How Corruption Affects Healthcare At The National Hospital Abuja

Patient-staff bribery and payment to private accounts are common practices at the National Hospital Abuja.

Mukhtar Sani’s brother, Yunusa, had descended the ladder after a plumbing fix, when he looked up and noticed that the job was not perfect. So, he climbed the ladder again. This was when he slipped and fell, the impact causing damage around his neck and back.

What happened to him afterwards could never have been imagined in a government owned hospital, and it led to his death.

He was rushed to the Federal Medical Centre, Jabi, where he was attended to and was soon referred to the National Hospital Abuja (NHA) due to the complicated nature of the surgery he required.

The Interim Invoice issued to Sani, and obtained by HumAngle, showed his brother’s medication history. The cost of his treatment, which included an x-ray, amounted to N175,780.

The invoice also indicated that his brother had been in the hospital for four days, from Feb. 6, 2020, by 10:06 p.m. until his death on Feb. 9, 2020. He was registered as patient 660461 and stayed both in the old ward of the National Hospital and the new ward. 

The Interim Invoice given to Mukhtar Sani contains Yunusa’s medical history at the National Hospital Abuja. Photo credit: Nathaniel Bivan/HumAngle.

They had a challenge with raising N500,000 within the shortest possible time for the surgery he required.

Fortunately, Yunusa’s boss was able to provide the money. Sani then approached one of the doctors with the intention to pay for the surgery. To his surprise, he was given the account details of one of the doctors.

“I refused and asked for evidence that I was sending to the hospital account,” Sani explained. “I said I wasn’t going to send it to an organisation I didn’t know.”

Previous payments made, according to the Interim Invoice HumAngle consulted, revealed that for every service/drug prescription given to the patient, a section in the document listed the names of those who billed the patient, including two receipt details for a total number of 27 different services and drugs provided.

So, when it came to payment for surgery, Sani did not send the money to the private account given to him. His refusal to do as others did cost his brother, Yunusa, his life. He died while awaiting surgery, leaving a wife and three children.

But they found a convenient excuse for his death.

“They told us that they knew he wouldn’t survive, that was why they didn’t do the surgery,” Sani said.

“I’m still fighting to get his death certificate because we have gotten some kind of sponsorship for his children’s education.”

“I wrote an application to the medical director, but I still haven’t been given. In fact, they were unable to find his file in the entire hospital, so it’s even impossible to get hold of the record that will make it possible for me to get the death certificate. I took the file number and documents of everything we did, but they are unable to find it.”

This is just one in several cases of alleged corruption at the NHA.

Give a bribe or keep waiting

The procedure for booking appointments at the NHA stipulates that: “All bookings are done in the various clinics of the hospital by Health Record Officers on duty. Patients are expected to give their hand card to the Record Officer in charge so that he/she will indicate the day, time and the Doctor to see in the next appointment.”

But this procedure is only on paper. Some intermediary staff at the hospital have devised their own rules. Such was the case with Mr and Mrs Yakubu who were patients at the hospital recently.

The couple, like Mukhtar Sani’s case, were also referred to NHA in 2020 when their six-year-old son had tonsillitis.

“We were given a letter from Nisa Premier Hospital to give to the National Hospital because they had the required equipment for our son’s surgery,” Lucy Yakubu said.

At NHA’s pediatric section, a Record Officer (RA) collected their file and shelved it. The husband and wife then waited for over four hours, hoping they would be called in to see the doctor.

A view of the hospital’s Emergencies entrance. Photo credit: Bernard Daniel/HumAngle

When the RA returned, the couple asked why they were left waiting for so long. But there was no apology because, according to the RA, “he had a lot of other things to attend to.”

Mr Yakubu then reminded the official that their situation was an emergency because their son had not eaten properly for three days and was in pain. But that was still not enough to sway the man.      

“At that moment some people walked in and he quickly attended to them,” Mr Yakubu claimed, adding that the patient appeared to have bribed the RA.

Mr Yakubu’s suspicion was confirmed when he and his wife approached a nurse and she told them that staff at the hospital prefer to attend to those who give them money. “‘If you don’t, they won’t, the nurse told us,” he recalled.

Mr Yakubu and his wife returned to Nisa Premier Hospital and relayed the incident to a nurse. She prescribed antibiotics to their son and advised them to take a local approach.

“We diluted salt in water and added alum,” Mr Yakubu narrated. “That was what helped our son.”

His wife added that when she gave birth at NHA, nurses liked to be given money before they would call a doctor “to attend to us.”

Money paid into private accounts

A HumAngle reporter visited the Ophthalmology Department of NHA for an eye test with the help of another staff member.

When she went in, the doctor was attending to patients so she had to wait. When she was finally called in, he asked a few questions before the tests began.

There were two students present and the doctor conducted the test using a machine while simultaneously teaching the students.

When they were done, he took down her details and then negotiated a price with the hospital employee that brought her. He wrote down the prescription on a piece of paper and handed it to the HumAngle reporter.

This reporter was later issued medicated glasses after payment of over N30,000 was made into the private account of the doctor (name withheld).   

“There are many acts of corruption to uncover in this hospital,” a staff member who pleaded anonymity told HumAngle. “In some places, you pay directly into the doctor’s private account.” 

The source also explained that patients are required or expected to pay bribes when consulting doctors who have assistants. These assistants ensure patients give them some money before they have access to a doctor.

“Also, a particular female doctor at the hospital who has her own practice has the habit of referring patients to National Hospital. But instead of the patients paying to National Hospital for the use of its facilities, they still pay to her because she ensures that she personally attends to them,” the source revealed.

There are reported cases where doctors collude with hospitals to scam Nigerians through a referral kickback scheme, but the former case is different.

When HumAngle reached out to Segun Adetola, Public Relations Officer at the Ministry of Health, he said he was not the right person to speak to regarding government hospitals in the capital. He directed HumAngle to the Ministry’s Director of Hospital Services, Dr Adebiyi Adebimpe.

But Dr Adepimbe asked HumAngle to write to the Minister of Health himself.

Meanwhile, the management of the NHA appeared to have received reports of corrupt practices among staff members. Tayo Haastrup, the facility’s Public Relations Officer, said NHA now has an e-payment system “which has really blocked these kinds of loopholes.”

Haastrup, who sent his response in text messages, added that the NHA has been running the e-payment system for about three years.

A source at the hospital agreed that, indeed, the e-payment system has helped to reduce corruption within the hospital, but added that staff members still find ways to engage in fraudulent practices.

This story was produced in partnership with Civic Media Lab under its Grassroots News Project.

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Nathaniel Bivan

Nathaniel Bivan is Features Editor at HumAngle. He tweets @nathanielbivan

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