How University of Nigeria Teaching Hospital [UNTH] Enugu, Killed my Nephew

Following my nephew’s diagnosis of leukemia at UNTH, in Enugu, I requested that the hematology department send a referral note by e-mail to Saint Jude’s, a children’s cancer research hospital in Memphis, Tennessee, USA. This institution is a center of excellence for the condition my nephew had.

Why did I ask for a referral?  Early red flags indicated that UNTH Enugu was not the right place for my nephew, and hindsight confirmed that it was a mistake to have sent my nephew there. They lacked blood and blood products. They lacked medication, and they lacked empathy. They even sent my brother to hunt for blood and medicines with which to treat my nephew.

The hematology department stalled on my request for referral. They pulled out every delaying trick in their manual. First they said they knew what they were doing. Secondly they asked that I send them a referral request letter by mail. Finally, they wanted to know my rank as a doctor, I guess for having the audacity to express my desire for a referral. I don’t know why, but each time I say or remember this part I sob and cry.

Tell me how a kid who walked into what was supposedly a tertiary hospital ends up dying in less than two weeks from a condition as common as leukemia. Between two hematologists and a head of department, they proved themselves incapable of lowering his temperature. They were unable to raise his hemoglobin or platelets above the levels he had when he arrived from another department. In the two weeks he was there, the doctors were on strike half the time.

A day or so after his admission to UNTH my brother was driving when I called him to check on my nephew’s status. ‘Where are you going?’ I asked. ‘Hunting for blood donors,’ he said. The department sent my brother to roam the rugged hills of Enugu for blood. He also had a list of medications they asked him to buy to treat his son. How can a parent deal simultaneously with the impending disaster of losing a child and run a blood errand for a teaching hospital? The department ought to be ashamed.

The male hematologist had challenged my brother to go to the village, to bring everybody in to donate blood. You could tell by the tone of his voice that he despised people from the villages. The female hematologist blamed parents such as my brother for the reason why the department had not a drop of blood in the blood bank.

Faced with my nephew’s impending doom at the hands of UNTH, I reiterated my plea for an urgent referral note to Saint Jude’s. ‘Don’t beg me,’ fumed the female hematologist, ‘we will refer when appropriate. And, by the way,’ she added, ‘the doctors are on strike.’

On July 6, barely twelve hours before he passed, the department hurriedly wrote a referral letter. They did not bother sending the referral by e-mail as urgency demanded. They tossed the referral note over to my brother. ‘Do whatever you want with it’ was their attitude.

Tall, light-skinned, sweet-hearted and handsome, my nephew loved to play soccer. ‘My role,’ I consistently informed the department ‘is that of a big uncle.’ They were bewildered.

The department maintained that he was getting the best of care. It was easy to tell that they were living on another planet. Where else on earth but UNTH would the distraught parent of a very sick child be sent to roam the hills of Enugu in the hunt for blood and medicine? They should have consulted other experts in the field, but they did not; they should have reached out to the outside world, but they did not; above all, they should have left their egos at home but they did not. What a shame.

They never gave my nephew a second chance. They watched him as he died but he was not on any continuous monitoring for vital signs required of a child this sick. They diagnosed him with leukemia but never gave him a single dose of chemotherapy. Despite the seriousness of his condition, they only obtained a blood count once every three days.

So sad: the two hematologists didn’t comprehend how rusty the unit is as a place of care, how handicapped is the tertiary center in which they operate, and how out of touch they are as doctors.

I am not alone. Many people tell similar sad stories when relatives attend UNTH.  Compared to other Nigerian hospitals in the same category, UNTH Enugu is in the dust, stuck at the bottom of the pit. Other teaching hospitals have functioning websites, contact telephone numbers and e-mail addresses, whereas UNTH has none.  Many have devoted staff, whereas UNTH has mercenary doctors who devote most of their time to their private practice.

This pernicious culture of incompetence must stop. UNTH Enugu is not under the gun to accept patients, but once they do they are one hundred percent responsible for the care of those patients. It is a medical malpractice to accept a patient today and allow the staff to walk out of the job the next day.

A hallmark of good medical practice is to seek immediate help for diseases in which a practitioner lacks experience or the resources to manage it. It was obvious that these doctors had no clue what they were doing. They were unaware of their incapability.  They were no experts on leukemia as they claimed.

Given the circumstances of my nephew’s death, the head of the department should have reached out to my family to explain what happened, and what they did trying to treat him. Instead they have refused to discuss with me my nephew’s final days. Of the two e-mails I sent, one was returned as undeliverable. I am still waiting for a reply to the other. If their e-mail address and telephone numbers are no good, how can their skills and knowledge be at the cutting edge of medical care?

No other family or child should go through this kind of agony. There was no basis for such a degree of malicious obstruction when family members asked for a referral to a better equipped and managed institution.

The hematology unit at UNTH Enugu woefully failed to meet the minimum standard of care expected of a tertiary teaching hospital. Until it is deemed fit for patient care, the department must be shut down.