Ikah Hospital: The Story of Over 5-Decade Battle Against Tuberculosis

Tuberculosis, one of the world’s most chronic diseases, may be one of the worst nightmares confronting Nigeria in recent times, a revelation from a mission hospital in a remote community in Ankpa Local Government Area of Kogi State has suggested. A shrill cry cut through the quiet night at the Ika Christian Hospital and its […]

Tuberculosis, one of the world’s most chronic diseases, may be one of the worst nightmares confronting Nigeria in recent times, a revelation from a mission hospital in a remote community in Ankpa Local Government Area of Kogi State has suggested.
A shrill cry cut through the quiet night at the Ika Christian Hospital and its neighbourhood few minutes past 11 o’clock on February 10. The occupants of the male ward of the popular Ibro Hall of the hospital were once again jolted by another death of a patient.
Zainab Ufaruna held tight to the remains of his last son, Malam Ibrahim, shaking it as if she could bring it back to life. “Please don’t leave me alone in this world,” she pleaded. It took much persuasion before two patients of the ward could release Ibrahim’s remains from her grasp, covering it with the hospital’s bed-sheet.
 She had lost six other sons within the last seven years, but not to tuberculosis like Ibrahim. Ibrahim was brought to the ward four days earlier on the hospital’s wheelchair, highly emaciated because the disease had taken its toll on him.
 “We have been moving from one hospital to another for the past two months in Katsina State where we lived, but the cough won’t stop,” his wife, Samira acknowledged. By the time he was brought to the facility in Ikah, his situation had already become chronic, with the legs and stomach visibly swollen. But Ibrahim’s condition seemed to have slightly improved few days in the hospital. He was his loquacious self again as Samira had testified, dominating all discussions among patients at the male ward. The cough had subsided and not accompanied with blood as before.
 But this fateful Friday night, he had relapsed into oblivion, barely talking to anyone and declining to eat anything offered him by his mother. He had called for a cup of water at 11 pm, breathed down loudly thereafter after a gulp and went leap.
Ibrahim’s demise had further worsened the atmosphere at the popular ward earlier dampened by the death of four other patients within a space of two days.  Stephen, Makoji, Amodu, Sylvester had died almost on an hourly basis. As each corpse was moved out by relatives, with the assistant of hospital officials, new patient took over the available spaces.
There seemed to be a surge of tuberculosis patients at that time of the year. But hospital officials said the situation had been like that. The rate at which people contacted tuberculosis was alarming, Dr. Oforbuike Onovo, a medical practitioner in the hospital lamented. He was not alone in this postulation as a recent World Health Organisation (WHO) report indicated that the figure for the epidemic had doubled that of the previous year. Experts at the tuberculosis conference in Durban, South Africa, put the estimated figure at 10 million with 1.5 million deaths recorded worldwide.
Despite the alarming statistics, health officials said the figure hardly represented the true picture of the epidemic worldwide.
“The rate of infection is higher in sub-Saharan Africa, where large population has no access to basic healthcare, much less a secondary facility where they could be diagnosed for a disease such as tuberculosis,” Dr. Onovo explained.
He said there had been a steady rise in the number of patients coming to the hospital yearly. A statistic of tuberculosis patients obtained by Daily Trust on Sunday in the hospital confirmed this rise. Findings revealed that in 2014 alone, 224 patients were admitted for tuberculosis in the hospital. The figure increased to 318 verifiable cases in 2015. It was also learnt that between January and July this year, a total of 151 patients were admitted in the hospital for tuberculosis cases.
Officials said many died before they could get to the hospital even as many more never attempt to seek orthodox solution because of ignorance and fear of stigmatisation.
The number of those who seek traditional means could be more because many hospitals do not have the facility to ascertain whether a persistent cough could be tuberculosis, a health official said. He said that by the time a patient would realise the enormity of the situation, the case may have become not just chronic, but the disease would be transmitted to others, including family members or co-workers as the case may be.
Onovo said some of the complications resulted in the death of patients because tuberculosis is a disease of the respiratory system, and no life survives without respiration.  “Anything that compromises it compromises life,” he noted.
Also, ignorance of its contagious nature seems to spread the disease the more. A tuberculosis patient, Julius Omale told our reporter penultimate Monday that he did not come to the facility because of the persistent cough but as result of weight loss and fever.
“I discovered that I was emaciating and those who know me closely were beginning to complain that I was getting lean by the day,” he said.  By the time he got to the hospital, the test result indicated that he was TB positive. He said his fear was that some members of his immediately family may have also contracted the disease due to his ignorance.
Another patient, Chris Joseph, also agreed that the high rate of infection is worsened by lack of access to a standard health facility for immediate diagnosis. 
“I had to go to a patent medicine store in my village first and was given a cough syrup. But the cough persisted even when I finished a bottle of the medicine. I went back there, and I was given a different syrup, but that also did not help mitigate the cough. I then went to a primary health care centre in a nearby community when fatigue and fever were setting in. I was treated for malaria and also given a cough syrup and asked to go home. But when the cough persisted, a cousin recommended that I should go to Ikah Christian Hospital, where it was discovered that I have tuberculosis,” he explained. He realised the danger the disease portends when he was admitted in the hospital.
Onovo further said that even at teaching hospitals and other tertiary health institutions, many cases of tuberculosis are not detected because the index of suspension and emphasis on training curriculum are very low.
“Most times, cases of tuberculosis escape undetected until the patient has developed complications. And this disease can affect one’s work because of the embarrassment involved in it.  He will also be afraid to appear in the public,” Onovo noted.
He said that normally, a person who coughs for a long interval will begin to lose weight and have difficulty in breathing. Fatigue and tiredness will set in, even as there will be problems of swollen legs, frequent fever and drop in blood level.
“The lung, which is the primary organ this disease affects, has a little function to perform, with regards to blood formation. If this persists for a long time, the patient will go down with anemia, and what will happen afterwards is better imagined,” he added. 
At the hospital, a patient is required to produce one patient-nurse, who will also be on medication because of the contagious nature of the disease. “I was also asked to get a container to always deposit the phlegm and a handkerchief to cover my mouth when coughing and during counselling to avoid spreading it,” Chris explained.
Chris spent almost a month at the Ibro Hall where patients are first admitted before they are moved to a separate hostel-like section after the first stage of treatment. Even as they are recuperating in the new section, they are barred from mixing with the public until after two months when they are certified okay to go home.
“You are considered a danger to the public; hence you have a separate plate with which your food is dished, a separate cup which you drink from, and all that. It is one hell of a disease,” he exclaimed, adding that the situation is worsened by the stigma patients suffer.
Speaking further, Onovo said tuberculosis was more dangerous than HIV/AIDS because there’s no intervention against it. “It requires the kind of attention HIV/AIDS is getting. People need to know how to avoid contracting the disease, they also need to know at what point a person who is showing the signs has to go for test. There is also the need to remove the stigma and superstition attached to it,” he advised.
The Ikah Christian Hospital was established in 1961 by a Canadian missionary, Raymon Dibble. But the facility is currently managed by his granddaughter, Mrs. Lois Wheeler, a nurse, after the demise of her father, Spencer Debble, who was a translator.
Raymon acquired the land for the hospital in 1952 but had been in Nigeria as a Christian missionary since 1921. Although a translator with no experience in medicine, Raymon managed the hospital with medical personnel from abroad at inception. The hospital recruits and trains its own personnel in different medical fields to serve its purpose. Apart from medical doctors who have to present their academic certificates before they could be employed in the hospital, WAEC holders are recruited and trained in different medical fields and deployed appropriately.
Friday Achenje, a medical record, as well as monitoring and evaluation officer, who has put in 25 years in the hospital, said he could also work in all sections of the facility. “The condition of service is fair because we enjoy free accommodation, light and water here,” Mr. Acheneje told our reporter.
Daily Trust on Sunday noticed that the hospital accommodates all its personnel within the facility.
According to Mrs. Wheeler, the motivation for the establishment of the hospital is physical and spiritual healing. “The aim is to win souls by treating their illnesses while also preaching the gospel of Jesus Christ,” she noted. She said the hospital was for general OPD even at inception. “I learnt that with the rampart cases of leprosy, the hospital also takes on its treatment but it was later phased out when the federal government stepped in,” she explained.
She said the treatment of tuberculosis, which the hospital has come to be synonymous with, came later. “We continued with the treatment of tuberculosis because there seems to be nowhere around where such cases could be excellently handled,” she stated.
It was observed that virtually all the structures on ground were as old as the hospital, except Ibro Hall, which was donated by the administration of the former Kogi State governor, Alhaji Ibrahim Idris, and the hostel-like buildings, which house the patients. The older structures were built with mud blocks and maintained over the years. The facility, which serves about four local government areas of the state and many other communities in the nieghbouring Benue State, has been overstretched.
The situation is compounded by the fact that patients come from all parts of the country as information of its efficiency in handling the disease spreads. It was further observed that the hospital is being run on a generator due to the non-availability of electricity. The road linking the hospital to the outside world is also in a bad shape.
“If it rains, nobody would go out or come into the community in a vehicle,’’ a resident, Saibu Madaki said.
Our reporter learnt that contract for the construction of the road was awarded by former Governor Ibrahim Idris at the sum of N2 billion, but it was abandoned.
“The story we are getting is that the road was constructed, but as you can see, it was graded midway and abandoned,” Madaki said. 
The hospital also dug boreholes for its water needs. Mrs. Wheeler admitted that the challenges of providing quality and affordable health care to the people in so many communities by a private establishment such as the mission hospital were enormous. However, she did not rule out the possibility of assistance, especially from the government.
“Doing the road is out of our reach. And we cannot do more than we are doing now in terms of power. We don’t mind an intervention in those areas and other infrastructure that would aid our services,” Mrs. Wheeler stated.
Apart from the hospital project, Daily Trust on Sunday learnt that the Dibbles also translated the bible into the Igala language. Many books have also been written in the language. An educationist, Francis Omede, said the contributions of the Dibbles to education in Igala land could not be quantified.