Adeleke: To Curb Medical Tourism, Govt Should Strengthen Healthcare, Bring Professionals Home

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Prof Kamar Adeleke is the President/CEO, Tristate Cardiovascular Institute. In this exclusive interview with Martins Ifijeh, he posited that if government gives healthcare the priority it deserves, no Nigerian will travel abroad for medical tourism. He also spoke on how world class cardiac programmes by Tristate are changing healthcare narratives in Nigeria

Why do many Nigerians go abroad for cardiac surgery when it can be done in here?
Nigerians lack information on the capacity of cardiac programmes that can be done in Nigeria. Unfortunately, doctors in Nigeria cannot advertise themselves because it is against the law, unlike in the US where for instance, I can say, Prof. Adeleke is the best in cardiac surgeries, he has done a number of so, so, and so successful surgeries. But here, we are not allowed to talk about our capabilities.

nformation is very powerful, if we don’t talk about what we do, nobody will know us. Nigerians must solve Nigeria’s problems. No foreigner will solve our problems for us.

Now we have Babcock University, Reddington Hospital, Tristate Cardiac Centre, Aminu Kanu Teaching Hopsital, Afe Babalola University that are doing tremendous work in heart surgeries. Afe Bablola University for instance, has done over 14 open heart surgeries, but few people know. Tristate has done hundreds of these surgeries within the last three years.

You had a successful career in the US. Why did you come back to Nigeria?

I trained and lived in the US for over 40 years, and in 2012, I did a medical mission to Nigeria where we saw over 5000 patients in two weeks. And during that time, I realised Nigeria was in trouble with the average life expectancy put at 46 years at the time. So that was not good. Cuba was about 80, while the US was 79, at the time. So that is part of what brought me back to Nigeria to come help, because we found out that the number one cause of death in Nigeria is no longer communicable disease but non communicable, with heart diseases taking a bunch of this.

At that time also, there were only two cardiologists that could really do the job in the whole of Nigeria; Yemi Johnson and one other person, with a population at the time of about 175 million people. What can the two of them do? In US where I practiced, I have helped in saving many lives from heart diseases, so why can’t I do same in my own country? That is why I came back home.
So, I decided to replicate our Tristate Cardiac Centre in Pennsylvania, Delaware, and New Jersey here in Nigeria.

What has Tristate done in Nigeria?

We started at University College Hospital, Ibadan where we did over 40 open heart surgeries. We moved to Babcock University where we started a cardiac programme which cost us about 2.4 billion naira. That was three years ago. Today, Babcock is practically doing open heart surgeries every day. We have now done over 400 cases at Babcock. We have done very close to that in the Cardiac CatLab. Then we opened another hospital in Ibadan. Now we are partnering Reddington Hospital.

Our success rate on diagnosis is 100 per cent; on procedures, there is the noninvasive, which is 100 per cent, as well as the invasive procedure, which is also 100 per cent. We have not lost anybody during our procedures.
On open heart surgeries, for paediatrics, we have 100 per cent; for the high risk or for the elderly, we have about 60 per cent. In Nigeria, Tristate is like a dumping ground for the high risk because people believe such conditions can only be tackled in our clinics.

Would you be taking your professionals and equipment to Reddington?

Reddington has the equipment, Tristate is coming in with the professionals, so we are collaborating. Their new cardiac hospital is in GRA, very close to the airport, and it is a 100 bed space, where open heart surgeries are done. Although some of the equipment will be brought in by Tristate. So these two big brands will be coming together to address issues around heart surgeries in the country.

Tristate is the number one in terms of volume, complexity of cases, 247 trainings, and we are expanding very rapidly so that at the end of the day, Nigerians can access facilities anywhere in the country.

How will cardiac programmes benefit Nigeria?

This will cut down on cost and medical tourism. Nigerians do not need to travel abroad for heart surgeries when it can be done right here successfully. It will improve the country’s financial strength. Healthcare in the US contributes 16 to 20 per cent of the total GDP, that’s about 19 trillion dollars. It may have changed a little bit now, but we are less than one per cent in healthcare contribution to the economy. Yet, healthcare is a big business; employments will be made, there will be pharmacies, we will be manufacturing, there will be equipment company, among others. All these will improve the economy of the country. To achieve this, we are getting a lot of support, and Aliko Dangote Foundation is one of those supporting us.

Will indigent Nigerians be able to undertake open heart surgeries?

That is our goal. We are on our own way supporting. There are times we contribute N1 million, N200, 000, and so on. We have done about five like that in the past one month. Our goal is to make sure people do not have to lose their lives because they are unable to pay for surgeries.

That is why we are partnering with government at all levels and private sectors so that people who can’t afford treatment will have the treatments they require for a healthy heart.

The mentality that people must travel out for treatment has to change. Whites are not better than us. If you go anywhere in the world, you would see Nigerians are very brilliant people.

Would this also curb medical tourism?

If we give our healthcare priority and ensure every Nigerian has access to quality and affordable healthcare, no one will need to travel for treatment. Does it even make sense that our leaders are going abroad for treatment. All we need to do is strengthen our healthcare and bring Nigerian healthcare professionals in diaspora back home. They will complement what Nigerians here are doing. Nigerians are some of the most brilliant people in the world. I have never seen any more brilliant doctors than Nigerians. Government has no business doing business.

They should create enough business environments so that even those abroad can come home. A lot of countries envy our brilliancy, resilient, population and resources. There is no reason any Nigerian should be poor or not have access to quality healthcare.

Can’t Universal Health Coverage address issues about indigent Nigerians not able to afford treatment?

There is no free lunch anywhere. We borrowed 2.4 billion to start Tristate in Babcock. It started at 16 per cent interest rate, went to 21 percent interest rate, and at a time, we almost went bankrupt. If not Babcock University that bailed Tristate out, that would have been the end. The first 75 cases we did were done for free because we had to convince Nigerians that it was doable. So because of that, the only people we could do it on were people who didn’t have the money for it.

There no countries in the world that does UHC for free. Someone has to pay, and the only safest way is insurance where everyone is pooled together. Majority of Nigerians will only have money spent on them for prevention and minor treatment. Only about one per cent will actually require heart surgeries. If 100 people pays, and only one per cent needed the surgeries, you will see the problem will being solved without we sweating. That is the reason why insurance makes sense. Without insurance we can’t get to where we want to be.

How can we make health insurance work in Nigeria?

All over the world, if you buy a car you have to insure it, because it is mandatory. That is what we should in the health sector; make health insurance mandatory. So, those who are able to pay must pay. If you work, the employer has to contribute to it, government has to, private persons also have to. Then the poor becomes the responsibility of the government. This is how it is done all over the world. We can’t lie to ourselves, Nigeria don’t have the money. The only way this can be done is if we make it mandatory.

Shouldn’t passing the NHIS Mandatory Bill be priority at this time?

This is a high priority. I have seen several people die because they are unable to pay for treatments and surgeries. The National Assembly should dl the needful while the executive should assent to it. This should speedily be one of our priorities for now if we really want to tackle our healthcare challenges. We are playing with fire because people are increasingly coming down with non-communicable diseases. After food, next on the priority list should be health, and then education. We can’t push this aside.

What are the risk factors and how do we prevent heart problems?

Prevention and healthcare generally starts from preconception. Before the woman gets pregnant, she should be healthy, including avoiding environmental hazards. Pregnant women should have a very good routine care because the site of the placenta is directly correlated to the growth of the baby, and studies show women with poor nutrition passes poor health down to their babies, as these babies may have diabetes, hypertension, heart disease and death.

Once the baby is born, make sure the child doesn’t have heart murmur, those with anaemia should be treated, and those with defects should be corrected. People go to hospitals only when they are sick. Preventive checks are very necessary. From ages 0 to 12 years should do necessary immunisation. As an adult, certain risk factors have to be modified, including alcohol intake, and smoking.

Nigerians should take exercise seriously. We should ensure we do not have high cholesterol. If you don’t take care of all these, when the issue starts it will be too expensive to treat.