By Chukwuma NNAMDI
THE management of Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, Anambra State, recently averted industrial unrest after reaching an agreement with members of the National Association of Nigeria Nurses and Midwives, (NANNM), that had threatened to begin strike action after a one-week ultimatum.
A letter titled “NANNM NAUTH DEMANDS: Re: Covid-19 Pandemic in NAUTH addressed to the Chief Medical Director of the Hospital expresses the concerns of the nurses and midwives of the teaching hospital.
The health workers wanted an adequate supply of personal protective equipment, and information on the number of suspected cases of COVID-19 managed by NAUTH.
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The information should include the number of confirmed COVID-19 cases in NAUTH, number of nurses exposed to COVID 19, number of nurses tested and their results.
They also want to know why CMAC is not signing unit heads’ requests in view of the provision of adequate PPE, among other requests.
The letter noted that as front liners in the battle against COVID 19, the nurses have the legal right to a healthy and safe workplace hence they are not under obligation to provide high-risk services without appropriate safety protection.
Signed by Chairman, Com H.U Nwobodo, and Secretary, B.N Emerson, the letter warned that the nurses would withdraw their services if the demands were not met within one week.
In an interview, Nwobodo decried the delay by the management of NAUTH to address their concerns as well as cater for the welfare and well-being of members.
He accused the hospital management of exposing staff (including nurses) to danger, noting that recently when a patient, who finally tested positive for COVID 19, came into the hospital through the Accident and Emergency Unit and was later transferred to the medical ward, it caused palpable fear in all members of staff.
“The person came in through the Accident and Emergency Unit and was later transferred to the medical ward. This person was being treated in the ward and nobody knew about his status until a test was conducted on him and the result came out positive. The patient was then taken to the General Hospital, Onitsha, where they have an isolation centre.”
He is worried that many people were already exposed to the patient. “The question is – how are you treating those already exposed?” he wondered.
…a voice from isolation
One of the nurses in isolation who spoke with The ICIR under anonymity complained bitterly about the condition in the hospital.
“I am not surprised but I am disappointed in the management asking us to go into self-isolation in our respective homes. In fact, my own worry is that the patient should not have been treated in the ward. Once they suspected a case, they should have isolated such cases from other ones. But they left him for forty-eight hours after the sample had been collected and we were managing him. All the nurses in that place were just coming in contact with the patient. That was the disappointment”.
The nurse also was bitter that as at Wednesday, June 3, there had been no call from the management to find out how she was doing.
“They have not called. Tomorrow (Thursday) makes it a week since we were asked to go and isolate ourselves. I am on my own now, that’s what it means but I believe that nothing will happen to me. It’s just that whenever a case is suspected, they should remove such cases from every other patient. We have an isolation centre, which was meant for Lassa fever then. Currently, I don’t know it’s present state whether they are using it or not. I don’t know, I am not sure. I don’t work there”.
The nurse, who had gone spiritual hoping that nothing goes wrong with her, gave the management some advice.
“My advice is that whenever a case is suspected, they should not take it to where every other person is being treated. That person was there for one day I worked and I left him there. Nurses, portals and every other one stays longer in the hospital than doctors who will come only when on call. Nurses stay with patients and sometimes they will call you. When such calls come, you must attend to them twenty-four hours. That is why we are more endangered than doctors.
“However, we are expected to work with our conscience. While the treatment lasted, the only PPE we wore was N-95 masks. No other thing. But my own point is that that person should not have been where he was treated. He should have been separated from others. That place is not suitable for him. It’s not ventilated. He shouldn’t have been left there. This is not the first case. Sometimes, they allow suspected cases in the ward for forty-eight hours, seventy-two hours, even more than that, our lives had been endangered there. I appeal to the management to value the lives of their staff more than they do at the moment.
“The management is aware of our grievances. Our union leaders have met several times with them. We have also given them a week ultimatum to meet our demands or we withdraw our services. The fact is that we cannot continue to work under this condition. Our work is to save lives. It should not be heard that we are being exposed by our management to avoidable situations that can even lead to death” the nurse concluded.
…Most grievances out of ignorance
The Chief Medical Director of the Hospital, Professor Anthony Igwegbe, said in a telephone interview on Friday, June 5 that most of the issues raised by the members of the National Association of Nigeria Nurses and Midwives, NANNM, were out of ignorance of the realities surrounding the management of the facility.
“Well, most of these issues are raised out of ignorance. We have tried to do our best within the limited resources at our disposal. Yes, I know there are challenges but we are moving on, trying to ensure that what is necessary is always provided. If I tell you that even today, I have used my personal money to buy some items for use this weekend. That is to ensure that work does not stop until Monday when management will procure those materials. Nobody knows about this, if not that I am telling you about it now”.
Professor Igwegbe also reacted to the allegation that staff members are being made to treat suspected COVID 19 patients without adequate precautionary measures.
He said: “What we do is to ensure rational use of the protective wears. They are not meant only for treating COVID 19. They are used in treating other health challenges. As I am talking to you now, surgery is going on and surgeons are wearing PPE. So, we don’t encourage irrational use of these materials. It costs a lot to procure them and they are also not readily available.
“So, if they say they are being exposed to COVID-19, it is not true. We value the lives of our staff and we will not want to see any of them exposed to dangers on the line of duty. And I am happy to tell you that all issues with the association you mentioned had been resolved. We met with them and agreed to move on. So, the threatened industrial action had been aborted. That tells you how committed the management is to the welfare and well-being of all staff”.
Igwegbe had earlier described the COVID-19 patient as a case of auto hemolytic anaemia, being managed by the Haematology Unit.
“He was admitted into A/E on the 24th of May. He subsequently developed symptoms suggestive of COVID-19 infection. Samples were taken and sent to ISTH Irrua for testing. The result released today showed he tested positive to COVID-19. The management has met with all the units involved in the management of the case and instituted the appropriate measures in terms of self-isolation for our staff, and contact tracing has commenced. The patient has been moved to the treatment centre in Onitsha. The management will continue to take appropriate measures in protecting our members of staff especially the front line staff during this pandemic. Please, do adopt the universal standard precautions in carrying out your duties”.
Nwobodo, however, confirmed that the issues of concern to them had been resolved in the meeting, expressing hope that the management would not renege on all the agreements.
The complaints about non – availability of PPE for the treatment of COVID 19 is not new as several medical and health workers in various parts of the country, had at one time or the other cried out.
A retired Anglican Bishop, Right Reverend Raphael Okafor, recently appealed to the government at all levels to take the provision of PPE for medical personnel seriously to ensure they carry out their duties unhindered and with a sense of security.
Speaking when he led a team of clerics under the Igbo Christian Restoration Assembly, (ICRA) to the Government House, Awka, Bishop Okafor described as suicidal treating COVID-19 patients without PPE.
“The government must do more. No-one sees death and voluntarily wants to go and die. It’s a commitment for the doctors to attend to the patients. But when you know that the disease is infectious, then, it’s mandatory they have the PPE. When they are not provided, you don’t expect them to commit suicide because many doctors have died in the process”.
Similarly, Governor Willie Obiano in a recent COVID-19 broadcast advised all hospital to establish what he called mini holding-wards, where patients, whose samples had been taken for COVID-19 test, can be kept until the results are known.
The number of confirmed cases recently increased to twenty-nine with seventeen new cases confirmed on June 6. This is an indication that a greater challenge may lie ahead for the health workers.
