As coronavirus spreads to six states in Nigeria, with fear that the infection could get worse, highly-placed health workers have said that the nation does not have up to 500 ventilators across the 36 states and the Federal Capital Territory.
Findings by our correspondents show that hospitals may experience difficulties in handling seriously ill COVID-19 patients due to the lack of enough ventilators for patients’ use.
Lagos State, despite being the epicentre of the contagion with 28 confirmed COVID-19 cases out of the total national cases of 40, does not have enough ventilators to manage coronavirus patients who may present with breathing problems.
A ventilator is a machine designed to provide mechanical ventilation by moving breathable air in and out of the lungs, to deliver breaths to a patient who is physically unable to breathe, or breathing insufficiently.
It is attached to a tube inserted in the patient’s airway so it can deliver air into the lungs.
According to experts, COVID-19, the disease caused by the novel coronavirus, targets the lungs and can cause complications such as pneumonia and acute respiratory distress syndrome.
Severe cases will require a ventilator to be able to deliver enough oxygen from the lungs to the rest of the body, experts say.
President of the Nigerian Medical Association, Dr. Francis Faduyile, explained that the appliance for artificial respiration is necessary when treating severely ill patients; however, he quickly added that he did not know how many ventilators are available nationally.
Our correspondents went round some hospitals in Lagos State, and findings revealed that while some of them did not have ventilators at all, those who have do not have enough to take care of emergency situations such as posed by the COVID-19 pandemic.
At Orile Agege General Hospital, Lagos, a high-ranking health worker who did not want to be mentioned, disclosed that the secondary health facility did not have a single ventilator.
“It is not available. It is not necessarily needed here. If we have cases requiring ventilators, we’ll have to refer [the patient] to LASUTH.
“We have our guidelines on how to deal with any situation that occurs,” the source said.
At the Lagos State University Teaching Hospital, Ikeja, the Chief Medical Director, Prof. Adetokunbo Fabamwo, said the tertiary facility has at least 15 ventilators.
“We have not less than 15 ventilators. We have at the Critical Care Unit, Intensive Care Unit, Medical Emergency Unit, Surgical Emergency Unit, and Ayinke House; and they are all working,” Fabamwo said.
At the General Hospital, Ikorodu, visited by one of our correspondents on Monday, a reliable source said the secondary health facility had no ventilation machine.
Also, a source at the Imo State University Teaching Hospital, Orlu, said there were two ventilators, “but only one is functioning.”
“We have two ventilators at IMSUTH, but only one is functioning. Yet, in a teaching hospital like this, we are meant to have between 10 and 20 ventilators,” the source said.
Another source at the University of Benin Teaching Hospital said, “There are four ventilators at the hospital, but I doubt if they are all functioning.”
The management of Alimosho General Hospital, Igando, said the facility was equipped with about eight ventilators, comprising five in the wards and three in the theatre.
A part of the hospital has just been equipped with newly built Mother & Child Care facility for antenatal, postnatal and childcare.
According to a senior management staff that chose to be anonymous, the ventilators, which are stationed in the wards and in the theatres, are fully functional and could work for up to six hours without power supply.
“There are five ventilators in the wards and they can last up to six hours each.
“There are three for use in any of our three theatres comprising three suites each and are functioning at optimal level.
“The hospital has just restocked its oxygen supply and all the cylinders are stacked in a store,” the source said.
The Federal Medical Centre in Ebute Metta, Lagos, said it has acquired five ‘state-of-the-art’ ventilators.
While taking one of our correspondents on a facility tour, the Medical Director, Dr. Adedamola Dada, explained that three of the ventilators are always in use, while the remaining two are in the storage centre of the facility.
“As you can see, three of those ventilators are presently occupied here in the ICU, while the other two are in storage.”
The MD also said the hospital had four of its anaesthesia machines equipped with ventilators.
On how many patients use the equipment daily on the average, Dada said there was hardly any time that patients didn’t use them.
“Patients are always using them almost all the time. In fact, we discharged two patients who occupied the ventilators just last week.
“There was a time we had a patient on one for four months before he was discharged.
“It is also a known fact that some patients stay on ventilators for years or indefinitely,” he said.
The Lagos University Teaching Hospital, a federal government-owned tertiary healthcare facility, has only four ventilators, our correspondent has reported.
A visit to LUTH and Lagos State-owned Gbagada General Hospital on Monday showed that the hospitals are not well equipped to manage COVID-19 patients.
LUTH has only four ventilators, while Gbagada General Hospital, a major secondary health facility in the state, does not have any, our sources said.
A source at LUTH who spoke on condition of anonymity, said the hospital did not have enough ventilators to manage patients.
“I can confirm to you that we only have four ventilators in the Intensive Care Unit. Basic equipment needed to manage patients admitted at the ICU is in short supply, including ventilators.
“The coronavirus that we’re all talking about, if patients with breathing problems are brought to LUTH today, the ventilators are not there to manage them.
“The four that we have are not enough for our patients, let alone adding news ones,” the source said.
Another health worker in ICU said, “Ordinarily, a teaching hospital like LUTH, with large volume of patients and located in a thickly populated state like Lagos, should have between 50 and 100 ventilators.
“Although the problem is not associated with LUTH alone, other teaching hospitals in the country, both those owned by the federal and state governments, do not have enough ventilators.
“As I speak, Nigeria cannot boast of 500 ventilators across the 36 states and the FCT.”
While LUTH could still boast of four ventilators, Gbagada General Hospital, Lagos, has none to offer to patients with breathing problems, according to information gathered by our reporter during a visit to the hospital on Monday.
A staff at the general hospital who did not want his name in print, said what the hospital has was an anaesthetic machine and not a ventilator.
“We do not have an Intensive Care Unit for the management of patients with breathing problems, and we do not have a ventilator.
“When we have patients in need of ventilators, we refer them to the Lagos State University Teaching Hospital, Ikeja; or LUTH.
“What we have currently is an anaesthetic machine,” our source said.
When our correspondent sent an SMS to the Medical Director of Gbagada General Hospital, Dr. Kaka Adeleke, on Monday, asking him to confirm whether or not the hospital has an ICU, he responded in a text message, “Please, all your required data are with the Federal Ministry of Health.”
The Chief Medical Director of LUTH, Prof. Chris Bode, urged our correspondent to come to his office on Tuesday when asked to state the number of ventilators the hospital has.
He refused to disclose how many ventilators are available in the tertiary hospital, saying the number was “definitely not four.”