Long-hour of wait is a common phenomenon in Abuja hospitals. Jennifer UGWA who visited public hospitals in the Federal Capital City reports about the frustration of patients who have to endure long delays before they see doctors.

HAVING waited for nearly two hours, most of the patients have resigned to fate. Yet they seemed determined to see doctors before they go home for the day. Unable to stand hunger, some went to patronise the snack and beverages vendors at the hospital gate.

Nyanya General Hospital was established to cater to the medical needs of the residents within the Nyanya district so they can have access to prompt medical interventions at low costs without travelling far.

As is the procedure in the hospital, patients at the reception wait patiently on the queue taking turns to have their vital signs by the nurse on duty.

With only two doctors on duty and over 60 persons waiting, patients struggle to get seats closest to the consulting rooms.

 Chioma Melkam who accompanied her mother, Scholastica Melkam, to the hospital wonders why she prefers Nyanya General Hospital to others in the city.

“After my experience, you still insist on coming to this hospital to waste time?” she asked after waiting for hours.

Two months ago, Chioma had been down with malaria after having fainting episodes, she managed to come all by herself to the emergency ward of the hospital the next morning but the nurses asked her to leave the ward because her illness was not an emergency issue.

She then left the emergency ward to the General Outpatient Department where she was advised by one of the nurses to cry loudly to get attention from the doctors.

“One of the ladies at the GOPD advised that I should cry to get attention. ‘That should let them know that you need urgent attention,” Chioma recalled.

After waiting for three hours a doctor finally attended to her. But despite the poor services Chioma received at the hospital, she and her mother were back a few months later in the queue waiting to be seen by a doctor at the same hospital.

Scholastica paid the required N200 for her medical file to be retrieved from the archives while she waited patiently for her turn to see the doctor. To create a personal medical file at the hospital, the sum of N700  is stipulated as the fee, but N200 is often required before a patient’s file can be retrieved from the archives.

But this extra payment did not hasten access to the doctor. In fact, the mother and daughter waited for nearly five hours before they eventually saw one.

Patients’ waiting time at the hospital  is defined as “the length of time from when the patient entered the outpatient clinic to the time the patient actually leaves the General Outpatient Department not excluding the time used for registration but including the duration of time it takes to run a laboratory or diagnostic test and receiving the result of the various tests.”

Long  queue at Maitama District Hospital

The ICIR‘s next port of call was Maitama District Hospital.  At 11.am, there was a long queue of patients waiting to have their vital sign checks at the GOPD. The number of people waiting was a hundred and forty or thereabouts, and the queue continued to get longer as many more patients joined the line.

“Do you think I left my house this morning with my bed to be at the hospital?” an angry woman fired at another woman who joined the line without first inquiring who was next in line.

As the minutes dragged by, the waiting patients complained amongst themselves. As if to add injury to insult, a nurse came outside to announce that her colleague had gone for a lunch break.

Twenty minutes later, seated in front of a consulting room waiting for a doctor it was the turn of a dishevelled Rebecca Naalah to complain.

After an unfortunate miscarriage in November, leading to bleedings, she was scheduled for a pelvic scan but the absence of the doctor staled her treatment.

“So if na died I dey, I for don die since,” she lamented in Pidgin-English.

At intervals, the exasperated lady would grab her handbag and make fruitless trips as other patients to the injection room to badger the nurses.

“Is the doctor not back yet? I thought you said you have called him? What did he say? Is he still coming back? She queried the nurses in frustration.

With no one to prescribe medications for her, Rebbecca who had arrived at the hospital by 8 am that morning was still walking the hallways of the hospital five hours after arrival

Thirty minutes later, a dismayed Rebbeca was told she would have to return to the hospital again tomorrow for further examinations.

“My sister, you have seen it. Tomorrow again this is how they will start pushing people around,” the displeased patient told THE ICIR journalist.

According to some of the patients, Friday’s are the worst days to visit the hospitals as doctors don’t return to work after lunch breaks.

Chioma, Scholastica and Rebecca’s’ experience at the hospital lends credence to a 2013 survey carried out by Ogaji Daprim and Mezie Okoye, Margaret on the “Waiting time and patient satisfaction: Survey of patients seeking care at the general outpatient clinic of the University of Port Harcourt Teaching Hospital.”

The study revealed that “it took patients a total duration of 274 minutes (over four hours) to conclude all relevant activities in the course of seeking general practice service in the [Nigerian] hospital.”

Based on the findings from the research, delay of patients’ access to healthcare “could be a major contributor to negative patients experiences” considering patient-doctor brief consultation time in most cases.

The University of Abuja Teaching Hospital, no respite

By 10:40 am on 17th December, the hospital was already teeming with patients at the GOPD, despite having two personnel at the registration point and also at the pay point–an upgrade compared to the other hospitals already visited– the reception hall was also crowded by waiting patients.

Some patients sat quietly as others fixed gaze at the movie showing on television. 

From the registration point to the pay point and nurses station, it took close to an hour before the journalist was finally ushered into the consulting wing to wait for the doctors.

Patient’s file containing vital information about the patient which is often sent ahead of the owner to the doctor’s office that afternoon was misfiled.

Then came the pandemonium. Patients in a haste rushed into the doctor’s offices without been asked in, while the few polite ones knocked on the doors before barging in to question the bewildered doctors about their files and if they were supposed to be consulting in that room.

Offere Chika, a businesswoman, was amongst the angry vocal patients. She chastised the nurses for their oversight. She had hoped to return to her shop before 4 pm to relieve her partner. By 2: 30pm, when she was yet to see a doctor, she became worried whether she would be able to return to the shop on time.  

Despite the lapse from the nurses, they continued to blame patients for impatience.

Laughter and pains.

According to 2018 World happiness report, the Sustainable Development Solution Network (SDSN), Nigeria was ranked 91st happiest nation in the world and fifth in Africa.

The assessment which is based on six variables including healthy life expectancy and social support seems indisputable, as Nigerians love to make humour even in difficult situations.

For instance, a lady was laughing at a young man with weird behaviour in the queue. “If it has become that serious please let him go and see the doctor first because I don’t understand him again. It seems the malaria parasite has reached his brains,” said a 

The young man while waiting had started mimicking a guitarist to the amusement of other patients at  Nyanaya General. 

At Asokoro District Hospital, a similar incident also occurred as Boniface Veronica would scratch her body in public without care.

“Madam take it easy with this itching so we can tell when your illness takes another turn,”  a patient, Okafor said jokingly to Mrs Boniface Veronica who had rashes spread over her body due to a chickenpox infection.

“I can’t help it abeg,” Veronica retaliated in Pidgin-English, simultaneously reaching to scratch her derriere, producing more outbursts of laughter from the rest of the patients.

She explained to the journalist that she arrived by past 1:30 pm that afternoon but was told that doctors will resume consultation again by 4 pm in the evening, hence she has to wait till the said time.

Unlike other hospitals, anyone coming to the hospital at past 12 pm that afternoon paid an additional sum of N200, apart from N1,100  registration and consultancy fee for coming late.

Although some of the ailments that sent patients to the hospitals may be infectious in nature just like Bonifaces’, however exposure to unsanitary lavatories in the facilities could very well worsen their health.

Exhaustion or attitudinal problem?

In an interview with some of the medical practitioners at the various hospitals, most claimed that the prevalence of long waits and delays cannot be avoided due to the facilities lack of manpower and required equipment, others claimed that over tasking of doctors and nurses is another limitation

“We have taken an oath to care for people and we are committed to doing so no matter what.

“We are limited and it is quite unfortunate that we don’t have enough staff at the hospital to attend to all patients. We often have to work for over 72 hours at a stretch,” Nkechi, a nurse at Maitama General Hospital  said.

The doctors also explained that the delay is also caused as a result of patients leaving primary healthcentres within their vicinity to seek medical care in hospitals that are already overburdened with healthcare demand.

At the hospitals visited, (except UATH that had two active nurse posts) only one nurse is responsible for taking patients vitals, no matter the number of patients on the queue.

As one of the major health workforce-exporting country in Africa, Nigeria cannot adequately meet the country’s needs for medical practitioners, said the World Health Organization.

Among the hospitals visited by the journalist, Kuje General Hospital was the only place where doctors attended to patients within 45 minutes of arrival.

 Dr Maryanne Onwudiwe, Acting Director Hospital Management Services, Federal Capital Territory blamed the delay on poor staffing and equipment.

Onwudiwe whose office oversees hospitals like UATH also complained about wrong attitude of staff.

“I don’t think there is a shortage of staff in hospitals. The question is are the staff available at the appropriate cadre? A situation where a hospital is recruiting staff more in the administration department more than those on the clinical services who are supposed to render such services is a very big hindrance.”

“A patient might come sometimes to speak to the staff but the lousy way the requests are handled is appalling, ” said the ministry of health.

She noted that the delays at the experienced at hospitals might not be an issue that would be brought to an end very soon, especially as the ministry does not have adequate funds at its disposal to increase the number of medical personnel required.