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‘Why we don’t detain debtor-patients in Kubwa General Hospital, Abuja’

By Favour Nnabugwu, Victoria Ojeme & Alice Festus

Dr Mohammed Ahmed-DanFulani, Medical Director of Kubwa General Hospital, Abuja, in this interview, says Nigerians do not appreciate the expertise of their doctors as they prefer to go abroad for treatment, wasting so much money in the process, but returning home without improvement in their medical conditions. Ahmed-Danfulani also says Nigerian doctors are rated high anywhere in the world. Excerpts:

What is the magic behind the transformation of the hospital?
I will not call it magic. I will rather say persistency of aiming at a goal and working hard to achieve the goal. Again, when you have the people at the helm of affairs who listen to your ideas and they find some sense in them and then give you all the support needed to achieve such a goal, one cannot afford to disappoint them. It is the cooperation from everybody including the management, that is, the FCT Health Secretary and the FCT Minister that made some of those changes happen.

One thing is to get the funds; another is being able to use it well. How did you manage the funds that transformed the hospital?

We did our best. When I assumed office, l saw that there were a lot of gaps, I came in barely a year ago, l found that there were certain things not in place and needed to be corrected. That willingness to make those corrections is what has helped to judiciously apply the funds, but  we still have a long way to go.  If you look around, you will observe that we still have some challenges.

What are the challenges?
When I came into office, the hospital virtually stopped operating the theatre and I met about seven buildings that were locked up unused, and we were able to open all of them. In addition to opening all of the seven buildings, we have erected additional ones. Alsowe are at the verge of completing a special TB diagnostic laboratory which is going to be one of the very few in the country, an advanced form of resistant diagnosis of tuberculosis. The lab is very unique and I am sure it is an achievement that everybody will be happy about. We have upgraded our eye care unit. We now have a befitting theatre and specialised equipment for diagnosis and eye operation.

Dr. Ahmed-DanFulani
Dr. Ahmed-DanFulani

We were able to open a radio diagnostic centre where we have an x-ray, ultra sound which we didn’t have before. We also opened a locked up MDG building which is housing a new theatre just for maternity and postnatal process. We were able to open a dental unit, completely from the scratch with all the equipment. It is not just opening a dental unit we also have what we call the laboratory aspect. We get referrals from other hospitals in town to our lab here and that has been very tremendous in terms of the numbers.

The hospital did not have a laundry unit, they just wash behind the building but now we have a fantastic laundry unit with big industrial washing machines and dryer. We also have a new physiotherapy unit big enough for a good number of people. We have a restaurant which is completely new and then we have virtually renovated all the wards in the hospital and we have also increased the number of bed spaces from over 70 to 110.  We have started the process of getting a stand-alone pharmacy unit, another new building entirely.

We want to introduce admission facility specifically for psychiatric patients if we are able to do that, that will also be the first in FCT hospitals as currently nobody has a dedicated admission wards for psychiatric patients, they are just admitted into a general ward but we are trying to see how we can get about four beds strictly for psychiatric patients.

Again, the hospital didn’t have an intensive care unit.  If you look at the expansion, the number of surgeries we have done and the number of specialists we have on ground, you will agree that this hospital is one of the best. We have 14 specialists and they cover all areas.

What peculiar case has the hospital been able to treat that is exceptional?
There was obvious need for improvement of facilities when l assumed office but one thing that we did which l was really very happy about was that, in the past, when you have premature babies that are usually less than 1kg, most times, they don’t make it, but this particular one was just 0.8, that is, just less than about 24 weeks, they survive only in developed countries.  But that baby was able to survive here, that was the most impressive thing and then there was also another one, 1kg.

We also had a situation where an Okada rider was attacked by armed robbers who slashed his throat such that before we started the operation the patient had only four pints of blood. But with the grace of God, we were able to repair the neck, put it back in place. It was a wonderful experience otherwise that man couldn’t have made it. We also had a surgery on a hernia that was weighing almost 20kg, that is not common. We have also removed fibroid almost 5kg and it was successful.

What do you do with patients who are not able to pay their bills?
My principle which l believe applies to many other MDs in hospitals is the waiver system. We have a social welfare department which we refer such patients to and we carry out investigations including visiting their homes; when they give us report that this patient cannot pay, we waive it and release them. We are more particular about women and children who ordinarily are supposed to enjoy free ante-natal care. So the rule of engagement here is that from registration to antenatal, till delivery either by CS or by safe delivery, we don’t charge; if you book at the correct time, you can pass through that without paying and then, like we have noted in many instances, patients who ordinarily are not ANC having been admitted and cannot pay for their fees, we just waive it for them.

Do you think the level of people around can afford it?
Our medical bill is cheap; our philosophy is that the people that can pay should pay while those that cannot pay should be helped. A satellite like Kubwa has majority of FCT and federal civil servant who pay the bills. Some of them are under NHIS while others have health insurance scheme and can also afford to pay their bills. However, we still have a lot of people from the rural areas from as far as Suleja  Niger State coming to access care especially obstetrics and gynecology hence quite a number of them cannot afford to pay their bills. For instance, FCT staff are supposed to have what they call FCT health insurance system which means you don’t pay a dime and they are in the majority of not less than 80%.

Why do you think Nigerians still prefer to go abroad for treatment?
It is mentality. For instance, if you ask an average Nigerian where he bought a product which you admired on him, he will tell you he bought it from London; it may not necessarily be as good as the one you find in the Nigerian market. For example, somebody bought his shoes from Aba and many of us were crazy about the shoes.  The man initially told us it was from Italy but when he realised that everybody was interested, he confess that it wasn’t from Italy, that he bought it from Aba. I agree that some abroad things are very good but not all the time. We have a lot of good quality stuff now in our country that we are not making good use of.

l can also authoritatively tell you that Nigerian doctors, in spite of the limitations and all of that, can treat nothing less than 80 to 85% of all cases in Nigeria today.  But when it comes to rehabilitation, majority of the cases of rehabilitation can still be done here but l must also add that there are surgeries which even US refer to Indians and vice versa.  There are also surgeries that  require a bigger hospital and facilities but a good number of the people who go abroad for treatment, less than 10% of them actually need to do that while 90% of them can be taken care of here in Nigeria.

Nigerians spend so much money to travel abroad for treatment and pay huge medical bills that are not worth the stress of travelling for those numbers of hours spent in the air to India. The fatigue alone can kill yet they go and come back without solution. Then, another thing people who travel abroad don’t know is that there are some of the diseases that are peculiar to certain regions; so if such patient goes abroad for treatment, he is going to task the brain of the doctor treating him for him to understand the nature of the patient’s disease; if such patient is unlucky the doctors there will misdiognose him while he will not also get the required treatment.

Is it that they don’t have confidence in Nigerian doctors?
They make a lot of mistakes in terms of assessment, Nigeria doctors are among the best.  If you go to UK,  Australia even South Africa, you will discover that there is a good number of Nigerian specialist doctors working in those countries in competent areas. I hope that one day our government will encourage our doctors abroad to come back home so that Nigerians will not need to go abroad for  treatment. We have enough and competent doctors. What we need is just improve the facilities and find solution to the power problem etc after which we will be on top of the world. Nigerian doctors are rated very high anywhere we practise outside Nigeria.

Do you get enough income to sustain the hospital?
I won’t say that. The issue of funding is a general problem in Nigeria though World Health Organisation, WHO, recommended that every country in the world should allocate like 15% of its budgetary allocation to health, but the best we get in Africa is 10%; even in Nigeria it has been very difficult to get to that level.

However, l need to give kudos to the Federal Government and the FCT administration for their giant strides in addressing the challenges in the health sector in the face of  competing demands for government funds. I must say that funding should not be left alone for government. There must be private sector participation. In Nigeria today, businessmen are not investing seriously in the health sector, but the South Africa’s health sector is private sector driven. What government should do is to provide the enabling environment that will allow investors who don’t have to be doctors to invest in the health sector.


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