Cassandra Akinde is a public health physician, a Chevening Alumna and the Executive Director of The Neo Child Initiative for Africa (TNCI). She recently won The Future Award Africa Prize for Health and Wellness 2022. In this interview by Kingsley Alumona, she speaks about her medical and humanitarian works, the Nigerian health care challenges and how she would minimise medical tourism if she were the president of Nigeria, among others.
Tell us about your work as a medical doctor?
I am a public health physician with interests in infectious disease epidemiology and surveillance, policy advocacy, implementation research and health system development. I have over six years of experience in the implementation of community-based projects and providing health policy-oriented solutions for underserved communities in Nigeria.
Where do you currently work, and what is your rank/position there?
I currently work as a research coordinator with the Henry Jackson Medical Research International (HJFMRI) on a WRAIR/IAVI Lassa seroprevalence study (EID023), a Nigerian component of the CEPI-funded Phase II Lassa Fever Vaccine Efficacy and Prevention for West Africa Consortium (LEAP4WA). We are concluding the study protocol implementation across the sites in Nigeria.
I also serve as the Executive Director for The Neo Child Initiative for Africa (TNCI), a non-profit organisation focused on combating health disparities in children living in underserved communities in Nigeria. We are currently partnering with Alive &Thrive/FHI360 to scale up programmes that improve maternal, infant and young child (MIYCN) nutrition practices across seven states in Nigeria.
Which area of medicine do you specialise in? And, is there a reason you choose to major in this area?
I am currently working in the nexus of preventive medicine and epidemiology. I chose this field because I am passionate about ending preventable diseases, promoting health equity, and improving population health outcomes.
Your profile says that part of your work involves medical research. Which area(s) of medical research do you specialise in?
I am trained in infectious disease epidemiology and have an extensive experience with infectious diseases such as HIV/AIDS, malaria, tuberculosis, vaccine-preventable diseases such as tetanus, diphtheria and pneumonia, viral hemorrhagic diseases including Ebola and Lassa, as well as neglected tropical diseases such as scabies, trachoma and soil-transmitted helminths.
I am currently working on a Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) project with the London School of Hygiene and Tropical Medicine (LSHTM). I am also working on an impact evaluation of Water Sanitation and Hygiene Education Against Diarrhea, Undernutrition and Pneumonia (WASHED-UP) campaign in primary schools in Nigeria with Costello Medical UK and TNCI.
How would you describe/rank the Nigerian health sector under the current Federal Government?
I would say that despite the Federal Government`s best efforts, the Nigerian health sector is still not performing adequately. It is grossly underfunded; there is dilapidated infrastructure, a mass exodus of the health workforce to greener pastures, and the majority of the people are unable to access quality healthcare.
The latest World Health Organisation (WHO) survey ranks Nigeria’s healthcare system as the fourth worst in the world. The government must explore innovative ways of addressing healthcare delivery in a manner that focuses on partnership between states, the private sector, and the huge talent of Nigerian health professionals in the diaspora to rehabilitate the dying health sector.
There is a bill at the National Assembly, which has passed the second reading, seeking to mandate medical doctors to practice for five years before granting them full licence. What are your thoughts on this?
Well, it is very unfortunate to see that despite the best intentions of the lawmakers, they still don`t understand the true picture of what is happening to Nigerian doctors. The brain drain is a critical problem that requires immediate attention. Unless the ‘push factors’ for medical doctors and other healthcare workers, such as higher remuneration/welfare package, improved conditions of service, better quality of life and job security are addressed, retaining healthcare experts will remain a challenge. The solution is not to impose a draconian law of modern slavery but to find ways to incentivise doctors to remain in Nigeria.
In addition, there are opportunities to leverage on the diaspora network by implementing policies that lead to brain gain with doctors in the diaspora playing an active role in improving the health sector in Nigeria.
If you were the president of Nigeria, what would you do to stop or minimise medical tourism among the political/elite class?
If I were the president of Nigeria, I would reverse medical tourism in the following ways: 1) Invest in health infrastructure and upgrading of primary, secondary, and tertiary healthcare facilities. 2) Improve remuneration/welfare packages for healthcare workers. 3) Increase recruitment of healthcare workers in rural and urban areas. 4) Improve the conditions of service and security of health personnel. 5) Ensure career progression and professional development opportunities for all cadres of healthcare workers. 6) Equip facilities, such as research institutes, dialysis centres, cancer treatment and diagnostic centres with modern equipment and tools.
Others include: 7) Optimise universal health insurance packages for healthcare workers and for their families. 8) Leverage on telemedicine to improve access to healthcare in remote areas. 9) Implement policies and penalties to ensure political leaders and public office holders do not use public money to fund their medical treatment or that of their families abroad. I would lead by example by seeking healthcare in public and private Nigerian hospitals. 10) Encourage diaspora networks to return and provide them with high-earning consultation fees as expatriates, welfare packages, better quality of life and health insurance for their families, and subsidised school fees for their children.
You have considerable years of medical experience and even a master’s degree in Tropical Medicine and International Health. Have you thought of working as a doctor in the United Kingdom where you studied or elsewhere where you would be paid well?
Yes, I have thought about this long and hard. To be honest, I am quite happy with my current work and remuneration as a public health physician. Besides, my work involves conducting primary research, obtaining relevant data, and strategically using these data to propose and implement disease control and prevention programmes in low- and middle-income countries. These are some of the hands-on skills I learnt during my master’s degree, and I am now applying them effectively in my community.
The work I currently do is impact-driven and very fulfilling for me as an aspiring global health leader. My primary focus right now is on gaining enough professional public health and applied field experience to enable me to provide expert services in the near future with a global mindset and with relevant local context to it.
Tell us about your engagement and position at The Neo Child Initiative for Africa (TNCI).
TNCI is a volunteer-driven non-profit organisation with a core focus on child health promotion and education for sustainable development. TNCI exists because we are passionate about ensuring that every Nigerian child, regardless of social strata, religion or ethnicity, can live up to their full potential and lead extraordinary lives. We want to empower every child with sound health, a strong value system, and the mentorship they need to become change agents in their schools, homes, and communities.
TNCI is deeply committed to combating health disparities among children. From health initiatives such as StopPneumonia, EndTetanus to ReachOut, the goal remains the same: to ensure that every Nigerian child has access to quality primary healthcare services and health education in schools and communities through the implementation of community health-based projects and awareness campaigns targeting the most underserved communities.
In this position, my organisation has reached out to over 20,000 children with essential healthcare services such as nutritional assessments, malaria screening, immunisation, deworming, free medical and dental checkups, and provision of essential drugs.
Tell us how you came to be a Chevening Alumni.
In 2019, a friend informed me about the Chevening Scholarship and how I was an ideal candidate for it, for all the humanitarian work I have been engaging in. I researched it online, applied for it, and got the scholarship to pursue my Master`s at my dream school, the London School of Hygiene and Tropical Medicine (LSHTM) in the UK.
Since then, my life has never been the same. I have been privileged to be part of an amazing network of Chevening alumni who are crème de la crème of society and privy to limitless professional development opportunities and research grants.
Where do you see yourself in five years?
In the next five years, I plan to pursue a doctorate in public health, and to set up a consulting firm.
Tell us about your social life and how you manage the stress from work.
My social life is quite active. I am very fortunate to have a strong support network of loved ones, friends, mentors, and well-wishers with whom I regularly keep in contact and who support me unconditionally. To relieve stress, I practice self-care, meditation, and yoga.
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