Saidat Akanbi: Unnecessary deaths at the emergency room door (Y! Policy Hub)

by Saidat Akanbi

Saidat Akanbi ((Y! Policy Hub)

Patients with gunshot injuries should be attended to immediately without requesting police reports… Even a criminal’s life is worth saving, if not for anything but the wealth of Intelligence information it holds.

A couple of days ago, while my aunt narrated her experience of her clinic visit a particular incidence caught my attention. A pregnant woman had been rushed in from another hospital for what seemed to be a complicated labour. The husband and relatives, panting and sweaty had stormed into the Emergency Room (ER), putting forward the referral letter to the nurses. The nurses had promptly attended to the woman in the taxi that served as ambulance, and turned back to the husband and relatives to say she was in a critical condition and would need urgent admission and care which could only be instituted after a deposit of N10,000 was made. The husband had pleaded that treatment be commenced immediately to save the lives of his dear wife and the bundle of joy they had eagerly awaited for nine months whilst they go source for money as they had exhausted their cash at the hospital of referral where the woman had labored for over a day. When their pleas seemed to fall on deaf ears, the husband had to leave to get money. He came back shortly with N4,000, to find, amidst wailing and yelling, his wife and son-yet-unborn still lying exactly where he had left them, but now lifeless.

I did not bother to confirm the credibility of the story, perhaps because I had witnessed a couple of similar occurrences where emergency care was withheld, though with outcomes I couldn’t follow through. On one occasion, a patient with gunshot injuries was denied medical care because the relatives could not present a police report to show that he wasn’t a criminal. I don’t know if he survived, but in Nigeria, a police report is not very easy to obtain (and even more difficult if the incidence occurred at night). On another occasion, a pregnant woman who was actively in labour was turned down at the hospital because she had not registered earlier at that hospital. An earlier registration (called ‘booking’) at the hospital means the woman would have been monitored through pregnancy giving the doctors enough information to guide a safe delivery. But turning her down at such a critical time undoubtedly spells D.O.O.M as she might have ended up popping out the baby in the taxi (with its attendant complications for both mother and baby) on her way to another hospital. Who knows, she and/or her baby might have died from such complications.

Incidences like these call for a scrutiny of some Nigerian ER processes.

A medical emergency means the condition involves acute symptoms of sufficient severity that puts one’s life, body parts or bodily functions at risk of damage or loss unless immediate medical attention is received. In such cases, a delay in instituting emergency care could place the health of the individual (or with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy, or cause serious impairments to bodily functions or organs. In the case of a pregnant woman who is having contractions (in labour), an emergency medical condition (EMC) exists when there is inadequate time to make a safe transfer to another hospital before delivery, or when such transfer might pose a threat to the health or safety of the woman or the unborn child.

In developed countries, where every life is precious, there are laws which protect every patient who presents an EMC. Such laws ensure that a patient’s life is not wagered for money while he is at the brink of death. Every patient is attended to immediately and even emergency surgeries are carried out without discussing money. An example of such laws is the Emergency Treatment and Labour Act (EMTALA ) which has being in use in the United States since 1986. The act gives individuals the right to emergency care regardless of their ability to pay. The hospital must provide ‘stabilizing care’ for a patient with an emergency condition, and this it must do without inquiring about the patient’s ability to pay. After a patient has been stabilized, and his life no more in danger, then the hospital has the option of transferring him to another facility or continuing the management. If he has health insurance coverage, the ultimate question of payment is between him and his insurance company. But if he doesn’t, he will be asked to make payment arrangements with the hospital.

Laws similar to above need to be instituted in Nigeria to protect the lives of every citizen, rich or poor. It is not unheard of that a wealthy man whilst away from his home becomes a victim of a ghastly road traffic accident, becomes unconscious and was rescued by good Samaritans, but was denied emergency care due to lack of funds (ironic). When these laws are in place, the government needs to ensure hospitals comply, and institute penalties for flouting it, which may range from fines to lawsuits.

Patients with gunshot injuries should be attended to immediately without requesting police reports. Rather such patients should be treated, with hospital security keeping watch and the hospital should thereafter notify the closest police station before discharging the patient. Even a criminal’s life is worth saving, if not for anything but the wealth of Intelligence information it holds. Measures also need be put in place to protect medical practitioners from some underhanded policemen who harass them for treating such patients without a police report.

Although it may seem far-fetched at the moment, the Nigerian healthcare system is in need of an electronic central data bank, so that medical records of a patient can be retrieved by doctors when needed, irrespective of where the patient finds himself. This way, a pregnant woman in labour need not be sent back to the hospital where she booked.

Human life is invaluable, and ALL efforts must be made to save every life irrespective of the prevalent circumstances, and without putting a price tag to it.


Dr. Saidat Akanbi: (nee Bello) is presently undertaking the mandatory one year National Youth Service at the 2Div Military Hospital, Ibadan after graduating in 2010 from the University of Ibadan Medical School where she was a prize-winning student. She hopes to specialise in Public health & community medicine. She tweets from @drsaidah.


Op-ed pieces and contributions are the opinions of the writers only and do not represent the opinions of Y!/YNaija.


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