Saturday, June 7, 2008

The Story of Stella, Part 2: In Search of Neurosurgeon & Race to Get Stella out of Nigeria


By Mike Egboh

Part 2

Stella Iwuagwu is the founder and CEO of the Center for the Right to Health (CRH), non-profit organizations that has provided voice for the voiceless and hope for the hopeless. A nurse by profession, Stella had just completed course work for her PhD program at the Southern Illinois University in Carbondale, USA. She returned home to collect data for her dissertation . The previous post Part 1 described her immediate post auto accident treatment for her severe spinal cord injuries and trying to get a bed in ICU at National Hospital in Nigeria...

In Search of a Neurosurgeon

The attending consultant recommended expert evaluation by a neurosurgeon. We were shocked to find out that an apex Hospital has no neuron surgeon. We were told that a consultant neuro-surgeon by name Dr. Shehu normally comes in from Othman Dan Fodio University Teaching Hospital in Sokoto. Dr Shehu we were told was expected the next day which was Friday but warned that the possibility of having Dr Shehu see Stella was remote because he had a long list, but again if we were able to talk with the CMD, she can be seen. We embarked on another session of getting to see the CMD in other to get Stella to be evaluated as she was now not able to move her limbs and body up to the breast level. Some of the very senior consultants at the Hospital approached to help talk to the CMD painted a grimmer picture. They were irked by the fact that the only Neuro-surgeon they had left because of differences of opinion with some management staff. He returned to the US where he was practicing before he returned home to serve. Different persons made spirited efforts to reach the CMD to ensure Stella was on the list of those to be seen. Very late on Friday night, (Stella’s 3rd day at the hospital), one Dr Nasiru that work with Dr Shehu arrived Abuja and was able to evaluate Stella about midnight. His evaluation confirmed our greatest fears, a spinal cord injury. Dr Nasiru knew what needed to be done but did not have the requisite tools to do it.

In order to save Stella’s life, the friends decided to evacuate her to where she can get expert care. In order to expedite this, a medical report (MRI) was required to be forwarded to the potential hospital that would accept her for treatment. While we scanned the various countries for suitable places including the US, Germany, South Africa, France, the UK and Ghana, we had another challenge as we were told that there was no letter head paper to write the official report until Monday when the administrative offices will be opened. Again we were told to get in touch with the CMD to obtain letter headed paper. This necessitated another round of networking to reach the CMD. This time we spread our dragnet to the Chairman of the Senate Committee on Health, Senator Iyabo Obasanjo-Bello who was outside the Country with the Honorable Minister for Health. She gave the phone number to reach the CMD. The team coordinator followed up with a call on Saturday morning and was able to get through to CMD who was at the time in the Hospital premises. Reassured that a letter head will be made available, Dr Nasiru was called and informed of the new development and he promptly said he will be in the available to do the report. The CMD was eventually met and when asked why there was no Neuro-surgeon at the hospital considering the strategic position of the institution, the CMD replied that there was actually one who according to him was “old, retired and tired”. He went further to state that the hospital was established for Women and Children eight years ago and not meant to cope with the current issues (Stella is a woman). Reminded that there were several highly qualified Nigerians practicing Neuro-surgery outside the country the CMD retorted: asked them to apply, its online, they do not want to come home. Why will a well qualified and highly skilled professional come to such institution where management decisions that concerns human lives seemed to be centralized in an institution that require an environment that is supportive of on-the spot decision making and innovation? While at the ICU the CMD met with Dr Nasiru and the Dr. on duty and had discussion on our decision to move Stella out of the Hospital. While this was going on, efforts were being made to identify suitable hospitals in the countries earlier mentioned. It was unbelievable to see the CMD call his secretary to come and work on the report. In the year 2007 when the hospital is networked, we still depend on secretaries to type a report? The report was finally sent to the various specialists in four countries including Ghana. The responses from them were very rapid and in unison confirmed the need to get Stella out fast. It was decided that she be flown to Korlebu Hospital in Accra, Ghana.

Race to Get Stella Out of Nigeria

The next battle was to get an air ambulance, River’s State government, Julius Berger, Aero Contractors, Virgin etc were all contacted. It was Mr. Tunde Oremule the MD of Associated Airline that came to the rescue and had to mobilize his crew within short period to evacuate Stella. Back at the National Hospital, preparations were on gear by friends of Stella to mobilize resources to pay for the aircraft and to get medical staff to accompany her to Accra. By Sunday morning, one of the doctors agreed to go, but we were told on the day of departure the he spoke to the CMD who said he was not aware of the decision, and so the doctor disappeared and turned off his phone. The CMD on the other hand was not picking up his phone either. The frustration encountered in trying to get a doctor and a nurse to accompany Stella in-flight, incase of emergency is better imagined as some of us broke down in tears not for Stella but for Nigeria. One of Stella’s , a highly trained Nurse volunteered to be on board with one of the ICU nurse. The head of the ICU had to pace the hospital several times to get an Ambulance to convey Stella to the airport. We had to rely on friends to get Stella into the ambulance as there were no real paramedics available to handle what is a very delicate case that needed specialized hands.

While we were having hell in Nigeria trying to get the National Hospital to do the needful to get Stella out, the medical team in Ghana were calling almost every 30 minutes to know when the flight will be departing and landing so they could be there to receive her. While it was difficult to get National hospital to act in Abuja, the reverse was the case in Accra as on arrival there were at least ten medical and paramedical personnel waiting at the airport with ambulance to receive Stella, what a sharp contrast.

Stella got the first professional care in six days of having the accident. Her case got worse in Abuja because of very poor professional care, poor attitude and crippling management decision making process.

The Story of Stella, Part 1: Accident & Treatment, National Hospital, Nigeria


By Mike Egboh

Stella Iwuagwu is the founder and CEO of the Center for the Right to Health (CRH), non-profit organizations that has provided voice for the voiceless and hope for the hopeless. A nurse by profession, Stella had just completed course work for her PhD program at the Southern Illinois University in Carbondale, USA. She returned home to collect data for her dissertation.

On Tuesday the 18th of September 2007, Stella traveled to Kano by road; she did not make it there as the vehicle she was traveling in had an accident around Zaria. When Stella gained consciousness, she realized she has fractured her Spine, and was able to speak to the good Samaritans at the scene on how to carry her out of the crashed vehicle, to prevent complications, and they did well. Stella and her driver were first taken to Limi Hospital and maternity in Zaria, as the nearby Ahmadu Bello University Teaching hospital was on strike. At limi hospital, Stella was transferred from the van that brought her into a stretcher and from a stretcher into a bed and then another bed. All while, Stella was screaming from the pain on her back. No attempt was made to use a back board or log roll to minimize damage to her spine. X-ray could not be done to either because the X-ray place had closed. Stella was given shots to reduce pain and the bleeding from the multiple lacerations on her head and knee were controlled. On Wednesday the 19th of September, 2007, Stella was taken to Abuja with the hope of getting expert care from Nigeria’s high brow National Hospital.

The National Hospital Debacle

On arrival at the emergency section of the National hospital, Stella was again transferred from the ambulance into the hospital stretcher without a backboard despite her repeated plea that her spine is broken. In the emergency room, the attending doctor focusing only on Stella’s head injury ordered a cervical collar, Xray and MRI of the head and cervical spine, ignoring Stella’s insistent complain of pain on her back that was radiating to her chest. Stella’s family rallied around to raise money for the X-ray and MRI. Stella was wheeled to the X-ray and MRI department by a hospital orderly and her relatives.

There are no Paramedics at the National Hospital, security men and passers by were asked to help move Stella first from her bed to the MRI stretcher and from the Stretcher to the scan machine; Stella was giving directives on how to move her without causing more damage. At the X-ray point, people around Stella were asked to pull her hands very hard in order to get good X-ray of her cervical spine. Stella’s chilling scream of pain was completely ignored by the belligerent, insensitive attending X-ray technician. Both MRI and X-ray revealed that there was no head or cervical spine fracture to the joy of Stella and her family.

The next hurdle was how to get her admitted as she was told there was no bed space. She was told that only the CMD could influence her getting a bed space. Friends of Stella (including Ford Foundation West African Representative, their Senior Program officer, staff of CRH, the Country Representative of NIH and other development colleagues) who were by now aware of the accident started to network to get to the CMD. Finally, the Senior Special Adviser to the President on MDGs was contacted among others who got through to the CMD and a bed space was made available at the intensive care unit.

The Intensive Care Unit (ICU) Drama

On getting to the ICU, Stella was completely ignored while the nurse yelled at the Orderly and Stella’s relative saying she did not have any bed space and was not expecting Stella. After several back and forth between the nurse and the emergency room via the phone, the nurse grudgingly made a bed for Stella in the ICU. Again Stella was transferred into her bed with no thoughts to her spine, while she screams in pain. The next morning Thursday, September 20th 2007, the attending consultant (name forgotten) assessed Stella during ward round with his team. At his directive, Stella was able to lift both legs and wiggle her toes. He reviewed her X-ray and MRI and was miffed that a full spine X-ray and MRI was not done despite Stella. He ordered urgent MRI of the full spine. Again, Stella’s family had to rally round to raise money for another MRI as the MRI bluntly refused to do the MRI without cash on hand, even though Stella is an inpatient. The consultant reviewed the MRI that evening and confirmed spinal fracture at the T4 and T5 level, to the sorrow of Stella, her family and friends. By the next morning Stella was unable to raise her legs or wiggle her toes and had lost feelings from her toes up to her chest. Meanwhile, Stella’s need for nourishment was completely ignored; Stella’s friends had to complain to the matron in-charge before the nurses finally ordered food for her on Friday night.

in the next post: Part II, In Search of Neuro Surgeon and the Race to Get Stella out of Nigeria....

Friday, June 6, 2008

The First Hard Step

This introduction to my blog was harder than taking my first step after months of paralysis following a vehicle accident in Nigeria in September of 2007. During and after many months of hospitalization, my friends and mentors gave me Journals encouraging me to reap the benefit that comes from reflective journaling. Sadly these journals including the one from my benefactress Oprah Winfrey has remained blank. One of the reason for this reluctance is my inability to still my mind long enough to put one thought down. My mind runs more riotously than my life. My accident in a way is a blessing that has slowed me down physically and hopefully mentally enough to take stock of where I was coming from, where I am and where I go.

My mentor Kathryn Ward helped me set up this blog as a way to start the hard journey of being still enough to reflect and share my personal and professional journey. When it came to what name to call this blog, my mind as usual went hay wire. I was rescued thank God by my smart daughter Crystal who calmly said “Step by Step” Aha! Wisdom from the mouth of babes! This is exactly what I craved my life to be. Rather than the hydra steps I had taken in the past, taking too many steps and of course literally falling flat on my face. In this blog, I will try to share with my family, friends and colleagues among others the little steps I am taking in my life. Sometimes, I may take little steps back, stand still to regain my balance and focus on taking the next step. This is exactly what my physical, mental and spiritual rehab is about.

As much as I can, I will share with you tit bits of my life as a mother, sister, daughter, auntie, mentor, mentee, friend, colleague, executive director of Center for the Right to Health (Nigeria & USA), activist, student, survivor, and a paraplegic patient. These are who I am; I am truly rich and blessed. I am thankful to many persons too numerous to mention who have contributed to whom I am, but in the course of this blog, your names will emerge, not in any order of importance. I will share with words, pictures, voice and sometimes Vblogs. This will be one way to share my life with all of you who have shared your richly with me.

Not knowing exactly what next to share, I will share with you to the account mainly written by my friend and mentor Mike Egboh, Nigerian Country Rep, Pathfinder International. He was directly in the fore-front of ensuring that I received the best care possible the first critical weeks after my accident. (See Mike’s story). Here are a few pictures of me in my recovery journey.