Governance and the burden of creativity.....1

THERE are many ways in which government
can make progress without necessarily
spending humongous sums on consultants or
other categories of contractors. Let us start
with hospitals. In the typical Nigerian
hospital, you can get to the Accident and
Emergency, A & E, where you are asked to
get a card from Records, which is probably
some 20 metres from A & E. At Records you
are asked to go and pay for the card at
Accounts which is another 20 metres from
A & E in the opposite direction from
Records. So you walk 40 metres from
Records to Accounts and thus adding the
initial 20 minutes you walked from A & E to
Records you have thus far traversed 60
metres. You then walk another 60 metres to
Records to get the card and then yet
another 20 metres back to A & E. After
having been attended to by the doctor, you
take whatever prescription you are given to
Pharmacy which may be up to 50 metres
from A & E.
Thus far you have covered 170 metres but
your forced exercise in spite of your health
condition is far from over! The drugs are
costed at the Pharmacy only for you to be
asked to return to Accounts to pay and thus
you return the other way 70 metres, pay and
then turn back another 70 metres for the
drugs. So far you have covered 310 metres
in your condition! Wow!
This is obviously a problem of poor hospital
architecture but also one of poor hospital
management. How can it be really that
difficult to design a hospital such that these
important departments are within close
proximity of one another for patients not to
be forced to embark on potentially life
threatening exercises in a hospital to which
they have come to preserve their lives? And
even if the architect was dumb, clueless
and unimaginative enough to design a
hospital in such manner as to pose a public
health challenge, how come the medical
authorities who run the place did not take
the initiative to reconfigure their workplace?
It cannot really be that difficult for services
to be optimally rendered simply by
concerned stakeholders being proactive,
imaginative and up and doing. So a Minister
for Health who ensures that hospitals are
configured or reconfigured in such manner
as not to subject patients to avoidable
ordeals while attending clinic, and indeed,
goes further to institute a minimum standard
of hospital design with inter-proximity of
crucial departments in mind, would be
considered a success while one that does
not, is incontestably a failure.