The Lagos University Teaching Hospital (LUTH) is a Federal Government owned tertiary health care provider located in Idi-Araba, Surulere Lagos. It is one of twin organisations (alongside The College of Medicine of the University of Lagos) established by the Federal Government of Nigeria for the education and training of medical personnel (undergraduate and post-graduate) as well as for providing specialised medical care for patients.
This is a two-fold review of my LUTH experience as a Medical Student and as a Patient.
LUTH employs thousands of workers and they range from the highly specialised consultant doctors to cleaners, and all work in tandem to ensure that the patient has a memorable experience during their treatment and rehabilitation in the hospital. But Alas! The experience, while always memorable, isn’t always savoury and thus to the common man, the hospital is a recipient of mixed reviews. Some believe that LUTH is the pinnacle of Nigerian medical science and thus is Nigeria’s last beacon of hope to the ailing and to the deathly ill. Well, that belief isn’t entirely unfounded as LUTH currently boasts, by a wide margin, of the highest amount of specialist doctors in any Nigerian hospital and thus patients are guaranteed knowledgeable professionals in their search for resolution of specific illnesses. Others believe LUTH to be the devil’s own receptacle, hence the saying; “You only go to LUTH for treatment when you are ready to die”. To the average observer of the Accident and Emergency department of LUTH, which is often the main point of entry into the hospital, there appears to be an awful amount of death going on as every other half-hour, you see a corpse getting wheeled out and all you see is either the bustle of the relatives of those hanging on to life by a thread or the sorrow of relatives who have just lost a loved one. The truth about any hospital is that not all the patients that come in are going to leave alive and what every hospital does is to maximise the chances of survival of their patient.
At LUTH, there’s the caste system of seniority with each level being firmly under the next; Consultant, Senior Registrar, Junior Registrar, House Officer, Medical Student. Doctors go on rounds (in groups) everyday, checking up on each patient that has been placed in care of their units but due to the sheer amount of patients remitted to each unit, these doctors are unable to spend more than just a few minutes at each patient’s bedside. All they check for are the basics; stability of the patient, improvements or new devolvement and then they make their comments in case notes. The Consultant Ward rounds are worse as most Consultants are more interested in discussing the patients and ‘tackling’ the knowledge of the junior doctors, as opposed to actually checking up on the patient. So what a Consultant round often yields is just a confirmation of the observation of resident doctors and nothing more. At night, there often are doctors from each unit ‘on call’ in each ward but in reality, only a House Officer is present and this persons sole job is to disturb his superior only when the patient’s case has gotten out of hand and often at death.
There is the Bureaucratic Inter-departmental passing of the buck in which various departments or units (especially those at loggerheads) constantly reject patients referred to them or dally in their acceptance of such referrals. There’s also interdepartmental conflict (what a lay man would relate to as friction). Take for instance, the ward rounds. During these rounds as a student, you get to witness this friction on first hand basis. A practical example can be seen in a case of an accident victim. The consultant instructs that the patient should be ambulated (start walking re-education) and the physiotherapist who specialises in this area insists that the patient isn’t fit to start walking. Both practitioners end up confusing the patient. Nurses are not exempt from this practice as you often have nurses who conclude that their patient’s moans of pain and discomfort are just a ploy to get attention (duh, that’s why they are in a hospital). So the nurses busy themselves chatting away while their ‘attention-seeking’ patients slowly moan to their deaths then there is the rush of ‘writing memos’ which are simply devices of absolving themselves of blame in a patient’s death. Most patients don’t even know that there’s something called Rights and Responsibilities of the patient. These patients are left at the mercy of the medical practitioners, who are not to be blamed most times because of the swamp of patients in their care and degenerating facilities available for patient care.
Patients of the hospital often accuse their care-givers of negligence, however, the LUTH employees counter this accusation with the argument of being effectively under-staffed. Take for instance, the average ward which contains 28 beds, most of which are occupied by critically ill patients who require much attention. Such a ward is manned for most of the day by 4 nurses who are then required to use their discretion in deciphering which patients to attend to and at what time.
My own first hand experience as a patient in LUTH: On this particular day I had this deep cut on my foot from a broken glass. I was rushed to Accidents and Emergency and on getting there, the nurses totally ignored me with the excuse that the nurse meant to attend to me wasn’t on her work post. I spent close to 2hours before I was attended to (not regarding the fact that I am a Medical Student). This definitely shouldn’t be the case in a prestigious hospital like LUTH. It is called Accidents and Emergencies for the intention of all cases passing through to be treated as emergencies. When all is said and done, LUTH is one of the major health providers in the country and I must say that I feel privileged having had the LUTH experience. Like every other organisation, LUTH is subject both to the advantages and the disadvantages of having human beings work together in tandem towards a common goal and these disadvantages, in my opinion, are more magnified at LUTH as the the doctors are highly cerebral, well-read people with huge egos. The organisation is just a potpourri of egos where each department’s sole goal is to prove themselves better than the next and not necessarily to help their patients attain good health or get better.