8 years after their one-month old baby, Kehinde Babalola, had her arm amputated following bungled treatment, an Ibadan-based family tackles the venerable University College Hospital (UCH), Ibadan in the courts in their quest for justice. Steve Aborisade reports.
It was May 3, 2004, a day that Alfa Ahmed Babalola would record as one of the happiest in his life. That was the day he christened his two bundles of joy – Taiye and Kehinde. It’s not every day a man is blessed with a set of twins! A week earlier, his wife, Hajia Muyimat Babalola had given birth to the two perfectly formed girls and he was particularly happy that virtually everyone who saw the tiny tots remarked that they were his split image. The reality that he was now a father was overpowering, and as he celebrated with family and friends, he was looking forward to fatherhood with great expectations.
But life has its twists and turns and, sometimes, it’s doesn’t go the way we want. Just as Babalola was settling down to his new role as a father, like a pack of dominos, his world came crashing down in the twinkle of an eye. Barely three weeks after the naming ceremony, on May 22, one of the girls, Baby Taiye, died after a brief illness. As if that wasn’t enough, just four days later, on May 26, one-month old Baby Kehinde also became ill. She was immediately rushed to the University College Hospital (UCH), Ibadan, with the hope that being the foremost medical facility in town, she would get the best of treatment and attention.
Baby Kehinde was admitted in the 2nd paediatric ward CI on account of diarrhoea-related symptoms that same day. The mother was, naturally, hysterical – crying and pleading with medical personnel to help save the life of her only remaining daughter. If only she knew that the tragedy in her household was about to take a more sinister turn. She recalls, “We got to UCH around 4pm that day, and by the time my baby’s admission was perfected, it was already night. They placed her on drip. I was told I couldn’t stay with her; that I should go home. I thought it was because I was already distraught.” So she went home.
Alas, in the course of treatment, a tourniquet that was tied on Kehinde’s arm to facilitate the fixing of an infusion was forgotten on the arm overnight! The mother laments, “If I had known what would happen to my baby, I would have insisted on staying with her.“I was the one that discovered the tourniquet on my baby’s arm the next day. I noticed she was in great pain, and showed discomfort when I got close to her right arm. I was alarmed when I saw her hand reddened and swollen, and the tourniquet still firmly clasped in place! “
I screamed, and that attracted their attention. When the doctor that rushed to examine my baby saw her arm, he was just shaking his head. It was then I knew something bad had happened.” The heartbroken mother continued, “I wept, and became inconsolable.” Hajia Babalola claims that by the third day the condition of Baby Kehinde’s right arm had started deteriorating with massive gangrene infection; and without adequate explanations as regards what went wrong and with no form of counselling offered to the distraught parent. “UCH authorities merely informed the parents that their baby’s arm would have to be amputated,” said Obatunde Oladapo, Executive Director at Positive Life Association of Nigeria (PLAN), a non-governmental organisation. Understandably, the Babalolas were horrified at the very idea of some doctor sawing off their baby’s arm just like that, and so they vehemently resisted initially. It was Oladapo’s PLAN that eventually convinced them of the urgent need to save the child’s life first before engaging the hospital on remedying the wrong it had done. The UCH subsequently amputated the infected arm on or about June 18, 2004, according to reports.
A case of negligence or discrimination?
Why would an institution as reputable as UCH find itself embroiled in this kind of muddle? Lawyer, human rights activist, and HIV/AIDS counsellor, Jumai Danuk, offers a simple explanation: The Babalolas were most probably victims of acts of discrimination by hospital officials on duty that night. The family and other human activists who have been involved in this matter one way or the other echo the same view.
According to reports, the couple are known patients of the HIV/AIDS Clinic of UCH and Oladapo contends that, on sighting them that night, “the general assumption was that their baby too must be HIV-positive; even though they failed to first scientifically determined her true status.” Danuk opines that it was this faulty assumption that made the teaching hospital to erroneously place Baby Kehinde on anti-retroviral therapy (ARV) in May 2004. Indeed Hajia Babalola confirmed that the infant was on this therapy for the first 18 months of her life, adding that the ARV was abruptly discontinued in August 2005 without adequate explanations. She said: “They just told us she would no longer be taking the drugs, and when we sought to find out what informed that decision, they said her case was now good.” Danuk is of the view that what transpired in this case is typical of the prevailing attitude towards HIV/ AIDS and people living with the virus/disease. She insists that questions remain unanswered about the implications of placing someone who is not HIV-positive on ARV. There are also ethical considerations that surround that decision.
Toyin Gbadegesin, of Social and Economic Rights Action Centre (SERAC), a legal aid human rights organisation, is also of the view that a letter dated July 13, 2006, from UCH to the Babalolas further reinforced the institution’s apathy as a result of the baby’s perceived HIV status. The letter titled ‘Case of Alleged Gangrene of the Arm of Baby Kehinde Hassanat Babalola’, according to Gbadegesin, bears testimony to the institution’s unfounded belief that Baby Kehinde was HIV-positive and is responsible for the manner in which she was treated.
In that letter obtained by the NigeriaHIVinfo.com, Gbadegesin drew attention to a section which read, “The patient as you will recall was HIV-Positive but this notwithstanding, the hospital performed its obligation by giving prompt medical attention to her.” According to Gbadegesin, two things can be deduced from the above paragraph. “One is that the statement gave the impression that the UCH was doing Baby Kehinde a favour by attending to her ‘despite her HIV status’, and secondly, their conclusion about her status was never on the basis of sound medical science but on a bizarre and speculative inference that because the parents were HIV-positive, then the child must also be HIV-positive.”
What is the truth about Kehinde Babalola’s HIV status? It is obvious that Oladapo is not ready to give a straight or categorical answer. “The case is pending in court.” And as he adds, “the true status of Kehinde is at the centre of this case, and I will leave it to the courts to determine when we get there.” However, he is of the opinion that that question is better put to UCH authorities to answer. “UCH must definitely have a reason for discontinuing the ARV it placed Kehinde on. On our part, we have conducted several tests at different reputable testing facilities, and we know the results. Kehinde is seven years old now, healthy, and of a sound mind. The only problem she has is the challenge of coming to terms with the fact that she is different from her peers.”
A panel of enquiry
In a letter addressed to the Babalolas and signed by the Professor, A. O. Ilesanmi, UCH Chief Medical Director (CMD), dated July 13, 2006, which was in response to growing agitations of the Babalola camp over the issue, UCH indicated that a panel of inquiry had been established regarding the gangrene infection and amputation of Kehinde’s arm. Till date, however, the Babalolas claim they had neither received any official response regarding the purported panel’s findings nor were they furnished with the panel’s report.
According to Alfa Babalola, The family, PLAN and a representative of the Centre for the Right to Health (CRH) participated in the enquiry meeting that was held at UCH’s Committee Meeting Room. He says: “At the meeting, UCH authorities admitted the culpability of their staff on duty when the incident occurred and further indicated their readiness to compensate the family while putting in place measures that would assist the baby to cope with her permanent disability – especially through quality health care and education. More importantly, the UCH authorities then pledged to ensure that the findings and recommendations of the panel would be made public.”
UCH’s idea of settlement
Four months later, still in line with fulfilling their pledge to compensate the Babalolas, UCH dispatched another letter dated, November 8, 2006, and signed by I.G. Owosekun, Director of Administration and Secretary to the UCH Board. Four key recommendations came out of the Board’s meeting, namely:
- That UCH is prepared to relocate the family to a more conducive environment, by constructing a three bedroom bungalow in a modest area of Ibadan for them.
- That the institution will provide scholarship to Kehinde from nursery to University Bachelors Degree level.
- That the University College Hospital will provide prosthesis for the child.
- UCH will give free treatment for any ailment for the child.
However, the hospital’s offer came with a proviso: that implementation of the above recommendations would be the full and final settlement and that the Babalolas acceptance of the offer should come in writing. This was promptly rejected by the family.
According to Babalola: “It was wrong. They want to be the judge in their own case, not minding the implication of their actions.” This opinion was also shared by PLAN which by this time had invited SERAC for legal guidance. The family was eager that a meeting point would arise, and had actually begun to access UCH educational support for Kehinde. “UCH had contributed approximately N243, 000.00 (Two hundred and forty three thousand naira only), to paying her school fees before we realised that their commitment on the other promises might not hold. And they were not ready to even review their terms of settlement.” Hajia Babalola added, “UCH promised that they would give free treatment to my baby, but when I went back to treat Kehinde, they said I should pay first; that subsequently treatment for her would be free. I drew their attention to the fact that they had offered her free treatment, but they would not budge. I had to pay.”
In Danuk’s view, settlements in circumstances like this need to be properly and clearly defined, specified and legally binding on both parties. “In this instance, this was not the case. UCH drew out terms of settlement that suited them, and they expected compliance of the family, just because they are poor and HIV- positive?” According to Dr. Doyin Odebowale, a university lecturer and legal practitioner, “What the parties should have done was engage the services of an insurance company which will project the cost of education from primary to university level, and again engage a Health Maintenance Organization to project the cost of a life health insurance cover for Kehinde.“These apart,” he continued, “consideration must be given for the emotional pain and suffering that UCH actions have inflicted on the family. It is obvious that the hospital acted negligently and recklessly towards Baby Kehinde and caused irreparable bodily damage to her. This much they have accepted. Furthermore, UCH had subjected Kehinde to unlawful discrimination and untold indignities during and since the incident. It has equally treated her family with utter disrespect and contempt in the quest to understand and ramify what happened to their baby.”
Instituting a lawsuit
Buoyed on by the reality that justice might not come their way, on May 7, 2007, SERAC filed a suit at the Federal High Court, Ibadan, Oyo State, on behalf of the Babalolas to hold UCH accountable for its actions and conduct. According to Gbadegesin, “After the case was filed, the court encouraged that we both settle the matter amicably between ourselves. In fact, it was UCH that initiated settlement out of court. Justice Sharkarho ordered that we should report the settlement to the court periodically.”
In court papers obtained by NigeriaHIVinfo.com, a breakdown in negotiations arose from sharp disagreements by both parties on the extent of liabilities on the part of the hospital. UCH then informed the court that settlement had broken down and that they would prefer the case to go on to trial. The Head of UCH legal unit, Mr. Niyi Ajayi, admits that the out of court settlement negotiations broke down because “the complainants were not satisfied with what we were offering.” However, he insisted that since the case is in court, he would not comment further. “No problem,” Alfa Babalola says. “I want justice for my daughter. I also need to know the circumstances that led to the gangrene infection of the arm of my baby who was barely a month old at the time of the incident. UCH should equally provide my family with an explanation for placing my baby on ARV for over one year without determining if she was HIV-positive or not.”
The court directed on the November 22, 2010, that the parties proceed to trial. However, ever since then, it has been one adjournment or another. Trial is yet to commence, although the next appearance is slated for December 13, 2011.
The battle in court is like two sides of a coin. For the Babalolas it is a cry for justice and, for UCH, it is the battle to salvage its reputation. Will Kehinde and her family get justice? Will the truth of what happened that night be finally revealed? Or will UCH come out of this with its reputation intact or in tatters? Time will tell.