₦airaland Forum

The generation of those involve in such cruel action wil neva deliva safely....iseee..
they must surely reap what they sow....iseee...
Dos nurses and doctorrg wil die out of ignorance.....Iseee......

bushdoc9919:
Takeaways with Bushdoc....loading....


Before I talk......RIP to the woman

I have a few questions for the case....

1.We do not know how long the woman was in labour before she got to the hospital. That is crucial. If she had been in labour for a prolonged period of time...something tells me that her condtion was a disaster waiting to happen.

Note that the water breaks when the cervix is fully dilated....meaning that by then the woman HAS been in labour for over ten hours. The man AND wife presented late to the hospital.....and something tells me that his wife did not go for ANC.

2.Why do we tell women to go for ANC?

Because disasters like this could happen?

We do not know the woman's ANC history at all. How long she attended clinic, whether she did ultrasound....so that we can catch any possible complications on time.

3.Yes the nurses sent her to Igando General....because this was an obstetric emergency....and I doubt a small clinic could handle post partum hemmorhage that bad.For that you need a specialist.....and that is why they sent them to Igando General. But our husband did not go...and vital time was wasted.

4.When she was taken there....there was no space. Husband made noise...they found a bed....but if she had lost lots of blood....the case was too late. She needed ICU plus transfusion of lots of blood And a hysterectomy. Am sure the lack of space hampered care....everyone is busy with lots of emergencies....and one more stretches the whole workload.

5.In my opinion, the woman died not because of nurse....but because of lack of adequate facilties, and lack of specialists.


NOW HERE IS WHAT SHOULD HAVE BEEN DONE.

1.Labour starts.

2.Woman is rushed to the nearest hospital by ambulance. LONG BEFORE THE WATER BREAKS.

3.Active management of labour starts with every change noted on a PARTOGRAM

4.Based on the changes....labour can be terminated medically or surgically (CS).

5.Post partum haemorrhage can be stopped by active measures.


The problem started long before the woman went into labour....and was prolonged by the fact that there was no adequately trained staff, and no adequately equipped hospitals.(Government .....una don hear? especially the APC governor of this state).....and poor health education.We also need more specialists....especially obstetricians.

If you are a woman reading this

1.Register for ANC as soon as you are pregnant.

2.Go to hospital when labour starts...do not wait for water to break.

3.Make sure there is an obstetrician on standby.

Pennywise:
Well done doc. It appears your entire post was aimed at absolving a doctor earning call duty of any blame whatsoever for being absent when he was needed but rather blaming govt. U have further wounded the bereaved husband of a woman who dutifully registered for ante natal care in a govt health facility.

A timely intervention by a medical officer would have prevented this catastrophe. Mind you a hysterectomy perfectly executed by an obsterician may not have stopped this bleeding if there has been a DIC occasioned by an initial heavy out pour. Unless u want a haematologist to be present at every delivery as well.

I don't know where u got the info that a woman has to labour for 10hrs bf she breaks water. Besides, she has a 3yr old. In any case delivery occurred at the hospital while waiting for almighty doctor.

This woman died of negligence, indiscipline and the tragically poor work ethic prevalent esp in govt hospitals in Nigeria.

I am no forensic expert but there is enough here to hang at least one doctor with a few nurses for jarah.

The Director of Information at the ministry, Mrs. Deola Salako, corroborated Ariyibi’s claims, saying that an investigative panel had been sent to the health centres involved and any one found to have contributed to the death will be sanctioned

bushdoc9919:
Well, there are two sides to every story....and lots of complex things



Yeah.,.....and if there was a DIC, or a PPH......the woman should be in a tertiary hosptial. Not a primary health care center....where they really cannot do much.

75% of deliveries happen safely. Obsteriticans exist for the 15% that don't.



Not all the time(you right)....but still, on the average....it can last up to ten hours. My point is the woman should have been inside the hospital before the water breaks.



No,she died most likely because a primary health care center in Nigeria is not equipped to deal with PPH., most primary health care centers do not have a doctor on call at all times , and because we do not have a good ambulance service,as well as a good system of triage that would have gotten madam to the nearest good hospital within minutes.....and with doctors and nurses waiting on arrival for her.



While you are busy channelling Jack Ketch....you should also get some better funding for training, ambulances, more specialists, more tertiary hospitals, more communications.....

You should also consider that no doctor would manage a case that is beyond him or her....they usually refer, especially to a specilaist. Perhaps the nurses understood that ....which is why they told husband to go to the big general hospital....which unfortunately.....was crowded to the max as usual .

Now...here is how it should have been done.

1.Water breaks

2.Hubby calls for ambulance.

3.Ambulance arrives,paramedics stabilise patient

4.Ambulance gets patient to the nearest hospital....as determined by a central dispatch office. Meanwhile Dispatch has alerted the hospital concerned.

5.On arrival....woman is promptly treated.

Of course...I know some of us medics deserve a date with Jack Ketch....but most of us are working with our hands tied behind our backs. Like most sectors in this country. All because we do not have enough money to improve things.....being a resource dependent country and all.

Alal:
Nurses aren't devilish and wicked, nursing is a good profession anywhere in the World.
It'll do u well to stop generalizing. Thanks

HaneefahRN:
Eeyah, poor woman. This is a very pathetic case. RIP to the mother and child.
My observation is that the hospital is a primary health care centre and sincerely many of our PHCs are nothing to write home abt, they can barely handle normal cases not to talk of critical ones due to lack of equipment and personnels. Most Drs don't want to work at the grassroots and the ones that do, might not been seen around for weeks. The PHC in my area, I av never even met the Dr posted there once. So the work falls on the nurses and CHEWS. Sometimes only one or 2 nurses and several CHEWS. I don't know abt that particular PHC but most I see around where I reside av just at most 3 nurses and the other workers are CHEWS and record officers. It might even be possible the two women the man met that nyt were CHEWS not nurses, and the man shld av listened instead of being persistent when he was told they can't handle the case and found his way out, u don't claim stubborn when the lives of ur loved ones are at stake. Leave and find somewhere else they can be managed.
The system is a very bad one, I must say. It isn't even advisable for a woman to register at only one ANC, she cld register to 2 probably a PHC and a hospital with more facilities in case of emergency, that way both will have her history.
May God give him the fortitude to bear the loss.

Alal:
Nurses aren't devilish and wicked, nursing is a good profession anywhere in the World.
It'll do u well to stop generalizing. Thanks

jerinapi1:
yeye country. May their soul rest in peace. Amen. In other news, Check out this HOT TRANSGENDER PHOTOS (+18) irrestible photos

http://www.latestamebonaija.com/2015/10/meet-transgender-beauty-queen-formerly.html

Pennywise:
U either missed the point or choose to ignore it. what could have been a routine primary intervention yes some pph cases are became secondary, tertiary case then death. The only way a doctor can be absolved here is if none was on call.

A lot of doctors are working under extreme conditions to save lives in our hospitals yet they generally are not appreciated bc of bad eggs.

They should actively look out for them when culpable and punished when found guilty not protected on account of sentiments.

Pennywise:
U either missed the point or choose to ignore it. what could have been a routine primary intervention yes some pph cases are became secondary, tertiary case then death. The only way a doctor can be absolved here is if none was on call.

A lot of doctors are working under extreme conditions to save lives in our hospitals yet they generally are not appreciated bc of bad eggs.

They should actively look out for them when culpable and punished when found guilty not protected on account of sentiments.

bushdoc9919:
Now, you are reducing it to another Doc vs Nurses things.

If you read the tale....you would have come across the bit where the nurses initally told them to go to the general hospital. That means they must have seen something wrong that made them say that.

If anything.,...I ain't blaming the nurses in this case.....and you should have seen that.



True.....



Well.....if this was a bad case of PPH.....then she had no business being in a PHC....that's a tertiary hospital case. Something the nurses at the PHC probably realised....but time wastage by the patient.....

P.S...Better go back and read my post again.

bushdoc9919:
Takeaways with Bushdoc....loading....


Before I talk......RIP to the woman

I have a few questions for the case....

1.We do not know how long the woman was in labour before she got to the hospital. That is crucial. If she had been in labour for a prolonged period of time...something tells me that her condtion was a disaster waiting to happen.

Note that the water breaks when the cervix is fully dilated....meaning that by then the woman HAS been in labour for over ten hours. The man AND wife presented late to the hospital.....and something tells me that his wife did not go for ANC.

2.Why do we tell women to go for ANC?

Because disasters like this could happen?

We do not know the woman's ANC history at all. How long she attended clinic, whether she did ultrasound....so that we can catch any possible complications on time.

3.Yes the nurses sent her to Igando General....because this was an obstetric emergency....and I doubt a small clinic could handle post partum hemmorhage that bad.For that you need a specialist.....and that is why they sent them to Igando General. But our husband did not go...and vital time was wasted.

4.When she was taken there....there was no space. Husband made noise...they found a bed....but if she had lost lots of blood....the case was too late. She needed ICU plus transfusion of lots of blood And a hysterectomy. Am sure the lack of space hampered care....everyone is busy with lots of emergencies....and one more stretches the whole workload.

5.In my opinion, the woman died not because of nurse....but because of lack of adequate facilties, and lack of specialists.


NOW HERE IS WHAT SHOULD HAVE BEEN DONE.

1.Labour starts.

2.Woman is rushed to the nearest hospital by ambulance. LONG BEFORE THE WATER BREAKS.

3.Active management of labour starts with every change noted on a PARTOGRAM

4.Based on the changes....labour can be terminated medically or surgically (CS).

5.Post partum haemorrhage can be stopped by active measures.


The problem started long before the woman went into labour....and was prolonged by the fact that there was no adequately trained staff, and no adequately equipped hospitals.(Government .....una don hear? especially the APC governor of this state).....and poor health education.We also need more specialists....especially obstetricians.

If you are a woman reading this

1.Register for ANC as soon as you are pregnant.

2.Go to hospital when labour starts...do not wait for water to break.

3.Make sure there is an obstetrician on standby.

shoboy9:
I don't think I like this op at all. I'm trying to give him benefit of doubt here but...
Really, why did he waste vital time? From his own story, labour began at 5am and he was at the health centre by 5am. Hmmm. Also he says he was at ikotun general hospital by 6am. First is it possible for labour to happen under 1 hour? Plus all the other drama that took place? This woman should have been in a hospital when she started having labour pains. Not when she began bleeding.
And why take wife and baby to a hospital where there is no doctor? Are there no other hospitals around? Or he just wanted to avoid spending money at the cost of his wife and child? If truly everything happened in hour including the 25 mins the husband spent demanding for a note, then the hospital responded quickly. I would like to hear their side of the story including why a govt hospital does not have a dr available.
Government provides hospital services to care for all citizens. But some people prefer not to pay for those services. These kind make it difficult for those who are in genuine need to get help readily. I wish the wife eternal peace.

menix:
Ooooohh my Gawd!!

What exactly works in this our country called Nigeria..
ABSOLUTELY NOTHING

Ow I just wish the British can come annex this country, everything about this nation is just so pathetic..

With tears, I mourn with the husband, this is an ugly way to die in a country.


Ow I wish thunder hears our prayer..

RIP to these innocent souls....

Onegai:
The husband took her to the first clinic because she was registered for ante-natal there. It's in the story so let's not pass the buck. Why were there no doctors on call? The nurses, well, they were trying to avoid getting into trouble and they couldn't handle the emergency.

Pennywise:
I have read your post and my conclusion is that it is full of presumptions including that you are interacting with a nurse bc he doesnt agree with you. You are wrong. For all u know, I may have been a doctor bf you entered medical school and bf you did residency (if you have). Stop the presumptions and stop getting personal.

This doctor is an employee of govt. He has no right to be absent from his duty post and not expect consequences when a catastrophe like this happens. Or does he own the health facility? Or you think he should be absolved bc he is a doctor? The dead woman can be anybody's sister or relation. She and her husband deserve justice. The state should also see this as a good example to whip irresponsible doctors into line.

You can be a bushdoc but you dont have to be a bush man

bushdoc9919:
Thank you, and good afternoon.

tunesoft:
Now to the General public that are so quick to judge the government hospitals when issues like this come up....I will say...keep quiet and go sit down Joor. We choose to be blind and deaf tonthe yearning demands of the public health sector forgetting that we live in the same community and if not us a relatuve might need the system urgently someday. Lagos state population is in millions yet it can only boost of 26 gen hosthospitals and 1 teaching Hosp. these hospitals are greatly overwhelmed some attend to more th a one thousand patients a day with just few doctors and nurses working. Are they robots? Them no get family? They must eat now.. they do what they can do and stretch their consciences to the limits before leaving the rest to fate. Are we aware that the whole lagos state can't boost of more than 15 to 20 functioning intensive care units (private and public) to serve the millions? Are we aware personnel are short in supply? are we aware that some General hospitals in lagos here have 1 or 2 delivery beds for pregnant women yet they take 10 to 15 deliveries per day...ask yourself how these personnel cope with instruments and all. with 2 patients sharing a bed in labor wards...
please all when next health polices are being made think twice before you look away and better get involved. Shout out when strikes are on and get involved. Ask for a better health sector/system rather than waiting for the next person to die and then laying the same blames over and over again...if not, in 5 -10 years time, it will be the same blames we make and I pray it won't be our loved one involved then.

HaneefahRN:
Thanks for that observation. Most Drs posted to the PHCs are hardly ever at their duty post. There is a PHC near my house, sincerely I av never come across the Dr posted there and a PHC where I had my community health experience. Yet, these absentees will get paid for the work not done even more than the 1-2 nurses and the CHEWS working with them. But at the end of the day when something goes wrong, these bad eggs will be covered up by their ogas and the nurses will be the scapegoat. I think it's high time erring health workers are made to face the music for their wrongdoings.

eyinjuege:
The little I know about a lot of PHCs. Usually one corper doctor is posted there if any at all. There is no accommodation available for staff, so no resident doctor. One doctor cannot be on duty 24hours everyday of the week. They usually have an ambulance to transfer bad delivery cases, cos they know the midwife on duty can only do so much. The midwives there try to sort cases during antenatal, often referring patients that may likely have complications ab initio to teriary or secondary centers for antenatal. PHCs don't have a blood bank, and cannot handle any case other than a normal delivery. This was obtainable like 8 to 10 years ago. Things may be different now though.
I would have suggested they scrap taking deliveries in PHCs, but they do cater successfully to most people in the neighborhood that utilise them, and scrapping them would further overburden secondary centers that are already overwhelmed. The need for accommodation in the area or in the center itself for the doctor posted there is also important unless they have like 3 of them that can rotate calls. The need to ensure ambulances are always functional can also not be overemphasized. I know Gov Ambode donated several ambulances to secondary centers all around Lagos recently. I also know PHCs have always had ambulances even way before General hospitals. The question now is why was the one in question not working especially in a center that takes delivery?
Now regarding secondary centers or general hospitals, in most states, they are simply NOT ENOUGH. There will always be no space available. For a state like Lagos that has how many million residents, there are only 24 general hospitals catering for them. That is an absolute joke.........

Onegai:
The husband took her to the first clinic because she was registered for ante-natal there. It's in the story so let's not pass the buck. Why were there no doctors on call? The nurses, well, they were trying to avoid getting into trouble and they couldn't handle the emergency.

HaneefahRN:
Thanks for that observation. Most Drs posted to the PHCs are hardly ever at their duty post. There is a PHC near my house, sincerely I av never come across the Dr posted there and a PHC where I had my community health experience. Yet, these absentees will get paid for the work not done even more than the 1-2 nurses and the CHEWS working with them. But at the end of the day when something goes wrong, these bad eggs will be covered up by their ogas and the nurses will be the scapegoat. I think it's high time erring health workers are made to face the music for their wrongdoings.

menix:
Ooooohh my Gawd!!

What exactly works in this our country called Nigeria..

Ow I just wish the British can come annex this country, everything about this nation is just so pathetic..

With tears, I mourn with the husband, this is an ugly way to die in a country.


Ow I wish thunder hears our prayer..

RIP to these innocent souls....

DebateNigeria:
Well said. Most importantly, we must hear the other side of the story. This story doesn't add up at all. This case is not for PHCs,not even when there is a secondary center less than 10 mins away. The man wasted vital time due to no fault of his. I know that hospital and such a hospital would have been well equipped.
My solutions:
1. The government must employ more medical doctors and trained nurses
2. There must be at least one obstetrician per local government area serving all PHCs in that local government
3. Better referral system that includes ambulance services
4. More paramedics should be employed
5. Primary healthcare centers must start running an uninterrupted 24hours service.
6. The citizens must be enlightened to know when to present at primary centers or secondary centers.
7. Hospitals across board must be well equipped.
8. 24hours power supply

eyinjuege:
A lot of PHCs usually have one corper doctor posted to the clinic. No accommodation is provided.It would be assuming too much to ask that one doctor who doesn't live in the hospital premises to be there 24 hours everyday of the week. It is infact impossible.
However, I don't have the details of this particular case, but if I were to go by what used to be obtainable then its most likely a corper doc the PHC has.

chubby98:
I agree with you. However, there is no other sector in nigeria that can compete favourably with our health sector with regards to sanity and competence. That tells you how incompetent and useless you parents are in there own areas of endeavour.