Inside S’east hospital where patients learn “patience” the hard way

Hospital

By Chinedum Elekwachi

When Peter Clever walked into one of the Southeast’s major hospitals in February last year, he knew he needed surgery. What he didn’t know was that his first prescription would be for “patience” — and in large doses.

The doctors told him there was a long queue ahead. His surgery date? May. That meant three months of waiting, wondering whether his condition would worsen before it was his turn. But that was only the beginning of an ordeal that revealed, in painful detail, how shortage of manpower, equipment deficits, and administrative lapses are silently sabotaging healthcare delivery in Nigeria.

In the months between booking and surgery, Clever was required to run several pre-surgery tests. The unwritten rule was clear: arrive as early as 6:30 a.m., before any staff appeared. This was the only way to secure a spot on the day’s patient list. Arrive late, and you risked being told to return another day — a prospect that could add weeks of delay.

Even after getting his name on the list, the waiting continued. Two hours or more before the medical officials arrived, followed by another half-hour delay before they actually began work.

Then there was the issue of his folder — the crucial document containing his medical history. Often, it had been moved to a different department. In theory, hospital attendants were responsible for transferring folders. In practice, Clever discovered some were more interested in selling snacks or other petty goods around the premises than in tracking patient files.
Left to fend for himself, he sometimes had to sneak his folder back under his arm or inside his clothing, lest an official see him carrying it — an act apparently considered an embarrassment to the staff whose job it was to handle such records.

No bed at last

When May finally arrived, Clever took no chances. He came to the hospital a day before his scheduled surgery. But when he got to the male medical ward, every bed was occupied. The ward was crammed with in-patients, out-patients waiting for procedures, and “awaiting patients” — those medically ready to go home but unable to leave because they had unpaid bills.A doctor ordered that these awaiting patients be moved to another ward to make space, but they refused. The alternative location, they argued, was in worse condition. It took 30 minutes before a bed was freed for Clever.

On the morning of his surgery, yet another delay struck. The hospital had no stretcher available to move him to the theatre, and there were no surgical clothes for him to change into. The attendant assigned to transfer him admitted he had been running around the hospital trying to “source” both.

An hour later, with stretcher and clothes finally in hand, Clever was wheeled to the theatre — only for the medical team to discover that certain required items were missing from the surgery list. His wife was sent scurrying across town to buy them before the operation could proceed.

Back in the ward, back to waiting

After the surgery, Clever returned to the ward expecting to focus on recovery. But the waiting game continued.
To change or remove his drip, he had to wait for a doctor — nurses were not allowed to do it without direct permission. On weekends, the problem was worse. With few doctors on duty, each attending to at least 20 patients, delays stretched into hours. Overwork sometimes left doctors irritable, and their frustration often spilled over onto patients.

Nights brought new challenges Mosquitoes and rats roamed the ward, depriving patients of sleep. One night at 2 a.m., his drip finished and needed removal. No staff were in sight. Desperate, Clever asked the daughter of a fellow patient to look for help. She found the doctors and nurses asleep behind closed doors. He remained hooked up until morning.

Even at the point of discharge, Clever’s ordeal wasn’t over. A doctor had to officially certify him fit to leave. That took over an hour. Then the accounts department needed to confirm all bills were paid. By then it was almost closing time. Only after his wife pleaded with the staff to complete the process did he avoid spending yet another night in the hospital.

Clever’s story is far from unique. Across the Southeast, patients face similar and sometimes, worse experiences. In a system designed for speed and precision, delays can be deadly.

Why the delays

Dr. Emma Okechukwu, a medical practitioner, says the situation is “pitiable” but largely driven by structural problems — most notably manpower shortages made worse by brain drain, outdated equipment, poor facilities, and mismanagement of funds.

He explains that in most hospitals, surgeries are scheduled based on an “elective surgery” book. Life-threatening emergencies take priority, pushing back non-urgent cases.

“Some surgeries can wait without endangering the patient’s life,” Okechukwu says. “But when emergencies pile up — and there are many — they take precedence. That’s why a January booking can be pushed to May.”

According to him, doctors often have only one surgery day per week, sometimes two. This limitation is compounded by other duties like outpatient clinics and administrative work.

The strain on doctors

“By the time you add all our responsibilities together, you may have just one day left for surgeries,” Okechukwu says. “We do everything possible to save lives — even borrowing theatre time from other units for semi-urgent cases. Sometimes doctors bring their own surgical instruments when the hospital doesn’t have them. But once a life is lost, the blame falls on the doctor.”

The patient load is overwhelming. The World Health Organization recommends one doctor for every 600 patients. Nigeria’s current ratio is about 1:2,753 — roughly 36.6 doctors per 100,000 people.

“This is far from what is obtainable in advanced countries,” Okechukwu notes. “The workload can affect a doctor’s mental clarity. Mistakes can happen, like writing ‘paracetamol’ instead of ‘flagyl’. Not because the doctor doesn’t know, but because they’re exhausted.”
Manpower isn’t the only issue. A hospital may have 10 operating theatres, but only four functional ones. The rest could be out of service due to faulty lighting or broken anaesthesia monitors.

“I recall a patient whose surgery was cancelled and postponed three times,” Okechukwu says. “That’s purely a managerial failure.”

Poor working conditions also erode morale. Unpaid salaries, low pay, long commutes, and lack of basic facilities leave many medical staff stressed and irritable. Some take on side jobs to make ends meet.

What needs to change

Okechukwu believes the problems are deep-rooted but solvable. His recommendations include regular provision and functionality of basic and advanced equipment, regular recruitment of more medical personnel to close the gap.

“For retention to take place, government must offer better pay, incentives, and good aworking conditions to discourage brain drain. There are many qualified doctors in Nigeria who are unemployed,” he says.

“They should be absorbed into the system. And for those already working, let’s make it worthwhile for them to stay.”

For patients like Clever, the long waits and endless queues are more than an inconvenience — they can be life-threatening. The current system demands patience from those least able to give it.

Healthcare, by its nature, is supposed to move quickly when lives are on the line. But until systemic reforms address the shortages, inefficiencies, and managerial lapses that plague Nigeria’s hospitals, patients in the Southeast – and beyond – will keep learning the hardest lesson of all: how to wait when they should be healing.

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