BY WALE AKINOLA
*’How to stem rising psychiatric disorders’
Dr Ayodele Lawrence Majekodunmi boasts of solid credentials to earn him the office of the chief medical director of the Federal Medical Centre (FMC), Ido Ekiti. A consultant psychiatrist at the FMC and head of clinical services/chairman, medical advisory council of the institution prior to his assumption of office as CMD, he is a Fellow of the West African College of Physicians. A professional of note and leader of men, the CMD, in this encounter, fields questions on FMCs and his primary constituency, psychiatry. Excerpts:
Some people say Federal Medical Centres (FMCs) are glorified tertiary healthcare providers because they are not properly equipped for that role. How true is the claim?
Right from inception, FMCs were established as tertiary health institutions so that they can handle all categories of medicare. Over the years now, FMCs, all over the country, have grown in leaps and bounds to the extent that, quite a large number of FMCs or average number of FMCs like our own, are comparable to teaching hospitals. So a large vacuum has been filled in tertiary healthcare contrary to the insinuation you mentioned.
In Ekiti and Ondo States where there are no federal teaching hospitals, patients with severe medical problems do not need to be transferred or referred to Obafemi Awolowo University Teaching Hospital or UCH or LUTH as it used to be. The FMCs do everything that all these teaching hospitals do. Ofcourse because of inadequate funding and some rare areas of specialisation, you still have reason to refer patients to other hospitals but substantial vacuum created by the lack of teaching hospitals in many parts of the country has virtually been filled.
FMCs base their operations on the law that established teaching hospitals. As we speak, there is still no law backing the establishment of FMCs. The enabling law is before the National Assembly. But because it is a tertiary institution and all the things that happen in the teaching hospitals happen here, we adopt the Act that established teaching hospitals.
Does that put the FMCs in the category of hospitals that train interns, house officers?
Let me take the FMC Ido-Ekiti as an example. When you talk about health care delivery or tertiary health institution of this calibre, we can categorise our functions to include service delivery which is delivering healthcare, treatment of patients, diseases. Two, manpower development. The question you raised falls under manpower development. In this hospital, the highest cadre of training that happens in teaching hospitals is training of qualified medical doctors to become experts, specialists in their chosen areas. And so, in FMC, Ido-Ekiti, we are already there.
Now, we train specialists in psychiaty. Just like UCH, Ibadan; we train specialists in paediatrics, community medicare, family medicine, obstetics and gynaecology, surgery, ENT. Apart from that, we train house officers, interns in all medical areas – pharmacy, physiotheraphy, laboratory science. Interns are those that have graduated but need one year training before they are licenced to practise.
How have you built on what you met on ground when you came in as CMD six months ago?
When I came in, in September 2012, I met a lot on ground that had been achieved by the previous administration. I was part and parcel of that administration. The training I spoke about, we already achieved a lot. The only addition in the last six months is in the ENT. In the area of infrastructural development, all the things we have on ground, we met them. If there is anything we have done in that area, it is modification and improvement of the structures. Even this administrative building, it could not have been done in six months. I met it on ground.
I understand you now have a nursing school?
We started it a long time ago. It was a challenge that stalled the take-off. And as God would have it, it is taking off under my administration. The students are in their first year, ready for their exam. Administration is a continuous thing. We are lucky here.
The new MD is an insider. I have been in the system for close to nine years. I worked with former Mds almost from the beginning to the end. I joined the hospital as the head of psychiatry and built my department right from the scratch. Today the department compares with the best in West Africa.
So we are lucky that one of us who has been part of the system, who witnessed the growth of the hospital and understands the dynamics of the environment is the MD. That is why the things have been relatively easy. He knows the areas of deficiency, where to adjust, to make the people happy and put the system in perfect shape.
Where do you hope to see the FMC, Ido-Ekiti at the end of your tenure?
I don’t even pray it remains on FMC. I believe it would have changed to a bigger facility/ As we speak,. We are expecting students from Afe Babalola University to join us, maybe in another two years. We have started planning for their arrival. Once they join us, that means we have taken another step forward because that qualifies us as a teaching hospital.
Afe Babalola Univesity is a private institution while we are federal government institution, but don’t forget that the Federal University, Oye is there. I believe that with a very good partnership, the Oye University will soon start their admission. I don’t see the federal government spending money to build a brand new teaching hospital for the Oye University if they have medical school. That means we can serve as their teaching hospital.
There appears to be rising cases of psychiatric problems in the Nigeria. How did we find ourselves in the unsavoury situation?
Talking professionally, it is not unexpected. If you look at mental problems, you can classify them as genetic or biological, and environmental. The environmental aspect has classification too. One of them is economic or social environment, or, better still, socio-economic environment. In Nigeria today, our socio-economic environment is terrible. Where do we start from? From the spate of unemployment? As the chief executive here, I know what I face. Sometimes it is like it is because of employment that I am here, not to do any other thing.
In one day, I receive employment requests of about 100. But it is not their fault. Majority of them are university graduates. Where there is such high level of unemployment, other things will follow, there will be vices on a high scale. Indian hemp smoking, drug taking. Even you have high rate of divorce leading to depression on the part of the victims and consequently mental disorder. These factors in the country are enough to make anybody run amak.
You go to work only to return to meet your house burnt down by Boko Haram and your family killed. You need to be extraordinarily strong not to end up in the psychiatry world-the trauma, the shock will be too much. Everyday we have armed robbery. So the simply solution is improvement in the socio-economic environment. And government alone cannot do it. People should see what they can do to ameliorate the situation so that it doesn’t lead to psychiatry cases.