Sickle cell disorder: My frequent trips to the hospital motivated me to study medicine —Dr Muideen Bakare

Dr. Muideen Owolabi Bakare is a Psychiatrist at the Federal Neuropsychiatric Hospital, Enugu State, Nigeria. He also chairs a non-governmental organisation named Childhood Neuropsychiatric Disorders Initiatives that is committed to promoting the physical and mental well-being of children and adolescents in Nigeria and other parts of Africa. In this interview, he shares his experience with Sickle Cell Disorder with Haemoglobin genotype SS with The Sickle Cell Foundation of Nigeria..

 

Can tell us about your family background?

I am the first child of my parents. We are three boys and one girl My immediate younger brother also suffers from Sickle Cell Disorder, but of a milder form in severity with 1-Iaernoglobin SS. That makes two of us with the sickle disorder in the family. As 1 would get to know later, my late dad had Haemoglobin SC while my Mum had Haemoglobin AS. My other brother and sister are free from Sickle Cell Disorder although they are carriers as both of them  are AS.

 

Can  you  tell us your educational background?

I attended Omoyeni Memorial Primary School at Adesola, Orita Aperin, Ibadan while I had my secondary school education at Ibadan Christ Apostolic Grammar School (ICAGS) also at Aperin, Ibadan. I had to stay home after my secondary school education for a period of about three years because I kept missing the cut-off point to study Medicine and Surgery at University of Ibadan by about 3 to 4 points. I eventually  met the cut-off point in 1991 and got admitted to  the College of Medicine, University of Ibadan.

 

When did your parents discover that you have sickle cell disorder and how did it affect your studies?

From what I was told, my parents discovered this when I started having swollen and painful feet at the age of 9 months. Tests carried out subsequently showed that I had the Sickle Cell Disorder. Since then I have been making repeated visits to hospitals on account of one crisis or the other. My primary and secondary education were significantly affected as I was absent from class for up to fifty percent of the school year as a result of hospitalisation arising from crises. However, I had my way of catching up by copying the school notes I missed. Also,  I dedicated most of my time to studying, a strategy that helped me avoid repeating classes.  My first year at Ibadan Christ Apostolic Grammar School witnessed repeated crises and my performance at the end of that year was barely average. My  class  teacher  then,  not  understanding my condition, wrote in my report card “Muideen has a great room for improvement if he can desist from his acts of truancy, that is, absenting himself from school unnecessarily”.

 

 How did your parents react to this?

I did not get a rebuke for  this comment because my parents understood and subsequently the school principal was notified of my condition.

 

 How did your schoolmates relate to you. Did you ever  feel   disadvantaged  or stigmatised?

Sometimes I felt isolated,  a    form  of self- perceived stigma, because  I couldn’t play football with my mates and I could not participate in any of our inter- house  sports  events. I did things slowly and was not very physically active like the others. So, my colleagues nicknamed me ’jeje l’ayegba’, it literally means ’easy  does  it’ in a derogatory way though. I also experienced bullying because I was small for my age and sometimes found it difficult to stand up for myself. I was disadvantaged in other ways too. For lnstance, I was among the most brllliant pupils in my secondary school and could have been made a prefect since one of the key criteria for choosing school prefects in our  final  year was academic performance. However, I feel I never got the opportunity because the school authorities assumed that my small stature would be to my disadvantage

 

 Was there any particular challenge you had while in school?

Sometime during my primary and secondary school days, I developed avascular necrosis at the head of my left femur bone. I started limping and I had to endure chronic pain in my hip. I still have the pains till now. Initially I was placed on anti-inflammatory medication (piroxicam), but over time I adjusted to the pain. I experienced occasional drops in my blood haemoglobin referred to as Packed Cell Volume (PCV). Each time, these episodes are characterised by tiredness and some symptoms that often mimic a state of depression.

 

Why did you insist on studying Medicine?

I insisted on reading Medicine because of my numerous visits to University College Hospital (UCH), Ibadan as a child when I had Sickle Cell Disorder crises and had to go for regular follow- up visits at the Haematology clinic. I was very fascinated by the young men and women I saw in ward coats with stethoscopes hanging around their necks – I got to know that they were medical students/ student doctors. I loved the sight of them and wanted to be like them. So I made up my mind to study Medicine right from my primary school days. Unfortunately, when I finished from secondary school I did not make the JAMB cut-off point for two years! Nevertheless, I decided to see it through to achieve the goal that I had nursed since primary school. I decided to keep trying until I succeeded. Eventually I did gain admission to study Medicine at College of Medicine, University of Ibadan, Nigeria. I graduated from College of Medicine, University of Ibadan in January 1999 after spending a little over seven years for a course that was supposed to be six years. This was essentially due to ASUU strike and the June 12 crisis.

 

 That must have been very tough for you. What did you do after graduating?

After graduating from the College of Medicine in 1995, I did my one year Physician Internship at University College Hospital (UCH), Ibadan After that, I worked briefly as Medical Officer in Paediatrics at Our Lady of Apostles (OLA) Catholic Hospital at Oluyoro, Oke-Ofa in Ibadan before going for the one-year mandatory National Youth Service at the Federal Medical Centre in Lokoja, Kogi State, Nigeria from 2000 to 2001. Upon completion of the service year, I returned to OLA Catholic Hospital and had barely worked for two months when I secured a place to study Psychiatry and  Mental Health at postgraduate level at the Federal Neutopsychiatric Hospital, Calabar, Cross River State, Nigeria. This I completed in 2005 but there was no vacancy for me to start work as a Consultant Psychiatrist until 2007 when I secured an appointment as a Consultant Psychiatrist at the Federal Neuropsychiatric Hospital, Enugu, Enugu State, Nigeria. Since then, I have been involved with clinical practice in mental health, teaching and research that border largely on Maternal and Child Health and Childhood Neurodevelopmental Disorders. I have attended academic conferences in different parts of the world presenting my research findings on the mental health  of  children, adolescents and their parents

 

Why did you decide to specialise in Psychiatry?

My specialisation in Psychiatry and Mental Health can be said to have happened by serenpidity, My desire was to specialise in Haematology, an area that addresses , including siickle cell disorder. disease condition of the blood. However, the first person I talked to about this, an experienced haematologist, discouraged me saying I would not be able to cope and said even if I was successful in the primary  examination for the specialty, she would not take me (she was then  the  Head   of Hematology, Department, College of Medicine, University of Ibadan). She advised me to opt for specialisation in Public Health. I wrote and passed the Primary Examination in Public Health, but I couldn’t find a  vacancy to commence the programme on time. So along the line,  I accompanied a colleague           to an interview for a place in Psychiatry Residency at the Federal Neuropsychiatric Hospital, Calabar. On arrival, I asked if I could participate in the interview even without prior application since I had travelled with my credentials. I was allowed to and  was  offered  a  job  as  a  Junior  Psychiatrist and this was how I came to specialize in the field. Since then I have found it fascinating.

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