An excellent and very touching piece on the experiences within Nigerian Health Services which we represent with respects to the author Adinoyi Ojo Onukaba and his late wife Rachael.
It is quite inevitable that there will be some soul-searching after the tragic loss of my wife, Rachael Onukaba, on August 29, 2009. I have spent this past week reviewing what happened, reliving the last moments of a life that was so full of promise.Could this death have been prevented? Were there things that could have been done differently by family members and the so-called care givers? Could Rachael’s life have been saved? Should people be dying from common malaria in 21st century Nigeria?
I am fully convinced that early diagnosis, timely application of the right medication, efficient and professional management of the ailment could have saved her life. There is no doubt in my mind that she would have survived if she had been offered quality care at the private clinic and at our now notorious National Hospital, Abuja. My experience at both health-care centres points to the urgent need to overhaul our health care system to make it more responsive, efficient and professional.
Although Rachael suffered from a mild strain of sickle cell anaemia that led to crisis once in five or six years, she was generally a healthy, strong and active person. Weeks before her death, she had complained of persistent headache that often subsided after taking common pain killers. Sometimes, it was catarrh, bringing with it a running nose and feverish condition.
“You better go for a comprehensive check-up”, I said casually to her one day. I thought the rate of recurrence of these common ailments was not normal and that she needed to see a doctor. She continued to self medicate while dutifully playing her role as a mother, wife and worker. Now, I wished I had pushed her to go for a thorough check.
It was mid August when the pain in the head became almost unbearable that she rang me up one evening to come home early to take her to the hospital. I picked her up immediately. We both decided to head for a private clinic in Garki II, Abuja, which our family had always used.
The owner-physician is a friend of the family and he knew our medical history. He personally examined Rachael and recommended a blood test. It was done and the result, according to him, showed chronic malaria and typhoid infection.
The doctor commenced treatment immediately with an injection and a cocktail of drugs to fight the infection. Rachael rested at home for two days while taking the medication. By the third day, she was up and doing again.
She was even planning to resume her daily exercise at Agura Hotel Gym where she had made a lot of friends since registering there about two years ago. Looking trim and fit had become a daily obsession ever since I teased her about her weight after a short stay in London in 2007.
“You are beginning to look like a Japanese Sumo wrestler”, that was all she needed to hear to rush to the gym where her younger sister, Ethel Ogirri, a staff of Virgin Nigeria, had already registered.
“I am not going to allow some skinny girls to take my husband away from me”, she said. She did not consider the “Japanese Sumo wrestler” remark a joke at all. She was determined not to give me an excuse to mess around.
So, every day after closing from Officetron where she worked as an administrative manager, she would go home, take our children, Asuku and Ebikere, through their homework, change into her gym suits and then head for Agura Hotel at 6 pm. She would not return home until after 8 pm. She did that religiously every week day and on Saturdays.
In addition to her family, colleagues at work and old school mates, her next most important circle of friends were the people she met and befriended at the gym.
She met and became friends with the Anosikes, the Atiku boys, some NNPC staff who use the gym, former Minister of State for Transport John Emeka, Hon. Acho Obioma, a former Action Congress gubernatorial candidate for Abia State, the brother of singer Asa, and several others.
One old lady liked her so much she adopted her as her daughter. Having lost her mother in 2005, Rachael was happy to have a mother figure again in her life.
With regular exercise and a healthy diet, she shed the excess weight within a few months. She felt good with herself and swore never to go back to the old days of unhealthy living. I was proud of her. She looked sexy in her gym suits. And she had plenty of them. Friends at the gym found it difficult to believe that she was a mother of two. She was happy to be complimented about her figure.
On Sunday August 23, 2009, we had breakfast, read the newspapers and sang and danced with the children. The children wanted to go out. She chose to remain at home while I took them to a nearby playground.
We returned and found her watching some home videos, one of her favourite pastimes. Later at about 8 pm, she picked her car keys and announced that she was going to buy some pain killers because the headache had returned. I was surprised.
I wanted to know if she had used all the drugs she collected from the clinic. She said she had taken them, but had not been healed. I warned her about a possible addiction to pain killers, drawing her attention to the fate of Michael Jackson.
“My head is pounding. What am I supposed to do? I cannot take it any longer”.
She bought and took the pain killers and quickly retired upstairs to the bedroom we shared. I joined her at 11 pm only to find her crying in pain.
Every part of her body was paining her, she said. I quickly called the family doctor to confirm he was at the clinic. We left the house quietly so as not to wake up the children. Within 10 minutes we were at the clinic.
The doctor examined her and declared that she was having a crisis, provoked of course by the lingering malaria and typhoid.
She was given an intravenous fluid to open up blocked blood vessels that was responsible for the intense pain she was experiencing. She also received injections to stop the pain and put her to sleep. But she could hardly sleep. She slept for an hour or two at a stretch. The pain was too intense and unbearable, she said.
She got more Fortuin injections to stop the pain and took more valium to put her to sleep. They only offered temporary relief. She wanted more.
By this time, her sister, Ethel, had joined us at the hospital. Rachael had called her at 3 am when I went out to procure more fluids. Ethel and I began to worry about a possible overdose of pain killers and sleeping tablets. The seemingly ceaseless flow of intravenous fluids for three days was also a source of concern to us.
Rachael spent two nights at the clinic. She said the pain had migrated from her head, chest and waist to her laps and feet. Ethel and I took turn to massage her body. Later, one of my younger sisters, Fatima, joined us.
On the third day at the clinic, Rachael said she wanted to go home and recuperate. She was feeling a little better. The pain has localised around her legs. She walked with great pain and difficulty.
She was welcomed home with much excitement by the children and my two nieces who live with us. We forced her to eat a little solid food before taking her drugs.
Shortly after, I walked her upstairs to our bedroom. I left the room as soon as she settled in bed. I did not return until 11 pm. She had been waiting for me to take her to the toilet. I did. I noticed immediately that her speech was slurring. I was surprised. I thought she was being dramatic.
“Please take it easy with me”, she said. I asked why she was no longer speaking coherently. She said she did not know. She said I should get her into bed. I did.
The following morning, I woke her to find out what she wanted for breakfast but she did not respond. She was breathing heavily and noisily too. I tried to raise her up and discovered that she was no longer able to move any part of her body.
Her cousin, Festus Ogirri, had been dispatched from Lagos by the family the previous day to join Ethel and I in taking care of her. Festus assisted me in carrying her out of the bed room to the family van. The children were still in bed.
We were glad that they did not see their mother in such a helpless situation. We drove her straight to the same clinic fearing that a new healthcare centre would waste valuable time investigating her situation.
Two young doctors were in charge at the hospital in addition to a matron, nurse and anesthesist. The owner of the clinic travelled the second day after Rachael was first admitted and had not returned. The doctors said her sugar level was low. They gave her glucose. Her blood was taken and tested. The result showed that malaria was still in her system. They said her blood count was low and Ethel volunteered to donate.
More drips, some injections and reassurances that she would soon regain her consciousness.
A consultant from the teaching hospital in Makurdi was called to review her case. He queried some of the steps taken, ordered more tests and recommended new drugs. He pressed Rachael’s chest to know if she had suffered a stroke. She had not.
When he was done, the consultant announced without any emotion that Rachael’s case was a bad one. For the first time since the sickness began, it dawned on me that it was more serious than we had all thought. I was frightened.
“Bad as in she will not survive?” I managed to ask the consultant by the time I found my voice.
“She may - with prayers”, the consultant replied.
He said Rachael had suffered overwhelming infection and that more potent antibiotics should have been given to her from the beginning. Her malaria treatment, he continued, had not been effective. Her system had collapsed because of the infection, he went on to say.
Later in the evening, the doctors advised me to take my wife to the intensive care unit of the National Hospital where round-the-clock care could be given to her.
By then my friend, Tunde Olusunle, had joined me along with others. He placed a call to Dr Segun Ajuwon, the chief medical director of the National Hospital who was once our colleague at the State House. Ajuwon prepared the hospital’s emergency services to receive us. He also directed that a bed be made available to us at the intensive care unit.
We put Rachael on a stretcher and headed for the hospital, accompanied by a doctor and about a dozen friends and relatives. We went with the two-page note the consultant had prepared on Rachael.
We arrived at the National Hospital to find no one waiting for us. Rachael laid on the stretcher still immobile as our team broke into groups to fetch the emergency services while a group began the registration process.
It took 25 minutes to get Rachael to the intensive care unit and I could not help but wonder if she had arrived at the hospital with less than 20 minutes to live. I would later learn that our 25-minute waiting time was one of the shortest ever.
A friend said he once took an accident victim to the same hospital and spent nearly two hours trying to find a doctor to attend to him. The accident victim bled to death without ever being seen by a doctor. Human life means very little to some of the healthcare workers.
At the intensive care unit, Rachael was immediately hooked to some gadgets. I was educated on the workings of the intensive care unit. The unit would not only take care of her treatment, it would wash her, feed her and care for her. I was told not bother about anything. She was in safe hands, I was assured.
I looked around and found five other patients hanging to life with the aid of machines. Rachael did not need a respirator. Her breathing was fine. I was asked to bring a bathing soap, face towels, cup and water flask for her use. And to deposit N200,000. It costs N50,000 a day to stay at the intensive care unit. I was not worried about money.
I was worried more about Rachael’s recovery. I was willing to pay any price to save her life. Despite the two-page note from the clinic, the doctor, nurse and anesthesist insisted I tell them what happened.
We left late that night convinced that we had come to the right place and that Rachael would greet us the following morning wanting to know how she got there.
I arrived at the hospital the following morning at 7 am and I was given just five minutes to see Rachael. She was still sleeping. I called her name and she opened her eyes. I waited for her to speak but she did not. She looked at me with those two bright eyeballs that attracted me to her when we first met in April 2002.
The nurse asked if I had noticed any improvement in her. I said she seemed to be regaining her consciousness gradually. The nurse said it was true.
I left the hospital on that happy note. By the time I returned at noon, several people in white overalls were gathered around her bed. I was frightened. What had happened? Had she taken a turn for the worse? I asked a nurse what was happening and he said all the experts were reviewing her case.
A doctor came out of the unit and summoned me to an adjoining room. He asked me to take what he was going to tell me like a man. “I am sorry she did not make it”, he said, staring at me. My heart was beating fast. She did not make it? Was that why there was a crowd around her? Why was the nurse lying to me? I decided to ask more questions. “Who did not make it?” He was surprised at the question.
“Mama”.
“Which mama?”
“The old woman who was operated on yesterday”.
“I don’t know her. I am here because of my wife”.
“Ah, I am sorry. I thought you were her son”.
I was relieved. But I was also troubled by such sloppiness. Why would he deliver such a tragic news without first ascertaining my identity.
Of course I would later find out that sloppiness is commonplace at the hospital. Blood samples have been lost there or test results swapped.
A corpse was once stolen from the mortuary. Cases of misdiagnosis are rampant. A man who was once told that he had defective kidneys flew to India for a transplant only to discover that there was nothing wrong with his kidneys.
I have heard of wrong injections or drugs being administered on patients. Absent-mindedness is a common malady at the hospital. There seems to be no one in charge. People did whatever they liked.
Despite the outrageous charges at the hospital, you would have to beg and coax many hospital staff to do their jobs. I found many of them rude, saucy and heartless.
A good tip, I was told, could do some magic. The blood that was not available in the blood bank would suddenly surface. A space that was hitherto not available in the mortuary would suddenly be available.
Narcotized by the daily sight of blood, body decay and death, most of the workers have no human feelings and they are incapable of empathy. The National Hospital is a microcosm of the terrible rot in the larger society.
As the doctors filed out of the intensive care unit that Thursday August 27, 2009, I excused the one who had been in charge of Rachael. I wanted to know if she was getting better. He said she was. He also told me that they had decided to do a brain scan to know if there was a problem there. He told me not to worry and that my wife would be fine.
He spoke with confidence and with the oracular power of an experienced physician. I was hopeful. But the brain scan scared me. What if she had suffered a brain damage? How would we cope with that for the rest of our lives?
Five hours after the brain scan was ordered, I arrived at the hospital to find Rachael on her bed in the hallway of the block housing the intensive care unit. There was a tired looking nursing assistant holding a rusty oxygen cylinder by the bed. I introduced myself and sought to know why my wife was wheeled from the intensive care unit into the hallway. He just ignored me.
Passer-bys would take a quick look at Rachael, shake their head in sympathy and offer prayers for a quick recovery.
Soon, the nurse appeared with a doctor in a green apron, plastic cap and mouth cover. He took a quick look at Rachael and then made U-turn. “I am busy with another patient. This is not my business”, he disappeared through the door he had emerged. He ignored the nurse’s plea to accompany Rachael to the MRI (Magnetic Resonance Imaging??). The nurse stood there helpless.
She decided to take Rachael back to the intensive care unit through the same creaky elevator that could barely contain the bed and its attendants. When I watched as they struggled with the restless elevator door that almost trapped Rachael’s dangling hands, I lost my cool.
“You are not fair to her at all. Look at what you are doing to her. How can you be going up and down the elevator with an unconscious patient? This stress will worsen her condition”. The nurse ignored me.
I assisted them into the elevator, but the nurse would not let me go upstairs with them. I cursed not just the nurse and the doctor who had refused to attend to my wife but the entire system that allowed those nonchalant, unfeeling and wicked people to be masquerading as care givers.
The elevator door finally closed as my sister-in-law, Ethel, came down the stairs still cursing another doctor who was initially assigned to accompany Rachael to the MRI but declined because he had closed for the day. Ethel had begged him to spare a few minutes of his closing time but he vehemently refused. She could not hold back again. She descended on the doctor, hurled several insults at him and then stormed out of the intensive care unit.
It was difficult to believe that the National Hospital could not find a doctor to accompany a patient in the intensive care unit to the MRI, less than 200 metres away. I was horrified by the unprofessional attitude of some of the medical doctors there.
Most of the hospital staff have serious attitude problem. They are rude and unfriendly. There is no sense of urgency in the way they conduct their affairs. A brain scan that was ordered before noon was yet to commence at 5 pm. I had no choice but to put a call through to Dr Segun Ajuwon, the chief medical director.
I had avoided reporting every problem to him because I did not want it to seem like an abuse access.
If I were being so shabbily treated, what about ordinary Nigerians who did not have access to the chief medical director? Why must I even know the chief medical director to receive quality service at the hospital? I had no choice in the matter. My wife was dying.
Dr Ajuwon heard me out, calmed me down and promised to sort out the problem immediately. He sent a fair lady to assemble the MRI team and a doctor to attend to my wife. Ethel sighted a cocky, stocky consultant in a three piece suit and suggested we followed him. He was said to be in charge of the intensive care unit. We followed him into the MRI where a doctor and two MRI staff were already waiting.
“Where is the patient?” The fair lady wanted to know. I said she had been taken back upstairs to the intensive care unit.
“Why did they take her there? Who took her upstairs? She was supposed to be brought here”.
There was confusion.
There had been no proper communication between the intensive care unit and the MRI, less than three minutes walk away. The nurse had wheeled Rachael out of the intensive care unit not knowing who had been assigned to her.
What a shame! One unit does not seem to know what the other is doing. There is no co-ordination between the different sections. No planning. No communication. There is an ad hoc approach to health care delivery. Everything works haphazardly. Chaos is the organizing principle here.
No wonder few people come to the National Hospital and expect to be treated or healed these days. “Come and die here”, that is the literal nickname for the hospital in Hausa. Some call it “pre-mortuary”. Yet, nobody seems to care. No one seems to care that people walk in there on their own only to be taken out in body bags.
A doctor once spoke about hearing a nurse tell a woman in labour not to push hard yet until she (the nurse) was through with her lunch.
As the MRI team waited impatiently for my wife to be wheeled in, the fair lady in red who had been dispatched by Dr. Ajuwon spoke about the unprecedented sacrifice made by the MRI team. She said some were on their way home and had to be recalled and that others had closed but had been ordered to wait. I was being made to appreciate the fact that they were bending over backwards to please me and my sick wife.
As she spoke, I wondered why the MRI could not have been staffed round the clock.
We continued to wait for the nurse to reappear with my wife. It seemed there was no telephone link between the MRI and the intensive care unit. Getting the nurse on the mobile phone was out of the question because none of the people in the MRI knew the particular nurse. And the puffy consultant in dark suit did not seem to know either.
At last, the lady in red decided to send one of the MRI staff to the intensive care unit to lead the nurse and the patient to the right place.
It took another 20 minutes before they emerged from a nearby elevator. By then two of my siblings had also arrived to offer assistance. We joined in wheeling the patient, ensuring that her hands were not trapped in the door and that the oxygen tubes did not get caught in the wheels of the bed. It was drizzling.
There was a 20-meter uncovered space between the elevator block and the MRI. There was no umbrella to cover my wife. It did not occur to the hospital staff that the patient be shielded from the rain. Rachael was wheeled through the drizzle as Ethel and I struggled to pull the thin white cotton cover up to her chest so that pneumonia would not be our new worry. We finally made it to the entrance door and an MRI staff struggled to open a section of the door to allow the bed to pass through. He seemed unfamiliar with the locks. Another staff went to help.
The door was finally swung open for the patient to pass. We stopped in the waiting room while a stretcher was fetched. Using the bed sheet beneath, we lifted Rachael on to the stretcher and took her to the huge scanner known as the MRI. We – the relatives/helpers – were ordered to leave the place immediately. We retired to the waiting room. Shortly after, I was invited back to the MRI.
The oxygen cylinder cable was not long enough and I was asked to stand by the scanner with the oxygen cylinder while the scanning was in progress. Someone showed up with a longer cable and I was told to leave again.
In the middle of the scanning, the public power supply went off. I went to consult an MRI staff on the implication of the blackout.
“Don’t worry, the machine is on UPS”, he assured me. It was little consolation. I have heard stories of power failure in the middle of critical operations in many hospitals around the country. The time lag between the public power supply and the standby generators could be matter of life and death.
Many people have died in our hospitals as a result of power failure or fluctuations. Sometimes the standby generators would not work due to mechanical problem or lack of fuel or diesel or the absence of an operator. In our case, we were lucky that the generators at the National Hospital came alive five minutes later. We waited nervously, praying the brain scan report would be positive.
When they were done, we were called to assist in transferring Rachael back into her hospital bed and to wheel the bed back into the elevator. From the elevator, we walked through a long corridor on the first floor to the intensive care unit.
As we were going, the surly fellow with the oxygen cylinder mistakenly touched something and the oxygen supply tubes began to spew water into Rachael’s nose. Rachael struggled.
I drew the nurse’s attention to the problem. She fiddled with some controls and the flow of water stopped. Problem solved, we resumed the journey back to the intensive care unit. Poor Rachael! She had suffered so much in four days.
Looking at the dirty cylinder, I wondered if any life-sustaining thing could actually come out of that contraption.
When I first got to the intensive care unit, I was not mesmerized by the array of equipment there. I was cynical. I know my country. How was I sure that the equipment had not seen the best of times? I was sure that some of them were overdue for replacement. Even if they were still serviceable, were the operators well trained to use and read them accurately? We have a poor maintenance culture.
The evidence was all there in the turn blinds in the intensive care unit, the rusty equipment in many wards, the dirty, stained walls and the smelly toilets. The failure of a nation manifests in such little things _ the little things that truly count in life.
Rachael finally arrived at her space in the intensive care unit. She was immediately connected to an array of dangling tubes by the nurse while the dirty oxygen cylinder was taken away. We were asked to take our leave.
As we made for the door, a nurse announced that there was a second patient in the intensive care unit that needed a brain scan. The team that attended to Rachael said they were done for the day and that some other people would have to take the patient there. I felt sorry for the patient. I had used my connection to ginger them into doing their jobs.
What about those who were not so lucky? The result of Rachael’s brain scan came almost immediately, but it took another one hour to get the consultant to speak about it.
“Her brain is normal. There is no infection and no damage”, he announced to me in the hallway leading to the entrance of the intensive care unit.
“She will make it. She is not one of the patients I am worried about”, he added.
“Thank you, doctor. Thank you so much”, I said joyfully.
“I don’t know if you have been told. She spoke in the morning”, he continued.
“No. I am hearing for the first time. She actually spoke?” I lied. One fat but pleasant nurse had earlier given me this message of hope. But I wanted to hear from the consultant.
“Yes, she spoke to me and the nurse”.
“Please what did she say?”
“We greeted her and she answered. We asked how she felt and she said she was fine”.
“She said that? Oh, thank you, doctor. Thank you”.
“Don’t worry, my friend. Your wife will be fine”. The consultant assured me and then walked away confidently.
I broke the good news to my sister-in-law, Ethel, to my brother, Audu, and others around. I called my father-in-law, Sir Robert Ogirri, to announce the good news. They were in the middle of one of the prayer services they had been holding daily for Rachael. They broke into jubilation. Rachael’s elder sister, Henrietta Obueh and her husband, Joe, were also there. I then called brother-in-law Oshioke Ogirri and his wife, Titi, to tell them the good news. My friend, Tunde Olusunle, called and I informed him too that Rachael had spoken for the first time in three days. When my colleague, Adeolu Akande, also sought to know about her situation, I informed him confidently that Rachael was recovering fast. We went back home on that happy note.
I was back at the hospital again at 7 am on Friday August 28, 2009. I had brought more face towels and soap for washing her. I waited at the door for nearly an hour before being allowed to see Rachael.
The doctor, nurse, anasthesist and nursing assistant on duty were busy attending to a patient in crisis. There were six patients in the intensive care unit that day and I could not help but wonder how these four staff would cope if one or two other patients went into crisis at the same time.
The intensive care unit was understaffed. There ought to be at least one doctor and a nurse for each patient at any particular time. There was nothing intensive about the intensive care unit. It was intensive in name. In reality, it was just like any other ward staffed by inadequate, ill trained, ill motivated, unprofessional, slow and careless staff. I told myself that Rachael would make it out of there alive only by the grace of God.
Corpses were being wheeled out of the intensive care unit daily. The old lady who died the night Rachael arrived at the intensive care unit was left on her bed for hours before being moved to the mortuary.
I spent five minutes with Rachael before leaving. I called her name and she responded by opening her eyes. She could not talk. I told her to remain strong, that she will be fine and that the family is doing everything possible to save her life. It was difficult to know if she heard me. She just stared blankly at me.
A few days earlier, we were laughing, joking, arguing, playing and dreaming together. Now, she just stares, unable to speak her mind. It was hurting.
I returned late afternoon on Friday to find my sister-in-law Ethel by the entrance of the intensive care unit. She was not looking happy at all. My heart jumped. She said Rachael was on a respirator.
I sought out the same puffy consultant in his favourite three-piece suit to know what had happened. He dismissed my fears about a possible worsening situation. Rachael’s heart, he said, was beating too fast. He did not like it. He had therefore ordered a chest X-ray.
The result showed that the malaria infection had spread to her chest. It was being treated, he assured me. He said he had sedated her and put her on the respirator to take away the burden of breathing on her own. How long would this last for, I wanted to know? He said she might be able to breathe on her own by Sunday. Again, he told me not to worry and that she would be okay.
“By the way, she would need three pints of blood. She is getting pale”, he said as he turned to go.
I was asked to see the nurse on duty for details. The nurse directed me to the hospital blood bank for the three pints of blood.
As I made my way through a maze of buildings and staircases, I thought about the respirator. How was I sure that the consultant had made the right decision by sedating her and giving her breathing power to a machine? Was the machine in good condition? Giving the level of decay in the country, it is difficult to place one’s trust in man or institutions or machines. I also thought about the chest X-ray. Why was it not done earlier? Why was it delayed till that Friday?
Perhaps if all the tests had been done as soon as Rachael arrived at the hospital, the so-called care givers would have known the extent of the spread of the infection and would have started treating her earlier. Perhaps her life could have been saved. Perhaps.
In our confusion, nobody remembered to call Rachael’s maternal uncle, Dr Peter Okoh, a consultant at the University of Port Harcourt Teaching Hospital. He would have flown into Abuja for a second opinion on the management of the illness.
Ethel, her friend, Cynthia and I arrived at the blood bank only to be told that it did not have Rachael’s blood type. We were given a number of places to source from. Ethel and Cynthia drove to Garki Hospital where they were able to get only two pints. The attendant promised to get the third one by 7 am the following day.
Each pint was sold for N7,000 – N2,000 above the normal price. The attendant read their desperation and decided to take advantage of it. There was no time to haggle. A fair, gangling male attendant collected N14,000 from them without issuing a receipt.
They brought the bags of blood to the National Hospital blood bank and they were asked to pay N4,000 to re-screen each bag. They located the hospital cashier and paid the N8,000. They came back to the blood bank with the receipt. The blood was collected from them and told to go.
They wanted to know if they could wait and collect the screened blood and deliver it to the intensive care unit where it was urgently needed. The dark, slim, and bespectacled lady at the bank said the hospital had a procedure of getting the blood to where it was needed.
Ethel and Cynthia met me in a small waiting room adjoining the intensive care unit where a doctor once scared the life out of me by telling me “She did not make it”.
After being briefed by them, I rose to inform the nurse on duty about the arrival of the bags of blood for Rachael. I was told not to worry that the blood bank would contact them. We waited for half an hour, one hour and more. Still, the blood bank had not contacted the intensive care unit.
The hospital procedure for delivering blood to where it was needed had obviously not worked for Rachael. I went to remind the nurse about it. I was told that someone had been sent to collect it. The blood had not got to the intensive care unit by the time we left late that night. The hospital staff were never in a hurry. They had their own pace. Nobody could hurry them up. There was no sense of urgency. They went about their duties in a leisurely manner.
If we had not visited the hospital at 4 pm that Friday, we would not have known about the required three pints of blood. Yet, the hospital had my number as the next of kin.
They had discovered early that Friday that Rachael was getting pale and that she needed three pints of blood. No effort was made to get the blood or to reach her relatives to get the blood until we arrived at the hospital in the evening.
I arrived the following morning, Saturday August 29, 2009 to find the two blood bags exhausted. I alerted the staff on duty. I asked if the third bag was still needed. The nurse said I should bring it.
I headed for Garki Hospital to meet the tall, lanky blood laboratory attendant. He remembered Ethel and Cynthia and the promise he made to them. I gave him N7,000 and collected the bag of blood. Again, no receipt was issued.
As I made my way back to the hospital, the police had blocked most roads in the name of the inaugural edition of the monthly cleaning exercise in the city. Nobody was allowed to move around until noon except those on what was vaguely defined as essential duties.
At each checkpoint, I brought out the blood I had just bought for my wife and her hospital card. I was waved on. It still does not make sense why the city has to be shut down for five hours every month in the name of environmental sanitation. In other cities around the world, it is the responsibility of the municipal authorities to sweep the city clean every day.
I took the blood to the bank after paying for the re-screening and I was again told that the blood would be delivered to the intensive care unit through the same ill-defined, snail speed channel. I informed the intensive care unit about it and they said it was fine.
I took a quick look at Rachael and wondered how long she would have to endure her present ordeal. I asked the doctor on duty why her chest was open and I was told that she was running temperature. I asked if that was normal and I was told it was. She would be alright, the doctor said.
I went back home, read the newspapers, ate lunch, and went with my son to a nearby hotel for a haircut. My daughter and my niece accompanied us. I later dropped them off at home and headed for the hospital at 3.45 pm.
The children wanted to come with me. I said Mommy was not in a position to see them yet. They wanted to know when she would be returning home and I said soon.
At the hospital, I remembered David Aremu, my former driver at the State House. I had run into him in the morning. He was trying to retrieve the body of his son whom he had just lost to a midnight fire in one of the villages around Abuja.
Aremu’s daughter whom the boy had tried to save escaped with bruises and she was also in the hospital. I sympathized with him and promised to call him later. I told him that Rachael was in the intensive care unit and he expressed shock and offered prayers.
Aremu, like all our other personal staff, has remained a close family friend four years after public office. I got Aremu on the phone and he said he was on his way back from Kaduna where he had gone to bury his son. He promised to see “madam” on his return to the hospital.
As I stepped into the building housing the intensive care unit, another corpse was being taken out in a coffin-like wooden box. My heart was beating fast. I saw two people following the coffin, and deduced that they must be relatives of the dead patient. I was still not at ease.
I got to the intensive care unit, rang the bell and was ushered in immediately. I quickly checked Rachael’s bed space and it was empty. I asked the staff on duty about Rachael and they kept quiet.
“What is going on? Where is my wife? Where is she?” I was getting hysterical. One male nurse led me to the small adjoining room to deliver the bombshell.
“You see, we were not the ones on duty. From the hand over note, the people we took over from said she went into cardiac arrest and that they had tried to save her life but couldn’t”. He said calmly.
He did not make any sense to me.
“What exactly are you telling me? Where is my wife?”
“They have taken the body to the mortuary”.
I collapsed.
Minutes later, my sister-in-law called. She heard only my cries and alerted everyone.
Rachael died at 12.35 pm. I was listed as her next of kin with my telephone. Yet, the National Hospital did not call me until I showed up at 4 pm.
They would probably never have contacted me if I did not show up for days, weeks, months and years. Her body would have been declared “abandoned” and sold to body part merchants by callous mortuary attendants.
That Saturday evening, my brother-in-law led a team to inspect Rachael’s body at the mortuary. It was dumped on the floor in the same wooden box in which it was carried from the intensive care unit. There were several other bodies on the floor. The mortuary attendant, a young fearless fellow, had dozed off at the entrance. He said there was no space left.
One of the people who went with my brother-in-law called the attendant aside and greased his palm. Suddenly, a slot was found for Rachael. It was Cabin 19.
Rachael was born January 19, 1977. We got married October 19, 2002. She died August 29, 2009.
Two days after losing Rachael to cerebral malaria, I went to the intensive care unit of the National Hospital to sign the death certificate without which we could not carry the body for burial.
“Oga, sorry. It’s God’s work”.
“God giveth and God taketh”.
“May her soul rest in peace”.
“May God help you raise the children”.
So, these people know God? Why didn’t this piousness reflect in the way they treat patients? In Nigeria, there is a wide gulf between what we claim to believe and what we actually do.
The hospital staff know that they will not be sued them. They know that most Nigerians do not have the patience to wait for as long as 20 years for justice. They prefer to take their cases to the court of the Almighty.
They know that whatever people sow they shall reap in this world. But this is not enough. We must cry out against injustice. We must fight for a country where people will no longer die needlessly every day.
Just before I took my leave of the pretenders at the intensive care unit, I asked why nobody had called to inform me about Rachael’s death.
“Oga, we don’t have credit”, someone said on behalf of the doctor, nurse and others on duty that day.
Adinoyi Ojo Onukaba
