The Chief Medical Director (CMD) of the University College Hospital, UCH, Ibadan, Prof. Jesse Abiodun Otegbayo has said that the hospital is never the house of death. This is contrary to the notion in some quarters that once you are referred to UCH, that is the end.
Speaking on a radio program (Parrot Xtra Hour) last week, the ever-busy Professor speaks extensively on his experience running hospital such as UCH, which a flagship teaching hospital in Nigeria and indeed in Africa.
How does it feel running UCH, what are the challenges and how is Professor Otegbayo planning to tackle the issues?
“Well, like some people have said that UCH is like a city on its own and that is why in those days, there used to be only three governors in Nigeria. We had state governors, the governor of CBN and the house governor in UCH. That later transmitted to Director of Administration. So it is like governor a city or an enterprise of immense status,” Otegbayo said.
Overseeing such an estate, according to the amiable professor, is exciting and also very challenging.
“It is exciting because if God helps you, you have the right people around you, you can make so many impacts that would the lives of clients and also the staff.
He is challenging in the sense that many times we do not have enough resources that you wished you had to run the system to a world-class institution. That is why from time to time, we appeal to well-meaning individuals, high net worth individuals to assist us. Because the government can’t do it alone. Government is doing so much but then it can’t be enough when it comes to running a perfect healthcare system.”
On the main purpose for which UCH was established.
“UCH was established for three major reasons; one, to train healthcare workers, starting from Nurse, Pharmacist, Doctor, Laboratory Scientist, Physiotherapist etc.
In making sure that the health workers have adequate training for them to go to other hospitals whether private or general hospitals or primary healthcare centres, to be treating those who may have one ailment or the other.
The second reason is to research on anything that has to do it with health generally. If a disease is killing people, our responsibility at UCH is to research into such disease. What kind of disease it is? How do we treat it? As per drugs, examination and health education.
The third purpose is to treat those who are suffering of one ailment or the other.”
Professor Otegbayo stated that all these three purposes are however related.
“Because if there is no patient, you can’t train people on the disease. If there is no disease you can’t do research on patient and disease. So the three purposes are interwoven,” he said.
When asked about the challenges UCH is facing event before he came on board, having been part of the system right from his time as a student and how will address those challenges.
Professor Otegbayo has this to say. “I started getting associated with UCH in 1983 when I entered the University of Ibadan. At that time, if I can remember clearly, it was Prof. Osuntokun that was the Chief Medical Director. He had been preceded by others; Prof. Oluwole Akande and Co.
He was the first Chief Executive of the University College Hospital. And having been part of the system, when we came in 1984/1986 and up till 89, the economy of the country was more vibrant.
The poverty rate, which today 60% of the population of Nigeria leaves below the poverty line, was not like this. The economy was more buoyant, people could afford healthcare. In fact, I can’t even remember the incident of people going outside the country for healthcare services. At a time, the prince of Saudi Arabia used to come and receive treatment here at UCH. Even during my time as a resident doctor in 1992-1993, people were coming from Acra and some other neighbouring countries to come and receive treatment. I participated in their treatment so I know what I am saying.
The story is not like that today. Many more people now prefer to go to other developing countries in the name of India even Ghana and some other developed countries for those who can afford it, like U.K and USA.”
“I have noticed that over time there was a decline in the quality of healthcare services and of course that will definitely affect training and research. Because of lack of resources, lack of funds. So before I vied for this office, I took a step backwards and analysed what were the reasons for this. And I decided to write what looks like a proposal on my vision document which I titled “Shared Vision For Excellence”, believing that, like the former governor in this state used to say, ‘Ajumose Gbogbo Wa Ni’.
As shared vision goes with shared responsibility, everybody has a role to play, talk of the government, talk about the leader of the hospital, the workers and the students and the community at large, both local and international.
We all have roles to play. And my intention was to harness the collective contribution and efforts of all these aforementioned categories of people, to help UCH to come back to the old glory. My intention is to improve clinical services so that patients will come to UCH and feel relieved, patients would be told that they are taking them to UCH and they feel secure that they are going to get the best healthcare services. Not like oh, like some people do now when they say you are going to UCH like (temi baje) the end of the world has come. That is the narrative I want to change.’’
“I have also noticed that some people who are related to me one way or the other, not necessarily vilia relationship, when they want to go to UCH they want to call me or call somebody, thinking that when they get there nobody will attend to them very well.
So what I want to achieve is that if somebody is coming from Adeoyo, Oje or Beere or Sango, you get there without knowing anybody and you are given the appropriate treatment and you are going back you are blessing the nurses, blessing the doctors.
Those are the kind of things I intend to bring back to UCH and I want to leave as a legacy.”
With all the efforts of UCH in providing excellent healthcare services for the society, where then did the notion that the place is a kind of house of death come from?
“When I was much younger than this, while playing with people, some would say “I will beat you UCH will reject you”. That means that any disease or ailment that UCH can’t handle, nobody can accommodate such in Nigeria or West Africa or Africa back then. Because UCH used to be one of the four hospitals in the whole of Commonwealth then. We all know Commonwealth include U.K, New Zealand, Australia etc. That was the category we were then. But all that seems to be a thing of the history. We are about to bring back the old glory now.
The reason people normally say or want to believe UCH is a place to die however is that, until an ailment has gone out of hand, people won’t come to UCH.
There is also an issue within private hospital owners, they will be treating patients till the problem gets out control before they refer them to UCH. They would not want such patients to die in their hospitals in order not to give them a bad name. This is not good enough or when a patient must have become exhausted financially that they will now say come and be going to a government hospital.
Moreso, there some ailments like cancer, in the area of my specialization there is what is called liver cancer. From here to abroad, anybody who has this cancer and it has become a full-blown one, between six weeks to three months at most six months, the person will die. Because that is the most important part of the body. There is no hospital that can accommodate such ailment except a teaching hospital like UCH, LUTH or OAU.
So before they even get to the hospital, in most cases, the situation must have gone out of hand. There won’t be a remedy for such ailment except for palliative care. That is why some people say such patient want to go and die but it is not so. Within those who have come to UCH for treatment since its establishment, if you see one case of death, 100 must have come and gone back home hail and healthy.
But you know bad news spread faster more than good new.”
On the efforts of state governments across the South West in taking the enormous stress off UCH.
“Healthcare in our constitution is said to be on the exclusive list. That means that the Federal Government has its own part to play, the state has its own that Federal can’t intervein and so also the local governments, they also have primary healthcare. All of them are running in parallel, one doesn’t have power on the other. For this reason, I don’t have the power to tell those in the state or local governments that you should do it this way. Unless there is a crisis like the pandemic we are currently battling with, then we can now work together.
What UCH is doing in its capacity is that, between the past government and the present one, there is an understanding for us to be using experienced health workers in assisting the state. So that they can be treating some of these patients that may want to go to UCH. So that UCH can face the three core reasons for which it was established. We will be able to do more research, training and clinical services.”
What is Otegbayo doing to improve the Accident & Emergency section of the hospital?
‘There is something called carrying capacity. In the whole of Ibadan or should I say Oyo State, it is only UCH that has a sufficiently equipped Accident & Emergency. And how many beds do we have at the section? We have 36 beds. Because there is a limit to what we can accommodate. UCH is owned by the Federal Government. There is a specific number of doctors and nurses we are allowed to take. So you can’t take more than your limit but we have the grace to request for more. But the space to even accommodate patients is another issue. At times space may not be enough. The past government has embarked on the expansion of the Accident and Emergency section. When that one is completed we will be able to accommodate more than we are doing now.
Ideally, Ibadan alone should have about six teaching hospitals because of the population.”
ON THE WORKING CAPACITY OF UCH
“We have 250 consultants, 470 resident doctors and 260 housemanship doctors. There are also some who have left that we have not replaced. But the figures I have given is what we are allowed to take or train,” he said.
ON HIS EXPERIENCE AS A CORONAVIRUS SURVIVOR
“ I see life as when there is an issue, what is the solution? Once I was told I had the virus and I had an idea where it came from. I asked the doctor, where do we go from here? I was asymptomatic, no sign whatsoever. I was eating normally, no headache or temperature. I went into the isolation and I was tested the fourth day, it turned out negative. The second and third time. I was placed on drugs but not cure for Coronavirus.
Coronavirus is a new disease and there is no cure for now. But there are some drugs that can boost the immune system. They make the parts of the body strong in order to battle the virus. Those are the things the drugs can do but not to cure. Anybody with the virus is also advised to eat well and exercise.”
– Dare Adeniran