I have always had some brain waves about what service delivery mean to different people and what influence the “deliverers” and the “receivers”. Looking inside-out, my thought is, “are there specific things that make a person deliver good service to the others?” Your guess might be as good as mine. Although, I agree that most customer service oriented persons have more innate than acquired characteristics. I also wonder if good service delivery is determined/influenced by race or genes. There are instances where it is said that a group of people are somewhat more polite than the others. e.g., it is common knowledge that the average british man would do his utmost to stay polite even as he locks you behind bars.
Alas, I am of the school of thought that service delivery just like many other individual actions have very many strong influences from external factors that are well captured by the PESTEL environments. This would explain why a taxi driver in Singapore is as polite as the Executive in his highbrow office. It might also explain why the average Somali in the recent past would charge at any foreign vessel navigating their territorial waters.
Imagine scenario below where a patient with the regular symptons of malaria got the rudest shock of her life in what started as a routine check and conversation with her physician:
Doctor: with what I see, you might be needing further tests.
Patient: Really? In the meantime, is there anything you can do to relieve my excrutiating pain?
Doctor: I am afraid not. You must bring XXX naira before any treatment
Patient: Doctor, abeg do something while my family go get the money
Doctor: Oh please, go and get the money first , several other patients are waiting
with so much pains, tears in her eyes, a 10 month old baby to tend to, she resigned to fate. Several hours later, family returns, goes through a long bureaucracy for payment, tellers, cashiers, receipts, dockets and some special lexicons, with a bit of relief and a dying patient, below excerpts ensued.
Family: Sir, we’ve paid for all and are now ready for the test and treatment
Doctor: Ok, what do you expect me to do? (with absolute non-challance)
Family: Kindly give us the prescriptions for the laboratory
Doctor: Don’t you have a watch? I am done for the day, you may please come tomorrow
Ouch! that did sound like a knell. All pleas fell to deaf ears. With no time to waste, they tried other hospitals around, they either have no power or no equipment. With the usual Nigerian God factor, she survived a long harrowing night just outside the Doctor’s office.
She would be the first patient to be attended to we had hoped. The Doctor resumed rather late and his look scolded everyone present in rather loud silence wondering if we were still there. In unison, everyone chorused, “welcome Doctor”. With a wave of hand, he gestured “I’ll be right back”. True to his words, he came back 90mins later, “I am afraid the equipment is not working and there are no supplies”. He however, was kind enough to refer us to another hospital in Sagamu which is 2 hours away.
After a successful test, the initial “malaria” symptom was diagnosed as total renal failure. Her kidneys were totally gone. She would need quick dialysis if she’s to stand a chance. Further grope for funds, a few documentation and pawing of signatures, the first dialysis section was done. With some hanging relief, she came back home to a short-lived embrace of her little babies and family.
Few days later, some bloating face, legs and nagging pains were clear indications of the need for yet another session of dialysis. With finances thinning out for a very humble family and limited support from acquaintances, stronger determination and the quest for survival squeezed out required funds for yet another session of dialysis.
Coming back for the regular rituals after yet another bout with the painful indicators, the facility in Sagamu also got jinxed. She was referred to the Federal Medical Center in Abeokuta. That would be her albatross. An overstretched facility, not necessarily affordable to the average citizen of , plenty run around, so much paper work, yet some more paper work and even more paper work. While the family members were struggling to conquer the herculean red tapes, Tolani was lying in the congested open office, without any care or potential show of same. Pleas of prompt attention fell into deaf ears while she wriggled with nagging pains.
Two Nurses on duty were engrossed in their world discussing consummate details of their boyfriends and the wish for a repeat of the previous weekend’s escapade in the starting weekend. Intermittent “thank God it’s friday” was their tunes as they took turns to take pictures with their blackberry phones and making choices of which of their pictures breasts the tape for the best DP. All of these while Tolani’s soul was fading away. Her plea for pain killers met no consent.
It was about 5pm when the whole paper work was concluded. As the husband returned with some sense of relief, he presented the papers to the nurses and hoped the session would start in ernest. Alas! the Nurses like two agents from the pit of hell advised them to bring Tolani on Monday as it was too late to carry out dialysis as they are closed for the day. Out of desperation and determination to live, Tolani pulled together whatever is left of her strength and holding power to plead with them. It did not yield any much sympathy. She would later say to them, “unless you both do not want to live to cater for your children just like the fate you are about to hand me, them you may not carry out this session”. Wow! that seemed to have worked.
They would later carry out this session but a bit too late. Tolani died on the 27th of June after just 3 weeks struggle with kidney failure. Tolani struggled more with poor healthcare and facilities, inhumane environment and treatment, lack of regard for life and living, money before life and I dare say the total lack of care for the people by our government. As if the challenges she had in life was not enough, the handling of human remains with arrant lack of respect by our public health officials would make even the devil weep. Handling of the dead is better imagined; that is a discussion for another time. Well, Tolani has since been buried according to islamic rites. May her soul rest.
In contrast, I have a son with congenital anomalies including renal problems, although the situation can be emotional, traumatic, financially draining and sometimes gloomy, the least of your worries would be the care he gets from the health practitioners. Of course, while some of the health practitioners are Nigerians and Africans, their attitude and professionalism are miles apart. In case you are wondering, that hospital is not within our space.
The case of OJB Jezreel the prolific music producer comes to mind. Was the drama necessary if he was in a sane society? A case of a citizen struggling for his own life when it’s not a war zone. What is the essence of government and governance if not to serve and care for their citizenry? I wish him strength and GOODLUCK.
Some challenges are totally inevitable. Often times they are even beyond our controls and many times they are inexplicable. The million dollar question is, “DOES IT REALLY HURT TO BE KIND, DELIVER GOOD SERVICE AND RESPECT LIFE?” Courtesy costs nothing but gives much more. I very much believe that if treated differently, maybe Tolani will still be here with us or at least happier even in her passing.
...Killed or Dead?
The BIG question, was Tolani dead or killed? Did she die of natural courses or killed by an inhumane system with no respect for life? Did she die at her own time or forced to death by human agents of death encourage by a comatose health system lacking every form of monitoring and control? Is it possible Tolani could still be around if mother nature did not bequeath her the misfortune of being born in callous society? Who knows maybe Tolani would still be around to be the mother of AbdulSamod and Sophiat if she lived in God’s own country? Maybe she would find rest in the warm embrace of her husband and home rather than 6ft below. May karma grant our health officials, callous society and comatose system the fortitude to bear this underserving loss.
This piece is in loving memory of Tolani Ifenuga – my sister in-law and all those struggling to live and many other lives cut short through the misfortune of birth, inhumane people and systems. Until the next time, let us learn to love as we find, aim and shoot at whatever life brings our way.
- Rural dialysis clinics could face closure under budget cuts (nebraskaradionetwork.com)
- The frequency and duration of patient-doctor contact during dialysis care key to patients’ health (medicalnewstoday.com)
- Up to ten years for a new kidney in B.C.? This Surrey man may turn to India for transplant (vancouverdesi.com)