Thread by @fimiletoks

Few years ago, I had an experience that changed my perception about Healthcare and being a doctor in Nigeria. I was done, I knew I had to find joy and peace in other fields of healthcare.
I needed to keep my sanity and the love I had for medicine as a child..
👇

I was working as a casualty officer at the State Hospital Akure. I ran shifts with my colleagues and we were in charge of all emergencies ranging from medical, Obs/Gyn, pediatrics, surgical emergencies. I thrive in emergency situations, I like the A&E.

It is a place of work, sober reflection and fun when everything goes well. Reality check, different stories, different people.
Back then the hospital had a theater and an emergency cupboard, well stocked to ensure that patients got the required attention in minutes.

No health insurance, of course most of the patients had no money so the consumables were used freely on emergency cases brought in. Often times we run out of consumables and we had to sort it out either by loaning some or buying from our purse.

On this particular day, there was an accident along owo road, patients were brought in, it was terrible. In perfect systems abroad, all teams would be on standby..in Nigeria emergencies = chaos. Patients, police, relatives, onlookers, gbeborun, prayer warriors..

"Stay outside", é Ja de.. crowd control na wahala..
So I "scanned" all the casualties, those screaming "egbami o" I wasn't looking out for them, they were conscious enough to survive for few more minutes. I usually tell the nurses to handle them, analgesia, fluids, wounds, etc.

The unconscious victims were top priority. Road safety guys would bring unconscious victims at the back of hilux vans, no ambulance points on the highway. FRSC's is just to evacuate, they pile them on each other, compromising breathing and blood supply.

At times while handling and transporting victims from accident site, they complicate issues. No emergency responders, no paramedics.
Spinal cord trauma, they ll complete the cord transection in their hilux and bumpy roads..

On this day, I noticed this patient who wasn't conscious. We wheeled her into the theater, I saw a deep cut by her neck, tore her blouse and skirt and I noticed a numeral and femoral fracture.
Closed femoral fracture = massive blood loss plus the deep laceration on the neck

The laceration at neck with vascular injuries was too much for me to handle. I saw different vessels, some bleeders that only a cardiovascular surgeon could explore.

Let us secure airway, pack the wound, transfuse and send to OAUTH.

The relatives were screaming doctor "doctor do something na" So I called the one of them and explained to him the complexity of the case, If I touched the neck, should would bleed to death right there. I explained that transfer was the best option. We had blood, oxygen, fluids..

The guy was calm, I gave my nurse 5k to ensure that she gets enough supply of whatever she needs with the 2 pints of blood. I tipped the ambulance driver and he promised to make Ife in 90mins - 2hrs. The relatives were grateful..
Ambulance departed..

I kept on calling, I was in touch with the nurse and the relative that accompanied the ambulance. The 5k was to sort out any money issue at OAUTH..

2 hrs gone they weren't in Ife yet, traffic wahala..after 3 hrs they got the OAUTH. I knew the battle was lost..

The system had failed the patient at three points..
1. Emergency response at site of accident
2. Transfer to my centre..
3. Air transfer to a tertiary facility

When they got to OAUTH, one retarded soul who didn't bother to read my referral letter looked and the patient..

He made a nasty statement that nothing was done for the patient and that I should be held responsible for if the patient eventually dies..
20mins after patient packed..
My ordeal began, my nurse kept on sending messages to me to leave the hospital..the relative was fuming..

He called me that he was coming back to teach me a lesson. My nurse kept on begging me to leave that Akure guys are dangerous..

So I left for the call room within the A&E and locked myself in there for a while. I heard noises from people asking where the f'ck I was..

In 2011, I had a 2009 Honda Accord. It was a "big" car, only few were in Akure. I called my friend to come take my car home, sneaked out and jump on a bike home. I was like WTF? After 9 yrs in medical school, blood and sweat, salary was 85k, left the comfort of my home..

Only to get abused and lynched.. I couldn't sleep that night. Why did I choose medicine of all courses? The guys came to the hospital and found out I had left. The threats continued and by morning I got a call to come defend myself in front of a panel..

I wrote my report with some pictures and sent it to my consultant, He went there and cleared me. I was traumatized. I spent my lifetime putting in shifts, earned peanuts, spent my own money to keep people alive but the system & the crowd wanted me buried.

I hung my ward coat and I was done.
I was practically done with the harsh system.
To all my colleagues who have suffered so much, still in practice, trying to save lives with the little reward, you guys are the real HEROES.

Those that the system has burnt, career regression, sleepless nights, struggling to make a living, struggling to fend for your family in a society that is quick to put you down despite the obvious gaps in the system..
I salute una..
One day you will all smile...

*ran*

*needed*

I chickened out..I couldn't cope. How you guys source the strength and mental capacity to cope with this system is a mystery.
We can only hope that things will get better overtime but until then keep the light shining!