The current naira scarcity, occasioned by the currency swap policy of the Central Bank of Nigeria (CBN), is taking a toll on healthcare services across the country.
Patients are increasingly denied access to care at health facilities as many of the facilities operate mainly cash-only systems or have poor e-payment systems. These facilities turn down transfers, insisting on cash payments before attending to patients.
Investigations by Daily Trust on Sunday revealed that as a result of these, many of the patients die at home or the facilities, or get worse while waiting to get cash to pay and access care.
Our reporters gathered that even at health facilities that operate e-payments systems, the absence of the alternative of cash payments due to naira scarcity had led to such long queues and network issues that patients get worse or are denied care all together.
Pregnant woman dies over naira scarcity
It was a bitter experience for the family of James Auta, a resident of Kasuwar Magani in Kajuru Local Government Area of Kaduna State, who lost his pregnant wife due to failure to access cash in his bank and Point of Sale (POS) channels.
The incident happened early this month after Auta’s wife went into labour but was rejected, simply because her husband couldn’t make payment due to naira scarcity.
Daily Trust on Sunday gathered that the woman died at home after giving birth but continued to bleed.
The incident caused concerns across the state as patients and their family members found it difficult to make payments to access treatments due to the naira shortage.
Findings revealed that some patients face rejection in some hospitals for lack of cash.
Auwal Sani, whose younger brother was admitted at a private hospital at the Kudenda area of Kaduna said, “We face the same situation as hospital staff refuse to accept transfer; they prefer cash, which we don’t have. However, they now allow us to make cash transfer since naira is scarce.”
To mitigate the present challenges, the Kaduna State Government, through the Internal Revenue Service (KADIRS), directed all public hospitals to accept electronic transfer for all payments.
In his reaction, the executive chairman of the Kaduna State Internal Revenue Service, Dr Ziad Abubakar noted that the state had already abolished cash payments.
“Before the currency swap, the Kaduna State Government had abolished cash payments, pursuant to section 51 of the Kaduna State Tax Codification and Consolidation Law, 2020. So, there is no justification for public hospitals to reject electronic cash transfers,’’ he said.
He acknowledged that ‘’the currency swap of the federal government has brought a lot of challenges to all the sectors of Nigeria’s economy.’’
He, however, said that in spite of the present situation, electronic cash transfer remained the only option of payment in public hospitals in the state going by the Tax Codification Law.
The commissioner for health in the state, Amina Baloni, could not be reached as her phone line failed to connect.
Emergency cases abandoned in Abuja
Uche’s younger brother slumped due to extremely low sugar level despite that he was rushed to one of the tertiary public hospitals in Abuja.
He narrated that the emergency unit of the hospital was almost empty.
“There were very few patients as the medical practitioners were only willing to attend to patients that had already made payments.
“I was asked to make payment before medical attention would be given to my brother. On getting to the cash point, they made it clear that they were not receiving transfers.
“They had four POS machines but none of them was working. They rejected all bank cards as there was no service. So, we were told that the hospital would only take cash. And I didn’t have any cash on me because of the naira scarcity.
“It was at that point that one of the nurses confided in us that the hospital lost a patient because his family members couldn’t make cash payments for him to be treated.
“Looking around, I saw other families looking as if all hope had been lost as they were yet to access cash to pay for their relatives in need of emergency care.
“We had to leave the hospital and rush to the bureau de change at Wuse Zone 3, where I luckily got enough cash to take to the hospital and pay so that they would start treating my brother that night,” he narrated.
Daily Trust on Sunday learnt that Uche’s experience is one among many across public and private hospitals in Abuja since the naira scarcity started. Many lives have been put at risk.
Another caregiver identified as Bose also narrated her experience when she took her sick mother to a hospital.
She said, “We only had N1, 000 cash on us, which we used for transportation during the first lap of the journey. The last lap was N500 and we didn’t have the money. The drivers we approached insisted on cash. They refused to allow me transfer money to them. So we had to trek to the hospital. Getting there, the hospital’s POS was not working and they said no transfer. They said they were yet to receive transfers some people claimed to have made some days earlier. We sat there waiting before network was restored. And by then, my mother was getting weak.
“This whole thing is like punishment. Why would cash be scarce and POS and transfer would become more difficult too? Thank God that my mother was treated and we had to call and beg a friend to take us home.”
Patients, caregivers decry hardship in Borno
When Daily Trust on Sunday visited some hospitals in Maiduguri, the Borno State capital, the situation was also tense as many patients and caregivers complained about slow services due to cash scarcity.
It was learnt that the payment system at the University of Maiduguri Teaching Hospital (UMTH) is centralised, so transactions were made in cash or into the hospital’s account, using POS. However, patients are facing hardship due to scarcity of naira.
“We were not given prescribed drugs by the pharmacy until we paid in cash. This kept many patients stranded,” a patient who preferred not to be identified said.
Another patient, Aisha Kaomi, said the cash crunch was having effects on patients, caregivers and services rendered.
“Since I was rushed to this hospital 19 days ago, my husband always covers a long distance to visit me twice every day (from Abuja Talakawa to UMTH). He passes through a lot of pains.
“It has brought unbearable pain to us as a family. My husband queued at the ATM yesterday but couldn’t get money to buy some drugs prescribed for me.
Today, he left the hospital at 4am to the bank but he is not yet back as I am talking to you now at 12:40pm,” she said.
She appealed to the federal government to make money available to the people so that patients would be properly attended to.
Another patient on admission, Raheem Abdullahi said, “We are suffering; government should look into our plight. Many people don’t have cash to pay Keke Napep operators or medicine stores, and they don’t accept transfers due to bad network.
“If you go to the ATMs in Maiduguri you would see thousands of people queuing under the scotching sun. We are begging the CBN to look into our situation and show some mercy. We can’t get our drugs and basic needs.
“We stay in long queues to get cash; and POS machines occasionally fail or decline transaction but would debit you.
“A man was lamenting that a POS issued a declined message. And it was the only money he had and wanted to buy the drugs prescribed for his child. Now, nobody knows where the man would find money to treat his child. This is a very pathetic situation.”
Poor e-payment system in Kano
In Kano, majority of the hospitals operate an analogue system of collecting cash for consultancy, medical bills or other charges.
Daily Trust on Sunday reports that the present naira crunch has subjected many patients, including those on admission, to difficulties as most hospitals only collect cash.
When our correspondent went round some of the hospitals, they were congested, with people narrating divergent scenarios and experiences.
A patient, Musa Saidu, said he went to the hospital by 6:00am but could not see a doctor because of cash scarcity.
“Network has been the major issue here. They have POS but there is no network; and I don’t have cash to pay. I am in pain right now, but I have no option than to go back home. I watch people passing me on the queue because they have cash,” he lamented.
A caregiver to a patient who was on a wheelchair said she suffered a lot because they were out of cash until someone helped them.
“She is battling with diabetes and it has been a long time since we came here. The hospital we are attending is far and we are not sure they would accept e-payment; and her condition is worsening. If not that someone pitied her situation, anything could happen; but we thank God. What remains for us now is to see the doctor,” she said.
At the Abubakar Imam Urology Hospital, patients were seen battling with cash issues as the facility was not using any banking system
Daily Trust on Sunday, however, learnt that the hospital rushed to open an account in Polaris Bank for people to deposit but there were challenges.
“It is not easy for us here because we never used a bank account; we collect cash. But seeing the difficulties people went into last week, the management of the hospital brought one account, yet people are suffering. The network problem is the major obstacle now,” the staff member who craved anonymity said.
At Sir Sunusi Hospital, a patient narrated how a woman almost gave birth on a bare floor and her family had to rush her back home.
“They came here last week but did not have money to pay for hospital charges. They were waiting for someone to bring cash but he didn’t get it. When she started showing symptoms of delivery to the extent that blood started coming out, they quietly rushed her back home.
“Many incidents similar to this had happened on that day but they don’t want anyone to know. In fact, it was said that one of the patients died here,” a patient who came for the second time in the midst of the crisis, Hassana Ibrahim, said.
A senior administrative officer in the Aminu Kano Teaching Hospital, who asked not to be named, said, “I am not authorised to talk about this, but the situation is almost the same everywhere. We don’t have a sustainable and reliable e-payment system. Honestly, people are suffering.”
Efforts to get government officials speak on the situation were not successful as the commissioner for health in the state, Dr Aminu Ibrahim Tsanyawa, did not respond to calls and text message by our correspondent at the time of filing this report.
Similarly, findings revealed that a number of health facilities in Lagos turn down cash transfers and insist on cash before attending to patients.
A nurse at the Oko Awo Youth-friendly Healthcare Centre, located at Lagos Island West Local Government Area, Catherine Chinyere, said the naira scarcity led to a reduction in the influx of patients.
Another nurse at Onilekere Primary Healthcare Centre, Ikeja, Nnenna Oparajiaku, confirmed that patients who did not stay far from the facility were still accessing their services.
“Patients still walk in here to be attended to, irrespective of the naira scarcity. But we are no longer recording many new patients at our antenatal clinics. We are only seeing old patients,” she said.
A nursing mother identified as Rose, who visited the health centre for immunisation, said she had been well attended to.
Many rural dwellers denied care in Bayelsa
Although no patient has lost his/her life in Bayelsa State due to the current naira scarcity in the country, the crisis has dealt a big blow to healthcare services.
The worst affected are those in rural areas, especially during emergencies, as online banking is not prominent in rural settings.
When Daily Trust on Sunday visited the Federal Medical Centre (FMC) and the Bayelsa Specialist Hospital in Yenagoa, only few patients were seen in most of the wards, unlike what obtained before the naira scarcity.
It was gathered that as a result of this, most people prefer treating their ailments at home through traditional methods.