Dr. (Mrs.) Abiodun Oduwole, the Ogun State Commissioner for Health, spoke with YEMISI ADENIRAN on the challenging situation of health facilities in the state-owned hospitals and measures being taken to overcome them

Q: Please, describe the state of health in Ogun State when the current administration came on board.
A: The number of medical staff on ground then was nothing to write home about. But over a couple of years, they had increased by over 1,000. And since they came in, the administration has been able to build three additional hospitals. They are at Omu, Itori and another one at Atan. At the same time, equipment were bought and some were renovated. Besides, the Otunba Gbenga Daniel administration also instituted a community relationship. As far as this government is concerned, these people are the ones that really know what is happening in the hospitals, as none of us here can get to know what is wrong, and where to improve. The community relationship is designed to allow community members have input by giving us prompt and precise information about happenings. With this, intervention like the OGUMES, the Ogun State Rural Medical Services, was initiated and this has been a tremendous success. OGUMES is free and funded with a sum of N2 million every month. With OGUMES, we have performed a lot of surgeries in sensitive parts of the body, like the eyes, private parts and give drugs without any delay. We use the doctors and parameds from within the system to reduce the charges and to give their own quota to the development of their states too. Again, there is the Ogun State Accident and Emergencies Services, OGSAES, which was instituted at the inception of this administration. It sees to the number of accidents that occur in a week, the number of casualties, deaths, and where and how they are treated. We have a monthly report on this. OGSAES consists of 16 medical and paramedical people. As of now, we have four ambulances stationed in four strategic locations. One is by roundabout, one at Wasimi, the third one in the Ijebu-Ode axis and the fourth is at Ibafo, in the Lagos axis.

Q: In spite of these claims, there are complaints that these ambulances don’t work as promptly as expected, wasting lives of accident victims. Why?
A: You know that in everything that is good, there are always challenges. One of the challenges is just what you have just mentioned; we call it delay in response. This usually happens around or after 7:00pm. These ambulances are to be at their points of call between 6am and 7pm. By 6pm, they are supposed to leave for security purpose. If an accident thus happens at about 8pm, the ambulances would have gone to their stations and by the time you call the people to man their vehicles, they might have gone home. For a driver living at Ijaye or any other distant place, before he gets to the expressway, the scene of the accident, there would have been great agitation from people around, especially when the victims are already in pains and are probably bleeding. Empathy is bound to be much in the air. But we have seen this as a major constraint and we plan to address it as soon as possible.

Q: How many hospitals are there in the state and how are they run?
A: We have about 20 in all. Hospitals or health services are like a pyramid. At the top of the pyramid we have the tertiary institutions, with the local government clinic, health posts and things like that at the base, while the middle contains the general hospitals. It is the responsibility of the local government administration to care for the clinics and the health posts under it, but as it were, we do not leave it in their hands because medicine is very capital intensive. It needs a lot of money, which is what is being done, whereas we do not generate money. These local governments health posts may appear as not doing anything but it is because they are not aware of many things expected of them.

Just recently, we organised a sensitisation workshop geared towards creating awareness on the importance of the various projects the government is embarking on, and other things they should be aware of. They are the nearest to our people as we have about 428 health posts scattered around the state. I cannot go and monitor them adequately because when I do, I will only go and come back. But when I am not there, who does the monitoring? For the Olabisi Onabanjo University, OOU, its condition was very bad when we came in. The structures were dilapidated, the gynaecology building, especially, was on the verge of collapse; they had to move the patients out. But if you visit the place now, you will see that a lot of work has been done towards its improvement. The roofing which was almost collapsing on the inmates has been done, the landscaping work has also been done. The Accident and Emergency Unit again, has been completely rebuilt. Because it is strategically located, we needed to make it a centre of excellence. For instance, it is always the first point of call for victims of accidents along the Lagos/Ibadan or Shagamu/Ijebu-Ode axis. It was supposed to be sidelined for trauma victims but we said no, it should be a centre of excellence for all specialties, where you would visit and get well treated.

Q: Most of the hospitals are well-structured, but they appear to be lacking specialists. How would they then  be the centres of excellence you have proposed them to be?
A: The specialists are supposed to be there but you see, it is what you see that will motivate you. What was on ground was not a conducive structure to live in; the buildings were cracked and the environment was waterlogged. You could see the level of the water compromising the integrity of the building. To this end, a 14- unit one-bedroom apartment was built and we are proud of it. No doubt, there will definitely be complaints still. All the same, if Ogun State was created over 30 years ago and successive administrations had been doing something, the doctors’ quarters would not have been what it is. There was even no water, and the roofs were leaking. But we’ve done a lot of things to remedy this and I am sure, most of our doctors now feel better and safer to live within the hospital premises.

Q: Does this explain why some of your consultants come from Lagos and other places to resume work in the state?
A: In a way, but I am sure the number of those that do this has been relatively reduced. We don’t owe them salaries, and they are promptly paid too. I mean, all our doctors at the secondary and tertiary levels are equally rated.

Q: There is also this problem of the central generator not working. What do you say to this?
A: The central generators do not work because of diesel problem. But to solve this, each unit has a small generator to use and these are functioning. We have also provided shuttle buses within the hospitals and are also into what is called a Public-Private Partnership, PPP, in conjunction with foundations to make our patients comfortable. What I want people to appreciate is that we know what to do and we have an idea of what we want, but we have to work within the limit of our resources. It is not only health that the government is involved in.

Q: Even when health is wealth?
A: Yes, health is wealth and it is a major sector by which an administration can be judged. But we would take each step at a time. We must not focus on the Olabisi Onabanjo unit only.

Q: There is also the issue of equipment lacking in some of the secondary hospitals which is making patients uncomfortable. For instance, the Orthopaedic unit of the Ijebu-Ode General Hospital where a lot of basic things like screens and special beds for spinal cord patients are absent. What do you say to this?
A: I think not too long ago, we had an agitation from the doctors and a breakfast meeting was held with them. This involved the Executive Governor, the medical director and a representative from the Accounts and myself. Right there, a list of their needs was compiled, and the sum N15 million was approved by his Excellency for equipment. He told them it was a test and that they should text messages to him often on these needs.

Q: Is it true that Nursing Schools in Ogun State have had their accreditation withdrawn as well as that of the Ijebu-Ode School of Midwifery?
A: This is not limited to Ogun State. Most schools of Nursing had their accreditation either partially or totally withdrawn. That of Ijebu-Ode School of Midwifery: the council visited  and was not happy that the school was sited within the premises of the hospital. We were asked to move it out, and we are happy at what we have on ground now. We have met all their requirements and I am sure very soon, its accreditation will be returned. Even that of Ijaye has met their standards. The only one we are yet to clear is that at Ilaro and we are doing everything to meet their standards.

Q: What exactly are the standards to be met?
A: Precisely, the council requires separate complexes for three nursing and midwifery schools. These we are doing. The foundation has been laid and the cost ranges between N60 to N70 million outside equipment. We are going to commission that of Ilaro by March.

Q: What are your plans to improve the deplorable condition of these hospitals?
A: As I said, they are challenges. We intend to extend the hours of service of the ambulances. Very soon they will begin to work for 24 hours. Automatically, this will entail getting more hands to work, buying more ambulances that are equipped with emergency resuscitative care. The proposal for that is being approved by his Excellency. Also we are proposing training of all paramedical staff in emergency care in Israel and South Africa. This, you will agree with me, is cost-demanding, even when it is necessary.

It is for this fact that we are embarking on another exercise tagged Train the Trainers. With this, nurses and the auxiliaries will benefit and get to know what to do at such critical times. Apart from this, we are going to re-orientate our medical staff. We want to work on their attitude. They need to be empathetical towards patients at all times, and in spite of whatever the case may be. We are also going to bring them under a programme called Herald, where specialists would  be brought  round to tackle topics of relevance.

For Ijaye, we have noticed the emergency unit is not very good. We intend to build a better place but it will take some time to get people to work. We intend to have, like in OOUTH, state-of-the-art X-ray unit, C.T. Scan, radio diagnostic and get more equipment. We also need to involve banks in collecting money and helping us in keeping track of money collected from patients, for example on cards, investigation etc for all the hospitals.

We intend to involve more hands, as in consultants, nurses etc. For now we have six consultants as against eight; 12 medical officers; 156 nurses but we still need 64. We also need pharmacists, laboratory technicians, medical laboratory scientists, physiotherapists, social welfare workers, radiographers and health attendants. We have put the cost requirement there. And we will be taking each hospital one after the other. The state hospitals are first on the list and we intend to submit all our needs/requirements soon but we need to get all right. As you know, the Governor is a details man, we wouldn’t want to allow him see any fault or mistake in whatever we may present. That’s why this hasn’t gone. We need a three-channel ECG machine for Ijaye, patient multi-parameter measure oxygen concentrator and this also applies to other hospitals. We are also trying to purchase mobile X-ray unit to make accessibility to the patient easy. Of course, we plan to buy other small things needed.