By Fatima Sanda Usara
A delegation of National Hajj Commission of Nigeria (NAHCON) comprising board members, senior management staff and journalists on Sunday, 18th August, visited seven Nigerian clinics within Makkah to assess the level of their operations. Chief Doctor, Dr Usman Galadima, took the team, headed by board member representing Ministry of Foreign Affairs, Amb. Nura Rimi, round the clinics to ascertain the arrangements for themselves.
It would interest the reader to know that NAHCON received commendation from the Saudi Ministry of Health for the health care support put in place for Nigerian pilgrims. By the end of the visit, the team was more impressed with what it met on ground than the image it arrived with.
Clinic HQ1, Masfala, was the largest of all the clinics and records about 600 patients everyday. It has two different consultation sections. The first area on the ground floor is designed as treatment unit for pilgrims with mild complains. The upper floor, where two wards bearing six admission beds, an observation room and a seclusion area are carved out, is like the referral section where only serious or complicated cases are treated.
The doctors on this latter floor are consultants. At the time of visit, one of the doctors had relocated downstairs to help attend to patients in the minor ailments’ unit because of their large number.
A minimum of 42 doctors run the clinics on a daily basis on an average ratio of three doctors respectively for the three shifts. Approximately 2,550 patients visit the clinics on a daily basis, resulting to a random statistics of at least 61 patients to each doctor everyday. It is therefore no wonder that the patients overwhelm the doctors on ground. However, the triage strategy was employed to reduce the waiting time thereby easing the crowding.
The team inquired over what could be responsible for the large turnout of patients at the clinics. The explanation is deductible. It was gathered that approximately 236 referrals to major Saudi hospitals were made since the arrival of Nigerian pilgrims on 10th of July in Madinah to the 18th of this month when the visitation was conducted. Therefore, it could safely be concluded that of the 2, 550 patients that visit the clinics daily since 10th of July 2019, only an average of six serious cases visited the clinics per day leaving the remaining 2, 544 as other ailments. Notwithstanding, the clinics do register some degree of emergencies that do not need referrals but treated in the facilities or even admitted. At the time of visit, there was one such case on admission due to heat stroke and dehydration. He was placed on intravenous fluid because he ran the risk of running into shock and sudden death if not placed on fluid immediately.
Therefore, majority of the cases are body aches, malaria and minor respiratory infections
The clinics are known to witness two peak periods of patients’ visits: in the mornings after returning from the sacred mosque and in the late evening after most pilgrims as well return from night (isha’i) prayer in the Haram. Since those with major complaints do not wait for a convenient time to visit the clinics, this indicates the general inference above. Besides, it was disclosed to the team that when an apparent emergency situation is brought to the clinic during these peak periods forcing the doctor to divert attention to the patient, those on the queue begin to grumble with signs of agitation and impatience. Such are times when they mostly complain of favouritism, being kept waiting and so forth. However, a doctor’s professional instinct tells him to do the right thing always.
As data do not lie, it was discovered by the team that drugs that are constantly replenished are analgesics, anti-malarial drugs; upper respiratory track drugs such as cough syrup and antibiotics. Others are gastro-intestinal drugs like antacids. And of course, the strenuous nature of Hajj activities or due to physiology of Hajj as a place where large congregations of people gather explain the increased risk of respiratory infections and the other complaints.
Drug dispensary is one of the key indicators of the frequently reported illnesses. And the dispensary system is one of the well-coordinated networking activities in the clinics. All clinics are connected through what is known as the Electronic Medical Record (EMR) System. This means that all computers in the clinics are connected to the central system such that drug dispensary is being monitored from the central store. Where any drug runs out in a particular clinic, the supervising officer picks the information and immediately supplies that clinic with the drug. However, where the server is down and monitoring at the central store is hindered, the pharmacist sends a text message and soon, ambulance is dispatched with the supply. This network ensures no clinic runs out of any drug that is available in the store thereby questioning the claim that clinics are being left without drugs.
Another advantage of the EMR is that it detects the number of times pilgrims visit one or multiple clinics. And indeed it paid off. Data has captured pilgrims who visit multiple clinics gathering drugs for reasons best known to them. So far, the EMR has been able to track many of these drug collectors and appropriate action taken to apprehend them and others. It was revealed that many of those who gather during the peak periods do so because the dugs are free and would like to transport them back to Nigeria as gifts to their loved ones. Many instances of these occurrences were narrated to the team. Some of them, it was revealed confessed after they were subjected to serious diagnostic steps.
All Nigerian clinics are located in areas where majority of Nigerian pilgrims are lodged thereby making access to them as easy as it could be.
Although the team is preparing reports and recommendations on how best to tackle the problem of over crowdedness to reduce waiting period, however, preliminary observation by the team is that unless Nigerians adjust their mentality of rushing for freebies, real patients that deserve serious medical attention will continue to suffer the consequences of some few individuals’ greed. Serious enlightenment by well meaning Nigerians might help.
At the end of the visit, the leader of the delegation expressed delight at the strategies put in place for the healthcare of Nigerian pilgrims. He prayed the Almighty to reward them tremendously because no amount will compensate the sacrifices they collectively make for the wellbeing of the Nigerian pilgrim.