Death by blackout

A few days ago, the management of Aminu Kano Teaching Hospital appealed to the Kano Electricity Distribution Company (KEDCO) to restore electricity to the facility. Three patients allegedly died while the power was out. AKTH is not the first teaching hospital in Nigeria to have its lights disconnected for not paying accumulated electricity bills. Similar […]

A few days ago, the management of Aminu Kano Teaching Hospital appealed to the Kano Electricity Distribution Company (KEDCO) to restore electricity to the facility. Three patients allegedly died while the power was out.

AKTH is not the first teaching hospital in Nigeria to have its lights disconnected for not paying accumulated electricity bills. Similar stories have emerged from Lagos University Teaching Hospital (LUTH). Nigeria’s premier teaching hospital, the University College Hospital (UCH) in Ibadan, had blackout for months.

My own university teaching hospital is currently running on rationed generators because they have been disconnected due to unpaid electricity bills. Even smaller state-owned tertiary facilities face the same crisis. Each time, patients—already burdened with illness—pay the ultimate price for our systemic dysfunctions.

That our hospitals don’t have light is probably not surprising, because we all know the state of electricity in Nigeria. The national grid collapses every eke market day. Some communities haven’t had light in weeks. Some have it a few days a week, or a few hours a day. The categorisation of distribution into bands hasn’t improved the situation for many.

But our hospitals should operate at higher standards. No one goes to the hospital to relax. Electricity in hospitals is not just to power bulbs, fans, and ACs, but to keep lifesaving equipment like incubators, dialysis machines, ventilators, and operating theatres running. It should be available and stable, not epileptic.

The irony is striking: hospitals are where people go to be saved, yet in Nigeria, a power outage can turn them into death traps. Patients can use hand fans to keep out the heat, surgeons can improvise with handheld or mounted lamps, but how long can we continue to improvise with ventilators, incubators, diathermy blades, and other essential medical equipment? Once the lights go out, survival becomes a matter of chance.

At the heart of the problem are three key factors: inadequate funding, ineffective management, and an unreliable power sector. Teaching hospitals depend heavily on government subsidies, which often arrive late or are too small to meet their needs. Hospital management, on the other hand, seems more focused on paying salaries and renovating offices than fixing gaping holes in their systems. What can they even do, really, with the meagre allocations they receive? I don’t envy them.

Patients, it seems, can’t afford the high cost of care that would allow hospitals to raise enough revenue (IGR) to meet their obligations. Hospitals, on the other hand, underperform without electricity, water, consumables, and other essentials that depend on steady funding. This creates a vicious cycle: patients are undercharged to make care accessible, hospitals accumulate debts they cannot offset, and utility providers treat them like any other defaulting customer. In the end, the very institutions meant to save lives are left financially crippled, unable to guarantee the most basic conditions for treatment.

Meanwhile, power distribution companies—whether IBEDC, AEDC, or KEDCO—operate as businesses; they will cut supply if bills are not paid. In the middle of this tug-of-war are ordinary Nigerians, forced to weigh their lives against the fragility of a system that sees healthcare as an expense, not an investment.

We need to revise our healthcare funding strategies and develop effective systems to ensure judicious use of scarce resources. This means going beyond paltry subsidies and ad-hoc government bailouts, toward sustainable financing models such as community-led health insurance schemes, public–private partnerships, and investment in renewable energy to reduce reliance on the fragile power grid.

We also need stronger accountability frameworks to ensure that CMDs and other relevant hospital management staff manage the allocated funds transparently, effectively, and target them towards patient care. Without these reforms, Nigeria’s hospitals will remain trapped in a cycle of underfunding, inefficiency, and preventable loss of lives.

In the interest of efficiency, we should also do away with the idea that only medical doctors should be CMDs. Leadership in teaching hospitals is about administration, resource management, and strategic planning—not just clinical expertise. Other health professionals such as pharmacists, nurses, laboratory scientists, or even seasoned health administrators can bring valuable perspectives and managerial competence to the role. By widening the pool of eligible leaders, hospitals can benefit from diverse skills, reduce inter-professional tensions, and focus on what truly matters: delivering efficient, patient-centred care.

All that may not work until we confront a difficult reality as a people: either accept poor health services that are free or cheap, or be ready to pay more for improved and more reliable services. These are no easy choices, because both options carry weighty consequences: affordability on one hand, and quality on the other. The government is not yet ready to do better.

But until we confront this reality honestly, we will remain stuck in a system where everyone expects world-class care funded by shoestring budgets. A national conversation on what level of healthcare we are willing to pay for—and how best to structure that payment—is overdue. Only then can we begin to build a system that is fair, functional, and worthy of the lives it is meant to protect.

 

Adoto wrote via [email protected].