is also the same at Ladoke Akintola University of Technology, Ogbomoso, where drugs are also scarce even to buy.

A doctor at LAUTECH told one of our correspondents on the condition of anonymity that the hospital’s pharmacy had been grounded.

Meanwhile, a former President of the Nigeria Medical Association, Dr. Kayode Obembe, said the health sector could be better managed at a time like this through public-private partnership, noting that such would take some financial burden off the public health institutions.

He added that government should explore the benefits of health insurance, so that people could afford health care, as they would only be required to pay little.

He said, “For example, under a PPP arrangement, government can partner with solar energy providers for power generation, while MRI scan, laboratory services, and such other services can be transferred to private companies in a way that both sides can benefit.

“What is the business of the doctor in keeping the generator running? These things should be transferred to the private sector under a PPP so that doctors and health care professionals can focus on core clinical areas. And these steps or intervention need no postponement. If they want to start tomorrow, it is possible.”


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