Saturday, June 7, 2008

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....

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