Hospital ward

Odimegwu Onwumere

The harsh economic times in Nigeria is currently forcing humanitarian organisations to do the absurd. For instance in the health sector, all the good virtues of Florence Nightingale, the mother of nursing, have been thrown into the abyss. Medical doctors act on patients no matter how critical the condition, based on the colour of their currency bill.

Kidnapping, which was used by the Niger Delta militants to pursue their course, has become a big business even for hospitals across the country. Virtually on daily basis news reports from the media assault our collective conscience of hospitals, and health centres taking their patients hostage due to their inability to settle their bills. The most piteous is the agonising sight of mothers and babies being held captive by health organisations because of their inability to pay bills on time.

Findings by this writer showed that many mothers have been detained by hospital officials they were delivered of their babies in, for failure to pay hospital bills popularly known as Awaiting Bill Settlement (ABS).

They were billed money ranging from N500, 000 to N200, 000 as the case may be, checks have revealed, whereas many of the mothers were housewives and their husbands had little or no means of resources.

Government hospitals charged between N11, 000 and N40, 000 for antenatal alone, while private hospitals charged between N25, 000 and N100, 000, said editors of a leading newspaper.

They said the monies exclude charges for birth “either through normal delivery or by Caesarean Section (CS) and post natal care including the use of phototherapy and incubator for babies with jaundice and premature respectively.”

In some cases, the women’s husbands eloped or stopped picking calls from their wives or the hospitals authorities when they had exhausted all avenues to raise money and get their wives out of the hook.

The biting wit in most cases was that many of the women had to feed themselves and their babies, when those who were supposed to be bringing food to them from their homes, stopped bringing food on ground of scarce resources to afford food.

Solicit for public help
In June 2016, Gloria Okore was under arrest by the authorities of a private hospital in Lagos she was delivered of her set of triplets in, for her incapacitation to offset her medical bills of N35, 000, which was a fraction of N120,000, she was supposed to pay at the hospital.

“A disturbing but common practice in many developing countries is the detainment of women who have recently given birth and who cannot afford their hospital charges.

“Contrary to policies aimed at encouraging women to deliver in health facilities, this practice is an abuse of their rights and has implications for wider maternal and neonatal health,” reported researchers Delan Devakumar and Rob Yates, June 2016.

Narrating what transpired, Okore said that although she had her babies without complications except that they were born prematurely.

It was learned that one of the babies died after, due to lack of incubator in the hospital to keep the children warm.

She appealed to government to assist redeem her of the hospital cost since her husband was a roadside trader with modicum income.

Okore later gave out her bank details, soliciting for financial help from the general public.

Many Nigerian mothers undergo the same fate as Okore’s. On October 28 2015, a similar occurrence occurred to a 23yr old B. Godwin, from Eket L.G.A in Akwa Ibom State.

When she was admitted in the labour room on that day at about 6pm, little did she know that she would be delayed by parturition, hence the suggestion by the hospital that she be transferred to an upgraded hospital.

The VOC News could testify that Godwin recounted her puzzlement at Ilasamaja health center, saying, “I was stranded because there was no cash on me.

“My husband and I stayed from 11pm to 4:30 am the following morning, before we could get assistance to take us to Isolo General Hospital.”

She was not saved at the Isolo General Hospital, either. With fear narrated by a nurse on duty that her unborn baby might die in her womb if she delayed, she was moved to Mater Christi: A specialist hospital located at 8, Bishop Okogie Street, off Ago palace way, Balogun B/stop Okota Lagos.

Instead of the baby would die, a Caesarian was performed. An outstanding bill of N150, 000 was given her out of which the husband was able to pay N50, 000.

“As a result of the inability to pay up the complete bill, the poor woman has been detained by the hospital management for the past 2-weeks, because she and husband could not afford to pay the outstanding hospital bill,” the source educated.

Like Okore gave out her bank details for public assistance, Godwin did not shy away to do the same.

Corruption at government hospitals
While private hospitals charge exorbitant bills, the government hospitals that charge subsidised rates for their services, including antenatal treatment, was observed not to pay women the urgent attention they needed.

“If you want quick service, you have to part with N200 and another N100 for urine sample, which are compulsorily charged on every visiting day for the antenatal patients.

“If you don’t pay this extra charge for urine, then it’s as good as you did not come,” one pregnant woman at a government hospital, told newsmen.

Women die giving birth
Many mothers and their babies have given up the ghost in the harsh birthing environment in Nigeria.

A study of The Pan African Medical Journal attributed “Nigeria still remains a major contributor to under-five mortality, contributing about 13 per cent, 9.4 per cent and 14 per cent of global under-five, neonatal and maternal deaths respectively.”

A pregnant mother of three, died at a private hospital in Onitsha, during delivery on April 27 2015.

Her relatives, who upon admitting her to the hospital, went to source for elusive funds on the permission of the doctor, took her corpse to the hospital’s morgue, but hadn’t N70, 000 to pay as mortuary bill, therefore they returned the corpse to the doctor.

In December 28, 2014, a 44-year old printer recounted before journalists with International Centre for Investigative Reporting (ICIR), of how he lost his wife, F. Oduyoye, 35, in the course of putting to bed and how he paid through his nostrils.

He attributed her death to over-priced health services of the Lagos University, teaching Hospital (LUTH), Idi- Araba, known as one of Nigeria’s foremost teaching hospitals.

Patients pay for drugs/services yet given mountainous bills
His problem started on getting to LUTH, 7th of September, 2014, and his wife was in Accident and Emergency for three days.

“They said there were no beds, but that they will take us to the Intensive Care Unit, ICU,” the aggrieved man said.

He added that he spent N230, 000 to do X-ray, for drugs, scan and treatment on that particular day. And after donating nine pints of blood, the hospital collected N54, 000, and told him that the money was for the screening of the blood.

When hope seemed to be dwindling, the hospital’s authorities moved Folake to the theatre to operate on her on Wednesday, September 10 2014.

The man was told that the wife had infection; and after the operation, N135, 000 was charged, he paid another N250, 000 cash for ICU.

After the operation and the initial payment, N70, 000 was demanded from him again. It was noted that he paid N15, 000 every day, apart from N1, 500 for meal ticket he paid every day to the kitchen.

When Folake was discharged from the female ward on October 31, 2014, where she was later moved to, however, not discharged to go home, N1, 382, 700 was outstanding bill that he had to offset.

The hospital officials had to lock Folake in a ward until he could pay her outstanding bills.

“He had spent almost N2 million before the new bill came, meaning that he was charged a total of N3, 382, 700. The agitated husband’s anxiety heightened two weeks after his wife’s detention in the hospital when she developed cough and her health began to deteriorate.

“He alleged that even as she was being forced to remain in the hospital against her will, when Folake progressively got worse, the hospital refused to treat her, with the excuse that she had been discharged,” Abiose Adelaja Adams of ICIR reported. They killed my wife. The management of LUTH,” the bereaved man yelled, throwing his two hands in the air, while narrating his story. “They value money more than life.”

Detained for more than 6 months
After delivery, many mothers and their babies who were unable to afford their hospital bills, stayed for nearly 6 months or more, before reprieve could come their way through politicians looking for public stunt, or through amiable persons in the society.

A 23-year-old single mother whose name was given as A. Amadi that gave birth in Umuahia, the capital of Abia State, was in hospital by July this year, four months after she gave birth.

“While the mother and her daughter are in good health, they are not allowed to leave the public hospital until Amadi settles the N543, 000 ($1,900) bill for their care,” reported News Agency International.

The sarcasm was that Amadi who cried out that she had really suffered and they did not allow her to go out, eked a living “selling stones to construction workers for 40 naira ($0.15) per sack, and fears she may never be able to clear her debt – leaving her and her baby trapped in the Umuahia Federal Medical Centre (FMC) for the foreseeable future.”

One of the nurses who claimed anonymity hued of how mothers and their babies were treated, saying, “Sometimes, we place all the babies on one bed while the mothers sleep in chairs. Some babies have stayed here until they started crawling.”

Increment in antenatal cost
On 27 September 2015, the editors highlighted on antenatal fee in Lagos hospitals, where the government increased the cost of medical treatment, equipment and personnel fees to N18, 000 from what it used to be.

“But the need to make the citizens, especially the poor, have access to antenatal services should be the prime consideration in the review of the fee. Already, most of the pregnant women who use public hospitals are complaining that the new fee is too much for them. With the increase, most of these women who cannot afford private hospitals would be shut out of care as most are not gainfully employed,” said the editors.

Resort to putting to bed at home
In spite of efforts to encourage pregnant women to seek help in the hospital, some of them wouldn’t, because of what they go through, as a result of precipitous hospital bills.

“In spite of efforts by the Federal Government and Kaduna State Government to ensure that all pregnant women dutifully attend antenatal care as well as deliver their babies in hospitals under the close supervision of well trained health workers, many women in the state still deliver at home,” exclaimed Christiana T. Alabi, a journalist based in Kaduna.

Doctors arrested
Some doctors have been either arrested or taken to court for detaining mothers in their hospitals.
This was the fate of Dr. O. Afolabi, medical director of Afolabi Hospital, located at 78, Oworo Road, Oworonsoki in Bariga Local Council Development Area of Lagos, which was uncovered for detaining mothers and their babies by officials of the Lagos State Ministry of Women Affairs and Poverty Alleviation, WAPA, in collaboration with the Office of the Public Defender, after a tip off.

P.M. News informed that on December 2, 2013, seven nursing mothers and their babies who could not pay the hilly bills the hospital gave them were rescued from the hospital by the government officials.

Afolabi, who delivered women of their babies through caesarian operation for a minimum of N150, 000 or more depending on their cases, was arrested by the Task Force and later released on bail after writing a statement, the source added.

People/government don’t know their rights
“This is happening because people don’t know their rights or where to go when such happened,” the then Director, Office of the Public Defender, Mrs. Rotimi Omotola said; but the arrest may not deter unruly doctors from the practice.

“Criminal charges will be filed against the owner of the hospital if he is found guilty in the course of our investigation,” the source added.

Mary Kimani from Africa Renewal, said that mothers are experiencing this because government at all levels has refused to overcome the decline in government financing hospitals, therefore many hospitals and clinics began asking patients to pay more for services.

“The government also needs to extend the National Health Insurance Scheme so it goes to the grassroots,” experts have said. “Only government workers and some private workers are entitled to it.”

Onwumere is award-winning journalist based in Rivers State. Email: odimegwu@journalist.com