Seven-year-old Delta State University Teaching Hospital (DELSUTH), Oghara, is, today, enjoying an outstanding status among tertiary health institutions in Nigeria. Leading this initiative is Chief Medical Director (CMD) Dr Onome Ogueh, an Obstetrician/Gynaecologist, who tells BOLAJI OGUNDELE, how his intervention is meeting the founding fathers’ vision of a world-class hospital that emhasises ‘’excellence in patients’ care.’’
Nine months in the saddle
It’s been quite challenging; there were loads of issues that I came to meet, but we’ve been working through all of those issues, which I know we are going to make real progress on them…
Specifics?
Take for an instance the time I got here this facility has not had electricity for three months, we were cut off from the power source because we were having issues with payments, we were running on generator and that was something good for a hospital, where we had equipment that rely on power. We have three generators; a 1000 KVA, 500 KVA and a 200 KVA generators. These were what were being used to run the place, but very quickly, with the help of the state government, under the leadership of Dr Ifeanyi Okowa, we were able to restore power. The state governor has been very magnanimous to this institution since I came on board. With the help of an initial grant, we were able to pay some of the money we owed the electricity company, so we were able to quickly reconnect the hospital to BEDC. That’s something that we have done since I came, but we also want to go beyond that by having a dedicated line that guarantees 24/7 electricity in this place and as we speak, we are currently in the process of connecting that. That’s what we should expect in a facility of this sort, especially when one of the main visions of the facility is to provide world class excellence in patients’ care and you cannot do that without having guaranteed 24/7 electricity supply.
Towards a world class excellence in patients’ care
By the time I got here in December 2016, we had a 64 slide CT Scan in this hospital that had not worked for about a year before I got here. We also have a 1.5 Tesla MRI, there’s probably only one or two in the whole of the South-South, top range equipment that had not worked for about 4 to 6 months by the time I got here and we had loads of such other equipment in this place. If I take the Radiology Department as an instance, we’ve had funds from the government since I came and we’ve now been able to revive the department so that now we can provide any kind of radiological services that people need. Now, unlike in the past, rather than go to Lagos or Abuja to have MRI or CT Scan, all that can now be done at the Delta State University Teaching Hospital.
We’ve made strides in that direction and you can say that in the 9 months that I have been in the saddle, I have been able to revive the Radiology Department, but one of the things we have also done , which is a bit different from what we used to have is that we now have a public/private partnership arrangement with EcoScan, which guarantees that the Radiology Department will remain functional all the time. They have a maintenance contract with us; if any equipment goes down, you won’t have the kind of downtime we had before my coming, now there’s no downtime anymore. Before patients get to know that there’s a problem with an equipment, it has been fixed because there’s that maintenance contract for managing all of those equipment in the department. They maintain the equipment and run the department so the service is now seamless. However, we still have the staff of the hospital, the teaching staff, they are still the ones delivering the services, but they now have the private partners who are ensuring that everything that they need for the functioning of the is there; they manage the facilities, they repair and fix things if necessary. With all of that being done, it means that the rest of us can concentrate on doing the real work of caring for the patient.
Well equipped, what about manpower?
We have manpower, but one of the things that we also find in this country is that we may not have all the man power we need in every area so if I take this hospital for instance, this is a major teaching hospital in this area, the only one in Delta state and which is quite close to a major thoroughfare between Warri and Lagos, which means that we see accident victims on a regular basis, but at the time I got here we did not have a neurosurgeon, we had to send cases in the need of neurosurgical care out, but since I came, with the kind approval of the governor, Dr Okowa, we now have neurosurgeon who came on board in May 2017 and since he came on board we are now able to treat people with brain injury or any kind of neurosurgical procedure we are able to provide here.
So we now have those kinds of manpower and that’s why it’s useful to say at this point that we are working at achieving the vision of this institution; which means that if people have medical conditions for which they need help, before they think about going South Africa or India or the UK or America, they should think about coming to DELSUTH first. That’s our drive; to be able to deliver that kind of care and I know that we are making real progress towards that.
DELSUTH’s future
I want us to achieve the vision of the founders of this hospital and the vision is to achieve world class excellence in patients’ care and some of the things I’ve said to you are working towards that goal, but even if we have that world class goal and we are able to do some of these things here, we still have to do the small things right. In terms of the small things that we are doing, as we speak, just yesterday, we have approved funding for an optic laboratory. We have an Ophthalmology Department in this hospital, we have ophthalmologists who do high end stuffs, who are able to operate on the eye and do all sorts of things for people who have problems with sights, but when patients need glasses for example, they now have to go outside to buy, but what my approval yesterday will do is that those patients no longer have to go outside, they now have the complete package here. That’s what I meant by doing even the small things well. Like we have the Eye, Nose and Throat (ENT) specialists, one of the other things I want to achieve in the next few months is to buy and audiometer to that we can also do hearing test here rather than do all the big complicated things, but we don’t do the small things; when you need a hearing test we send you out elsewhere, but now we’ll be able to do all of those.
We have a Maxillofacial Department, the Dentistry Department; we have loads of wonderful equipment that we have in the labs, but have not been used in the last 7 years. There re a few things left to complete a restorative dentistry lab, that’s something else that we are hoping for so in the next few months we should be looking at having a restorative dentistry lab where we can do interesting things for people, do tooth implant for instance and all of those kind of things that can add to the main work we do. In the Maxillofacial Department, for instance, we’ve been doing loads of interesting things. We recently removed a huge left-sided tumor from a young boy, an ossifying fibroma from the left mandible. This is a tumor that took over the whole of the left side of this boy’s face, but again I keep going back to our governor because he saw this boy in town hall meeting and referred him to us here and we managed to do that surgery. When people see the boy now, they wonder if he was taken to India for the operation. No, it was done here at the Delta State University Teaching Hospital. So we are doing those big things, but we also need to do the small things so all of those small things we will be achieving in time, we will continue to expand our services. We will grow the place so that we can really get to that vision of world class excellence in patients’ care.
Challenges and solutions
One of the biggest challenges in the role I’m playing here is attracting funding to the hospital to be able to provide the services that we need our people. That’s a major challenge, but like I’ve said, I’ve had a very good relationship with the governor, who has a keen interest in this place and has been quite forthcoming with funding to help us achieve some of the things we need to do. I’ve also said that we’ve been looking at public/private partnership to try and raise those funds. We have one in the Radiology Department, we also have a private partner for the laboratory services, that too is to ensure that we have some regular income without having to do too much in terms of investment into the lab. Money is a challenge, but we are doing what we can and we are hoping that as we improve the services that we give, as people begin to see the kind of quality of care that we provide that money will follow because people will want to come here. Like I said, people should about DELSUTH before thinking of going anywhere else. Growing the services is one way of attending to our challenges.
One other big challenge that we had in this place, I’ll say, is one of industrial disharmony. Before I came, situations were that out of the 365 days in a year, you had more than 200 days that the hospital was shut down because of industrial actions. But since I got here in December 2016, this is the first time this hospital has had a strike and as you know, this one is a national strike and none of the things they are talking about has anything to do with this hospital, but the resident doctors felt they needed to join the national body. But for the first time in the history of this institution, this hospital was opened in 2010, for the very first time, a group of doctors has gone on strike and the hospital is still open because for the first time once we knew that the resident doctors were going on strike, we immediately put measures in place to ensure that the doctors who are left, the consultants, the house officers, are able to continue services. For instance, even as we are on strike, the Outpatients Department is still running. I ran my own clinic on Wednesday. Other doctors are running their own clinics now. We also decided that patients who are already in the hospital must be looked after; so, we didn’t discharge patients in the hospital.
The laboratory is functioning fully, the Radiology Department is functioning fully. The only thing we said is that we will not bring in new patients because the resident doctors who should be the people on the ground are on strike, but the rest of us are still working and giving patients care. So in terms of dealing with the challenge of incessant strikes, we’ve now gone almost 10 months without strike and the only reason we have a strike now is because it is a national strike. The way we have been dealing with is by being proactive; I’ve met with all staff groups, all unions and we’ve been able to address issues that people may have in a positive and collaborative so that there’s really no need to begin to look at industrial action because in fairness there’s really no issue you cannot resolve with dialogue. For an institution like this, where people’s lives are put at risk, we must focus on using dialogue to change the way we address things.
Greatest challenge
I must say that the greatest challenge for me in the this place is about changing the hearts and minds of my people, the workforce, so that people can begin to think more positively about the work they do, about the institution, about where we are heading as an institution and what the vision for this place is.
