"Better Funding Will Transform Our Medical School To Centre Of Excellence"

Professor Robinson Ofiaeli is the Chief Medical Director of the Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State. Barely one year in the office, Ofiaeli has been able to transform the status of the teaching hospital. He spoke to Chukwunwikezarramu Okumephuna on how he did that and his vision for the hospital. Excerpts.

Seventeen years after its foundation, Nnamdi Azikiwe University Teaching Hospital is yet to move to its permanent site. Why?

One is that at no time was any take-off grant given to the teaching hospital. So, essentially no money has been provided for the development of the permanent site located in three communities of Nnewi, Oraifite and Ozubulu. The communities themselves are now complaining that seventeen years after donating their scarce commodity to the Federal Government out of their goodwill and not because they have much, government is yet to reciprocate the kind gesture. On many occasions they have threatened to take back their land which also is quite understandable if you put yourself in their shoe. Already some of them are now encroaching into the land. I think it will be nice for the Federal Government to reciprocate this kind gesture by making money available for us to decongest this place. This place used to be the old General Hospital Nnewi under the then Anambra State Health Management Board and which was established via the Anambra State of Nigeria Edict No. 10 of 1988. The Hospital was officially handed over to the Anambra State University of Science and Technology Teaching Hospital Management Board on 6th June 1990 and commissioned on Friday 19th July 1991. It was taken over by the Federal Government as Nnamdi Azikiwe University Teaching Hospital in September 1992. Since then nothing has been done by the Federal Government to develop it. Of course as you are seeing there is no way we can continue to function under this atmosphere as a University Teaching Hospital. So we are hoping that with the reform and recent visit of the Health Minister, Professor Eyitayo Lambo to the Teaching Hospital both the temporary and the permanent sites, he will make a case for the take-off grant to be given to us for its development. So money has been the main constraint.

University of Nigeria Teaching Hospital Enugu is well known as a Centre of Excellence for Cardiovascular Studies while Ahmadu Bello University Teaching Hospital Zaria has made a name for herself as a Centre of Excellence for Oncological Studies. What can NAUTH boast of and what is your vision for the University Teaching Hospital?

We have a dream and our dream is to make NAUTH a Centre of Excellence on HIV, AIDS and Sexually Transmitted Diseases Studies. Already things are happening here in that area and we are really committed to this. Unfortunately the problem of HIV and AIDS and of course other sexually transmitted diseases is today posing a great challenge to this nation. Am aware you know that Nigeria with about 3.5 million people living with the virus has the third highest rate of the virus in the world after India and South Africa. This is about 5% of our entire population, which is estimated to be about 120 million. So our mission and vision is to contribute academically and through thorough research and constant studies our quota as a Centre of Excellence in the nation’s war against the virus. Of course one of our main set back is how to move to a more spacious place. Our permanent site is there lying undeveloped 17 years after it was acquired. And for us to live up to expectation as a Centre of Excellence on HIV, AIDS and Sexually Transmitted Studies, we must move to the permanent site to allow us have enough fresh air and conducive atmosphere for our studies. Also we are very much afraid that the teaching hospital may not gain from the second batch of the VAMED Engineering Project which is meant to equip all the federal tertiary medical institutions in the country. We are afraid because we are wondering where all those equipment are going to be installed when it is our turn. As a matter of fact we are listed in the second batch which comes up in few months. This is definitely posing a great obstacle to our living up to expectation as a Centre of Excellence on HIV, AIDS and Sexually Transmitted Studies. But if you ask us to demand, we would say give us N2 billion. It will definitely do something at our permanent site.

Now, Professor let us forget the permanent campus for a mean time. What do you think are the most pressing problem or challenges facing the temporary campus?

Well we would like to complete the theatre complex and equip them. Currently we have more than 20 surgeons using one operating theatre. That in itself limits productivity. So completing that theatre complex and equipping it would enable us to operate at our maximum level.

Would you agree with me that we have lazy Chief Medical Directors calling the shots at our tertiary health institutions?

For sure!

Do you also agree that a good number of them have not been able to put up at least one befitting structure in their institutions not only as means of developing the institutions but also as a thing of legacy?

Of course!

Now let me ask you, what would you boast has been your achievement so far in this Teaching Hospital?

You caught me red handed. Well let me see if I will wriggle myself out of the mess you put me in. On assumption of office about a year ago, this administration inherited a debt of N420 million as unpaid arrears of 22%, leave allowance, teaching allowances, 12% and shortfall in salary, which resulted in payment of percentage salaries. Today all these debts are now historical facts in NAUTH Nnewi. Thanks to the effort of the Minister of Health for his fatherly understanding and to the President for making available the sum of N7.99 billion. Our only outstanding indebtedness is the balance of our co-operative debt and the debt to insurance companies which we owe the sum of N12 million being unpaid premium for the years 2002, 2003, 2004 and 2005. Also a first time visitor would not appreciate the deplorable state of infrastructural decay in this teaching hospital one year ago. We thank the Minister because we were able to use the N100 million we received for the 2004 capital appropriation to carry out massive internal and external renovation work in the hospital and also to execute some other vital projects which include procurement of a brand new 30-seaater fully air-conditioned coaster bus for the School of Nursing, purchasing and installation of a fluoroscopy machine bought at the rate of N25 million, tarring of roads within the campus, sinking of borehole, completion of the hospital incinerator building. Previously we spent over N125, 000 monthly to dispose our refuse here. So with the completion of the incinerator we are able to cut cost drastically. We also completed our previously uncompleted laundry, bought and installed a brand new 103 KVA generator for our Guinness Eye Centre at Onitsha as well as completion of its administrative block and a Comprehensive Health Centre at Umunya near Onitsha. It may also interest you to know that we have reached 90% completion of our multi-purpose theatre complex.

I think you have been able to accomplish a lot in just less than one year as the Chief Medical Director of this teaching hospital. How were you able to do that?

I think prudence in financial spending. The due process also helped a great deal. In fact we had just ten projects in mind, but by the time we went through the due process, we were able to add four additional projects in the budget from the N100 million Naira we had for the capital project. So due process helped us in being prudent in financial management.

That’s interesting. Now going through the SERVICOM CHARTER of the hospital, one would not be left in doubt that this hospital would be the best ran public hospitals in Nigeria, if they are followed to the letter. But I am curious to ask, do you really mean what is written there?

They are just like the advocacy meeting that the Minister is having at the moment with all the stakeholders in the nation’s healthcare. We have done our own advocacy within the teaching hospital and we are continuing to advocate that we treat our customers with utmost respect. That we will give them the necessary information that they need and that we will give them the dignity that they deserve as human beings. We also commit ourselves to giving them a timely and efficient service so that when next they are sick, that is not our prayer anyway, they will choose us as their healthcare providers. So it is continuous message, a continuous process and we are committed to preaching the message and practice what we preach. We are determined in being a model teaching hospital that has a cordial attitude and relationship with their customers. We also have a mission and our mission statement is to deliver qualitative healthcare to our people in a timely, effective and efficient way. Our vision statement is to improve the life expectancy of Nigerians by reduction in the incidence of communicable diseases and control of chronic disease conditions. Also as part of resolve to serve our people right as their right we have mandated that patients are not to spend more than 15 minutes at all other service points like revenue, pharmacy etc. All laboratory departments have produced their service charters indicating clearly when patients expect their results. We have also installed a service delivery unit whose function includes conduct of exit interviews on patients leaving all service points, monitoring compliance to the SERVICOM CHARTER by staff and receiving complaints.

Why the use of the word customers instead of the traditional patients?

Because that word patient connotes some degree of, will I say somebody pleading? But a customer is somebody who is willing to spend his money for value. So that is why we prefer using the word customer instead of patient. What we use to call a patient is actually a customer in need of healthcare and treatment and who is willing to pay for that care and treatment. So we should treat him as a somebody we so much desire his contribution towards our own development and growth and also see him as somebody who is a conditio sine qua non for our growth and whose absence would definitely cause our failure. They are needed for our hospitals to move forward and therefore we basically need them. And with these it becomes imperative that we change our orientation towards them otherwise we are going to be not just a failure but a monumental one indeed. These we have to do to ensure that their sickness do not get more complicated. But I think it will interest you more to know that we have reduced antenatal booking fee from N1, 200 to N300. This is our contribution towards reducing the nation’s maternal and infant mortality rate which is still one of the highest in the world. We have also procured Genotype Machine, Cold Centrifuge for blood fractionation by Haematology department and also resurfaced the laboratories, lecture hall, causality and other buildings with ceramic. This is to make our customers happy in line with the dictates of our SERVICOM CHARTER.

Professor sincerely speaking don’t you think that the recently launched National Health Insurance Scheme would be a complete and monumental failure because most of the hospitals that will provide the services especially public hospitals are poorly equipped?

Actually the National Health Insurance Scheme is a God-sent scheme because apart from the fact that it emphasis our being our brothers keeper which is an African concept, it will now enable the insurance companies to contribute their own quota to healthcare delivery in the country by providing more equipment to the teaching hospitals. It is better for an insurance company to get efficient treatment for Nigeria than to commit funds for overseas treatment for anybody. So they will now help to bring in some of the much-needed equipment into tertiary healthcare institutions, even at the primary and secondary care level. So the level of medical practice would improve with insurance funding.

Finally, take your teaching hospital as a case study. With what you have there on ground, do you think Nigeria would meet up with the health-related aspects of the Millennium Development Goals?

Certainly! If you listen to the Minister of Health, Lambo, he always talks about health being the cornerstone of the National Economic Empowerment and Development Strategy. A healthy nation of course you know is a wealthy nation. We in NAUTH Nnewi are contributing our own quota to the health of the nation and we will continue to improve with more facilities. We have the manpower. We have the resources. We have the equipment at least to start with. Now with all these on ground I therefore have no iota of doubt that the nation would achieve the Goals if things are organised and galvanised well. And of course if all is spiced with little political commitment and will from all tiers of government.