We are people that love to play on the emotions of others. Ours is a government that loves to bark and not bite—we make heroes of villains and villains out of the innocent. The question is, are hospitals designed to run as charitable organizations? Should doctors emphasize on money/payment before treatments?

Here is a story as narrated by one of the doctors in the South West Region of Nigeria. It is important to read through his story before passing judgement as this will put you in a better stead to know the right words to say…

I own a hospital in Southwest- (not Osun state Nigeria …lol). I currently have about 17 patients on my ward each of whom I have admitted at several occasions through emergency. None of these patients has paid up to 30% of his/her bill. Some of them have stayed up to 7 weeks on the ward. I admitted and attended to them based on the fact that their conditions were life-threatening as at the time they came. I made their bill known to them – and they signed before they were treated. But there is a common trend, as soon as they felt relief and became stable they pleaded for their bills to be reduced – this I vehemently refused.

About 4 weeks ago a woman was rushed in with Eclampsia having just convulsed while pregnant and she was unconscious. I promptly took her straight to the theatre without collecting a dime though i had informed the relatives of the charges – #120,000 for her operation and medications. They signed and I carried out the surgery successfully. Mother and baby survived. Within the following 6-days they paid a total sum of #12,000 and they began pleading to go home for the child’s christening ceremony. I looked at them with disdain. Till now, they have only managed to pay a total sum of #14,000.

Another man who was managed for strangulated hernia has only paid 20,000 out of 75,000 bill. And the list goes on. Their failure to pay has made it difficult for the hospital to replace consumables and medications needed to manage other people’s condition.
In the early hours of today 1:30am, a woman was rushed into the hospital following delivery at the referral centre. Blood had refused to stop gushing out. I did a quick assessment and realised she would need more materials than the hospital pharmacy currently had in store. I could have my staff get from a nearby pharmacy too. However, the husband said he had no money on him and so did the numerous relatives that accompanied. It was indeed a familiar pattern. I decided to let them go. I referred her to a government hospital. Of course they pleaded for me to help but there was nothing I could do. Few minutes after they left – just few metres from my hospital gate, she collapsed. She had lost a lot of blood. I rushed there and rigorously tried resuscitating her right there outside the hospital 2am early morning, but all efforts proved abortive. A young woman of 28years had just died after having her first baby. Screams, wails, cries ensued. I felt bad – this is not why I became a doctor. But her blood is not on my hands.

Her blood is on the hands and heads of all the patients on the ward who can afford to pay but refused to – on the grounds that – “What will they do? Her blood is on the hands and heads of the government officials past and present who have made it difficult and impossible for workers to get paid for their work. But the government officials are not the target of this my narrate. It is aimed at those who take hospital healthcare and medical doctors for granted. Those (including myself) who emphasise that doctors should not put money first before treating emergency conditions. In emergency cases, relatives would go to any length through any struggle to get money. As soon as the situation becomes calm, they relax and then they refuse to pay.

Last year a distant relative of mine was delivered of her baby via Caesarean section (in a hospital in Lagos- not mine). They were billed #180,000 which they accepted before the operation. After the surgery, her husband called me and asked how much I charge and i told him. He then began pleading with the management of the said hospital to review his bill. They declined. The husband being who he is, paid #120,000 and absconded with his wife and his newly born son. How he did this, I do not know, but i know that at the christening ceremony a week later, he had two cows slaughtered to celebrate the birth of his first son.

Many times we complain of doctors who ask for charges before treating patients but no one has ever bothered to ask the doctors why they do? Doctors are humans too; we need to pay bills. This is our trade, our profession, our means of livelihood. We have needs too. We cannot go to the market place with the ID showing that we’re doctors and hope to get food items on credit. We need to pay our children’s school fees, we need clothes, shelter etc just as you. Everywhere in the world healthcare is expensive, both services and materials are expensive. Well we understand that you may not have money. The government should find a way. The government should find a way/policy that ensures that we get our money back after we have rendered our service. In the UK there is the National Health Scheme, in the United states they have health insurance schemes too in addition to Medicare, Medicaid. In Nigeria we have the barely effective, poorly regulated and massively corrupt National Health Insurance Scheme.

Well i have decided to change the modus operandi of my institution. The previous one has not benefitted anybody. Henceforth if any one comes to my emergency room without a dime. I will not attend to. If such a person dies, the blood is not on my hands, it’s on the hands of those who have received treatment in the past and failed to pay afterwards.

The question I would love to ask is; on whose hand lies the blood of those patients who die because they were not attended to for lack of money? Is it the doctors, those who brought them in or the government?