© 2019 - International Centre for Investigative Reporting
How doctors’ negligence, malfunctioning equipment at Asokoro District Hospital led to the death of anti- human-trafficking advocate
WITH a big smile on his face and his baby cradled in his arms, a proud father of a newly-born infant and his wife made their way toward the taxi park at the Asokoro District Hospital in Abuja, the Federal Capital Territory (FCT).
The couple seemed too overwhelmed with joy to notice a group of protesters, dressed in black t-shirts on the other side of the hospital premises until they walked into them.
Tears were coursing down the eyes of some of the protesters as they sang in unison. Their sorrowful chorus made the couple stop in their tracks and inquired from the taxi drivers nearby. But the banner they were carrying said it all: #JusticeforKaffy. #Fixourhealthcaresystem. On the banner was the face of a young lady in her twenties.
On the last Valentine’s Day, Abdulazeez Kafayat, a 25 years old anti-human trafficking advocate had sought medical help in one of the country’s prestigious government hospitals – Asokoro District Hospital.
The hospital, sited in a highbrow area of the FCT, is often referred to as a medical centre for the middle class who can afford premium medical bills.
When she walked into the emergency ward on that fateful day due to a fever that had started a day earlier, Kafayat never knew she would be leaving the hospital in a body bag.
“She was a sickle cell patient. She had gone to the emergency unit herself that morning because she was running a high temperature. She had called me to meet up with her there. It was when I arrived that she told me it had taken hours for the hospital to place her on admission,” Jemilah Abdulazeez narrated the death of her sister to The ICIR.
Jemilah said the doctors had earlier started to treat her sister for pneumonia, but after a scan was run, the family was told it was an unidentified heart infection. Unfortunately, the X-ray film could not be interpreted as it was not submitted with a report.
“They said they didn’t know what the scan was saying, that the personnel at the X-ray department did not write a report and that they would need a specialist to interpret the scan before they could do anything,” Jemilah said.
With no specialist present to interpret the scan, the doctors had no clue on what the diagnosis was and could not treat her.
Kafayat spent the day in the emergency ward with no treatment but was drawing energy from the presence of her loved ones.
Abdul, Kafayat’s brother who is yet to accept the reality of the passing of his sister in an embittered voice interjected at this point, he told The ICIR that, “About 9.Oclock pm after I had fed her, I went home for the first time that day from the hospital. But after a few hours, I got a call from my mother.
“She said that my sister was acting funny. This was around 11: am to 12 am on Saturday morning. I rushed back to the hospital. Only to see my sister struggling to breathe. At some point, they told us to buy blood. But the blood was not transfused immediately due to her pulse level.
“One of the heartbreaking moments for me was that even after the transfusion was done, there was still no doctor to attend to her,” he said.
Jemilah told The ICIR, that when the nurses were calling the consultant, she overheard the person at the other end asking if it was an emergency and despite the affirmation, the consultant said she would not be coming until the next day.
When the consultant finally arrived at the facility in the morning, Abdul said her disposition to his sister’s medical condition did not bring any succour to the family.
“She just asked the nurses some questions and then told us that they have done everything they could, that we should just buy more antibiotics,” he said struggling with tears.
According to the doctor that first attended to Kafayat, the deceased was supposed to be placed on a particular medication.
However, twelve hours after the prescription had been made, the nurses did not tell Kafayat’s guardians about the drug prescription.
No oxygen for emergency patients
Jemilah also recounted how her sister was denied the use of the oxygen available at the time even though it was an emergency.
“’There was no oxygen’, they told us they don’t have and that the one in the ambulance stays in the ambulance no matter the condition of the patient. Though at that point we were at the emergency unit where this oxygen was meant to be used for emergency situations.
“Finally, when some were brought, it did not work properly. At some point, it stopped working altogether. and none of the nurses knew until a doctor came for the morning rounds and noticed that the oxygen was not working” Jemila said, pausing to ask her brother Abdul who was also at the hospital with Kafayat to continue from where she had stopped.
Abdul, the deceased elder brother also confirmed that twice between midnight and dawn the oxygen had stopped working.
“For the second time at midnight, my sister was struggling.”
Before her death, Kafayat was an active advocate in one of the anti-human trafficking agencies in the country—DEVATOP Centre for African Development.
Joseph Osuigwe, the Executive Director, DEVATOP, in an interview session told The ICIR that the death of Kafayat came as a shock as she was a committed member of the team
“Kafayat was a lady who has impacted communities, the less privileged, and even has a line-up of community projects for this month. So many indigent people depend on her to put a smile on their faces, as she usually does.
I am not the only one that can give her the injection … Nurse Ogochukwu
The sister of the deceased also told The ICIR that they had to plead with the nurses on duty to come to administer Kafayat malaria prescribed injection.
“I had to beg the nurse to come and give her the injections that the doctor prescribed for her.
“I overheard her asking whether she was the only one in the ward to give her the injection. It took about an hour for her to come and administer the treatment,” Jemilah said.
The deceased’s siblings said that a particular prescription was not administered within the first 24 hours of Kafayat admission because the nurses failed to inform the family promptly. They said it took the intervention of a doctor to get the nurses to do anything about it.
“This was over 12 hours from the time she was supposed to get that treatment,” Jemila said her trembling voice now rising.
“Why did the nurses not tell us? She questioned nobody in particular. I can assure you money was not the problem. She went to the hospital and called me when she was there. It was not as if she was rushed in like an accident patient.
Jemilah recounted that at a stage, it was taking the intervention of another patient in the same ward with Kafayat who seemed to have better connections and good rapport with the medical team in the A&E to give them the necessary attention.
“Those people, out of negligence, killed my sister. They let her die,” she said fuming.
Laboratory results obtained by The ICIR showed that she was also been treated for malaria at the time the hospital was also treating her for pneumonia and an unidentified heart infection that they had diagnosed through a scan.
Due to her experience in the government hospital, The ICIR gathered that Kafayat before her death had pledged to start a campaign against the inhuman treatment meted out to patients in the hospital in order to call attention to the issue. She was hopeful the conversation will draw the attention of all stakeholders, her sister recounted.
Hospital’s management defence—a delayed prescription did not kill her
Uche Ufomah, the medical director at Asokoro District Hospital dressed in African prints fabric, accompanied by the head nurse, Mrs Nengel and the Head Physician, Clinical Services Asokoro District Hospital, Nnabuche Chidi, invited this reporter to her office.
At her office, the MD preferred that Dr Nnabuche Chidi speak to The ICIR, expressing her discomfort at having her voice on tape.
“I would prefer you don’t record anything. Hear from us and make up your mind on what you need to do,” she said.
Dr Chidi, a fair and stoutly built man dressed in impeccably in English dress said he would not tell the ailment that brought Kafayat to the medical centre because of doctor-patients’ confidentiality.
“We cannot discuss her issues. Unless we have the go-ahead of the family,” he said.
“Yes, she was admitted in the emergency ward. When she came in, she was very ill and all the doctors were around to attend to her. There was never a time she was left unattended to.
“All the members of staff that were supposed to see her attended to her. She was seen by a cardiologist– Doctor Fagbemiro, and a nephrologist –Doctor Alatishe,”
Doctor Chidi vehemently refuted the claim made by the deceased family that the emergency ward didn’t have enough doctors and therefore had none to attend to Kafayat.
“No matter the shortage of doctors or nurses, there always close to three doctors in the emergency ward. So I don’t know where all these stories of another patient calling in favours for a doctor to come and see her came from.
“Occasionally, we lose patient from time to time I agree. But it is just the way it happens, it is not because the person didn’t receive the needed care, or just out of negligence.
“If you have done your best and the patient’s health keeps deteriorating and the person dies, there is nothing you can do. It happens everywhere in the world,” he said.
Chidi and Ufomah were equally quick to counter The ICIR when the question of negligence in the administration process was asked. They claimed that the prescription was just an additive to what was already administered.
“It was supposed to be an additional drug that was added to the first one,” the medical director said visibly irritated.
Dr Chidi dismissed the twelve-hour delay of medication as a trivial issue, stressing that a delayed medication does not have any grievous consequences for the patient as he likened the situation to a delay to take antibiotics for a boil. But he confirmed to The ICIR that every prescription for the deceased was important.
“So they [the deceased family] said that the prescriptions were not given. But those on duty said they were given the prescription. This is not the first time that prescriptions will be given to the patients and it is not provided immediately.
“She was on other treatments. She was on antibiotics. But that one or two treatments she didn’t get is not what killed her.
“For you to write a prescription that means that it is important but it was just an additional one.”
“When you have a boil on your eye and you don’t take antibiotics immediately and leave it for a few hours will you die?” He queried the reporter, comparing Kafayat’s situation to an infectious boil as the Medical Director soliloquising to herself at this point murmured sickle cell.
The family would later insist that Kafayat received only one antibiotic treatment on the 15th of February on Friday around 7 o’clock pm.
The Medical director also claimed that the hospital provided oxygen for Kafayat when she needed it.
“The oxygen in the emergency ward is not controlled by anyone. It is piped in the emergency through the wall.
“Here we go extra miles. If it is in some other hospital maybe like National Hospital, I wonder what you people would have been writing by now,” Dr Ufioma said comparing Asokoro General Hospital to other government hospitals.
“We have limitations but it is more of space limitation not when it is about care. Looking at her files, she had all her medications.”
However, The ICIR sought to confirm from other medical practitioners if the delay in the administration of a drug prescribed for an emergency patient could compromise the health status of the patient.
Doctor Benjamin Olowojebutu, a Maternal Health Specialist and founder of the Benjamin Olowojebutu Foundation (BOF), seem to have a different opinion from what the Head Physician and the Medical Director in Asokoro has.
Olowojebutu told the reporter that such a long delay in the administration of a medication for an emergency situation will lead to treatment failure.
“That would mean that other treatments given before then will relapse.”
Doctor Osifo of the Federal Medical Centre (FMC) also confirmed that any delay in the administration of a particular prescription for a patient that is in a precarious situation might likely hold severe consequences which might eventually lead to death.
Despite the counter-opinion of professional colleagues, the medical director of Asokoro General Hospital insisted that the medical team had done what they were supposed to do, and yet said the management would need two weeks to investigate the death of the young advocate.
The hospital management did not permit The ICIR reporter to speak to any of the doctors or nurses that attended to Kafayat while she was on admission in the hospital.