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FCTA hospitals crowded because people know we've standard facilities, services
Dr. Alu, Ag. GM, Hospitals Mgt Board
August, 2020

Dr. Francis Alu, Acting General Manager, Federal Capital Territory Administration (FCTA)'s Hospitals Management Board (HMB) is a juggernaut of the Medical profession with an enviable track record spanning over three decades. He has been with FCTA as long as anyone can remember, faithfully and conscientiously putting in his bit to save lives and create wealth for the common good.

The COVID-19 pandemic is an experience that compelled him to bring to bear all of his vast knowledge in Medicine and, with the full cooperation of his major principal, Minister of FCT, Malam Muhammad Musa Bello, much is being accomplished. Dr. Alu spoke to Abuja Digest Weekly trio of Josie Mudasiru, Felix Durumbah and Sarah Odugbo last week in his office on many issues, including an erroneous publications in a newspaper.

Abuja Digest Weekly: For the benefit of members of the public who may not know, what exactly are the functions of Hospitals Management Board (HMB), given that FCTA already has a Health and Human Services Secretariat (HHSS)?
Alu: Thank you very much. The Hospitals Management Board, as the name implies, coordinates the activities of all the hospitals run by FCTA. Presently we have 14 General Hospitals and these are hospitals under HMB. The Primary Health Care Board runs the Primary Health Care (PHC) facilities---these are not included in the HMB. As a board, we set up standards and guidelines for implementation at the hospitals. We are also in charge of deployment, postings and training of these staff in the hospitals. We provide secondary health care to residents of FCT and environs. We get referrals from PHCs and other facilities available.

The board presently is supposed to be autonomous. The President signed a law establishing it. However, the Honourable Minister is yet to inaugurate a board for it. So, we're still answerable to the HHSS which acts like the Ministry of Health. In each state, you have a Ministry of Health and then you have the HMB that runs the hospitals. So we implement the programmes made by the Secretariat (Ministry).

Abuja Digest Weekly: Does your board also oversee private hospitals in FCT?
Alu: No, the board does not oversee private hospitals. What the board does is to receive referrals from private hospitals as at when necessary. It is the HHSS through the Private Health Care and Monitoring Committee that oversees and registers all the private hospitals. There is a unit under the Department of Medical and Diagnostics that does that under HHSS. So, it's not under HMB.

Abuja Digest Weekly: How would you describe services rendered by FCTA-owned hospitals? Some persons write negative things on these.
Alu: Our services are of high standard. Our services are very, very affordable and we provide efficient and effective health care services in our hospitals. Some journalists criticize the hospitals when there is one problem or the other, forgetting that out of 10, there may be just one bad incident. That should not rubbish the work we're doing. When you visit our hospitals, you see the crowds; there are so many people coming to access health care. If the hospitals were that bad, people won't come.

But you see huge crowds every day. So, our services are of high quality and very cheap. As I'm talking to you now, we have over 116 consultants, specialists in various fields of specialization that attend to patients. And these hospitals were meant initially to be Health Centres, to Comprehensive Health Centres, and now General Hospitals; in fact we operate now as tertiary health care centres because we have specialists in virtually all the fields and we do residency training in Obstetrics and Gynaecology, Family Medicine, General Survey, Ophthalmology, Anesthesia and then, of course, internship in various fields.

This is a reflection of the quality of care that these hospitals are rendering because for you to be accredited to do these trainings and train people up to consultant level—what I'm telling you is we train people to become consultants---for you to do that, we're accredited by West African College of Surgeons, we're accredited by West African College of Physicians, and National Post-Graduate Medical College. For you to do these, it means that they have assessed you and found out that the quality of care and facilities available are up to standard. And because our services are good, people patronize us. And I tell you that that's what's happening here. Most General Hospitals in other states do not measure up to what we do in FCT.

Abuja Digest Weekly: You spoke of crowds visiting the hospitals. Would you be able to able to give us average number?
Alu: The numbers are massive; very, very massive for all the hospitals. For instance, in GOPD (General Out-Patient Department), a particular doctor could see over 150 patients alone. Multiply that by the other units in all the different hospitals. The numbers are very massive because people love what we're doing. Our services are so cheap, so people patronize us.

Abuja Digest Weekly: Let's shift attention to COVID-19. You're in the frontline of the fight against the pandemic. Tell us about your experiences.
Alu: Yes, COVID-19, as you know, is a pandemic. I remember when the first phase came to Nigeria, the Honourable Minister, FCT, summoned a meeting of all us---the board, the Secretariats and all that. He asked us 'what are going to do?' By then, we had not had any case in Abuja. It was just Lagos. He kept reminding us that 'people are moving

from Lagos to FCT every day; are you people telling me that this thing is not here?' So, we kept telling him that 'No, we're ready' and all that. The first thing we did was to advise him that we have adequate personal protective equipment (PPE). And to the glory of God Almighty and to the Minister's credit, FCT was given enough, maybe Lagos is only state that can boast of also enough PPE for its staff. I can assure you, go to the hospitals, everybody is happy with the level of provision of PPE; these can last us. If they weren't there, by now we would have been in trouble. But he made sure, it was over.

So, when the cases started increasing, Gwagwalada (Specialist Hospital) had only 20 beds, National Hospital had about two beds, for isolation; and there was no other place. So, when the Minister asked us 'what do we do?', we went round to look for places where we can use as isolation since we don't have any ready-made. So we advised him that we're going to close one of our hospitals, and that is Asokoro Hospital. It's ready-made and it has served the purpose because when we started having explosion, Asokoro became very ready for us to admit. And then, of course, Karu General Hospital that virtually came on board.

So, we are attending to the COVID cases. And then as a board, we went to the hospitals and were able to sensitize the health care workers for them to also protect themselves, use the PPE. What we usually advise is for them to use the appropriate equipment; it doesn't mean you must go and dress like a masquerade. Just a mask and a glove, you can attend to a COVID patient. It doesn't fail. Once the contact is there, the person is wearing mask.

So one of the things we also advised the Minister then was that in all our hospitals, any patient coming in should wear mask. This policy started even before the PTF (Presidential Task Force on COVID-19) and FCT started it. Patients coming in, you must wear mask, health care worker here, you must wear mask. That way, you reduce transmission. And we also ensured that people do not run away when they hear the word 'COVID'. Initially they panicked; if you cough, people would run away thinking that it's COVID, but we told them---those of us at the consultant level---that it's not like that, you can still attend to them. You'll still attend to the person. So, when people write that doctors and nurses are running

away from COVID, it's not true. The truth is that with time they (our staff) became overwhelmed. Asokoro is one of our major hospitals in FCT; large populations. NHIS (National Health Insurance Scheme enrollees) alone are 21,000, the highest in the whole country. So, when you close a hospital like that, all the patients that were supposed to be going there, are now in these other hospitals. So the crowd is so much. You come by 11am and you've not been attended to, you become to phone your connections that you've been waiting and nobody is attending to you. Meanwhile, people are working, attending to those who came before you because the number is so large. And, as I told you, if we were not providing those services, they won't come. There are several hospitals all over the place; who will go there? But because you know what you get here, you still come, and we became overwhelmed. So, when we say 'no bed space', people think it's a joke. There is no bed! Even before COVID, the spaces, if you visited the hospitals, one of our major problems was space constraint. We have expanded and expanded and expanded, and all that.

So, this is the situation. Some journalists write that 'health care workers are abandoning patients; they are running away because of COVID'. Nobody is running away. Some of the health care workers have contacted this COVID in the course of attending to these patients. Got treated ok. So, we're working. For COVID, we've been on top of it. We're one of the best in the country. After Lagos, it was FCT. And we're able to contain it. I must give credit to the Honourable Minister. Everything you mention about COVID, he's on top of it, approved everything we asked for.

We were the first to pay allowances, special allowances of N50, 000 to doctors, N30, 000 to hospital and health care workers, and then N10, 000 to drivers per day. All were paid. Only Lagos could pay that, even Lagos was not regular. We're in the process of paying the Federal Government-approved hazard allowance for other people too; that would cut across not only the health care workers but non-health care workers who are also working in the hospitals. So, the issue of COVID in FCT, the Minister has been on top of it and we're happy with that.

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