Health

It touched our hearts when you see people who have had hernia for 15 years —Olaitan, CMD, UTH

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2 years ago

Professor Peter Olaitan is the Chief Medical Director, University of Osun Teaching Hospital, Osogbo, and the chairman, Imole Medical and Surgical Outreach in Osun State. In this interview with SADE OGUNTOLA, he speaks about the push to get surgical care to the grassroots in the state, challenges in the health sector and how best to tackle them. Excerpts:

T HE Imole medical and surgical programme has been providing health services to people across Osun State in recent times. What informed the decision for the programme?

The Imole medical and surgical programme is an initiative that Governor Ademola Adeleke of Osun State bought into, because he wanted to touch the lives of people in his state, especially in the area of health. The Adeleke family has a history of helping people with health needs.

Governor Adeleke, in his celebration of 100 days in office, set up a 10-man committee, which I headed, to draw up a plan for the programme to have outreaches across the communities in the state. Until now, there had been few medical and surgical outreaches like this in the state, with say about 100 beneficiaries. Some also gave away free reading glasses.

But, with a lot of specialist doctors and over 150 registrars that give specialist care in the teaching hospital, in conjunction with many principal medical officers and other health workers who are operating in general hospitals across Osun State, I thought we could do far more than this, since they could be part of this programme.

At the outset, the plan was to have at least one centre in each of the nine federal constituencies in the state. That was what we started with, though at the end of the first phase, we added Ejigbo as the 10th location.

The full involvement of health workers at the secondary healthcare level alongside the team created a good environment for us to work in and a sense of ownership of the programme at every place we went.

That was how we started and the government was able to sponsor and make available the logistics, the consumables and a little stipend for the professionals and all supporting members of the team. Usually, we spent two days in every federal constituency for the surgeries; usually this is Wednesday and Thursday. By Friday, we go back for post-surgery care and complaints are taken. Complaints that cannot be handled by the physicians are then referred to our teaching hospital.

Of course, there is always a waiting ambulance for moving emergency cases immediately to our teaching hospital, where we have more staff and more facilities when it is required to do so in the course of the exercise. An example was the case of a small boy who is less than two years old in Ikirun, who just stopped breathing immediately after we started his surgery. We brought him to the teaching hospital and he was admitted into the intensive care unit. By the following morning, the child started breathing by himself and went home successfully without any problems.

What conditions were attended to during the medical outreach?

For surgeries, we considered cases that after surgery, they can go back home after two to three hours and do not need to be admitted to the hospital. These include hernia, hydrocele, lipoma, and other swellings on the body. For the eye, we limit it to cataracts and pterygium, as well as the dispensing of reading glasses.

Major medical conditions attended to included malaria, typhoid, hypertension, diabetes, epilepsy, and worms. They were all given free medications. Of course, there were screenings for different conditions, including HIV, hypertension and diabetes. In fact, a lot of people were finding out for the first time that they had hypertension during the programme and were advised to take medications and follow up on their blood pressure. While the most common surgeries in children were for hydrocele and hernia, in adults there were hernia, hydrocele, glaucoma, breast lumps, and swellings like fibroma.

Acceptance of the free medical and surgical intervention by the community was awesome. People trooped out and were grateful to the governor. When we started, it was just the local people that turned up. But subsequently, they started to call others to come and benefit. People came from different states, including Ondo, Benue, Nasarawa, Kaduna, and Lagos, who were indigenes of the state.

For instance, the man from Nasarawa had hernia and couldn’t afford the surgery, so he was called immediately the programme started and he had the surgery done. We also operated on some Hausa and Igbo residents in Osun State.

Truly, the Imole medical and surgical programme had been unprecedented. I actually looked through history in the state; there has not been any massive, comprehensive medical outreach like it that has been documented. We thought we would have 2,000 people in each constituency, making 18,000 people. But we ended up treating about 22,000 people in the first phase. The second phase was even more. We had about 50,000 for both the first phase and the second phase.

I was surprised by the increasing number of patients, but we found out that those that we could not attend to during the two-day surgical operation at a location followed us to our next location. As they were doing this, they were also inviting people to come for free medical and surgical services.

It was massive and impressive. It touched our hearts when we saw people who had had hernias for 15 years. Some had scrotum so big that it reached their knees, and some had the entire contents of their abdomen now housed in their scrotum. Within one hour, the problem is corrected surgically and they were happy.

Many times, some of these problems cannot be avoided with ageing. For instance, with age, a man’s prostate gets bigger as he strains to pass urine. But what is important is how fast we are able to attend to them. I realised in the course of this programme that many of them actually wanted to be attended to, but there was no money to pay for the treatment. Many of these people can benefit from health insurance.

Has this free medical and surgical outreach come to stay, or will it be a one-off?

Governor Adeleke has said it is not going to be a one-off thing. Already, we have had two episodes of it. The governor still hopes to have another one before the end of the year. He is planning to hold it every quarter. However, if you look at the cases we attended to critically, these were cases that one would expect to have been taken care of at the secondary healthcare level. As such, Governor Adeleke is also working on improving the state of things at the secondary healthcare level and if that happens over time, this might tail off as the secondary healthcare level takes up the responsibility that should be primarily theirs in the first instance.

Emigration of health workers is a big issue in Nigeria; has this affected the Imole medical and surgical programme?

Definitely; I wouldn’t say it has not. Looking at the secondary healthcare level, the number of workers is not as high as you would expect, because a lot of health workers have emigrated. Governor Adeleke has tried to reduce internal brain drain, which is health workers moving away from one place to another within Nigeria, by making their pay and allowances at par with health workers in Federal Government’s establishments. He just approved the same nursing entry point as that of the Federal Government teaching hospitals. Some of these steps taken by Governor Adeleke actually stabilised us a little. But this has not kept health workers from going to work outside Nigeria. It is a major problem that has affected every hospital in Nigeria. In the last two to three years, our teaching hospitals have lost over 200 staff members due to the Japa syndrome.

But the good thing about it is that Governor Adeleke has approved that they should be replaced as they go. However, we have a challenge here; we are replacing very experienced people with inexperienced ones who are just graduating. This will certainly affect the quality of healthcare that can be delivered. That is why the Federal Government needs to reduce the emigration of health workers. If this trend continues, in the next few years, our hospitals will be in trouble.

Imagine, at different forums, you read about different teaching hospitals calling and advertising for doctors for residency training and there is none, despite the fact that the conditions of recruiting them have been greatly lowered. It is a major problem.

But in the last few months, I think we are lucky because some of these steps taken by Governor Adeleke have actually stabilised us a little.

A circular recently released by the Federal Government calls for retired health workers to take on jobs on a contract basis to fill the gap. How do you see that solving the problem?

This is not a permanent solution. The Federal Government needs to rethink the retirement age of health workers. Why can’t we bring health workers’ retirement age to 70, rather than say those who retired should come back on a contract basis? Remember, many of them, as they retire, also emigrate for many reasons, including going abroad to live with their children. So, this solution is not going to be long-lasting; we should think of a better way to address the issue than this.

Medicine is evolving. Does the hospital have plans to be at par with older hospitals in Nigeria?

In the last few years, we have had a lot of challenges concerning finance. But the current government is trying its best to ensure that the service at our teaching hospital improves. We don’t turn patients back; we try to ensure that every emergency is attended to, even when the patient doesn’t have the money by giving them a waiver to start with. Our Itunu fund also helps indigent patients who cannot afford care. In the next couple of years, we are looking at including other services like the in-vitro fertilisation (IVF) centre, the kidney transplantation centre and laparoscopic and endoscopic surgeries for the teeming population in the state and we intend to explore the PPP arrangement to do this. Today, there is no public hospital that provides infertility care in Osun State and the available private hospitals offer services at very exorbitant prices.

So, what will be your advice to ensure that Nigerians stay healthy?

Health education for Nigerians is very important. People need to know that they have to undergo a regular medical checkup or routine screening. Somebody will brag that in the last 15 years, they have never visited a hospital. Fortunately, many deaths are actually preventable this way. Exercise and eating healthy are also important. One’s food choices determine a lot of things, including the disease that may end up in one’s death.

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