Tales from varsities' underfunded, understaffed medical centres — Features — The Guardian Nigeria News – Nigeria … – Guardian Nigeria
Nigerian Universities
Over the years, some university students have lost their lives while seeking urgent care at medical centres located in their various institutions. No thanks to the poor service delivery in such facilities, or the lack of drugs or prompt attention. While students have protested against poor service delivery by their institutions’ medical centres, some of them have boycotted the services outright, and now seek medical comfort elsewhere. In this report, Iyabo Lawal (Lagos), Lawrence Njoku (Enugu), Ann Godwin, Obinna Nwaoku (Port Harcourt), Murtala Adewale (Kano), Rotimi Agboluaje (Ibadan), Tina Todo (Calabar), Ayodele Afolabi (Ekiti) and Adewale Momoh (Akure), chronicle conditions prevalent in varsities’ clinics, and findings show that a lot still needs to be done to make them fit for purpose.
It was 7 pm, the onset of nightfall, and darkness was gradually enveloping the land. Along the narrow, but exquisitely tiled pathway leading to the waiting room of the Usmanu Danfodiyo University, Sokoto (UDUS) Health Centre, were some frustrated students whispering to one another in hushed tones.
One would have considered what was happening there as mere hissing, but it was beyond that, it was the reaction of “impatient patients,” who had waited patiently for hours for doctors to attend to them at the university’s clinic. Sadly, none was in sight. Incidentally, most students who visited the clinic that day retired to their hostels disappointed, and praying that their conditions should not deteriorate.
Among the disgruntled band of students was Amina, a 300-level Career Guidance and Counselling student, who took ill two days earlier, and was confined to her room in the hostel until her friends helped her to the school’s clinic. With no doctor in sight, Amina was tucked into one of the chairs located just by the exit.
Down South at the Jaja Clinic, University of Ibadan (UI), Tomi, a 200-level student in the Faculty of Education shared the story of a similar experience, even though he was lucky to see a doctor: “I had a terrible experience the day I was admitted at Jaja Clinic. When I got there, they didn’t attend to me until I started vomiting. They also had no drugs. So, after I was done with the consultation, I was handed a prescription sheet, and I proceeded to purchase the prescribed drugs in a pharmacy in town. With my experience, my simple advice to students is to go home when they are not feeling fine.”
Two months ago, students of the Federal University of Technology, Akure (FUTA), protested the death of their colleague, Ayomide Akeredolu, a 500-level student, following an allegation that the deceased died due to the inability to power oxygen to save his life, as a result of lack of electricity within the health centre.
Daily, the sheer number of students seeking medical attention in schools with large populations could be overwhelming. So, having functional medical centres on campus ensures that students receive prompt and appropriate medical care; minimises the risk of further complications, and ensures faster recovery.
However, such facilities are increasingly becoming a luxury in tertiary public institutions, even when accidents, injuries, and medical emergencies are common occurrences due to various physical activities and sports.
An ivory tower indeed!
Since universities attract students from diverse backgrounds, many of whom are with pre-existing medical conditions or require regular medical check-ups, well-equipped medical centres are a sine qua non that can provide routine medical examinations, vaccinations, and screenings for conditions like diabetes, hypertension, and sexually transmitted infections.
Because of the multidisciplinary nature of universities, experts are of the view that a well-equipped medical centre can provide immediate medical attention, including first aid treatment, stitching wounds, and treating fractures, which may occur from time to time in such setups.
They also maintain that since a proactive approach to healthcare helps in the early detection and prevention of illnesses, and enhances the overall well-being of students, sparing no expense to put in place fully-equipped medical centres remains a critical thing for every school administration to do.
But for many students in most public universities, their impressions of campus clinics are something akin to death traps. Findings by The Guardian after visits to some institutions showed that most medical centres in tertiary institutions are far from functioning optimally.
Some of the common challenges that they are battling include absentee doctors who are mostly unavailable at their duty posts, lack of equipment and drugs, and sometimes, uncaring medical staff. This much is confirmed by the gamut of complaints about poor healthcare reverberating across campuses.
Also, at a time when mental health concerns are prevalent among university students, having in place a well-equipped medical centre, with mental health professionals who can provide counseling and therapy to support students dealing with stress, anxiety, depression, and other psychological issues is simply indispensable.
However, apart from the recent protest in FUTA, poor service delivery at medical centres has sparked several protests in the past, including at the University of Ibadan, where students have repeatedly protested against Jaja Clinic’s alleged malfeasance, including that which led to the death of a 200-level student after he was denied treatment for failing to produce his medical card.
UNN Clinic
UNN: University clinic a-no-go area
At the Nnamdi Azikiwe University, Awka, Anambra State, a final-year nursing student reportedly died due to alleged negligence by staff at the university’s clinic. The development led to a students’ protest.
Dozens of students confirmed to The Guardian that they have boycotted school clinics because of a lack of medication, and waiting for lengthy periods before being attended to.
While a number of them said that they have resorted to patronising private medical facilities, in addition to consulting pharmacists off campus, some insist that they have never attempted to patronise these facilities to avoid swelling the ranks of students that have been exposed to bitter experiences in these medical facilities.
Despite the rehabilitation of buildings at the University of Nigeria (UNN), Nsukka, and the Enugu campus of the institution, the institution’s clinics are still challenged, hence serious cases are referred to other hospitals, while drugs are purchased outside the clinics.
It was gathered that the acting coordinator of facilities in the Enugu and Nsukka campuses had made a case for an upgrade in facilities to accommodate more complex health issues, and engage more qualified experts than the current practice of fresh graduates.
A 400-level student of the Faculty of Law who pleaded anonymity confirmed that the medical centre is lacking in equipment and manpower to cater for the medical needs of students who throng the facility.
Recounting a personal experience, he said that he had to wait for three days to run a laboratory test after he experienced something strange within his system. “For the three days that the symptoms persisted, I could not run a test because the laboratory scientist who was meant to attend to me was unavailable.
“After the test, I only got a few of the prescribed drugs, while the rest were acquired off campus. There was an incident where a student fainted in the hostel and was rushed to the centre, by his friends. After waiting for a long time for a doctor to attend to the student and seeing none on the ground, the student was rushed to an off-campus clinic.
UNIMAID: Open hours: 8 – 11 a.m. only
But Abdulmuiz Salman, a student at the University of Maiduguri, was left with no option but to visit the school’s medical centre a few months ago, after developing a toothache that resulted in a severe headache.
After initially resisting the idea because “doctors were only available in the mornings, and by 11 a.m. they would sign off forcing students to wait until 2 p.m. before another doctor resumes duty,” he reluctantly approached the clinic.
“The doctor on duty prescribed some drugs for me. As I took the prescription sheet to the pharmacy, the pharmacist on duty said the drugs were not available. I left the clinic sad,” he recalled.
At the UNIMAID Medical Centre, it was observed that the clinic does not have light, coupled with poor ventilation systems.
A student of the Faculty of Education, Fatima Mohammed, recalled her short, but sad experience when she was hospitalised at the clinic.
She said: “At the clinic, they have adequate staff, but there was no electricity, and drugs except Paracetamol tablets. I spent about four hours there, but it was hell. My experience at the clinic was not a good one. But the school authorities should build a new clinic with adequate beds because I think that the present one was built when the student population was less than 5, 000. The number of students now is far higher than what it was then,” she said.
FUTA
FUTA, AAUA: No emergency, please!
Findings by The Guardian at the Federal University of Technology, Akure (FUTA) and Adekunle Ajasin University, Akungba-Akoko (AAUA), showed that most students prefer to visit off-campus hospitals or pharmacies, due to poor healthcare services on the campuses.
They lamented the inability of the clinics to offer emergency services when the need for such urgent medical attention arises.
Despite paying N4,500 as medical fees per session, the students noted that their concerns are often not adequately addressed, nor do they get the required medical comfort when they visit the health centres.
They further alleged that most times, the centres do not even carry out laboratory tests to ascertain the cause of their illnesses.
One of the students, who identified herself as Biola Omoniyi, alleged that drugs are not readily available, especially in FUTA, while first aid services for students are very poor. She insisted that the life of her colleague who died recently would have been saved if the clinic had a functional power generating plant, adding that even an attempt to send her to an off-campus medical facility also failed because there was no petrol in the school’s ambulance.
“Most times, the only medication they give is paracetamol tablets, even when the student has malaria or typhoid symptoms,” she alleged.
At the AAUA, students alleged that they were wrongly diagnosed most times, hence the reason that many have stopped going to the campus clinic. One of them, Tolulope Fatukasi said: “When I was in 200-level, I fell ill and went to the health centre. I was given malaria drugs, but the sickness persisted. I was thereafter admitted for two days, but after being discharged, I realised that I still was not feeling better. So, I went back to the clinic, and because I was vomiting, they told me I was pregnant. So, I went to another hospital in town, where I was diagnosed with an ulcer, and eventually treated.”
Jaja clinic UI
UI: Doctors gone abroad
At the University of Ibadan, inadequate manpower is a challenge as most of the doctors have relocated abroad for greener pastures.
According to sources, out of about 25 doctors who were at the clinic, only eight are still around, and working under immense pressure.
Apart from the thinning number of doctors, the alleged lack of drugs at the facility is another major challenge, as students, most times head to town to buy prescribed drugs.
One of the nurses, who spoke on condition of anonymity, said: ‘’We need more hands; members of staff are overstretched, and understandably, clients don’t want to know that many hands have disengaged. We need an alternative power supply; fully equipped ambulance vehicles (for at least basic and preferably advanced life support), migration to full Electronic Medical Records (EMR), and improved staff welfare,’’ the source said.
EKSU: Overwhelmed staff equal wrong diagnosis
At the Ekiti State University (EKSU), students expressed almost similar opinions regarding their school’s clinic. According to Olayemi Josephine, a student in the Faculty of Arts, the ratio of medical personnel to the number of students seeking treatment is abysmally low, forcing many to seek treatment outside the university.
For another student, Taofeek Olasupo, one of the major issues that should be looked into is the wrong diagnosis.
Said he: “There was a case where a student who was diagnosed with malaria was later discovered to be suffering from kidney problems, and some other ailments when he was taken to another hospital by his parents. The boy eventually died as a result of what many attributed to improper tests conducted on him,” he said.
Another student who preferred anonymity said: “Most times, what they usually treat students of is malaria fever, but when you have the opportunity of going to another hospital, what you end up being treated for would be different. I had a roommate who was even told to do a pregnancy test, which was not the case at the end of the day.”
BSU: No doctors, equipment
The scenario at the Benue State University (BSU) is the same as what obtains in others, as the students maintain that the clinic has been overstretched and needs expansion to accommodate the ever-growing population of the institution.
According to a student from the Faculty of Arts, Kevin Pam:
“The school clinic does not have enough doctors and nurses, and it also lacks basic equipment.”
Another student, who simply gave his name as Dave, corroborated the story, saying: “The capacity of the clinic is too small to accommodate the population of the school, but I think the authorities are working on a new one that will be fit for purpose.”
UNICAL: Shortage of beds, drugs, tests
The University of Calabar, checks by The Guardian reveal is currently constructing a new medical centre to meet the medical demands of the increasing students’ population, as the present clinic has over the years become too small, and often over-stretched due to the high number of students that the facility records daily.
But the consensus among students of the institution is for it to generally improve its services, equip the facility adequately, as well as improve on its manpower needs.
But like in other tertiary institutions, a 200-level student in the Department of Business Management, Gift Udom, expressed concerns over the shortage of drugs at the centre, which forces students to patronise patent medicine stores and pharmacies off the campus.
Even though the medical centre has functional laboratories, Udom said the clinic does not run major tests.
The impression that Peace, a student of the University of Port Harcourt, has about the school’s medical centre is unappealing after she failed to get help when she visited the facility to get a cotton bud that was stuck in her ear removed.
“The clinic is not bad, but I do not think the place can tackle life-threatening emergencies. I visited the clinic when a cotton bud got stuck in my ear while I was cleaning it. On getting there, rather than use a simple pair of forceps to take out the bud, I was referred to another facility to see an Ear, Nose, and Throat (ENT) expert. Of course, I did not go, and the bud eventually fell off on its own.”
BUK: A functional facility
Students of Bayero University, Kano (BUK) appear to have a slightly different story to tell about the medical facility in their institution, as the three clinics serving the university community offer general services, as well as dental, eye care, laboratory services, x-ray, and pharmacy.
According to students, the average waiting time for consultation is between 30 minutes and, at maximum one hour.
One of the students, Usman Tanko, commended the clinic staff for being responsive to students’ health concerns.
He said: “It is understood that a clinic in a university community consisting of staff and students would sometimes run short of some drugs, and when that happens, what they do is give a prescription for us to buy outside, or wait till the clinic receives a new supply.”
UNILAG: Poor attitude of carers
At the University of Lagos (UNILAG), students complained of an allegedly unpleasant attitude of medical staff, which they say easily puts them off.
“They talk anyhow and are so insensitive to the point that even if you have a bleeding hand, they would still insist that you go and get your medical card, not minding the fact that the student is losing blood. The clinic is reasonably equipped, but the staff members are tilting towards being inhuman. In the area of staffing, I strongly believe that a lot can still be done.”
On her part, a law student, Tomi Adeeyo, said when compared with other clinics in Nigerian universities, UNILAG has one of the best campus clinics.
He said: “A friend of mine was admitted to the clinic some time ago, the clinic did not only provide for his feeding, but they also gave him free medications. However, the ambulance response time is very poor, so something needs to be done in that regard so that emergencies can be treated as emergencies. The medical staff also need to be polite,” she added.
A conducive environment for learning, research
Creating a healthy and conducive learning environment on campuses is incomplete without sufficient investment in medical facilities to take care of medical emergencies involving students, teachers, as well as visitors.
Well-equipped medical centres in universities are vital for the well-being and protection of students, as they not only provide immediate medical attention, but also offer routine healthcare services, mental health support, and public health initiatives, in addition to boosting a sense of security.
Indeed, for public health expert, Hassan Akiode, priority attention should be given to the health of students who are already going through so much stress while studying.
While speaking on the lack of drugs syndrome plaguing most medical centres, and poor access to treatment, Akiode, suggested that the Tertiary Institutions Social Health Insurance Programme (TISHIP), which also provides healthcare services for university students in the country should be introduced at the clinics.
TISHIP funds are sourced from the contributions of students, charged by universities. It aims to ensure access to quality healthcare services for undergraduate students and to create a conducive learning environment.
“There is a need to integrate the tertiary health insurance scheme in the state’s health insurance scheme so that students can choose between accessing healthcare in school clinics or outside facilities,” he said.
For the Director of University Health Services, University of Ibadan, Dr. Aderonke Ajav, a situation where the health facility is placed under the education sector is a major challenge because the focus is on education, not health.”
On his part, the Director of Health Services, at UDUS, Dr Ibraheem Omar, said the influx of patients, coupled with administrative bottlenecks, are twin factors affecting the school’s clinics.
“The influx of students to the clinic over the months has been alarming. Before now, we used to attend to almost 100 patients a day. But now, we attend to over 200 students daily. There was a day when we had over 100 files submitted, all of which must be attended to.”
On shortage of drugs, he said: “There is no hospital in the world today that would have all kinds of drugs available in its pharmacy. However, the shortage of drugs is a result of bottlenecks affecting prompt procurement of drugs as at when due.”
The Head of Public Affairs, BUK, Lamara Garba, and Vice-Chancellor, Maitama Sule University, Prof Muktar Kurawa, said their institutions have provided adequate manpower to ensure that their schools’ clinics render quality services to patients.
Kurawa described the account of poor service at the institution’s clinic as false, saying that those peddling the false information may not have visited the clinic in recent times.
The VC said: “The university has invested a lot to ensure that the clinic renders quality services to both students and staff. By our standing rules, the clinic is not supposed to make any demand from students, but staff members are expected to pay 50 per cent of the total cost of treatment.”
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