Resident doctors in Delta State University Teaching Hospital, Oghara have appealed passionately to the Governor of Delta State to as a matter of urgency look into the healthcare delivery system of the oil-rich State, which they described as simply deplorable.
In an open letter addressed to Governor Ifeanyi Okowa, the doctors related the sequence of events that have led to pockets of industrial disputes in the apex health institution of the State.
The letter in full:
OPEN LETTER TO THE EXECUTIVE GOVERNOR OF DELTA STATE ON INCESSANT INDUSTRIAL ACTIONS IN DELTA STATE UNIVERSITY TEACHING HOSPITAL: THE TRUE STORY
Delta State University Teaching Hospital (DELSUTH), located in Oghara, the headquarters of Ethiope West Local Government Area of Delta State, is the apex autochthonous health institution in the state. The basic functions of teaching hospitals include training, research and medical service provision. DELSUTH was thus established to provide skilled health care for the teeming population of people in every nook and cranny of the state and environs through the undergraduate training of medical students, residency training of doctors and paramedics.
Your Excellency, at the inception, DELSUTH, a pride of Delta, was arguably a hospital that could compete favorably with good hospitals in decent climes. This attracted well-meaning people of Delta and environs who believed in the Delta dream to come onboard to lend their time and make sacrifice of going through the rigorous training so as to address the dearth of skilled orthodox health professionals in the state. That dream has become an illusion as things are gradually falling apart in our hospital, state of which we describe as deplorable.
The hospital is now losing brains and skills to hospitals that are better run and patients are losing faith in the hospital.
The state is gradually becoming very risky to live in as she cannot guarantee her indigenes of quality health care. For instance, the state does not have general surgeons besides the two working in DELSUTH.
This is now the state of the only teaching hospital in Delta State. Where did we get it wrong? What are we doing wrong and how can we retrace our steps to achieve the original dream of establishing the institution? These are questions that bother the association.
Your Excellency, DELSUTH, our pride, has been bedeviled by incessant strike actions which are not in conformity with a progressing institution. The reasons for these incessant strike are avoidable but obviously a lot of people have refuse to do their work in ensuring peace in the hospital. Highlighted below are some of the preventable issues that have resulted into incessant industrial disharmony.
INIMICAL GOVERNMENT POLICIES
Industrial harmony is the responsibility of a responsible government. What we have in DELSUTH are policies that have over time engendered rancour and provided loopholes for persistent strike action. Government policies that have affected the smooth running of the hospital include:
Lack of funding: Health care is expensive worldwide hence federal government gives subvention to federal institutions because most Nigerians cannot pay the service charges that would enable the institutions to be self-sustaining. In a similar manner, DELSUTH needs subvention from the Delta state government but lack of it has snowballed into undesirable problems affecting service delivery and training in a young health institution.
Diaspora and local staff: Government’s creation of two tier salary system for these two categories of staff is widely adjudged to be unfair to one group and is perceived as a source of demotivation to one group. This bad blood in work place is not in the best interest of DELTANS. Government should be seen enacting and implementing policies that would give her staff level playing field.
Lack of government will: it is worrisome and condemnable how Delta government turns her face away from the lingering crises in DELSUTH. With genuine interest and strong political will to solve the hospital problems by government, the hospital will get back on the right path.
DEPLORABLE STATE OF THE HOSPITAL
Your Excellency, DELSUTH is too nascent to be living on past glory but this is present reality in the only teaching hospital in the State. Highlighted below are some of the decadence in the hospital:
Infrastructural decay and unavailability of equipment: A busy service delivering institutions need regular periodic checks, repair and replacement of their infrastructure and equipment but the converse is the case with DELSUTH. An institution that was built to function only with air conditioners is now extremely hot for both patients and practitioners due to non-functioning air conditioners. Equipment like sphygmomanometer has become luxuries in the hospital.
Poor electric power supply: DELSUTH can no longer boast of reasonable power supply or anything near it as there is now frequent power outage for unacceptable long periods of time. Sometimes, power is rationed leaving some places in darkness. This has hindered patient care and contributed to the background insecurity in the hospital.
Unavailability of consumables: Basic hospital consumables are in short supply. Methylated spirit and cotton wool are now diamonds. Doctors contribute money to buy soaps to wash their hands after assessment of patients.
Lack of stationeries: Basic stationeries such as laboratory request forms, continuation sheets and even patient folders are not available most times in the hospital. This makes assessment of patients cumbersome and clumsy.
Pharmacy: The hospital pharmacy is often time depleted. The hospital, presently, is unable to supply complete items paid for by patients. This is inimical to the smooth running of a hospital located in a rural area as there are no alternative sources of these items in the immediate vicinity of the hospital. This ultimately leads to delayed care for the patients.
Suboptimal functioning of DELSUTH theatres: The theatres do not function to full capacities occasioned by factors such as nonfunctioning air conditioners, occasional lack of oxygen, anaesthetic materials such as drugs, spinal needles, and endotracheal tubes e.t.c
LEADERSHIP OF THE HOSPITAL
We strongly believe that with minimal interference from government in the leadership tussle of the hospital and with provision of enabling environment, deserving leaders with genuine interest in moving the hospital forward would emerge and achieve the set goals of the hospital. The visible and palpable involvements of agents of government in this tussle have distracted everyone from addressing issues promptly in order to avert dysfunctional hospital.
FALLING STANDARD OF PATIENT CARE
There is unacceptable reduction in the number of DELTANS the hospital can care for at a given time and also the quality of care rendered to them owing to a number of reasons, some of which are stated below.
- Limited bed spaces
- Decaying hospital infrastructure
- Unavailability of hospital consumables
- Short and erratic supply of hospital items
Reduction in the number of doctors available to provide services: some departments have lost a significant number of their resident doctors to resignation for greener pastures without commensurable replacement. DELSUTH does not provide certain services like cardiothoracic, assisted reproductive techniques and neurosurgical services owing to lack of specialists and equipments.
High service charges: DELSUTH ought to be providing specialized health care for the teeming population of Deltans who either cannot afford or do not have access to government largesse to seek such care abroad. Contrary to this expectation, hospital charges are high and most Deltans cannot afford to pay for them, hence a strong contribution to the dwindling patronage.
TRAINING OF MEDICAL STUDENTS AND POSTGRADUATE DOCTORS
Your Excellency, DELSUTH was conceived to be a blessing to Delta State as it would have with time produced qualified medical doctors and specialists through the undergraduate medical students and postgraduate training of doctors. This would have ensured provision of quality health services for Deltans in every nook and cranny of the state but the present state of the hospital makes the future bleak for the health system of the state. The following contribute to the poor training:
- Total lack of training funds
- Update course and examination fees are owed resident doctors by the institution and government for four years now.
- Reduction in the number of available trainers: It is pertinent to state that most of the training departments stand the risk of losing their accreditation if urgent measures are not adopted.
POOR STAFF WELFARE
The gains of a well-motivated workforce cannot be overemphasized. A good welfare scheme is sine qua non for the success of any institution. DELSUTH is rated below par in the following aspects of staff welfare.
- Safety and protection of staff: There is deficiency of scrubs and protective foot wears in theatre and other places where they are needed. The call rooms are unacceptably unkempt due to lack of beddings and materials like soaps and disinfectants for cleaning. Most of the calls have dysfunctional air conditioners thereby predisposing occupants to airborne diseases.
- Inadequate coverage of the staff health scheme as it covers only a percentage of the bills for the individual staff. It would have been a lot better if it covered the immediate family of the staff.
- Multiple remuneration problems: this is worrisome and best explained by some examples as follows:
- Nine hospital staff were owed more than 14 months and when they were paid, it was a just month without arrears and no word and hope of when the arrears will be paid.
- House officers have worked for four months without pay despite completing their data capture.
- Update, examination and outstation posting fees are owed residents for more than three years now.
- The state is yet to pay staff of grade level 13 and above their June salaries
- The state is yet to accept and implement the payment of doctors’ full salaries (skipping), which other hospital staff have been enjoying.
- Frequent strikes were precipitated by government’s insensitivity to the plight of the staff of the hospital. For example, in the last three months, consultants have embarked on strike twice and are still on strike.
Your Excellency, this is an attempt to keep you inform the true story behind the incessant strike in DELSUTH and also give Deltans at home and abroad an insight into the real issues bedeviling our only tertiary health institution established with the hope of taking care of our health needs and those of our loved ones.
Your Excellency, we are using this medium to request for your urgent attention towards reviving the only Teaching Hospital in the State.
We are also making a clarion call to all well-meaning Deltans and friends of Delta to lend their support to the dream of Delta state by advising stakeholders and government to do the needful in reviving DELSUTH.
Thank you sir.
Dr. Okoacha Innocent
Dr. Ekpekpe Moses
Dr. Orhewere Ejiro