By Dayo Adesulu
Professor Babatunde Solagberu, a Professor of Orthopaedic Surgery and the Provost of Lagos State University College of Medicine, LASUCOM, in his exclusive interview with Vanguard, among other sundry issues, spoke on medical capital flight and the danger it portends for Nigerian economy. Excerpts:
What are your accomplishments as a professor of orthopaedic surgery?
I assumed office as the seventh Provost of Lagos State University College of Medicine, LASUCOM on March 1st, 2016.
I studied our past sixth provosts and I am improving on whatever they have done. There are some areas, as human beings, where we have done wrong, in such areas, I find a way to stop it and improve on where they have done well.
Medicine in Africa
Our vision is to be the leading college of medicine in Africa. Of course a vision is a tall order, the vision brings us together. There are 136 academic staff in LASUCOM where everybody claims he or she is right and we have the opportunity of disagreeing, but the vision binds us together. At the time of divergent views, I only ask one question: if our views fall in line with the vision and mission of the college, if no, we put it aside and if yes, we adopt it. That is one major thing we have achieved.
Also we had parents’ forum, where 157 stakeholders came to set up an endowment committee to raise N24 billion in the next five years.
What do you hope to do differently to be a leading college of medicine in Africa?
We will follow the World Bank idea about the world class universities before we can be the leading university in Africa. If we must be a world class university, we must not depend on government 100 per cent. We have to have a private source of funding. NUC recommendation is that at least 10 per cent of your subventions should come from donations. Our subventions is in the neighbourhood of N1.5 billion in a year, so we are supposed to get about N1.5m from donations in a year.
544 medical doctors
We have produced 544 medical doctors, but those alone don’t make a college of medicine. We have those in dental surgery who are in their final year, we need to produce pharmacists, we don’t have a faculty of pharmacy; that is what the endowment is meant for. If in each of the 52 weeks of the year we bring a professor from either Harvard or Oxford universities to lecture and interact with staff and students, it will enhance joint research and collaboration that will promote the college to get to where we aspire.
Globally, the quality of research that is solution-driven is pivotal to the ranking of tertiary institutions, do you have some specific research topics in mind for your students?
In the endowment fund I mentioned earlier, 5% is allocated to research and development and 10% is for professorial chairs. The university has three mandates to pursue; teaching, training and community service.
Impact on the society
The society is the most important among these. The research must have impact on the society. We are the think tank of the society, hence we must be able to solve their problems through our research. Now that we have a high level of non-communicable diseases like diabetes and cancer, the university should be able to proffer solution through research, to the communicable and non- communicable diseases. The equipment to carry out these researches are the main issues and that is why we need the endowment fund.
As a surgeon and the team leader, we were able to know how many cases of emergency surgries that we have. We have about 1,200 surgical patients in our surgical emergency in a month. I am sure that medical emergency sees more, but if they don’t have a registry, they will not know. We were able to classify and have a good idea compared to any other medical college in Nigeria.
There is no hospital to my knowledge that is as busy as LASUCOM. Lagos University Teaching Hospital, LUTH is a big hospital that has a combined emergency of three departments. It has paediatric emergency, medical emergency and surgical emergency. In a month, they don’t see more than 800 cases, all the three combined.
1,200 surgeries monthly
In LASUCOM, only surgery admits 1,200 in a month and we don’t have the manpower as they have. From the national average of the 1,200 that come here, 70 per cent are injuries, trauma-related, road traffic, fall, burns and gunshot. That tells you that you must organise a system of care and resources.
What can we do to minimize the inflow?
In a year, we have not less than 150 cases brought in dead. Lagos State Government is responding and like Oliver Twist, it is not enough. Just on the 11th of this month, Governor Akinwunmi Ambode was here and personally commissioned the equipment for ear transporting which has elevated our college’s status.
Research makes you have the confidence to tell a society that you care. Until we established the trauma registry we didn’t know all these. We are covering the entire Lagos State. We have assembled at fifteen centres. The four tertiary centres included LUTH and that is why I am able to tell you about LUTH, Igbobi and the Federal Medical Centre, Ebute Metta, as well as other 11 general hospitals.
What do you think is the reason for medical capital flight in this country and what can be done to arrest the situation?
We are a country that is sleeping and we need to wake up. It has even gone beyond capital flight. Go back to 1980. I graduated from the University of Ibadan in 1987. By the time we were finishing in the medical school, many of our lecturers had gone to Saudi Arabia. After that, our fresh graduates started going abroad. In my class, we were 240, next year will be 30 years we graduated.
From that 240 medical doctors, we discovered that 20 years later, about 150 of us have relocated to North America and Canada, and another 40 to 50 had gone to Europe and other parts of the world. That was my own 1987 graduation set alone. Only 40 to 50 of us stayed back in the country. I can tell you that it is like that in many Nigerian universities. This is what goes on in all universities across the country.
Right now, it is the patients that are now going abroad for medical treatment. Remember that it started with the lecturers going abroad, students followed and now the patients are going there to meet them for treatment. Why will our patients stay? They can’t stay because the experts that will take care of them are overseas. Our government has refused to fund health. Fifteen per cent of our budget should be devoted to health.
At the moment, they have started bringing their medical services down to Nigeria. You must give it to those medical doctors who decided to stay at home because the system in Nigeria does not encourage them to stay.
How can we solve this problem?
The first strategy is know the quantum of medical students, medical lecturers, and medical patients that move board. The government then has to bring together some experts like me and other like-minded people to look for the solutions and come up with a report. We can’t jump into a problem without knowing how big it is. Whatever money we have will just go down the drain.
Government should fund our medical colleges, provide equipment for our hospitals and encourage the medical doctors we have in Nigeria with the needed environment to thrive.
With the 9 years you have spent here, would you say that the rate at which commercial motorcycle riders were admitted has reduced since the ban of commercial motorcycles in 2012?
I am an employee of government, but I play a dual role. I am also a professional that is to advise the government, irrespective of what government says. However, at the end, the government has the final decision.
It doesn’t take serious intelligence to say ban ‘Okada” and reduce accidents. It was exactly in August 2011, one year after we had our registry that the ban happened, while the new traffic law started August 2012. So, by August 2013, we compared. Injury rate actually reduced, but there is an aspect that people are not looking at.
Zero death rate
Death rate from ‘Okada’ became zero, I mean those who died in our care, but 15 died in a year from ‘Okada’ accident. Those brought in dead reduced from 24 to 2.
However, injuries and death from tricycle, cars and buses went up but the total injuries reduced from about 1,200 to 400. So there is massive deduction in number. No doubt that the motorcyclists were contributors to the numbers of injuries and death statistics.
However, when you are taking decisions, you have to consider the pros and cons. However, our research identified four reasons people use the motorcycle.
First, it is the best way to beat traffic jam, very attractive. Two, it is about the only means to make your journey. We have people who have cars but could not take their cars to where they are living as the rest of journey is finished with motorcycles.
Means of livlihood
Third, it has provided a means of livelihood to those engaging in it. Our research in 2012 shows that the average income for an Okada rider is N30,000. I don’t know the current income. It makes it easy for many artisans to leave their job and ride ‘Okada’. It is attractive, profitable and very easy to posses. As at the time we did this study, in 2013/2014, with N60,000 or N80,000, you will get a brand new motorcycle. Without licence, they put it on the road and they are making money. There are many employed people, including our uniformed officers, who are ‘Okada’ riders on the side.
I know of a driver whose boss bought him a motorcycle for fear of others snatching him from him, when it was apparent that the salary was not enough for him. With that singular motorcycle, he bought another and also bought a piece of land from the proceeds. So, when you now ban Okada, you are oblivious of the fact that it helps people to beat traffic jam.
However, as a researcher, injuries from other vehicles increased, tricycle, buses and cars. I think Our concern should on enforcing injury preventive measures. You ban Okada and you are happy, but the injuries from car, buses and tricycles climb.
For example, in the United States, when they started with helmet law from three states to almost 36 states every state was passing the law. People started complaining that it was their fundamental human right to choose to use helmet or not. As a result, states started reverting the law on helmet and it dropped from 36 to about 13. Of course, injury and death rate started climbing up. You are getting your freedom, yet at the expense of your life.
My position is that when you ban Okada, it is like throwing away the baby with the water. Let us institute, injury preventive system. We have militarise our federal road safety commission in this country, which suppose not to be. Why should I be afraid of somebody who is suppose to make me live. It should be community participation.