Dominic Ukpong: If My Dad Wasn’t Firm with Me, I Wouldn’t be a Medical Doctor Today

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Brilliant and daring; he exudes cheerfulness, focus and resilience. Dominic Ukpong, an ex-student of St Patrick’s college, Calabar, graduated with MBBS from the University of Benin in 1976; he is a consultant occupational physician with a diploma in Industrial Health from London School of Hygiene and Tropical Medicine. He also holds certificates in Diving Medicine from the University of Aberdeen and Advanced Trauma and Life Support; ATLS, from the Witwatersrand University, Region Houghton, Gauteng, Republic of South Africa. He also trained in Advanced Burns Management from St Andrews Hospital, North East Thames Burns unit, Billericay, Essex in the United Kingdom, and Surgical Intensive Cardiac care in Jackson Memorial University, Miami Florida, USA. Growing up as a restless, energetic yet fearful child under the iron clad hands of his father, he played football on the street, fought on behalf of the oppressed. For decades, the Calabar-born medical expert has been at the forefront of direct-pay health care movement. He has worked at the clinical and policy levels to, as he says, “move direct practice away from the fringes and into the mainstream.”  The former chairman of Cross River State branch of the Nigerian Medical Association, NMA, and National Chairman of the Nigerian Medical Association Committee for the Regulation of Private Medical Practice in Nigeria, speaks with Adedayo Adejobi, about his 30 years as former Group Medical Director at ExxonMobil, his evolving vision for digital health, why primary health care will experience a rebirth under his watch as Akwa-Ibom State Commissioner for Health, life in government and being a pastor…

Did you venture into Medicine from childhood?
I didn’t venture into Medicine. It was a direct choice. I was a very brilliant student and was always topping the class. I won a lot of prizes both in sports and academics. Because of these performances, I was always made the class prefect.  My father was happy about my performance, but he always told me that he believed my classmates were very unintelligent and that was why I came first all the time. In the house, I was rascally and there were some questions he asked me in simple mathematics I couldn’t answer. The reason I couldn’t answer the questions weren’t because I didn’t know them, it was because there was always a cane beside him. And if I missed any mathematical question, I would receive several strokes of the cane. There was a book called Simple Mathematics by Peter Larcombe commonly referred to as Larcombe’s, and in it were 10 questions to solve always after every exercise. My dad did not allow me to sit down to work them. Instead, he would hold the book and read the question for me to answer offherd.  And I could have with just a little thinking because I was very brilliant. But because if I failed any, he would flog me, so each time he asked me about the question I was not thinking about the question but the cane. And the cane surely came in torrents. He felt because I couldn’t answer those questions, for me to be first in class, simply proved my classmates were the most stupid, unintelligent and definitely duller pupils than me. So he changed me from that school to another reputedly better one: The Sacred Heart School, Calabar, where prominent students have passed through. I went there and from the first term, I took the first position until Standard six. In standard six, only two of us had grade one school leaving certificates. And then, I passed common entrance into King’s College Lagos. I was second nationally. But I refused to go there because, I didn’t know much about the school apart from the fact that it was a government college which provided amenities. I preferred St Patrick’s College which was nearer home. They had very good footballer teams and a school band. So those things put together endeared me to the school. Throughout my stay, I was always the class prefect. At the end, I became the school prefect.
I was also the youngest and I must say a great football star in the school team. We used to play competitions in Onikan Stadium. In the course of playing these games in school, I lost my knee and the doctor who treated me, Dr Paul Niya, the first black Chief Medical Director of Shell Medical Services, was a senior alumnus of St Patrick’s College. He said I was very good and I played football, for that reason he was going to be my friend and he was going to mentor me. Since then, he became a great father to me. He is one of the finest doctors I have ever met. It was he who made me realign my thoughts in the area of my choice of Medicine. I would leave Benin for Warri where he was working and he would make me assist in surgeries. He taught me a lot and I became very proficient and well ahead of my counterparts in class. Being a doctor, for me, is born of an inner feeling of serving people, helping people who are sick. It comes very naturally to me.

You must have dreaded your father. Is he still alive?
My father is late. He died four years ago. Without any fear of contradiction, if my dad wasn’t firm with me I wouldn’t be a doctor today. I probably wouldn’t be anything but a radical. I was a very restless child who spent most of his time playing football on the street, using catapult to kill birds. The only way he could keep me in line to focus and get my energy aligned was with the cane. There are many ways to correct a child. But for some children like me, who are stubborn, the cane prevented me from doing naughty things, because I knew if and when my father came back, he would not spare the rod.

Having became a father, do you see your traits, especially, as a child in your children?
My son is a carbon copy of me because he loved dancing, was rascally and stubborn, and independent minded. One has to really convince him about something, else he won’t do it. When he was younger, he used to carry out my instructions because I said them but I could see it in his eyes that he was just obeying and that when he grew up, he’d make up his mind whether he wants to do what I say or not. And today, I see that clearly. I talk to him as an adult and he shrugs his shoulders meaning he doesn’t accept it. I don’t feed him, so he does what he wants to do. Sometimes, in very many cases, he’s confessed that my opinion turned out better and now seeks my opinions on many things. When he was young, I also had the cane I didn’t do too differently. But the use of the cane became less frequent as I balanced same with talking. Learning from my experience, I didn’t want him to lose focus because he saw the cane beside me. In very many ways, he was a team leader. Academically he was a very brilliant child but didn’t focus very well and didn’t score a first class as he wanted.
My daughters are gentle with a strong mind. They resemble me. The first two are in Canada, while the third child is a medical doctor here in Nigeria. She is married and works with Lagoon Hospitals. She is the most obedient and gentle among them.

You’ve been married for years. How has it been?
I had a first marriage which crumbled. I got married when I didn’t know and understand God’s purpose. I got married purely out of physical attraction. As a youth, I was blessed. I got out of university and got a good job, and was well paid. So I had a lot of problems some of which almost caused me my life. I got out of that marriage and got married to my wife whom God has blessed me with. I’ve had peace. Initially, because of the age difference, we had some teething problems. The disparity in ages and generational differences can cause problems in a marriage. After the first three years, we’ve afterwards enjoyed great peace like I never imagined in my life, having had a bad experience in the past.

How does it feel being a grandfather?
The joy of a granddad is the greatest joy of all. I did not understand it until I had one. I recall that when I heard my wife delivered my first child, a son, in Uyo. I was in Lagos at my office. I had initially stayed over the weekend for three days, thinking she would deliver as she had labour pains. When she delivered, I picked my phone and called my dad who was the territorial controller of P&T based in Marina, Lagos. I worked at the C.M.S. Bookshop junction, where Mobil was then. I called him to give him the news and my father was so overjoyed. He screamed ‘I am a grandfather, I am a grandfather!’ on and on and started to talk to some other persons underground in Yoruba language till he dropped the phone. In that joy, he forgot I was still on the phone. The love he had for the boy, my son, was so much that when the boy had a misunderstanding with me, he said I love my grandfather, I don’t love you. Till he died, they were best of friends. When my granddaughter was born, I couldn’t take my mind off the feeling until my daughter said, daddy, I am still your daughter. I said, yes I know.  The feeling was inexplicable.

You moved from private sector to civil service. You want to share the experience?
In my little experience, this past one year has been very eye opening, although initially mind boggling.  How one system can be so efficient and the other system less efficient, and doesn’t seem to care, amuses me. The corporate bodies make sure that if they want to make the best profit, the best hands are recruited. I worked in Exxon Mobil, the largest profit making establishment for 10 to 12 years. It was beaten eventually by Apple. Their recruitment process is impeccable. There have been flaws, but they make sure to keep it excellent. Their assessment process is reviewed on a constant basis. There are some consultants that they have hired, who are specialised in evolving ways of assessing people’s performance to reward them. Their reward and commission policy is untainted. They do upward and downward assessment. Your subordinate must assess you and send the result. When you leave there and get into the civil service, there are so many things that are like ‘how could it be?’ People could come to work any time they want? You are supposed to report to office at 8 o’clock, you come at 9 and sign 8 o’clock. You can stand there at 9 o’clock and someone is signing 7 o’clock. It doesn’t really matter. Work closes by four, by three people are already out. Somebody leaves office at one and goes out and nothing happens to the person. You go to some offices, people are gisting. They don’t seem to have any work to do. People can eat three times in the office. The laxity is impossible in a corporate environment. And, you cannot discipline easily. The procedures for discipline are meant to be just. First, you must query the person, and he answers the query. If he doesn’t accept, then you cannot give him the sack. You must give the person query about three occasions. By the time he has three queries, they know it’s serious. Even if he has to recommend, it has to go to the civil service commission of which the investigation might not finish in one year. The corporate system does not encourage inefficiency. Every year you are assessed. In fact, in the course of the year, there is continuous assessment. It is not so in the civil service. And I noticed also that civil servants are not well remunerated. The salaries they pay them are not such that it will encourage anybody to do serious work. The big ones among them who do not have integrity survive by stealing. The salary encourages them to steal. The system is so lax; there is no time consciousness. Coming to change the system, you can imagine the kind of challenges I’ve met; oppositions and some cunning politicking, blackmail and treachery. Unless you really believe that God sent you, you might run away in frustration. I had huge challenges. In the corporate world, paperwork was less especially with the advent of computer. I went in there, I didn’t have the internet and even when I bought my own modem in order to access the internet, majority of the workers didn’t have the internet. I asked myself how do I pass messages and send jobs to them. It was all paper work, whereas in the corporate world, you send me the job online and I return it online. You have it in the same minute. Some rooms are filled with files to the roof, and if fire occurs, all the records are damaged. The political intrigue is worse because as soon as you want to set it right, some big politicians call and ask you for slots to employ his kinsman. I ask myself: why should they give them slots? Are they competent? They spend a lot of money to get to the position which is wrong, and they want to recoup it. The political arrangement is not healthy.

Are there any particular projects that your ministry is working on the state?
The health sector has a primary, secondary and tertiary health system. We have a quaternary hospital and teaching hospital which forms some of the best hospitals we have in the whole of Africa in terms of equipment and expertise. The Ibom Specialist Hospital is yet to come into full operation and normally handled by local government, but it doesn’t do that well as many of the people are not paid. That is not government because people say government does not pay. The allocations for this purpose is different and given to them. Some of them stay for long without pay. Insecurity is a problem, whilst the facilities are not developed. Staff living on the premises are not secure, so night services become difficult. Dilapidated structures are not replaced and there is a general decay. We have plans to revive the primary health care agencies. We are trying to see how we can motivate the people who work there. On the aspect of reward for doctors, if you are reputed to be the best character with good academic grades, we give you scholarship to finish, and if you graduate with the best result and good character we will also reward you, thus stimulating others to emulate you. Also, for youth corps members who do very well, we give certificates and cash rewards and other gift items. One of the things that have been causing problems is that of corruption, which exists everywhere. Situations where items supplied to the hospital are not well accounted for gives room for pilfering. The records are not good if they are there. Sometimes, they are not there at all, and the government is blamed. There is no record of death and birth. When a patient dies, there must be death review in which all that took care of the dead body give account of their role in the patient’s treatment. Some deaths are avoidable, some are preventable. That’s how we learn the lesson through query. But, when that is not done, someone dies and is just carried away; it doesn’t help. Many of the people who were negligent just go scot-free. That is not how it is meant to be. We have to set those things right; reward the people positively if they do well, punish them if they do badly. These are motivations. It is not money, but money could be there. You can give them holidays paid for, promote them, and so forth. There are many thing to make someone feel they have appreciated what I have done. Many medical practitioners take laws into their hands and they just abuse it. You go to a pharmacy, somebody is there prescribing and he is not a doctor. There are many drugs that they are not supposed to sell off the counter. Abroad, it works, but in our country, we don’t implement that. Some people collapse from injections in the pharmacy store and die. Optometrists now are prescribing like doctors. They are supposed to study the kind of glasses people wear. They behave like doctor because when they have PhD, people think that they are medical doctors, and that is how they are working. Nobody stops them. They come with the argument that head of hospital is administrative, so anybody can do it. The doctor is the head of the medical team anywhere in the world. No patient goes to the hospital and says I want to go and see the pharmacist. They go to see the doctor for treatment. Everybody should be proud of the profession he has entered into. Pharmacy should be respected and anywhere in the world, they do their jobs, they don’t struggle to be the doctor.