LAGOS, NIGERIA: On September 9, 2023, Akpan’s* household, which includes his wife and two daughters, experienced a cooking gas explosion in their kitchen that caused severe burns. This was not only a terrible incident but they would also undergo the pain of being rejected for treatment in several hospitals, as well as the ones in the Ikorodu area where they lived.
“Within one week, we were rejected by seven hospitals, and the wounds kept getting worse,” Akpan said.
By the time the family finally found a hospital equipped to treat them six days later, they were diagnosed with multiple mixed-thickness burns (MTB). Akpan had 13% MTB with injuries on the leg, his wife, 45% MTB with intestinal injuries and burns across the face, chest, and limbs, and their 15- and 13-year-old daughters sustained 30% MTB with burns causing skin loss on both legs and 18% MTB with burns on both limbs, respectively.
The 2024 Nigeria Residential Energy Demand-Side Survey shows that over 19% of households in Nigeria rely on cooking gas, otherwise known as liquefied petroleum gas (LPG), for domestic, agricultural, commercial, and other purposes. LPG is considered highly inflammable and burn injuries from cooking gas explosions have been found to be a major source of mortality and morbidity in Nigerian households with low socioeconomic status.
The family was admitted to the Burns and Trauma Centre at the Lagos State University Teaching Hospital (LASUTH) in Gbagada. After an initial deposit of ₦200,000 ($128.91), they faced a financial crisis that compounded their plight.
“I was lost in thought, trying to figure out how to save my family and me from dying,” Akpan said. He noted he was approached by a group who seemed interested in his ordeal. “I didn’t know them before; they just approached me at my hospital bed and asked how I was doing.”
After listening to his story, they introduced themselves as Health Emergency Initiative (HEI) and then proceeded to pay ₦170,000 ($133.16) for the family’s treatment, followed by ₦80,000 ($53.25) for medication.
HEI, a non-profit, responds to health emergencies by paying the medical bills of poor accident victims who cannot afford it within the first 24 hours to ensure they are not rejected by hospitals for financial reasons.
Dr. Mojid Lateef Olabode, Head of Medical Social Services at Surulere General Hospital, Lagos, noted that the inability to pay an initial deposit has led to many accident casualties succumbing to their injuries as hospitals are forced to deny them medical care.
According to Dr. Olabode, hospitals have to insist on an initial deposit before treatment can commence on any patient in order to avoid the losses incurred from patients who would fail to make any payment for the treatment after being stabilized.
“Hence the rule that until the first deposit is made, no treatment commences in hospitals. Now the issue is that in the state of emergency, the patients can’t save themselves so they would need someone to make that first deposit and since we don’t at the time have any information about the patients, we can’t trace their families, which is why the HEI system is a huge blessing,” said Dr. Olabode.
“We begin treatment with the assurance that HEI will pay”
Raki*, a 28-year-old trader at Magodo mini-market, Kosofe local government, with an underlying peptic ulcer illness, sustained a 35% MTB injury from cooking gas leakage on July 23, 2023.
After getting admitted to LASUTH, her treatment was halted due to financial difficulties. “I had used all the money I made from my little tomato business, and it didn’t even cover half the cost. I was just waiting on God’s miracles,” she said.
The nurses at the hospital encouraged her to keep calm because the doctor had already written to a certain organization that could pay off her bills. “God answered my prayers by sending the HEI. I didn’t even know when they came in but the doctor told me after they had left for that day that they had paid 350,000 Naira ($233.85), which was the remaining amount both for my treatment and drugs,” Raki continued.
In 2008, Pascal Achunine, overjoyed by the birth of his first daughter, settled the payment of another woman at the Lagos Island Maternity Hospital who could not afford her bill 2 months after delivery.
Motivated by the relief he noticed on her face, Achunine decided to make it a recurrent activity. “Up until 2015, it [HEI] was not an organization; it was just me reaching out to people, then a friend drew my attention to the emergency rooms in the hospitals where people die daily due to as little as an initial deposit for treatment.”
HEI currently supports 78 hospitals across 12 states, including Lagos, Imo, Kaduna, Delta, Oyo, Ogun, and Rivers, by covering the costs of these hospitals stabilizing and resuscitating critically injured patients within the first 24 hours.
To enable seamless operation, HEI signs a memorandum of understanding with partner hospitals and then establishes an emergency line with medical social workers in these hospitals.
Through this contact line, HEI is promptly alerted whenever an emergency case is brought to any of its partner hospitals so its staff can be mobilized immediately to visit the hospital, inspect the case, and make the initial deposit for treatment to commence.
Although not all hospitals have the capacity to handle chronic emergencies, the medical social workers collaborate to transfer patients to appropriate facilities and alert HEI. “The process is seamless and effective. When we receive casualties, we begin treatment with the assurance that HEI will pay, and they always do. They inspect cases, make the initial deposit, and in some instances, cover the entire bill,” Dr. Olabode said.
Data from HEI show that the initiative has intervened in 3,750 emergency road and home accident cases, achieving a 72% survival rate, paid medical bills for 33,500 indigent patients, and trained 126,000 individuals in cardiopulmonary resuscitation (CPR) and first aid.
“More than 30% of accident victims die within one to four hours. Addressing these gaps in emergency care is our primary goal,” Pascal Achunine, founder of Health Emergency Initiative, told The SolutionsPaper.
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“We can only take in so many”
Initially, HEI aimed to cover the ₦20,000 deposit for emergency cases in order to kickstart treatment. The patient and his family were expected to pay the rest of the medical bills; however, “many victims, after being resuscitated, turn out to be indigent and depend entirely on us for complete treatment; unfortunately, we can only take in so many,” Pascal said.
Misconceptions about the nature of HEI also pose challenges. “Many people assume we are a government agency and see no need to support us. We’ve had to explain repeatedly that we are a non-governmental organization,” Pascal said.
With 30 more hospitals applying to join HEI’s network, the organization faces financial constraints, limiting its ability to expand the number of hospitals under its coverage. Dr. Olabode added that government partnerships could strengthen the HEI system and help save more lives.
Names with an asterisk* have been changed to protect identities.
Credits
Editing: Adebola Makinde, Chinonso Kenneth
Chidera Eze is a freelance journalist with bias for solutions journalism, a blockchain content writer and a public relations student.
