Nigerian surgeons operated Yusuf Buhari, not foreigners-Dr. Ogungbo

Dr. Biodun Ogungbo

 

….Nigeria has 80 neurosurgeons for 170 million populace 

 

Dr. Biodun Ogungbo, a neurosurgeon is the Chief Medical Director of Spine Fixed, Abuja. In this interview with Kemi Yesufu, Ogungbo, one of the doctors listed in the Thank You note released by the wife of the president, Hajiya Aisha Buhari following the recovery of her son, Yusuf, speaks on the seemingly unending controversy around his treatment. According to him, the life-saving surgery carried out on the president’s son was done right here in Abuja. Ogungbo also speaks on the dearth of doctors in his specialty, with the worrisome disclosure that Nigeria only has 80 neurosurgeons, when it needs about 5,000 of them for its 170 million strong population. This as he talked about the spike in younger people coming down with a stroke and how it can be prevented.

 

Would it be right to say there is a spike in number of people coming down with stroke in Nigeria and what do you blame for this disturbing trend?

 

In actual clinical practice, we have seen an increase in incidence. We have a lot of younger people coming down with a stroke. We don’t have good statistics, to say these are the actual numbers of people who came down with stroke in a year or the number of people, living with the condition, but in practice I have seen a lot more patients presenting with stroke. And a lot of them are younger than usual. Also a lot of these cases of stroke are related to hypertension. There are what we call wet strokes: one of the pipes in brain has burst open, so we have blood collecting inside the brain. That’s different from the dry stroke. The medical term for it (dry stroke) is ischaemic stroke and it occurs when the pipe is blocked such that no blood is going to the part of the brain. We now see, many more patients being treated for high blood pressure. Whether it’s now about unemployment and other problems…the issue is that we see a lot more patients being diagnosed with hypertension than ever before.

 

When you say a lot more younger people, what age are these patients?

 

They are mostly bellow 40. There are certainly more younger people suffering from, especially  hemorrhagic (wet) stroke.

 

What’s causing more people under 40 to suffer wet stroke?

 

To be honest, we certainly don’t know the real reasons  younger people are coming down with a stroke in Nigeria, because stroke in itself is as a result of the weakness in the blood vessel and this weakness comes with age- which is why older people suffer from stroke. In some other countries it’s mostly older people that suffer a stroke. That’s why you could hypothesize, that if it (increasing rate of stroke among young people) is related to the level of unemployment? Is it related to poverty and hardship? Government, clinicians and everybody, need to take note of this trend. Prevention of course, is key. This is because to treat stroke is quite expensive, it’s like your chasing the tail. Treating a stroke means that you are already dealing with a damaged brain.

 

So, how can stroke be prevented? Is it by taking things easy, more exercise or the right diet?

 

The most important thing is to even check to be sure, you are not suffering those non-communicable diseases like diabetes, hypertension, these two are key diseases that lead to stroke. Certainly , watching your diet to avoid being obese is quite important. Having an active social life is important. You should avoid a sedentary lifestyle, you have to go out , do sports or find ways to keep fit. Being active keeps the heat working better, it keep the blood moving better and  so the blood vessels going to the brain are not blocked with fatty tissues from obesity or neither does the vessels burst open because the pressure from the heart is too much for the pipes carrying the blood. But when people allow themselves to come under the stress of life, when they don’t exercise and become obese, fat blocks up their blood vessels.

 

You once mentioned that Nigeria has 23 neurosurgeons….

 

Now we have about 80 neurosurgeons. We are very far from the numbers we need. To be honest, we actually need about five thousand neurosurgeons to look after our population.  Right now the situation is pitiful.

 

You must be overworked as one of the very few neurosurgeons in the country?

 

I won’t say I am overworked. I am involved in private practice, so I can pick and chose. I am not overwhelmed with people who require my services. People have to pay out of pocket for my service and this limits the number of people who come to my practice . But I know doctors, neurosurgeons  in government hospitals  are overwhelmed. They work so hard, yet they can’t meet up with the demand.

Dr. Biodun Ogungbo

Your name appeared on the Thank You note from the wife of the President, Hajiya Aisha Buhari to the team that treated her son, Yusuf. You also received an award from a group of Anglican women for the role you played in the treatment that gotYusuf back on his feet. But there again is a controversy on where the first son underwent surgery. Was the minister of Health, Prof. Isaac Adewole being truthful, when he said, Yusuf was only flown to Germany for post-surgery care?

 

I don’t think there should be doubts on where this young man was treated. Like you said, the minister of Health has come out to say this gentleman was managed in Nigeria. We, through Cedacrest Hospital  have also confirmed that we actually operated the young man in Nigeria. So, I can also confirm that we operated on him in Nigeria and he was managed here post-surgery, until he was suitable to fly abroad for rehabilitation. So, all he went abroad was for physiotherapy and occupational therapy and sincerely those services are not available in Nigeria. But the expertise to manage brain injury and orthopedic (bone fracture) is available in Nigeria and was deployed to his care.

PMB welcomes Yusuf home after rehabilitation overseas

These services must have come at high cost. Could an average person in Nigeria have been able to pay for the services that restored Yusuf Buhari back to good health?

 

Oh, definitely they can. There is a misconception that neurosurgery, orthopedic surgery is out of the reach of people. Don’t forget that as doctors, we are compassionate people.  Often times, I don’t like to get involved in cases, because once I find out there is something I can do to help, I can’t walk away. Many doctors are like this. We just can’t turn our backs and walk away. With elective cases, like chronic diseases, you could give the patient time to raise money for treatment. You know, ultimately, someone has to pay for the services. But with emergencies, we have to first treat to save lives. Government has now said hospitals should treat people with gunshot wounds and they shouldn’t be rejected. We also don’t turn back road accident victims.

 

We’ve talked about the affordability of specialised care and you mentioned that someone has to pay for the services provided. You run Spine Fixed, how easy it running a facility like yours as a business?

 

It’s all about dedication I suppose and having a vision of what you want. When I was at the National Hospital which was my first neurosurgical practice in Nigeria, the hospital in a kind of way, wasn’t ready for the kind of practice I wanted to bring back here. So, I went into private practice to enable me do things my way, because for me, outcomes were much more important. To deliver on outcomes, you have to do things in a certain way. You can’t get good outcomes, when people say, ‘this is how we do things or we’ve always done things this way’. Going into private practice, now meant that I could create an environment where I could be able to deliver better outcomes for patients with neurosurgical diseases and that’s what we are doing here.

 

Adverts aren’t allowed for medical practice in Nigeria, but foreign hospitals have representatives here who market their services. Isn’t this a contributory factor in Nigerians being heavily involved in medical tourism? 

 

The National Health Act (NHA) has changed everything. But many doctors and even journalists don’t actually know this. The NHA has empowered doctors and hospitals, as a matter of duty, to inform and educate the public about who they are, what services they render and where they are. I am not talking about advertising, like ‘I’m the best thing since sliced bread’. But you can say, ‘I’m a neurosurgeon or I am an orthopedic surgeon and this is where I am’.  So things have changed.

Aside from the obvious reasons such as a dearth of specialists and the very poor doctor/patient ratio.

 

What other reasons would you blame the Nigerians spending millions of dollars annually for medical care overseas? 

 

We need to start trying hard to get patients better outcomes. For many patients, they will stay back if they get quality care, because that’s what they travel out for. So far as we are trying hard and we get patients better outcomes- that for each patient that in front of us, we move mountains to get them home safely,if we are not adding to their problems, certainly the Nigerian patient will trust us. And they will stay back home. It is at huge expense, and people are taking huge risks to go on medical tourism.

 

JOHESU recently suspended it’s strike, the House of Representatives has passed a bill on the residency programme to help stem strikes by doctors. But as someone who worked in a public hospital and now runs a facility that provides  specialised care, how do you think we can make strikes in the health sector a thing of the past?

 

There is a lot of insincerity on the part of government and maybe a lack of understanding of what is at stake. The allocations for health in the budget is pitiful. So, there is not enough money to create a health system that will be of benefit to everybody.

 

 

 

 

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