The Chief Medical Director of University of Ilorin Teaching Hospital (UITH), Professor Abdulwaheed Olatinwo recently spoke with journalists on the outbreak of Lassa fever, medical tourism, incessant strike actions, the healthcare delivery system, his vision, achievements and challenges since he took over the affairs of the hospital. Hammed Shittu was there
How would you describe the recent outbreak of Lassa fever in Nigeria?
There is a need for people to easily get access to medical attention at the sight of a symptom of an ailment in any hospital within their localities. That should be established within our medical system in Nigeria. And what we need to contain or avert a case like Lassa fever or any other one for that matter is surveillance. That is we quickly pick people identified with that ailment and mark that area. Some of these things have been lacking. Remember we had a case of Ebola, you could see the way the country moved at that period. I believe that these surveillance activities should be ongoing, we should not wait until when we have another crisis. Each of the local governments should have its own functional general hospital so that any ailment that breaks out within a locality can be effectively contained.
What are your thoughts on medical tourism even though some of these ailments can now be cured in Nigeria?
We should be able to strengthen our primary healthcare (PHC), while hospitals should be able to focus on complex cases, these are the things that people travel overseas for.
How would you assess the healthcare delivery system in the country?
The healthcare delivery in the country has gone through several stages. I remember during the days of Professor Olikoye Ransome Kuti, emphasis was on PHC level and invariably it got to the tertiary care level. With the commencement of the present administration and the change process, it has been established that PHC is the key, but there is also the need to strengthen the secondary health care. Of course, we should also be able to maintain the tempo at the tertiary care level too. That means that different governments at different levels must be able to perform their responsibilities in the area of healthcare delivery.
The local government must be saddled with the responsibility of ensuring an effective primary healthcare delivery officially. In our own case here, more than 80 per cent of the patients we treat here are supposed to be treated at the primary and secondary care levels, it’s not good for the system and that is actually affecting seriously our management system. The aspect of training, research and services, which are among our core mandate have been tampered with because the bulk of our patients fall within the category of primary and secondary healthcare.
So, my take home is that there must be functional general hospital, functional in terms of personnel and services.
We must have minimum of one functional and fully equipped general hospital each across the 774 general hospitals we have in Nigeria. And of course within the perimeter of where one is living, say about 200 metres, there must be primary care facility. Meaning that if everybody in the area register at that PHC facility, then you go to the general hospital. It’s the ailment that they cannot solve that you bring to the teaching hospital. This will conserve more money and make healthcare delivery more effective.
Discussions are already ongoing about how to make rural health care very effective. The local governments, states and federal government must be able to take due cognisance of their responsibilities in the area of healthcare delivery and also work harmoniously together. So, as we have 774 local governments across the country, there must be effective and functional 774 general hospitals across the local governments in the country.
What are your main goals for the Teaching Hospital?
When I came here, I realised that there was the need for attitudinal reorientation, the attitude is generally low, everybody looks at the job and say it’s government work. Meaning that whether you work or not, the possibility of getting your pay at the end of the month is very high. So, we focused on the patients because that is why we are all here. It was a one point agenda, what it simply means is that our performance rating would be decided from the perception of the patients. And to achieve this, we organised various workshops and seminars for the staff, then we also moved to “ownership”meaning that you do the work as if it’s your own. When you consider the fact that the next patient might be my relation, then you are bound to guide the job jealously. Then we move to stewardship, whereby you are able to access yourself and conclude that you have been able to do even far more than what is expected of you. Then we also focus on how we can give back to the system. The job is about love, we need to show concern about the patients that we treat. And ours is a complex job because our customers are complex, they always want their ailments to go immediately, so we successfully taught the staff communication skills of how best to speak with our patients. So, it’s from attitudinal change to massive transformation.
What are your thoughts on incessant strike actions by unions, including that of your constituency?
It is most unfortunate in our medical field here because it shows serious lack of sympathy. I know they talk about enforcement of their human rights, but people also have the right to better care. And we have to understand this basic fact that health is an essential service. You might say that government has not given you enough money today and tomorrow government gives you the money, how about the lives that have been lost during your strike, who will give them back their lives? I think going on strike in the hospitals is fundamentally wrong, we have to change our perception. Strike is a way to make government reason about workers demand, but I believe there are other means. In fact, it must be after every other option has been exhausted that workers should go on strike. And here, ideally they are not supposed to go on strike when you check the trade dispute act. Any worker that is on essential services cannot go on strike. Unfortunately, things have really degenerated badly, you can’t really blame the unions, you blame the government and the system to the extent that when agreements are reached, they are sometimes not implemented.
I think it’s important for us to have a rethink about going on strike in the hospital. It’s really worrisome and very unfortunate. It is unfortunate that the people who we look up to as leaders of tomorrow have not imbibed their spirit of love. So we are running this place working on how people’s sufferings can be minimised. I’m not saying that people’s right must not be expressed, but we must collectively know that a live once lost can never be recovered. When hospitals go on strike, everything is at a standstill and sincerely, 99 per cent of the reasons behind the strike is welfare package and the question is, can we really justify the welfare package they are always fighting for in terms of their performance in the hospital? So basically, there is need for people to know that strike in the health sector is crime against humanity.
What are the challenges facing your administration since you assumed the leadership of the hospital?
The major problem is dearth of support services. We are supposed to have light 24 hours daily, but unfortunately in the last two years or so, things have become so bad that we have not had electricity supply in two hours in a day, so meaning that we are solely on generator. There’s no way we can be working on generator 24 hours in a day that the generator will last longer than it’s expected, so virtually every time we are using our money to buy diesel and also we are not connected to national water, that means we depend on borehole and surface tanks.
Our other challenge is the problem of poor road system. No quick access to the hospital, though the kwara State government tried to dualise Zango up to Oyun bridge. We have made several efforts to expand the road from Oyun Bridge to this place, so what we are looking at now is to contact University of Ilorin, to connect from their light and that is about seven kilometres from here. So electricity supply is a major challenge.
We also realised that government is trying, but sincerely government cannot do it all alone, there is a need for individuals and organisations to come and support the government towards financing some of these things, though few organisations are showing up, there are lots to be done so we encourage others to follow suites. We also encourage the state government to complete Oke Osin water reservoir so that it can ease our water crisis in this place. We connected to that reservoir three to four years ago thinking that within few months we will get water from that place, but unfortunately up till now nothing has been done. We have the personnel, we have the people, we have the human resources, we have staff who are highly competent.
This Teaching Hospital under your management has recently celebrated a feat, kindly give us an insight?
We are at the stage of making an hospital for the future. Recently, we did a renal transplant and about three or four weeks ago we did another one. We have recorded a lot of successes. We did open heart surgery few months ago. We are partnering with an institution in India and we have this arrangement of secure transfer. By April/May, these people are coming around to train our people. By then, people would have been skilled enough to do some of these things on our own. We are also working on bone marrow transfer and we are partnering with them.
What are other achievements?
We have done other advanced surgeries such as neck surgeries, spine surgeries, appendix for young and old and many others that we have never done before. We are actually more of a referral centre and training centres for many institutions in Nigeria. And of course, we are now getting patients from outside Nigeria. I am sure that in the nearest future, people will come from other countries and benefit from our services.