Remain Steadfast In The Face Of Daunting Challenges. Mamora Tells Chief Medical Directors Of Federal Hospitals.

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The Honourable Minister of State for Health, Dr. Olorunnimbe Mamora has charged Chief Medical Directors (CMDs) and Chief Executives of hospitals to remain steadfast in the discharge of their duties in spite of the daunting challenges faced. In a press release signed by Signed Olujimi Oyetomi, Director, Information, Media & Public Relations,
FMOHFMOH and made available to Outlook Media said:

Dr. Mamora made this charge during a partially physical and partially virtual meeting he had with Chief Medical Directors from various Federal Medical Centres, Tertiary Hospitals and Specialty Hospitals across the country, held on Thursday, 2nd July, 2020.

The meeting which was called to feel the pulse of the Chief Executives on response efforts put in place at the various centres, as well as challenges faced in handling the corona virus pandemic. The CMDs reveal efforts made by their Centres to include successful treatment and discharge of COVID-19 patients; Excellent partnership/collaboration of some Centres with their host State Governors in tackling the pandemic through support purchases of ventilators, dialysis machines, ECG machines, Mobile Xray machines, donation of bed spaces and supply of consumables; PPEs and other equipment received by some centres from the Office of the First Lady, Federal Ministry of Health (FMOH), Sir Emeka Offor Foundation, Agip Oil, Non-Governmental Organizations (NGOs), Private Organizations and Individuals to mention a few.

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Some of the Health Care Centres reported upgrade of molecular laboratories by the NCDC for testing of samples. Some also reported growth of local capacity in some areas like the production of sanitizers, liquid soaps, theatre caps, masks, hand washing machines which are believed that post-COVID-19, will go a long way in reducing cost of procurement as well as domesticate production of these items.

Some of the CMDs reported that this was not the case in some centres, as there were also challenges which were general in nature to include: Low rate of testing and the need for molecular laboratories and GeneXpert machines to be set up to reduce turnaround time which will in turn reduce fatality rate.

There were reports of dwindling internally generated revenue (IGR) due to low turnout of regular routine cases with huge outsource services and overhead cost to be paid for.

There were reports of high cost of electricity bills; increased cost of providing services due to high cost of materials; delay in payment of inducement allowance to health workers working in isolation centres; lack of sufficient PPEs and bed spaces; lack of support/poor relationship with some host State Governors.

There were also reports of inappropriate demand for PPEs and demand for only N95 masks by staff, before they can work; infection of hospital workers/resignation of resident doctors and the need for employment waiver.

The litany of challenges encountered at the Government hospitals also include lack of oxygen supply; need for more ambulance/surgical facilities for COVID-19 cases; summons of the CMDs by NASS which they request should be stepped down for now, to enable them concentrate on the crisis on ground.

There were reports of the refusal of citizens to believe that COVID-19 exist; issues of security with families coming in with assault weapons to claim their corpses; and the safety of their colleagues in Kogi State.

In response to some of the challenges raised by the CMDs, the Honourable Minister of State for Health, took time to address them, while referring some to the Director, Hospital Services, FMoH, Dr, Adebimpe Adebiyi for response.

On the issue of dwindling Internally Generated Revenue (IGR) due to low turnout of regular routine cases and with huge outsource services and overhead to be met, the Honourable Minister of State informed the Chief Executives that the Ministry is in talks with the Ministry of Finance, Budget and National Planning in the area of out-source services to have a budget line and be funded regularly, but with the coming of COVD-19 plans were put on hold, he said.
The Honourable Minister of State assured that the process will be pursued further.

On the issue of IGR, Dr. Mamora acknowledged that it’s a major issue especially at this point in time and promised that the FMoH will do the best it can, because that is a duty owed to the CMDs/CEOs and the FMoH will not hold back if and when the need arises to do so.

On the issue of lack of support/poor relationship with some host State Governors, the Honourable Minister of State for Health said that there is need for synergy and collaboration with State Governments to be able to achieve results, saying that the response of COVID-19 is led by the State with the Federal Government supporting,”We are working on a common purpose, the FMoH would step in to appeal and solicit support from the State Governments.”

On the issue of infection of hospital workers/resignation of resident doctors, and the need for employment waiver, Dr. Mamora reiterated the need for health workers to be educated on the consciousness of infection, prevention and control (IPC) to further limit or eliminate infections.

On waiver for employment of nurses and doctors, Dr. Mamora said the request will be sent to the appropriate authorities and there will be a revert to the CEOs.

On summons by NASS to be stepped down for now, Dr. Mamora assured of his intervention with the law makers to put a halt to this to reduce undue risk and exposure to infection, stating that this is not the best time to take on journeys that are not very necessary and that this is against what is been preached from the PTF level to reduce exposure to contacting COVID-19.

On the issue of delay in payment of inducement allowances to health workers working in isolation centres, Dr. Mamora assured them that they will receive the payment of 20% special inducement allowances by Government, “It is a commitment that will be paid, the delay has been due to the fact that IPPIS office wanted to clear the hazard allowances before the inducement allowances.”

On the issue of inappropriate demand for PPEs and demand for only N95 masks by staff before they can work, Dr. Mamora said “N95 masks should be reserved for those going into the ward for surgical procedures, regular medical masks can be worn, PPEs must be appropriated for the right situation, there is need for understanding as well as educating staff in the use of mask, to maximize what we have.”

On the issue of the safety of their colleagues in Kogi State, the Honourable Minister of State, for Health said that he has been in touch with the CMD and that the issue has gone beyond the FMoH to the PTF and also to the level of the Presidency. “We are alerting the relevant authorities in terms of security beef up at the Centre as well as for the entire health worker, from the Centre, we have a duty to protect everyone of you in the course of carrying out your legitimate duties”, he stated.

On the issue of lack of sufficient PPEs and bed spaces, lack of oxygen, ambulance and surgical facilities for COVID-19, Dr. Mamora said the FMoH will continue to do its best to assist and proffer solutions in areas that it can, within the limits of what we have.

On the issue of low rate of testing and the need for molecular laboratories, the Director, Hospital Services of the FMoH, Dr. Adebimpe Adebiyi informed that starting from the FCT, testing will be ramped up with sample collection sites been established with directives from the Honourable Minister to repurpose some GeneXpert machines for reduced turnaround time testing.
The Director on behalf of the Honourable Minister of State for Health disclosed that tertiary hospitals have been identified to benefit from this, so as to free up bed spaces at the isolation centres.

On the issue of high cost of Electricity bills, Dr. Adebimpe Adebiyi also informed that there is an expression of support from the Rural Electrification Agency to support Federal Tertiary Hospitals and some General Hospitals, with the initial preliminary discussions started. “It is a development that will make power generation resolved in the shortest possible time”, she stated.

Dr. Mamora thanked the CMDs for their relentless spirit in the fight against COVID-19 and extended the warm wishes of the Honourable Minister of Health, Dr. Osagie Ehanire who could not be part of the meeting due to commitment at the PTF, stating that all their concerns have been noted. “A time of crisis is a time where true leadership comes out with the ability to adapt, innovate and be flexible, given the circumstance.” He further assured that the FMoH has a duty to look into all their challenges and proffer solutions and support.

He urged the CEOs not to be overwhelmed, to live up to expectation, remain undaunted and never say there is no solution to whatever challenges that comes. He also assured them that because every problem has a solution, they are not alone in this fight. He further gave a stern warning that on no account should any patient be turned back or rejected when they visit the hospital, reminding them of their first call of duty as Doctors which is to save lives, reduce pain and suffering. “There is a need to revisit the issue of Rapid Diagnostic Test Kits, some of them may not show or exhibit the level of specificity and sensitivity but it is still better to do something if and where available than not to do anything. “We can do that right now and within minutes, get results, we should examine the rapid test kits available, some are PCR-based, we should start looking at that, we are looking at what we can do within 15-20 minutes and get results and then follow up on what you need to do for the patient, that is what I think we need to look at in the immediate, while we await the recalibration of the GeneXpert machines which will take us an hour, which is even luxury. We should be pragmatic; so many patients have died while waiting even for 30 minutes. Let us be conscious of the IPC and do what we have to do, even if it means putting the patient in the corridor to screen; we should look at what can be done in the immediate to save lives”, Dr. Mamora stated.

Present at the meeting were the Senior Technical Assistant to the Honorable Minister of State, Dr. David Atuwo; Technical Assistant to the Honourable Minister of State, Dr. Nneka Orji and other staff of the Ministry.

The meeting by the Honourable Minister of State for Health with the CEOs of Hospitals is an experience sharing session, which is meant for regular sharing of ideas, interaction as well as encouraging one another, knowing that they are not alone, but working together to support one another.(outlook media).