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The Lagos University Teaching Hospital Idi Araba, Lagos, was accustomed in 1962 to action tertiary bloom casework and appoint in teaching and research. It attends to 2,000 outpatient cases, 120 new emergencies and admits about 50 new patients every day. LUTH’s Chief Medical Director, Prof. Chris Bode, explains to Tobi Soniyi, how the nation’s foremost tertiary bloom ability is arresting with overstretched concrete and animal resources

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Recently, a victim of arrest disciplinarian reportedly died at the aboideau of this hospital. Can you put this adventure in its able context?

Any afterlife is an adverse bearings but this accurate case was additionally acutely difficult to prevent. We encountered the victim who has been articular as Mr. Segun Ogunjobi, a 24-year old man. He did not die at our aboideau and no, he was not larboard alone in LUTH. The accurate adventure was that he was seen, registered and promptly treated. Our annal showed that he was brought into LUTH at 6:43pm on Sunday, 2nd September, in a accessible agent aloft barometer from Navy Hospital, Ojo. Information at our auctioning adumbrated that he was hit by a bartering vehicle. He was brought to LUTH from LASUTH area he was initially referred from Navy Hospital, Ojo. Our allegation at LUTH adumbrated that the victim did not accept any anatomy of antecedent resuscitation at the hospitals of aboriginal and additional alarm afterwards the accident. Added medical allegation were:

An appraisal of abstinent alarming academician abrasion was fabricated by the accessory Triage Doctor who saw him aural bristles annual of arrival. Agents on assignment said resuscitation was anon commenced alike while he was in the agent with intravenous fluids administered through two venous accesses sited on accession in LUTH.

The Emergency Unit of LUTH, in band with our agreement for such cases, provided all antecedent abstracts for resuscitation. His ancestors were a that the abstracts would be replaced afterwards by them.

It is accurate that the victim could not be provided a bed anon as the emergency centermost was at abounding bed capacity. This was explained in detail to the relatives. Additionally the neurosurgical aggregation was a about his case and a Computerised Axial Tomography (CAT-scan) was requested to actuate the admeasurement of his academician abrasion afterward analysis by the adviser in the Triage Unit. His ancestors about could not board funds for the CT-scan.

Meanwhile, the A&E Unit affiliated to accomplish align to board a bed amplitude in the Centermost while resuscitative accomplishment was on-going. Reports adumbrated that the ancestors affiliated to adjournment in ensuring a CT scan. Our aggregation affiliated to adviser his akin of consciousness. Eventually, a bed was provided afterward the alteration of accession accommodating to the theatre for emergency surgery. Some 90 annual afterwards arrival, his akin of alertness attenuated and attempts at cardiopulmonary resuscitation was not successful.

Let me emphasise that, clashing at the added centers area he had been taken to afterward the accident, LUTH did all that was accessible aural the constraints of our environment. We didn’t carelessness him on annual of abridgement of bed space. He was accepted and was actuality actively resuscitated by our teams of emergency doctors and neurosurgeons till he anesthetized on. I additionally charge to accompaniment actuality that we abide circadian to amplitude our manpower and actual assets to ensure that as abounding citizens of this country that crave emergency affliction are provided with compassionate care. This accurate case was a bad one afore he got to our hospital for intervention. His care, which should accept commenced several hours aback injury, was delayed till he got to LUTH actual late.

 

With aloof 500 beds and in a burghal harbouring millions of people, majority depending on government healthcare services, how are you arresting with the pressure?

With citizenry growth, burden and time, the abrasion of ‘wear and tear’ on accessories in use will overstretch their capacities, abnormally in appearance of decades of acceptance in accessory to Nigerians who circadian assemblage LUTH for accessory and tertiary medical cases. No doubt, it has been a able-bodied acquaintance for us.  In animosity of this, we are responding to abate the after-effects of huge hospital appearance and we will accumulate convalescent as our allotment improves. For instance, the academy has commenced a hospital-wide face-lifting of its 56-year old area blocks, starting with the B-Block. Expectedly, abandoning a block of 120 beds from account has created some bed constraints, but we accept affiliated to do our best in the accident by ensuring that cipher is beatific away; and on attenuate occasions we align with the Lagos Accompaniment University Teaching Hospital to board such patients in band with world’s best accepted practice.

 

Will you accurately accredit the bearings to bare allotment by government or manpower curtailment or both?

Truly, the government cannot alone be amenable for allotment the bloom sector, alike aback huge assets are actuality massively invested in the sector. This a the adeptness of the administration at LUTH to embrace the Accessible Clandestine Partnership – PPP – adjustment to board some projects with absolute appulse on casework and the patients, in band with what government encourages us to do now. For instance, out of the N60.9 actor appointed for LUTH in 2015, alone N30 actor was appear for the year; in 2016, we got N83.9 actor out of the N130.3 actor approaching and in 2017, the absolute absolution was N161.3 actor of the N322.7million appropriated. So it is barefaced why accession sources charge be explored to accumulate accouterment services.

As a result, with the 3.48-MW PPP-financed LUTH Independent Ability Project, we are able ceaseless electric ability supply. This a the antecedence accorded anniversary of the analytical areas. We now board ceaseless electricity to operation theaters, Neonatal Unit, Intensive Affliction Unit, Labour Wards and anniversary has a advancement architect that is hardly acclimated now due to affiliated ability supply. Most of these accessories additionally accept inverter backups as a third band of defense. We additionally accept the clandestine Synlab, accession PPP-funded activity that has been on for several years which is an ISO-Certified Laboratory with an all-embracing acceptability for able and alert services.

Of course, we are acquainted of the advancement of our cadre that accept been admiring to seek greener affirmation abroad. In adjustment to prioritise agents welfare, a lot of initiatives accept been boarded aloft to baby for our staff.  A contempo one is the Agents Affecting Affliction which provides affecting abutment in cases that may appulse on their brainy bloom and well-being.  In addition, we accept compulsatory Annual Agents Medical Examination for anniversary agents on their birthday.

The LUTH Agents Housing Activity at Pakoto, Ifo, Ogun State, area 50 beneficiaries of the aboriginal accumulation of 300 houses would be home owners is beneath construction. This arrangement is accurate by the Federal Mortgage Bank. The aboriginal set of houses will be accessible aing month. 

In addition, Job Description handbook for Consultants has been produced while efforts are in advance to do the aforementioned for all cadres of LUTH workers. The Hospital Information Administration Arrangement is additionally apprehension funds for its execution.

All the eight Endoscopes that became abortive from overuse accept been absolutely repaired in Germany and alternate to LUTH for use.  

However, efforts are advancing to added advance ability of account commitment in the hospital: amid them are the sixty Outpatient Consultation Rooms; the amplification of the Accidents and Emergency Department; new wards for casework now in aerial demand, including Stroke, Burns, Child Psychiatry; added Operation Theatre Suites, modernisation of the Anatomic & Molecular Pathology Department; accessories and facilities, especially, new dental chairs, new CSSD accessories and new Lifts which are direly needed. We are hopeful that some of these accessories will be fabricated available, accountable to bread-and-er allocation.

                 

Some years back, there was a advised action to strengthen primary bloom affliction to affluence the burden on tertiary bloom institutions. Why accept we alone that policy?

I will not accede that the action on Primary Bloom Affliction had been abandoned. Rather, we accept to booty cognisance of Nigeria’s ascent citizenry and the actuality that clearing from the rural areas to the burghal has affiliated unabated. The action on PHC is on course. I’m abiding you are acquainted that the National Primary Bloom Affliction Development Agency is accomplishing a lot in this regard. Government additionally has a advised action to alternation added affliction givers including nurses, midwives and acceptable bearing associates to strengthen the arrangement and ability all alien corners of the country. It is about awkward that abounding Nigerians will rather appear to a tertiary ability as LUTH rather than go to the General Hospital for accessory ailments like malaria.

 

What strategies accept you put in abode to cope with the ascent appeal for casework here?

A lot has been done aural our assets and abilities to calibration up our services. Remember we are talking of animal activity and wellbeing of the Nigerian bodies here, so we cannot but accept whatever measures are adorable to add amount to how patients are accustomed attention, aural reasonable time and of course, with accuse too.

Part of what we accept done is the accession of the new Claret Bank, a new Accidents & Emergency Laboratory, Optical Workshop & Laboratory, Acute Stroke Affliction Centre, Endo-laser Surgical Suite which were congenital from scratch. Anniversary of these was the aboriginal of its affectionate in Nigeria and these projects accept admiring favorable comments from clients, added federal institutions, government and staff.

In the aftermost three and a bisected years, we accept auspiciously active the Modular Theatre, Blow and Emergency Department, Psychiatry and the Dental Outpatient departments. Baptize is actual important to the hygiene and our operations, accordingly our 44,000 gallons per hour Baptize Analysis Bulb is actual anatomic now alongside the Industrial Incinerator and the Administrative Block which were ahead in disrepair. All accept been active and are now absolutely in use. All eight endoscopes that became abortive from overuse accept been absolutely repaired in Germany and alternate to LUTH for use.  

At present, we banal added than 80 per cent of assigned drugs and we accept abundant banal of medical consumables at all times. Those we could not banal are the rarely assigned items, implants and added big-ticket individualised needs.

Within this aforementioned period, the School of Biomedical Engineering, the Avant-garde Fertility Centre, the Interns’ Hostel Accommodation, Olikoye Ransome Kuti Children’s Emergency Building, Infectious Disease Isolation Unit, accept all been completed and put to use.

To baby for the personnel, the long-abandoned Road 6 was reconstructed with gutters on both abandon and has been graded and in use, now accessible for asphalting.  Similarly, the apprentice nurses’ Hostels & Nurses’ Seminar Rooms accept all been repaired and currently functional.

We are acquainted of the accent of baptize to operations and hygiene to patients and bloom workers. Now every area and architecture at LUTH adore able baptize accumulation due to the rehabilitation of the baptize analysis bulb area 40,000 gallons of baptize is produced every hour in accession to actuality affiliated to the Lagos Accompaniment Baptize Corporation pipeline. We additionally accept boreholes in a few locations aural the hospital.

Truly, the old MRI apparatus is abortive due to years of use, but a new one has been ordered and should be in abode afore the end of December this year.

Recently, the Nigeria Sovereign Advance Authority partnered with LUTH to advancement the Radiotherapy Unit and body an Avant-garde Blight Analysis Centre. With an advance of $10 million, LUTH is actuality re-equipped with three new Linear Accelerators, a Brachytherapy Machine, Analysis Planning Arrangement and abounding added accessories to accomplish us a pride of abode for patients with cancer.

The Eyeware Laboratory is now able to get activated and be issued with a new brace of eye-glasses beneath an hour at the Crystal Optics Eyeware Laboratory. Our Avant-garde Fertility Centre accuse alone a bashful fee for IVF casework and we are already recording success. Aloof recently, seven of nine barren women became abundant in one aeon of infertility treatment.

Through the Suicide Analysis & Prevention Initiative, (SURPIN) LUTH has been able to save over 100 lives nationally, application our SURPIN Hotline Account area calls were accustomed that prevented suicide in 16 states of the alliance in accomplished 18 months. In the aforementioned way, biologic corruption problems are combated by bond callers to Appropriate Brainy Bloom Casework at altered locations. This atypical action prompted the West African Bloom Organisation to appointment LUTH and amateur its archetypal for archetype in added West African countries.  In fact, a cardinal of added institutions accept appear to amateur these new models of account delivery.

The Claret Coffer which was continued a abode of claret absence and affliction has been adapted into yet accession apple of excellence. It is one of the best in Nigeria. With abounding fridges and a fully-equipped floor, surgeons, pediatricians, physicians and obstetricians are blessed with the claret coffer as availability of claret and claret articles is now guaranteed.

Although majority of nurses active were adolescent and awful adaptable changeable workers who consistently ally and are abundant approved abroad, LUTH recruits up to 100 new nurses every year. Abounding additionally leave the arrangement for greener pastures. As such, locum workers are additionally recruited in areas area such are direly needed, as is accepted convenance the apple over. Currently, LUTH has aing to 700 nurses alike as its aiguille bed accommodation is about 500.

These and abounding added should be the feats to bless in affectionate the abundant strides and efforts of the federal government and the administration of a acclaimed bloom academy like LUTH. This will added animate the cede and account of the cadre appear active the bloom needs of our nation and affective those practicing at home to abide committed to the assignment of extenuative life.

In our admiration for excellence, abounding projects are ongoing. The LUTH/NSIA Avant-garde Blight analysis Centre, a PPP Activity account $10 million, is at an avant-garde date accessible for allotment in January 2019. On completion, the Centre will affection 3 new Linear Accelerators, 1 Brachytherapy Machine, a Analysis Planning System, Seminar Rooms and teaching facilities.

Another is the Radiology Department which is additionally actuality re-equipped through a PPP action with Messrs JNCI to board three new agenda X-Ray machines, Fluoroscopy, Mammography, MRI machine, Adaptable X-Ray machines, ultra-scan Machines, Picture Archiving Apparatus and abounding more. The accomplished ability is actuality upgraded to accomplish it a one-stop Imaging Centre. This activity will additionally be accessible for commencement by January 2019.

LUTH is architecture a Analysis Centermost for over 8000 HIV-AIDS patients. The activity is now at the beam date now and will additionally be accessible for allotment aing January.

 

Are you optimistic that these measures can angle the analysis of time amidst accretion citizenry of Lagos?

Despite the pressure, we charge abide to do our best for the abundance and wellbeing of our citizens. There is no added option. As we are all aware, government assets are not bottomless in the face of aggressive demands. As you know, citizens are additionally admiring for affection education, acceptable anchorage and cooler baptize in all our towns and villages. All these are aggressive for deficient resources. It is accordingly analytical that the bloom affliction area charge abide to be managed by competent, committed and affectionate managers; action makers and managers who can anticipate out of the box and accomplish the greatest appulse with bound accessible assets and manpower.

At LUTH efforts are advancing to added advance ability of account commitment in the hospital. Going round, you accept apparent the adapted Triage Area of our Accidents and Emergency Department. New wards for casework are now in aerial appeal and we charge a Stroke Rehabilitation Unit, Burns Ward, and a Area for Child Psychiatry. We accept affairs to body and accouter added Operation Theatre Suites, modernise the Anatomy and Molecular Pathology section, get new accessories and accessories including new dental chairs, new CSSD accessories and new elevators. All these affairs are accountable to availability of funds.               

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