To seek prenatal care at Ede State Hospital after my family’s recent relocation to the state. It was my first installment in the state. My two pregnancies and past births were checked at an army hospital in Ibadan, where I was treated as a civilian patient. This was my third pregnancy and, classically, a high-risk pregnancy as I was already thirty years old and had two past C-sections. Despite this, I was fortunate to have had an incident-free pregnancy that resulted in a C-section delivery scheduled for December 31, 2019.
My first dilemma was to be informed that prenatal reservations will have to be delayed until the fifth month of pregnancy. Women then remain on a waiting list and have to wait several weeks before they can come to their first prenatal visit. In my case, I was given an appointment six weeks after my report to the hospital. I sense the hospital maintains a waiting list of 30 women to be treated one and both weeks. So, at the time of my reservation, more than 150 women were already on the waiting list. I believe that such a secondary hospital deserves to have a higher capacity to accommodate more women in a single day of reserve, thus reducing the waiting era for women.
The service delivery was another cause for concern. The nurses often talk rudely to pregnant women during the group antenatal sessions. In addition, they often fail to harness the opportunity to educate these women on maternal and child health issues. The interactive sessions often dwell on expected items to be brought to the hospital for delivery packs which include basic delivery essentials, hospital cleaning consumables, to the very ridiculous such as a plastic potty. The potty is expected to be used in lieu of toilet facilities which, painfully, are not available for the women during their hospital stay. Instead, they are expected to use the potty for defecation and urination. The patients’ relations are then expected to go dispose of the wastes in a dilapidated pit latrine standing far off a kilometre away from the ward right at the far end of the hospital premises.
The delivery service was in poor condition. Mattresses are used without sheets or screens. Often, a pelvic exam is performed to run women without any privacy, complete shame in the courtesy of other patients. Unfortunately, too, I heard that the roof is leaking rains. Nurses’ beds and workplaces are moved to avoid water droplets. Luckily, I gave birth to the rain-free harmattan season, so I got rid of this nightmare.
My surgical experience was another cause for concern. Although the procedure was said to be free, I was expected to provide all the materials and drugs needed. I was given a two-page list of items to buy ahead. I reported at the hospital a day before the surgery. First, the doctor was not forthcoming with much information. I guess he was not used to being questioned by patients.
I tried to ask the most likely time of the operation to know when to avoid meals as advised for primary surgery. He just said the next morning. To play safely, I avoided eating around 7 p.m., but the C-section segment started around 12 p.m. the next day. So I ran out of food or water for more than 15 hours until about 10 a.m., when I was placed in the intravenous fluid in preparation for surgery.
Now talk of the surgical theatre: it was, expectedly a humble one. The surgical light was an improvised large energy-saving bulb suspended on a plank of wood over the surgical table. I had regional anaesthesia and was awake during the procedure. This was a new experience for me as my previous C-sections were done under general anaesthesia. I would have preferred the general anaesthesia but I was not briefed at all before the procedure. I assume the essence of the regional anaesthesia was to keep me awake and aware during the procedure. However, the doctor took a major decision to make a new vertical incision apart from my previous low transverse incision without notifying me. I just heard him complaining about cutting through the previous incision site, and later said: “this baby needs to come out now”. I only found out after feeling my stomach after the procedure.
Recovery after operation some other “daunting” experience. My mother-in-law was forced to wear the theatre dresses as an unusual practice. Relatives of the patients were required to wear all surgical gowns used through the surgical team. In addition, a plastic bath provided to my mother-in-law in a corner of the room to bathe the bathtub. As a general rule, parents accompanying patients are guilty of bathing and feeding the bathtub and disposing of the trash bag.
There was minimal doctor check. Like the holiday season, the doctor who operated on me wasn’t supposed to take the test for my first day. He arrived at the time of day, showed my stool and allowed me to take food gradually. I had a persistent headache every time I sat down. Although I was told it would disappear after a while, I was behind in the hospital for some other day in an un auspicious environment without a genuine matrix. I was so worried about leaving the hospital for the fourth day with my little wife who was coming in. despite the nausea and a little appetite.
Despite everything, I recovered from a persistent headache and loss of appetite about two weeks later. However, it may not help, but I wonder how things could have happened if it had had complications. In maximum cases, no on-call doctors should be available in case of emergency. The hospital doesn’t seem to have any emergency services active. I have noticed some cases where nurses have had to return to emergencies due to unavailability of doctors. My general feeling of delighting me is the lack of motivation of fitness personnel in the state. I attended a verbal exchange between doctors during my prenatal scale about the exodus of fitness personnel from public fitness services. My interaction with various fitness equipment during my hospitalization reflects a harvest of unmotivated professionals through their race conditions. There have been court cases about administrative disorders in the management of your welfare and painting environment.
Incidentally, COVID-19 pandemic has come to affect almost all aspects of our lives, stretching limited resources and necessitating major cuts in government spending in vital sectors in an attempt to sustain the economy. In the health sector, it appears efforts are mostly focused on managing the pandemic with limited attention to existing health challenges.
It is evident that Osun state is among the least buoyant in Nigeria with the government giving the impression of providing basic amenities for its citizenry. But it should be duly recognised that the health sector is critical to the economy of any community as the quality of healthcare available to people impacts the quality of their lives. The health sector in Osun state appears to be struggling to meet the needs of the people. Officials of the state government, at a ministerial meeting recently, claimed the current administration had revitalised 258 primary healthcare centres which are already delivering services to the residents in both rural and urban areas. Alas, evidence of this seems invisible.
I confess that I may not be versed in the affairs of the state, but my experience over the past few months in seeking maternal and child healthcare has soaked me the reality of the extent of decay in the health sector. Hence, my worry about what may be happening now with the daunting task of managing the novel coronavirus, COVID-19 pandemic.
The physical environment of the State Hospital, Ede, is unwelcoming and would benefit from a general revitalisation of the facility. There should also be greater attention to the welfare of these health workers. This, I believe is imperative in this era of a public health crisis.
Raheemat Adeniran, PhD, is a health communication expert.
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