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What happened to me as minister was not for lack of experience

By Jemi EKUNKUNBOR
Until her furor into the murky waters of Nigeria politics, Professor Mrs Adenike Grange remained one of the finest Paediatricians the country ever produced. Her medical career began at the Lagos Island Maternity, the Creek hospital and the Massey Street Children’’s Hospital.

Prof. ADENIKE GRANGE

The author of over fifty scientific papers mainly on diarrhoeal and nutritional conditions in children, she rose through the ranks and became a Professor of Paediatrics, the Dean of Clinical Sciences as well as the Director of the Institute of Child Health in the College of Medicine at the University of Lagos in Nigeria.

By dint of hard work, she rose to become the first black woman to be president of the Paris based, international Paediatrics Association (IPA), a position she held until her appointment as Minister of Health in 2007.
When things fell apart with government, the amiable doctor, mother and grandmother, took up a new challenge to establish and manage an all Children’s hospital, the Otunba Tunwase National Paediatric Centre, Ijebu Remo where she is currently the Provost and Chief Executive.

Basking in self contentment, the 1964 graduate of the University of St Andrews in Scotland opened up on her new assignment and what truly happened as Minister of Health. We went down memory lane to the 50s when she first arrived UK as a young girl to complete her secondary education at the St Francis College, Letchworth.  Enjoy it.

What was it like at that time having to travel abroad to complete your secondary education?
It was rather bilwildering but because my personality is that of an adventurous one and also because I knew that my going there was to acquire more knowledge and to meet my life goals, I was determined. That determination made me over look everything else that could have actually made me fearful. So I was rather excited.

What was the racial situation like at that time?
We were very few blacks. On the street you would not know that anybody did not want you but in school, occasional, there was demonstration from somebody to say you are different. But as one person would say that, others would be on your side. So, what I got was mixed messages from school children.

But some of them were enlightened enough at that time and they are still my friends till today. But then provision was made for me to have a guardian and she was a kind and fantastic person of the Salvation Army faith.

On your return after your studies, you joined Massey Street Hospital. How would you compare what you had then with what we now have?

The Massey Street at that time was very crowded, ancient, and a bit drab and somewhat dangerous actually because, for us to look after all the children, we had to cross a road from the out-patient to the in-patient area and it was a bit of an enigma.

In terms of staffing, there was always inadequate staff and we were always overworked. Each doctor saw up to 200 patients a day. But I would say that now, possibly, there could be slight reduction because of the child health programmes which has been going on for quite some time; immunization, oral re-hydration etc.

But of all the cases seen, they would still be seeing more preventable conditions like malaria, diarrhea, respiratory tract infection etc. So, we really haven’t moved too far forward. We should have gotten rid of all these now but there are so many factors why we haven’t done so.

There are factors on the supply side and factors on the demand side. Not being enlightened means that some mothers would take their children late to the hospital and beside that, they will not take the right steps to prevent this conditions. They usually allow the condition to get worse before taking the child to the hospital. So you have heavy load of children coming but inadequate resources to cope with them.

How come not much has been done about the environment in children’s hospitals?
That is why you must find time to come to Ijebu Remo to see the hospital where I work now-  plenty of room, lots of colours, greenery and we do get our children better, faster. About two weeks ago, we had like 13 children and within three to five days, they were all gone and the doctors who are on duty 24 hours live there.

Why haven’t we been able to do that with government hospitals?
I think it’s a matter of prioritization. When a leader who is responsible for providing certain services is given a certain amount of resource, he has to prioritize and choose whether to give more money to education or to hospitals. But that process needs to be made transparent and also ensure that those who are going to give the service are involved. There are ways and means of coming up with the right formula so that no area is short changed.

So for children, it should not be a top down approach because it may not be the priority of that hospital. And that is the advantage that I now enjoy because I have made my assessment, my situation analysis and we have prioritized and we all decide what we should spend our resource on.

This is the way it should be done but it is not done that way in government hospitals.
How was your time as president of International Paediatric Association and how did that office prepare you for your next assignment as minister of health?

Many years ago, I was president of Paediatric Association of Nigeria and as president of the national body, that made me active internationally. Somehow, the IPA at some point, felt I had shown enough aptitude and interest to make me their president.

Of course,  I needed the support of my home base and other Paediatric associations which I got. And that made me the first African international Paediatric president south of the Sahara and certainly the first female. It was a three year period during which time, I was involved in a lot of traveling, keeping up political pressure on governments.

Now it was a different ball game to now become part of the political group that will make things happen. I wasn’t shy coming into that arena because we knew we had programmes, we knew we had to address system failures and mobilize support but what perhaps I did not factor in, was that the scenario in Nigeria was changing very rapidly.

Even though it was a democracy, the leadership was changing its complexion very rapidly. What made them invite me to come and be minister initially, was that they did not take into consideration that there was a political pressure group that will see me as not being part of them.

They saw me an alien. Ideally, in developed world, I would have fitted in very well because I had the skills, knowledge and will power. But coming here, it looked as though their expectation was more of playing the politics than actually doing the work. And this happens at every where. In retrospect, this was really a big problem for me.

Unfortunately, I did not foresee them. Now I see that it is going to be very difficult for people with pure motives to survive. What they said happened was not what happened but people took advantage of the fact that some people have assess to getting lies out and making them look real well, I’ve learnt my lesson
Would you take up another political assignment if offered?

Of course, I would if God directs me to do it. But, I would probably do things differently so as to ensure that I survived.
Why is it that Nigerian professionals do well when they go out but as soon as they are invited home to take up jobs, they get their records messed up?

I think that we are still at a stage where our people sometimes don’t want the truth because they know that getting the truth will mean that they will have to do a lot more work to put the right people in the right places and many of them are not absolutely honest.

The dishonesty is from top to bottom. So what happened to me was not for lack of experience. And one of the indicators of what should have ended up in successes was that some of the international agencies were very ready to work with me because they’ve known me for a very long time.

Within a short period, I was able to get the DG of World Health Organisation to come to Nigeria because I invited her to come. And she had asked, “now that you are minister of health, what do you want me to do for you?” So she came and I discussed and laid down certain things that I thought the WHO can help us to do. Just after that everything fell apart.
How would that affect friends that would have helped Nigeria?

Well, I wouldn’t know. But I know that one or two of them became more skeptical and more cautious because they could not really reconcile what happened with what they expected to happen because they expected government to use my special skill to reform that sector. But they were allowed to be distracted because as far as I was concerned, that was a distraction and they got carried away with the distraction. But I must thank my colleagues who stood by me because they were sure of me. With that I felt confident that the truth will prevail.

Where did this passion for children come from?
I would say I had passion for medicine first before I got interested in children. Learning about the many areas of medicine, I guess I got glued to children.

Along the way, I had several people who inspired me. My professors abroad also inspired me one of them died recently at the age of 100. When you meet people like that, you can’t help being passionate and I was moved by the fact that there was a lot to be done for children so I felt why not do what you can do to help?. So that was the basis of my action.

What would you advocate for parent to child transmission of HIV?
Well, there is a programme but the first thing to prevent HIV from getting to the child is part of the national programme that is, abstinence, use of condoms etc.

Then during pregnancy, you try to ensure that the virile load is contained so that you don’t pass it on through the placenta. Then at delivery, there are certain maneuvering that you have to do and then after delivery, the baby is treated immediately so that whatever viruses had passed in can be killed.

I believe that our policy now is that babies who are at risk of getting HIV through breast milk, the mothers would be counseled on how to feed the baby so that it does not expose the baby to risk. At Otunba Tunwase, all our staff have been trained on guidance and counseling and facility for making diagnosis. So we provide services within the frame work of the national programme.


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