Dear LIB readers; Letter from another Nigerian doctor

This is in response to this. Read below...

This write-up is from a Nigerian doctor to your LIB fans who responded to your post about the doctor that “forgot” a pad in a lady. What I think happened is that the woman had a pad placed to absorb the vaginal bleeding after the surgery. The pad was placed in the vagina and left there for two days, at which point the woman left her hospital bed for the doctor’s office to complain about it. Whatever the case, leaving that pad there for 2 days was an oversight on the team’s part whether the patient was informed to remove it or not, and it could have led to infections and other complications. For that, the doctor and nurses were at fault no matter the reason.

But what I want to address is the general hostile attitude of the public towards doctors over reasons such as: doctors are proud and arrogant, they love money, they are incompetent, etc. I can’t address all these points, but I’d love to address the obvious expectation of the Nigerian public that doctors should, in fact, be PERFECT.

Let’s start from the beginning of a doctor’s career: the training. Nigerian doctors are trained in the same Nigerian universities that produce virtually-intact illiterates. I mean graduates that cannot speak or write good English or spell words correctly (like most of those that comment on your blog or on Facebook). Just a few weeks ago, we gave a “corper” a form to fill and where she was to fill her “sex” after her name and age, she wrote “about twice a week” instead of “female.” Wow! And then she proceeded to bombard us with spelling and grammatical errors, yet she was teaching in a primary school. A graduate! Most Nigerian graduates cannot defend what they claim to have spent 4-5 years studying because of the low quality of education they receive. But the Nigerian doctors trained in these same universities are expected to sparkle like their foreign counterparts? Seriously? 

Let’s go to the issue of competence. A lot of doctors do great things every single day. I mean, a lot! But when a few doctors out of the thousands in the country do something wrong, it’s generalized. What about other professionals in Nigeria? Take engineers, for example. How are the roads in our country? I mean the ones that have been repaired about 5 times with billions of naira and still have gaping pot holes? What about the buildings and bridges that collapse all over the country? Or the road drains that don’t lead anywhere and only store stagnant water and garbage? Or the electric poles and street lights that fall on their own? Why does no one scream about the incompetence of our engineers? What about the bankers that steal from clients’ accounts? Every field inevitably has “bad eggs;” you don’t generalize what you experience with one case to every one!

Now, most of the government hospitals your government gives us to work in lack the basic resources needed for proper health care. They either don’t have equipment, or have non-functioning or out-dated ones - like X-ray, CT, and ECG machines built in the 80’s. Laboratory reagents and machines needed to carry out basic tests for diagnosis are usually lacking; of course, advanced tests are only read about in medical textbooks. Some expensive private labs I know send patients’ blood and other samples to S/Africa! We, the doctors, are not responsible for providing these equipment or paraphernalia; the government is. Yet when you come to the hospital and we are essentially handicapped, you’d say “these doctors don’t even know what they are treating or doing.” Even ordinary syringes, IV cannulas, urethral catheters etc are scarce commodities; it’s in Nigeria that syringes are prescribed with drugs for patients. As for the drugs? Even the “out-dated” drugs that were discovered decades ago that we still use (even though our foreign counterparts have abandoned them) are not readily available. Modern drugs can easily be gotten in South Africa or Egypt but not Nigeria. How then would the Nigerian doctor be able to make that same diagnosis that those doctors make? Or even treat you? Or treat the most basic of health issues? My people, don’t just shout. Think!!!

Should I talk about the staff shortage? Do you know that in developed countries it is illegal to work for a particular number of hours on a stretch? Even for company drivers, not to talk of doctors. It is because when you rest after some work, you function better later on. I once worked in a delicate unit in a teaching hospital where I was on call for one month straight! I would work in the morning from 8am – 4pm and then start my call from 4pm to 8am the next day (while most of you were in clubs or with your families). For one full month! Shebi I’m a machine? Or a slave? And I don’t want to see my family because they are masquerades, right? And then one night, while I was on the 5^th floor attending to a delicate patient we performed surgery on earlier in the day, they started calling me at Accident/Emergency (ground floor) for an emergency case that just rushed in for my unit. The same me that had to attend to this patient who needed immediate attention? The same me that stood all day in the theatre? The same me that hadn’t had a good night’s rest for almost 2wks? I didn’t have 4 hands, 8 legs or 10 heads, so I had to hurriedly finish with the patient upstairs and fly down there. If you were the one that came to the A/E with a loved one, you would say “the doctor wasn’t even around” or “the doctor was sleeping” and you would start screaming at me when I finally show up. Because you’re in your own world that’s very different from mine. When you see me unavoidably grumpy and irritable after two weeks of such calls, you would say doctors are rude and arrogant. Or when I end up forgetting something or doing something wrong cos of how over-worked I’ve been, you would scream murder! It’s depressing. I didn’t choose to work like that; I was forced to! You want to sue? I’m looking for who to sue too!

I have a lot to say, but let me stop and summarize: the Nigerian system as a whole is riddled with corruption and all its consequences. Nothing works, nothing is as it should be. The health care sector is part of the Nigerian system; you can’t have other sectors like power, agriculture, economy, judiciary, even foreign affairs (remember Morocco?) in a depressing mess and expect the health care sector to be all shiny and rosy simply because life is involved; the same issues affecting the others also affect it. It’s true that there are cases of malpractice now and then (which happen even in developed countries), but the main issue in most cases is the poor health care structure we have to work with. Until we can get our leaders to see such important things as important, you’ll just keep complaining. And until our leaders are constitutionally forced to send their children to Nigerian universities and seek medical care in Nigerian government hospitals (which would make them put things in order), nothing will change.

Thank you.