Dr Abuchi Okaro
For Dr Abuchi Okaro, the art of saving lives via medical practice is like a calling; something he has come to take as a creed. This outlook underpins his decision – along with two partners – to take his expertise to home soil. The result is a diagnostic and endoscopy centre in Lagos, writes Shaka Momodu
Medicine as a spiritual calling…
Looking back through his medical career, maybe he can look back and say, God has been merciful and it’s been a fulfilling career. Having graduated with a Bachelor of Medicine and Surgery degree (MBBS) from The University of Nigeria, Nsukka, in 1992, Abuchi arrived in the United Kingdom in 1994 to commence his postgraduate training, spending time in centers of excellence such as St Georges, Guy’s and St Thomas’ and The Royal Marsden Hospitals in London. Ten years later, he had bagged a Master’s in Surgery degree (MS) from the prestigious University of London, In addition by 2005 he had completed his training and passed his intercollegiate specialist exams (FRCS General Surgery).
In 2006 he spent 4 months in Tokyo, Japan in the world renowned National Cancer Center doing a fellowship in surgical oncology. Today, he is a registered in the UK as a specialist in General and Gastro-Intestinal (GI) surgery with particular expertise and interest in Upper GI cancer surgery, Laparoscopic anti-reflux (keyhole) and Bariatric (Weight loss) Surgery. And he has recorded some feats to show he is at the top of his game.
While it could be conceded that Abuchi never really practiced in Nigeria before he left for the United Kingdom as a medic, he would have noticed the difference between the two environments. This is especially against the background of the often hyped cold relationship between the patient and the medical personnel. Abuchi said apart from the fact that it is about the training the medical practitioner needs to be focused on the safety and well-being of the patient at all times.
“In a nutshell everything we do has the patient’s wellbeing and safety as the number one priority. This is largely a product of the Training system in the UK which is well organized, audited and importantly backed by the government policies.”
You may say the medical profession runs in the family. His maternal grand-father, both his parents, many of his uncles and, you won’t believe this: two of his brothers are medical doctors. Okaro is a Consultant General/ Laparoscopic/Upper GI surgeon at the Kent Oncology Centre, Maidstone. He has his private practices at the Wellington Hospital of St Johns and St Elizabeth’s in London. Okaro underwent specialized training in upper GI at the Royal Marden and St Thomas’ Hospital in London and at the National Cancer Centre in Tokyo, Japan. He is a fellow of the Royal College of Surgeons of England and holds a Masters in Surgery (MS) Degree from the University of London. His specialist practice interests are in management of benign and malignant upper gastro-intestinal disorders, anti-reflux and bariatric surgery.
Conceiving the new clinic…
Having stayed for such a considerable period of time in training overseas, Abuchi and his two colleagues Austin Obichere and Ayo Oshowo decided to set up their own clinic in Lagos. It is called the Diagnostic and Therapeutic Endoscopy Centre (D&TEC). It is a medical facility that has been purpose designed and equipped as a gastrointestinal tract (GIT) centre of excellence in Nigeria in that the team is trained and experienced in the modern day diagnosis and treatment (management) of GIT problems from the mouth down to the bottom. They offer their patients with the very latest and up to date practices delivered locally to a standard you can expect anywhere in the world. When asked what prompted them to come together in the first place and then set up the centre, Abuchi’s response was crisp and straight to the point.
“We have been colleagues for many years and individually had harbored a desire to return to practice in some form or the other to Nigeria, our collective ambitions, drives, energies and complementary skill sets formed the essential ingredients for the team’s philosophy, determination to succeed, motivation and appetite for hard work.”
The motivations, however, must have been there before deciding to set up the facility in the country. Abuchi concurred; saying that the “The motivations included trying to make a real difference and narrow some of the gaps in healthcare between what’s available locally and that of the developed world. In addition, we are passionate about getting involved in medical education and training of both colleagues.
While admitting that the passion to make a difference in their areas of expertise was an important driving factor for him and his colleagues in the set up of D&TEC, he was keen to point out some of their areas of specialist interest and the services they offer. Broadly put these include diagnostic procedures; such as endoscopy and colonoscopy. D&TEC also offers therapeutic (treatment) services like GIT polyp removal, placing feeding tubes and deploying gastric weight loss devises like balloons. Some of their off-site treatment involves surgeries for GIT cancer, gall bladder stones, hernia repair and anti-reflux procedures.
Coping with distance and referrals…
In all these, Abuchi and his colleagues, surprisingly, are still based in Europe. Though there is an America-trained doctor who is on ground to attend to patient needs, the three Docs still come down almost on a weekly basis to offer their services to patients. The question is how he and his partners cope with working across two continents: working in the clinic in London and working in the clinic in Nigeria: He took a deep breath, cleared his throat, smiled and explained.
“To be candid it can be challenging at times, but mostly it’s exciting. A key factor to the smooth running of our schedules both in the UK and in Nigeria we realize is efficient planning through good administration, good communication, and good time management.”
Good explanation but the other challenge is that D&TEC is not well known locally in Lagos not to mention around the country. Ironically, there are big hospitals out there, which are well known but clearly do not have the same approach nor level of expertise in GIT problems and solutions as Abuchi and his colleagues’ in D&TEC posses. Would there be an arrangement in place with these big hospitals to deal with referrals?
“Not really, we do work very closely with Saint Nicholas and The Lagoon Hospitals here in Lagos. In that those specialist procedures we routinely perform in the UK, that we cannot do in our clinic (usually case needing general anesthesia) we make arrangements for our patients to be admitted into one of the above hospitals under our care for treatment by one of our team members.” It’s a working relationship and professional collaboration we value and appreciate. The mutual benefits are such that would hope for it to grow in the future
The interesting thing is that diabetes control and surgical management of overweight patients are part of Abuchi’s expertise. As is well known, statistics have shown that there is an increasing number of young people becoming diabetic and obese. The question is what could be responsible for this. Eating habits and/or lack of exercise? Abuchi seems to have a solution for this category of people and wasted no time restating his expertise and training in this particular aspect of medicine. Hear him. “As a Bariatric surgeon and my passion and expertise is the surgical management of weight loss, Whereby I offer a select group of my patients’ surgical options to achieve and maintain weight loss. I run a regular appointments only weight loss clinic in the Ikoyi office every four weeks.
The other members of our team in the weight loss clinic include an Endocrinologist and a Consultant Nutritionist. We are very pleased to offer this first of its kind Multi-Disciplinary Weight Loss Service to the community. In order to offer our patients the very best standard of care we work very closely with our anesthetic colleagues, cardio-respiratory colleagues at 1st Cardiology and The Lagoon Hospital.”
According to him obesity interferes with the body’s ability to regulate the sugar level in the blood resulting in type 2 diabetes. Explaining further, he said there is a well-documented association between obesity and some forms of human cancer.
He concludes, “Weight loss leads to resolution of diabetes and cures hypertension. The earlier these are cured the better the outcome for the patient in terms of preventing long term damage to other organs like the eyes, kidneys and joints,” he explained.
While admitting that cancer is ravaging the country like never before and he said he would not be able to attribute this to a particular cause. He said this was a world-wide phenomenon and the lack of a reliable data in Nigeria does not allow one to comment on the problem as far as the country is concerned, saying “We lack any collective or reliable data in Nigeria to really make any factual comments regarding the true cancer incidences in Nigeria.”
When asked what the main causes of cancer are and if it could develop in any part of the body, he has this to say: “The causes and steps towards the development of cancer are multiple, they can be broadly classified into Inherited and acquired, inherited are genetic in origin (via genes). Acquired result from environmental influences like smoking, alcohol consumption, radiation exposure, chronic inflammations, certain diets for example. And to answer your question directly: yes cancer can develop in any part of the body.” He also explained that there are numerous variants, which are based on location, site of origin, cell of origin in the body.
Modest achievements ….
Asked if their clinic is unique based on the kind of service they are rendering and the equipment they have brought in. Abuchi’s response was quick and surprising; “There is nothing unique about our clinic in the real sense. We offer our patients the very best to allow us to assess their complaints and diagnose the underlying cause if any, this is done in a comfortable environment, with the patients experience and well being our core value.” I do believe our determination to make a difference when combined with our broad skills and expertise does allow us to break new ground and pioneer advanced surgical techniques and procedures in Nigeria.
Our modest accomplishments in our 2 years of practice do set the tone, for example we have been the first to undertake and complete a comprehensive GIT screening program akin to that performed in the west, another example we have performed the first Laparoscopic (key hole) techniques for weight loss surgeries, anti-reflux surgeries and treatment of Achalasia. This is not a very unusual situation, when capable, motivated and determined people team up
On the number of Nigerians going to the far-east; which is increasing every day with the attendant economic cost to the country, the expectation is that a clinic like D&TEC might be able to provide services that would make travelling abroad for GIT medical care unnecessary. He said their clinic could offer patients with an alternative to travelling abroad for with Weight and GIT related complaints or concerns.
He explains “When you are not getting what you expect, in healthcare terms, you are unsatisfied with what’s on offer with a complete lack of trust the result is health tourism. We cannot blame or criticise those patient who travel long distances for healthcare reasons. We in the healthcare business have a responsibility to work on offering our patients the quality of services they expect and deserve locally. Once we can achieve this patients I am sure will respond appropriately
“At D&TEC we believe we offer our patients the standard of care that they could expect if they were in our clinics in the UK. At the end of the day our patients will be the ones to judge the value of the services we offer in our Lagos clinic.
Asked if D&TEC offers emergency care? He replied, we offer our services from 0800-1700hrs daily except Sundays. At present we do not offer emergencies services, which are best received in hospitals. We have an experienced US trained colleague who covers our clinics and patients in our absence.”
Okaro and his colleagues earlier challenge in setting up the clinic have however not diminished his optimism for future, “I am always an optimist and strongly believe that it is very promising in the healthcare sector. There are many challenges ahead; to succeed we need both individual and collective efforts with better access to healthcare financing at competitive rates, greater industry involvement, more mutually beneficial healthcare provider collaboration and team working,” he decleared somewhat triumphantly.