By Abiose Adelaja Adams

Leafing through a collection of hospital receipts and duplicates of bank deposit slips, lanky Adeyemi Oduyoye’s face contours with grief.

It is two weeks since the 44-year old printer lost his wife, Folake Oduyoye, 35, to what he refers to as the over-priced health services of the Lagos University, teaching Hospital (LUTH), Idi- Araba, one Nigeria’s foremost teaching hospitals.

When this reporter visited him at his Ijesha residence in Lagos, he pensively narrated his ordeal, surrounded by relatives, mourners and friends. “They killed my wife. The management of LUTH,” he yelled, throwing his two hands in the air.  “They value money more than life.”

Folake was delivered of their fourth child, a baby girl, at Midas Touch private clinic in Aguda, Lagos, through Caesarean Section, CS, on August 30, 2014. On conclusion of the operation, it was discovered that she developed an infection.

Unable to manage the situation, the hospital referred her to Lagos Island Maternity Hospital, but on getting there she was further referred to LUTH.

“When we got to LUTH on 7th of September, my wife was in Accident and Emergency for three days. They said there were no beds, but that they will take us to the ICU (Intensive Care Unit),” he said.

“That day I spent N230,000 to do X-ray, drugs, scan  and treatment,” he recalled, adding, “later, we also donated nine pints of blood and they still collected N54,000 which they say they will use to screen the blood.”

Three days later, on Wednesday, September 10, they took Folake to the theatre to operate on her.

“They said she has infection. After the operation for which they charged N135,000, I paid another N250,000 cash for ICU. They warned me that if it remains N5, they will not collect it,” the aggrieve husband said.

According to the management of LUTH, the complication she developed was a “copious collection of pus in her intra-abdominal region” for which a major emergency abdominal surgery had to be carried out to drain of the unwanted fluid.

Oduyoye said that he was surprised when three days after the operation, considering all the money he had paid, he got another bill of N70,000

“The third day again, they brought another bill of N70,000, but I paid N35,000 out of it. That is how every day the bill kept increasing. We gave them N15,000 every day. That is apart from N1,500 meal ticket I pay every day to the kitchen.”

Finally, he said, his wife was moved to the female ward A4 on October 13, meaning that means she spent a total of one month at the ICU.

On October 31, Folake was discharged from the female ward, but she was not allowed to go home because she had an outstanding of N1,382,700, that had to be settled. The hospital management detained Folake in a ward where she was locked up until her family could pay her outstanding bills.

Her husband narrated her ordeal close to tears. “When she was discharged, I walked up to the acting CMD and told him that the money (N1,382,700) is too much and that after all I had paid, I didn’t have this huge money. But he just looked at me and put his hand in his pocket asking me, “should I give you money to pay?”

According to Oduyoye, he had spent almost N2 million before the new bill came, meaning that he was charged a total of N3,382,700. Unable to pay the outstanding bill but desperate to take his wife home, the poor man approached one of the people in the hospital who usually stands guarantor for those who find themselves in such situations but he could not get help as the man he talked to said he had just stood guarantor for somebody else.

After much more begging, the CMD eventually agreed to reduce the outstanding bill by 20 per cent.

Oduyoye said he was eventually able to raise and pay N300,000, leaving a balance of just over N800,000.

To show his commitment to pay the balance, he wrote a letter of appeal to the management of LUTH where he agreed to pay N15,000 in instalments over period of time and also got a guarantor to stand for him. Still, the hospital would not accept his appeal or release his wife.

The agitated husband’s anxiety heightened two weeks after his wife’s detention in the hospital when she developed cough and her health began to deteriorate. He alleged that even as she was being forced to remain in the hospital against her will, when Folake progressively got worse, the hospital refused to treat her, with the excuse that she had been discharged.

“When I noticed she developed cough and I was running from one doctor to the other begging them. They will tell me there is nothing they can do since she had been discharged. The nurses too were not taking care of her because they were on strike. But they locked her in one ward where there were other women.”

He alleged that a woman died in the ward in which his wife was detained and that “nobody touched her until night because the nurses were on strike at that time.” He said he had to move into the hospital ward with his wife so that he could care for her since she had been abandoned by the hospital management.

After his daily appeals to the management of the hospital and with his wife’s health deteriorating fast, Oduyoye was eventually asked to show up with his guarantor so that a deal could be struck for the payment of the outstanding bill for his wife’s treatment.

But the magnanimous gesture came too late as Folake died the next day, on December 13, even before her husband could get the guarantor to the hospital.

Our reporter was unable to gain access into the ward where Folake was held until she died. However, some junior hospital staff confirmed to her that LUTH has the habit of detaining patients who are unable to settle their bills until they clear the debt.

When approached to answer questions regarding Folake’s death, the Public Relations Officer of the hospital, Hope Nwalolo, was initially reluctant. However, following persistent calls on her, she emailed a letter to this website in which she stated the hospital’s position.

The letter contains no explanations for LUTH’s customary detention of patients who are unable to pay their medical bills.

Rather, the letter which was signed by the Hospital’s acting CMD, Chris Bode, ironically eulogises LUTH for what it said is its heroic efforts at saving lives.

“Contrary to the family’s claim, Mrs Oduyoye would have died from her many problems but for the gallant efforts of  conscientious doctors, nurses and other members of the healthcare team who kept her alive, even during the ongoing industrial crisis in the country,” said Bode.

The letter goes on to chronicle LUTH’s efforts to save Folake’s life.

“She underwent a major operation at which plenty of pus was evacuated from her abdomen. She underwent a tracheostomy, creating a hole on her neck to enable her breath to stay alive. She was admitted into the Intensive Care Unit for a month where she was on a ventilator, a high-tech machine which was breathing for her,” the letter offered.

It explained further, “Her multiple surgeries, drugs and consumables used for her cost a lot. The family paid a total of N300,000 and requested that a total bill of N1,200,000 be waived. It was carefully explained to the husband that ICU fee in LUTH is N250,000 per week, the cheapest among the four or five hospitals that offer this critical care service in Lagos. The cost of drugs alone consumed, which must be paid back to the Hospital’s Drug Revolving Fund, was N216,700.”

The acting CMD in his response also accused Oduyoye of neglecting the wife even though the husband said he moved in with her to the hospital since the nurses were no longer caring for her.

Bode also claimed that LUTH did not allow money to stand in the way of treating the poor woman before her death but did everything to save her life.

“She came here moribund, she did not have her baby here, she brought life-threatening complications to us and we in LUTH did all that should have been done, without asking for money from her.”

Oduyoye, however, disputes this claim, insisting that the hospital demanded and obtained money before providing Folake’s treatment, including the surgery she underwent as well as the drugs she took.

To prove that he had to pay at every stage before his wife was given treatment Oduyoye showed our reporter 42 bank deposit slips, evidence of payments made into LUTH’s UBA account. He also provided 38 receipts of payments to LUTH. The receipts showed that he paid nearly N 2 million to the hospital.

Folake’s unfortunate death and the role played in it by LUTH have not escaped the attention of some civil society groups which have decried the manner of her passing and have vowed to seek justice for her family.

The executive director of Women Advocates, Research and Documentation Centre, WARDC, Abiola Afolabi-Akiyode said that LUTH will be taken to court because this case raises a number of issues that border on the violation of fundamental human rights of women and children which are guaranteed in international and regional instruments to which Nigeria is a signatory.

WARDC has already written a petition to the Hospital management to investigate Folake’s death.

In the letter, the group said that the penalty for non-payment of hospital fees for maternal health care should not be forced imprisonment, especially as Section 35 (1) of the 1999 Nigeria Constitution provides that “no person shall be deprived of their liberty save in cases such as in execution of the sentence or order of a court in respect of a criminal offence of which he has been found guilty.

“In this instance, Mrs Oduyoye did not commit a criminal offence neither was there an order of court to sentence her yet she was imprisoned. The matter of not being able to pay up the balance is a civil matter and not a criminal one. The management of LUTH should have taken the option of going to court to compel the couple to pay their balance,” Afolabi-Akiyode stated.

She said further: “The neglect by LUTH contributed to the death of the Late Mrs Oduyoye. Since she was discharged on 31 October 2014, she received no further treatment despite her husband repeatedly informing the staff that she needed urgent medical attention yet they were prevented from seeking medical attention in another hospital. The right to life puts an obligation on the state to take measures to safeguard individuals from arbitrary and preventable losses of life and this includes protecting women against the unnecessary loss of life related to pregnancy and childbirth. The acts and omission of the management of LUTH by their negligence violated the right to life of Mrs Oduyoye.”

The right to life as enshrined in Section 33(1) of the 1999 Constitution provides that “every person has a right to life, and no one shall be deprived intentionally of his life, save in execution of the sentence of a court in respect of a criminal offence of which he has been found guilty in Nigeria.

Also, Article 9 of the International Covenant on Civil and Political Right to which Nigeria is a signatory also provides that “everyone has the right to liberty and security of person and no one shall be subjected to arbitrary arrest or detention except on such grounds and in accordance with such procedure as are established by law”.

Lending his voice to the issue, a public health specialist, Emmanuel Otolorin said the real problem is a lack of community health insurance that covers poor people.

“The National Health Insurance Scheme NHIS does not cover everybody. If there is health insurance, it will take care of all expenses relating to maternal and child health. Everything will be free.”

He expressed the hope that with the new Health Act, this will be addressed.

Several studies have found that introduction of user fees have adverse consequences on health care, including constituting a barrier to access amongst vulnerable groups, such as poor women.

Notably, Nigeria has the second highest maternal and child mortality. Although she survived her mother’s ordeal, Folake’s three month old baby who is being nursed by a relative will bear some of the brunt of her death.

The case against LUTH, according to Afolabi-Akiyode, will commence in January.