Posted on: Sun 29-11-2015

Aristotle: “ignorantia legis neminem excusat” (Ignorance of the law excuses no one)

Today we will be looking at some more of the dictates of the recently passed Nigerian health bill so that we are all on the same page as far as the laws that govern our health system is concerned. Kindly follow this link HERE to read the previous volumes

Today’s discourse will be kicked off with a very juicy segment of this bill. It goes thus:

Part III, no 20.

A health care provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason whatsoever.

(2) Any person who contravenes this section is guilty of an offence and is liable on conviction to a fine of Nl00, 000.00 (one hundred thousand naira) or to imprisonment for a period not exceeding six months or to both.

Perfect! Definitely perfect; for the patients…their relatives… dependents and every single person who will shed a tear if the patient in need of emergency medical services is lost because they are ignored.

A study conducted at Harvard Medical School and Cambridge Health Alliance found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts

One does not need a Nobel laureate to figure out that current advances in medicine means astronomically more people will survive medical scares if they receive appropriate and timely medical attention.

Still that leaves one unanswered question.

Who pays?

Yes, who will pay (especially in private institutions) for the consumables, man power, basic amenities, equipment and time that will be expended in trying to save that life. For victim A in hospital B, his immediate concern is the severe abdominal pain he feels after his bowels have been eviscerated by a gunshot injury. The doctors have made it clear he will need an emergency exploratory laparotomy and some talk of over a hundred grand came up in that discussion. Well, all he wants to do for now survive. Everything else is secondary. You know what they say, money cannot buy life.

True story…

What A does not know is that a day after his life saving operation, a 14 year old boyalso had emergency surgery for his ruptured appendix, and his 67 year old frail grand ma could barely afford paying the okada man who drove her down to the hospital not to talk of raising money for surgery and post-operative care. A also does not get that two days later, a 56 year old diabetic lady had a pro bono dialysis when her kidneys went into a total shut down.

Guess who knows all this?

That’s right. The hospital administrator who has to pay the bills of his hungry staff at the end of the month; who has to deal with that contract general surgeon’s arrogant demands; or continually marvel at how the hospital spends well over 3 million naira in powering their diesel generator each month. For goodness sake! Are they electrifying the sun?!!

I hope you get the picture. This is because that neighborhood private hospital that was always so hospitable and available when you were in dire need closed down because of the humanitarian exploits of its CMD. Now that CMD is searching for a new job, its staff is once again unemployed and you will have to travel through a very disagreeable traffic to reach the state’s general hospital where a mammoth and hostile crowd has gathered.

There is nonetheless hope. Or at least there will be if common sense is applied in the administration of the basic healthcare provision fund which was mentioned in the previous volume.

But I hear the pensioner lady down my street sigh. She knows how herculean it is getting money from government under such circumstances

Sighs….

Part III, no 21 part 2

(2) Subject to any applicable law, every health establishment shall implement measures to minimise-

(a) injury or damage to the person and property of health care personnel working at that establishment; and

(b) disease transmission.

At first glance this may look straight forward. But I’m afraid some of our senior colleagues across all health professions do not do enough to remind subordinates of the need to ensure that universal precautions are obeyed EVERYTIME.

Sadly, I’ve even had the unpleasant experience of over hearing senior colleagues shouting down junior ones when the latter rush for latex gloves before dealing with patients. The mantra at such instances is always hospital economy.

Sometimes, a very enthusiastic subordinate is eager to prove his mettle and show that he is not a sluggard so he rushes to apply pressure to a bleeding laceration with his bare hands. It is the duty of any senior colleague present to condemn, patiently and kindly, such behavior. It does not make public health sense at all!

In art, less is always more. It is for this reason that I feel secure pulling the curtains on today’s discourse. We will be back again via these same channels to discuss even more pressing sections of the health bill. It is a rare privilege travelling this erudite path with you…

“What you’re missing is that the path itself changes you.”

Julien Smith.   The Flinch

Ciao!

Dr. Oluwaseyi ADEBOLA.

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