Open Heart Surgery And Nigerians – My Experience By Hf Dauda MoiSoro
Okay, let me deadpan and say 2019 was a remarkable year for me, and particularly for my health. I am among the unfortunate percentile that suffers from chronic heart disease (since I have been on medication for close to 20 years). In early March 2019, the chest pains became regular and increasingly severe after any strenuous activity or a spell of high stress. It was quickly evident that if I do not get immediate medical intervention, the probability of a serious heart attack is eminent.
The search for relief started with the best possible (Nigerian) care in Abuja at the National Hospital. Sad to say that although many of our medical professionals are extremely qualified and highly capable, my five (5) or so visits, over the span of two months, were truly a lesson in antiquation and delay. The National Hospital’s consultant cardiologist is available only a couple of days week, but every heart patient can only have one appointment per week. So it took four (4) appointments to receive the diagnosis of my severe and, at the time, alarming chest pain. I was given confirmation that my arteries were blocked up. I was subsequently referred to the Turkish Nizamiye Hospital for second opinion that could lead to Angioplasty and Stenting or Open heart surgery if warranted and indicated by the angioplasty.
I immediately made an appointment at the Nizamiye Hospital for diagnostic confirmation and care. Only to be confronted with a list of charges for every procedure I might need and asked to deposit at least 70 per cent for the procedure; so that the hospital can make the necessary arrangements for the doctors to proceed with surgery. To say the least, I was flabbergasted.
No effort was made to answer my questions and allay my fears. Do they have the ability to perform the open heart procedure? Are they only going to try doing the angioplasty and if the open heart is indicated, then close me back up and refer me to another hospital outside Nigeria? How many surgeries have they performed and what is their success rate? What type of after care and post-op regiments do they have in place for heart patients? Nothing was answered. The triage/consultation nurses and doctors have become like all Nigerian businesses – money first and service last.
They have already guessed that I will probably need two new artery stents to make me healthy again. Their total cost estimate came to about N3m. They (graciously) gave me the option to pay within five days and get a 20 per cent discount. For my heart!!
Mind you, no doctor has examined me yet; even though I have paid N20,000 registrations. I was thus quickly convinced that they are a money making facility and not a hospital. I only visited once and never returned.
Everyone who knew about my condition at the time was offering the same advice, “do not allow yourself to be operated on here in Nigeria.” The choice was actually crystal clear, that I must seek care outside Nigeria. National Hospital cannot do it, even though we have the doctors, because our infrastructure and the intensive care system cannot sustain an open heart patient – the process will kill you or the environment will kill you. And although the ‘imported’ hospitals like Nizamiye, have the infrastructure, their eyes are fixed primarily on making money, and I have concluded that their doctors are usually second rate and many are incompetent.
I am aware that some Nigerians give hospitals like Nizamiye some credit for their ability to perform the minor heart procedures, but still submit that because they have found our hospital environment to be unregulated, they have misplaced and abandoned all health care priorities by only catering to our big man mentality. Nigerians think it is a good hospital because it is expensive. They are wrong. I know now that it is not government that build hospital, it is actually the doctors, and the money (capital), and painstaking time, and the airtight care systems that build hospitals. Do it any other way, and it will fail. Fancy equipment do not make a hospital.
Not long after my decision to go somewhere outside Nigeria for the care, my travels took me home to Yobe state during which I experienced a public fainting incident. We had driven to Damaturu from Potiskum, and upon arrival to our destination, I step out of the car, took one step, fainted and collapsed. I regained consciousness almost immediately, but out of necessity and abundance of caution, I was driven to the Yobe Stare University Teaching Hospital in Damaturu for emergency care and a complete check-up.
The care received in YSUTH was part of the reason why I am still here today. I pleasantly noted that they were well equipped and the doctor who reviewed my case and provided my care (Dr Benjamin), was extremely qualified and capable (and even modest) in his approach to provide me with a second opinion. He correctly advised against the futility of any angioplasty and insisted that I must only go for full care in a hospital that has a successful history of performing open heart surgeries – because he was convinced and the evidence shows that it is more than likely that I will need a very invasive open heart procedure. In the end, his advice was what saved my life medically. There were also two other brilliant doctors that guided my care while I was in hospital for the surgery. Thank you to Dr Babagana in the UK, and Dr Raabi in Nigeria. They monitored every decision and procedure and provided invaluable guidance.
I knew then that Nigerians can do great work in our hospitals if we will just invest appropriately.
(By the way, I eventually went to Egypt in November 2019 and had a successful surgery with full recovery.)
The care at YSUTH made me ask many questions about our healthcare system and it was always easy to point a finger and blame several governments, agencies, doctors, even patients, and sometimes our peculiarities as the culprits. But my mind eventually discarded those blame games and kept looking for reasons that are more conclusive.
So today as we face Coronavirus and as we are all under the ‘lockdown’ and trapped in Nigeria with the unworthy health care system and its dilapidated infrastructure – I decided to suggest some of the reasons Nigeria has failed at caring for our health.
• Nigeria has virtually no middle class. Without a safe and secure middle class you just cannot have genuine political or social advancement. Good health care depends on political and social development. The extreme poor are busy surviving and the extreme wealthy are busy protecting their assets. A large, stable middle class is the key to a modern society. A modern society will demand and build a great health care system, and supported by the middle class. And by the way, please forget the fallacy of free healthcare, Good health is not free! We must all pay and it is the middle class that can carry the burden and sustain great hospitals.
• Our education system is rote-based. It’s not as bad as in some other countries, but still, it does not encourage much creative expression. We do not build anything, we do not create anything and we do not innovate anything. In the world of great health care, you must build, create, and innovate. You must do research and develop technics. You must try the unknown and imagine the impossible. But our schools are not tooled for that. Our doctors are tired and exhausted of schooling by the time they graduate because of strikes and academic exploitation. Our population are also tired of seeking new thinking. The number of people whose thinking or analysis would just stop at a fixed point is astounding. Religion and tribalism and other sentiments have overtaken our common sense. People are told something, they believe it outright, and that’s that. We are therefore, stuck in one spot.
• People are reticent to challenge the status quo. Whether that is family customs, religious restrictions, or social mores, they will bend over backwards to accommodate and please others even if it means remaining stuck, sick, and unhappy. The politicians who destroy our commonwealth and leave us to die in penury are worshipped as gods when they bring a bag of garri, a pint of oil and a sachet of sugar! The government even makes us believe that we are good people so that we do not revolt against it by using a propaganda called “Great nation, good people.” We are not great about anything!! This reticence only confirms to the world that words of benighted and imprudent authority figures are rarely challenged. Change does not come through submissiveness!
• Women are very present in Nigeria’s public life – politics, business, academics, pop culture, medicine, etc – but there still exist the pervasive attitude that allows only for a narrow range of acceptable behaviour from a woman. Yes, you’ll find that all over the world, to a varying degrees, but it is always an impediment to progress and development.
Women are great care givers, but today in Nigeria, most nurses are overworked and have become unbearably abusive to patients because there are so few of them. Our nursing schools have died and the curriculum for nursing has become bastardized. A new effort must be deployed to revive and solidify the caregivers we have if we intend to have a system capable and strong enough to sustain a heart patient in an intensive care environment. I knew from experience, that the four days I spent in the intensive care ward in Egypt, would have extended to weeks in Nigeria and my chance of survival would have been less than 50 per cent after surgery – all due to poor care. It must change.
• We also acknowledge International impact. Nobody will help us build great hospitals when they can have us come to their own hospitals and pay them well for it. We must build our own hospitals. We must manufacture the beds and sew the linens and everything else in-between. That is what Egypt is doing, that is what India is doing, that is what Germany and the UK and the US have done. We must never say the government can build a great hospital. It is Nigerians who can build great hospitals. The government can only buy a great hospital, or pay for a great hospital.
COVID-19 is telling us to do it now or die. Very simple choice really.
My sense is that the current democratic era has seen a lot of forward movement quickly deteriorate into nothing, the chaos of these years, and rude of awakening of this COVID-19 pandemic will be exceedingly good for a renewal of dynamism, analysis, and action. Our health care system must be the immediate beneficiary of this vigour, dynamism and focus, so that we can at least walk away with a good lesson learned.
Both governments and businesses must get off their asses now!
