Tunde Ajaja

She had become thoroughly exhausted by the time her mother and her driver helped her out of the rear seat of the black sport utility vehicle that morning. With pockets of pain all over her face, she was limping, breathing with so much effort, as they slowly made their way to the entrance of the maternity ward of the Ifako Ijaye General Hospital in Lagos.

Her health seemed to be failing her, thus, she settled into one of the chairs outside the ward to have some rest and attend to her baby who had been crying in the arms of her mother. After some minutes of rest, she proceeded into the ward for treatment.Since about two months ago when she was delivered of a baby girl in the hospital, Mrs. Rose Adesina, as she later introduced herself, has been confined into a world of pain, and suffice it to say life has been hellish for her since then.

Struggling to muster some strength moments after her treatment, she told Saturday PUNCH that her failing health might not be unconnected with the way she was treated shortly after her delivery.

Her explanation was simple, but shocking. She said few hours after she was delivered of her baby boy, one of the nurses in the ward told her to pack her things, vacate the bed and sit on the chair to allow other women have access to the bed space.

That development, which findings revealed as being synonymous with the hospital because of the constraint of space and the need to attend to other women in labour, did not only rob her of the much needed rest after delivery, she has since been living in pains.

She recalled, “I was delivered of my baby girl around 1am and moments later I guess I slept off. Very early in the morning, a nurse came to me and said I should pack my things because I would need to go and sit on a chair, pending the time I would be discharged, so they could admit another person to use the bed.

“I thought I was dreaming, so I had to wipe my face and be sure what I heard was real because I was tired and could barely talk loudly. I asked her why she wanted me to stand up from the bed and sit on a plastic chair when I was just recuperating. She said there was no luxury of space and that there were people waiting to be admitted.

“By that time, all the parts of my body were aching and all I needed was rest, but I had to stand up. In fact, when my husband came in and met me sleeping on the chair, he was disturbed and screamed. They explained to him but it just didn’t make sense to him, just as it was like a dream to me.

“They laid my baby on the floor while I sat on the plastic chair for about five hours, writhing in pain. By the time I was discharged later in the day, I had become so depressed, miserable and weak, with cramps in my stomach and all over my body. Since then, I have been on drugs and that has made me a regular visitor to the hospital for post-natal treatment.

“It’s painful. If I had known, I would have gone to a private hospital because even when I had my twins; a boy and a girl, I wasn’t this sick. All through the time I was on that chair, it was as if I was dying because all the parts of my body were going numb. I had a backbreaking delivery, so, to deny me of a quality rest was simply wicked.

“In fact, the nurses told me that someone stood up for me so I had to stand up for someone else. It was during a brief interaction with other women on my way out of the ward that they told me it was a norm because of the crowd and the inadequate bed space.”

Adesina’s experience highlights what pregnant women go through in this all-important hospital, where women who had just been delivered of their babies are told, sometimes compelled, to vacate the bed and sit on plastic chairs so that other pregnant women in the queue could be admitted.

As the only main General Hospital in the area, catering for the health needs of residents of this part of Lagos, including Ogba, Ojodu, Agege, Abule Egba and many others from neighbouring towns in Ogun State, including Agbado, Sango, Mowe, Ibafo, among many others, the number of patients, especially pregnant women, that besiege the hospital almost on a daily basis is often enormous.

On entering the hospital, the maternity is about the only new building, standing gigantically on the left side of the premises. It comprises emergency ward, children ward and four other maternity wards. Each of the four wards comprises about 16 bed spaces. But as fascinating as it appears, it appears inadequate to cater for the number of pregnant women that besiege the hospital daily.

During our correspondent’s visits to the hospital, the number of pregnant women at the premises was simply alarming. It was however gathered that the facility receives tens of pregnant women on daily basis.

This was further evidenced when our correspondent visited the premises on Thursday, the day set aside for them. The number of women at the antenatal waiting area was about 100 as they were being attended to by the nurses.

Due to the enormous pressure on the hospital, our correspondent observed that pregnant women are constantly in the queue for bed space to have their babies, and as soon as one is delivered of her baby, another one would be warming up to take possession of the bed space. One of the nurses confided in our correspondent that any woman who had a normal delivery and without complications would “definitely” be discharged outright because of the shortage of space.

Ifako as preferred choice for many

The Ifako General Hospital does not attract such human traffic only because of its location, findings revealed that the relatively cheap cost of medical care and the expertise of its medical personnel have made it a preferred choice for many.

For example, the cost of registering for antenatal care in the hospital is about N7,000, which includes the cost of certain kits that would be made available to the woman before, during and after delivery. This is largely in sharp contrast to what obtains in some private hospitals in the area whereby the amount payable for antenatal care falls between N15,000 and N30,000, which is considered by many as unaffordable. And in some cases, the payment continues till the woman is delivered of the baby.

Furthermore, the cost of delivery in the hospital is also considered as cheap when compared to others. A member of staff who is privy to the charges said, “If a woman gives birth to a girl and it’s through normal delivery, it costs N25,000, but if it’s a boy, the cost is N27,000 and the N2,000 difference is for circumcision. If the delivery is through Caesarean section, the cost is about N100,000. It could be more or less. However, if the woman didn’t register for antenatal care with us, it could be more than that for both normal delivery and CS. The cheap cost of medical care and availability of specialists are part of the things that endear the hospital to many and that is almost becoming a problem because there are too many people.”

In comparison, when our correspondent visited some private hospitals in the area to be able to compare their charges, apart from the fact that there were fewer patients, the cost in the private hospitals were higher.

Cost of normal delivery in some of the hospitals range from N30,000 to N45,000 while CS could be as high as N150,000, depending on the complexity of the situation.

It is worthy of note that the amount payable for delivery is independent of the one paid for antenatal care.

It was also observed that majority of the patients at the General Hospital were low- and middle-income earners, who are remunerated based on N18,000 minimum wage. While most of those at the private hospitals appeared to be above-average citizens, in terms of income.

Some pregnant women told our correspondent that the proficiency of the hospital in maternity issues drew them to it. “And that is why people come from far places to use it. Even though the idea of telling people to quit the bed and sit on a plastic chair after delivery has left some people in agony, complications and unpleasant experiences, people still come here,” a pregnant woman from Ikorodu told our correspondent.

On occasions when our correspondent gained access into the wards, it was usually a pitiable atmosphere, as some women sat on chairs with newly-born babies on their hands, all the bed spaces were occupied. Due to the constraint of space in the ward, some had to sit at the entrance and were obviously waiting for their turn.

On one of such visits that our correspondent entered the ward, from one end of the ward, one could not but notice the cries of a new-born. Wrapped in a wool blanket and placed on a chair beside her mother who was visibly weak and frustrated, the baby kept crying and was inconsolable.

Findings showed that the mother and child had been moved to sit on the chair shortly after the delivery because of an emergency case for which another woman had to be admitted on the bed.

Endless frustration of patients

The agonising experience of Mrs. Jegede Josephine can be likened to what Adesina also went through in the same hospital. She had shunned the private hospital in her area for the Ifako Ijaye General Hospital so as to save some money. However, she said that apart from spending more than she expected, she left the hospital in pains.

Our correspondent met with Josephine in the premises of the hospital, where she sat under the waiting shed, fanning herself and pampering her twins on the Tuesday afternoon while on a visit for treatment for post natal care. She was apparently still recuperating. She said that despite the fact that she had a laborious delivery of her set of twins, few hours after, she was asked to stand up from the bed and sit on the chair pending her discharge “so as to admit another person.”

She added, “I was delivered of my babies around 7pm. About five hours later, a woman was rushed in and all the beds were occupied, so, I was told to stand up and use the chair so they could admit the woman who had an emergency, because other women in the ward were either close to delivery or were delivered of their babies after me.

“Eventually, I had to stand up and sit on the chair by the entrance while they quickly rushed the woman in. I sat on that plastic chair for hours. I couldn’t even sleep very well. I had to be moving up and down because my legs and some parts of my body were getting numb until a nurse gave me a cloth that I laid on the floor. Then, they laid my babies on a piece of thick cloth on the floor beside me. I was terrified.

“I felt like crying with what I was going through and seeing my babies on the floor, and that was how we all slept till the following morning. As early as possible, I made sure I was discharged and I went home to rest. If I have to conceive again, this is the last place I will come to because I heard that is the way it has always been in this hospital because of space problem.

“In fairness to them, it’s not entirely their fault. They just need to save lives and help those in labour and since there is no adequate bed space, they have to find a way, just that some women who are not strong might end up with some post-natal complications, and that is I why I’m here for treatment.”

Josephine said even though she was constrained to stand up because of the situation of the person being brought in to take over her bed space, she had yet to recover from the trauma she suffered from the development, saying she could have been moved to another ward just to sleep instead of leaving her and her babies to sit on the chair.

In Ifako hospital, pregnant women dread ‘Nigeria’

While women with natural delivery go through such a terrifying experience, the experience of those (pregnant women) who go through caesarean section does not seem better. Findings showed that usually, three days after the operation, in order to create space for others to be admitted, such women would be moved to the old two storey building, popularly known as ‘Nigeria’ for their recovery.

But ‘Nigeria’, which is behind the new edifice, called ‘London,’ is dreaded by most pregnant women, especially those who have been admitted there before, and the main reason for the reluctance is the swarm of mosquitoes in the building. The wards reserved for such pregnant women were labelled Annex one and two on the ground floor.

Due to the bed space shortage, women in this hospital are either compelled to sit on the chair (for normal delivery) or transferred to Nigeria, where mosquitoes roam freely.

Mrs. Emmanuel Sefunmi bemoaned her experience in the hospital in a chat with our correspondent. She said after she was operated upon to have her baby, she was moved to ‘Nigeria’ after three days in the ward so that other people could make use of the bed.

She said, “In Nigeria, I saw hell. The mosquitoes there were just too many. It was as if they were on a special assignment. I and my baby left that place with malaria symptoms and since then, we’ve been treating malaria. The hospital looks very attractive, and no doubt many people prefer to use it, but some of the experiences here are just painful.

“Assuming I was left in the ‘London’ maternity ward, I wouldn’t have had malaria because the place is safe and healthy, but that ‘Nigeria’ is something else, especially with the issue of mosquitoes.

“And what I went through is the same with what many other persons go through because there is no enough bed space. Once they see that you are getting better and you are able to move, you are on your way to ‘Nigeria’ because other people are waiting.”

Interestingly, as much as patients dread ‘Nigeria’, there is a suitable alternative for those who can afford it. Findings showed that there is a private ward in the new building where people who went through CS can be admitted for a higher fee, especially those who don’t want to go to ‘Nigeria.’

A nurse, who spoke to Saturday PUNCH on the condition of anonymity for the fear of recrimination, said the cost of staying in the private ward is about N2,800 per day after paying a certain amount.

“And the place is fitted with items of comfort, just that it is not everybody that can afford it. But for those who can, it is a good place to be after delivery,” the nurse added.

Beyond the rather painful experience of pregnant women in the hospital, patients queue and sit endlessly to be attended to, while some other people who visit the hospital have had to go back and look for alternatives because of the shortage of bed space in some other wards in the hospital.

No doubt, the hospital buildings are modern and very appealing, but beyond the aesthetics, the hospital is in dire need of expansion and improved service delivery from the health care providers, to forestall the volume of avoidable pains and lamentations emanating from it, occasioned by the inadequate bed space.

Suffering in the midst of plenty

Notably, beside the hospital is an uncompleted stadium occupying a large expanse of land. Some of the patients and visitors to the hospital wondered why the hospital should be starved of space while an uncompleted stadium that had not been put into maximum use would boast of better space.

They, however, called on the state government to look for ways to expand the hospital and build more general hospitals in other areas to reduce the pressure.

One of the nurses said, “We are overwhelmed by the crowd and that is why in our maternity ward, people are discharged as soon as it’s safe to do so. Sometimes, people come from Mowe, Ibafo, and even Ikorodu. It’s that serious. So, government needs to help us to help the people.”

When confronted with some of the issues raised concerning the hospital, the Lagos State Commissioner for Health, Dr. Jide Idris, told our correspondent on the telephone that the government was working to improve the health care system in the state.

He explained that government was aware that some of its heath facilities had been overwhelmed due to the influx of patients and inadequate health facilities across the state, but noted that more health care centres would be created to adequately cater for people’s health needs.

He added, “I don’t have the details of the situation in the hospital, but on a general note, we are focusing on increasing people’s access to medical care in all dimensions. We would also make sure that facilities that are not functioning optimally are maximised. That is why we are working on boosting our primary health care system to take care of such preliminary cases.

“No doubt, we have more people than the facilities available, so, we will create more centres to adequately serve parts of Lagos that have not been covered, and the quality of health care will also be improved upon. So, I will get details of that hospital and deal with it appropriately.”

When asked about the poor attitude of some health workers to patients, Idris promised that the situation would be addressed, but noted that it would be a continuous exercise.

He added, “I agree with you that it (health workers’ relationship with patients) is one other area that we need to address, and in addressing that, we have to find out the causes and work on them. The primary objective is for patients to be treated with respect, but unfortunately, some of our health workers have not imbibed that. On this, we are going to focus more on attitudinal change. It is not something we can do overnight. It has to be done continuously.

“Another thing we would do is to teach them about this vital issue right from when they are in medical school, so that this attitude can be properly inculcated into them. I do agree it’s a major problem that we need to address and we will address it.”