The Federal Government has upgraded its Federal Medical Centre (FMC), Ido-Ekiti, in Ido/Osi Local Government Area, Ekiti State to a teaching hospital. The Chief Medical Director of the hospital, Dr. Majekodunmi Ayodele, in this chat with ODUNAYO OGUNMOLA, bares his mind on the benefits of the upgrade in the delivery of quality healthcare. He says the hospital’s new status will enhance medical students’ access to training.
Can we have insight on your background?
I am a trained psychiatric and came to this hospital as a consultant more than 10 years ago. I pioneered the psychiatric department with the support of Dr. Ololade Ojo, who was then my boss and the Chief Medical Officer (CMD). We worked together to take the department to an enviable height that earned us recognition by the West African Medical College as one of the best training psychiatric centres in Nigeria .To the glory of God, I moved from there to become the Head of Clinical Services of the hospital. That position I held for two years. During my tenure, I brought a paradigm shift to that office. I had to sit in as acting CMD Dr. Ojo completed her second term. In September 2012, I was made the substantive
CMD. Since then, the struggle to get a teaching hospital status for the Federal Medical Centre (FMC) and with the mighty weight and philanthropic gesture of our revered Aare Afe Babalola, we have been able to achieve this dream.
The feat was achieved not until the philanthropist has expended about N2 billion in putting the infrastructures in place according to the dictate of the Medical and Dental Council of Nigeria (MDCN) and the National University Commission (NUC). Now, we when clinical hostels that you would probably not find in any teaching hospital in this country because, each room is en- suite for all the students. We also have fully equipped teaching laboratories, for the training of these students. It is all with the efforts of the sage himself and we are able to sign a Memorandum of Understanding (MoU) with the Afe Babalola University (ABUAD) which was facilitated by the Ministry of Health (federal).
The FMC has just been upgraded into a Federal Teaching Hospital by the President, Dr Goodluck Jonathan. The hospital is now in the club of those hospitals where medical students undergo clinical training.
When did the idea of upgrading started?
As a matter of fact, I would say that the renaissance started with my predecessor. We shared a common vision and she opened the floodgate of this hospital to a number of consultants during her eight- year tenure. We have up to 50 consultants then. Although, the number is not fixed because, as some of them are coming in, others relocating to other
institutions within and outside the country. It was during that time we started the idea of changing the hospital to the status of a teaching hospital. And that is why I pioneered the training of clinical students in this hospital. My Mental Health was the first to go into residency training.
Before now, we had departments that were given partial accreditation. So, when I came on board, I ensured that we had full accreditation for some of these departments. Apart from that, we had new departments like the Ear, Nose and Throat (ENT) department. We also have new Pathology Departments – the Chemical and Microbiology. They are all into investigation. What we concern ourselves with is the strengthening of the already laid down structures in the hospital. And for us to do this, a number of reforms have been carried out in the last two years that I came on board. These are fundamental to any institution like ours.
The first step I took was to ensure that all the Internally Generated Revenues (IGR) are paid directly into the banks. It was to end the culture of business as usual. Because, one thing that can easily frustrate the operation of this institution is lack of finance, more so, that government is not 100 per cent responsible for its funding owing to the austerity measures here and there. So, we fought that battle and won. Although, it is not a new thing because, other institutions do it but we happy that that is also entrenched in our system here. I am also happy that my people also realise that I meant well for them by introducing such measure. Even as CMD, if I had to spend a dime, I had to raise a voucher for that purpose. I cannot just draw any money from any cashier.
That was what was in operation before I took over. Part of the reforms is that, we had to constitute some bodies that were never in existence before, like procurement committee. It existed in law but not in practice before I came. This is important so that the CMD or anybody would not just appoint anybody based on closeness or friendship to be buying all the items needed in the hospital. The law is clear on who should head the committee and there are processes. Then I also resuscitated the Drug Revolving Fund (DRF). The head of Clinical Services is to head the body and the Chief Pharmacist The ServiCom now is in operation.
Above all, we laid emphases on discipline and hardworking since we are providing the necessary infrastructure. The reforms are directed towards improving clinical services and welfare of workers too.
With the teaching hospital status, is your management considering the possibilities of raising charges for patients in this hospital?
We will be shooting ourselves in the leg if we increase our charges in a hospital that has just being upgraded. What we need most now is the number of patients patronising us because we cannot afford a teaching hospital that is empty. Also, considering the level of poverty in this part of the country, doing so might be counter-productive. If you increase their charges beyond their reach, they naturally stay away. They rather wait until they see somebody who will assist them or they die. So, it is better to bring the charges down to the barest minimum. What we are planning to do here is this; the issue of austerity in Nigeria is not a new thing. And some people are saying that it is just being pronounced officially. Our overhead is so negligence – almost non-existence. I mean what is being given to us from the Federal Government to run the hospital per year. We get an average of N4 million per month which is not even enough to power our generating sets. As I am taking, we are still running on generators and we must ensure that this place runs like a standard hospital. You will probably turn back if you come into the hospital at night and everywhere is dark. We are also strengthening our outreach programmes to the nooks and crannies of the state and beyond so that people can have a feel of the services we render. Apart from that, we need to device other means of generating funds. This is why we established the ventures that are self-sustaining. These would generate income for the hospital. It has been registered with the Corporate Affairs Commission (CAC). We intend to have among others things car wash business, poultry farming, water plants and so on.
How was the idea of teaching hospital conceived?
Well, let us give God the glory. I am only fortunate to be the pioneer medical director of the Federal Teaching Hospital, Ido-Ekiti but the whole idea emanated from Aare Afe Babalola himself. He told us that from his experience outside the country, we have varsities that run medical schools but never had teaching hospitals of their own because they could just reach out to any standard hospital around and affiliate. Aare cited many examples of where such is done in Europe and America. So, he brought the request to my predecessor. Although, there was initial error in the sense that my former boss took the whole matter on her own shoulder, thinking she could grant the request. Eventually, the Ministry of Health got to know about it and nullified everything. It was only last year that we restart the process through the normal channel. The former Health Minister Prof Onyebuchi Chukwu said only the President of the Federal Republic of Nigeria could upgrade a hospital to a teaching status. And without being in a teaching status, it cannot train medical students. The minister advised that we should apply to Mr. President through my office, telling him the facilities that we have on ground and why we think we could do it. He later said he would send the ministry’s team to access the facilities before he puts forward the recommendation to Mr. President. That was exactly what
happened and it took us almost a year to complete the process. All these were made possible because Aare Babalola was a tenacious person and one bid lesson that learnt from him is that he did not believe in impossibilities. Aare Babalola is a philanthropic of high repute who will commit any amount to a course he believes in. All these he did for the betterment of humanity. For somebody to commit as much as N2 billion in
a project, even if somebody is rich, I don’t how many people would want to do that, knowing that all the facilities would not
be his own after ten years. I don’t know whether the MOU states anything about a sharing formula. It only says that after 10 year, Aare Babalola ceases to make use of the place. He was optimistic that before the expiration of the agreement, he would have put up his own Teaching Hospital. In other words, it is like providing facilities for government for a period of 10 years. Aare uses his name, his goodwill to remove all impediments along the way.
After the expiration of the 10-year agreement, does the university have the plan to renew it?
I must believe so. Although, it is not clearly stated in the MoU but I think there can be room for that. So, I don’t think it would be too difficult to do that if the ABUAD hasn’t gotten her own teaching hospital.
What do you think could be done to discourage medical tourism by Nigerian leaders?
Let me start by saying that I don’t believe that our leaders travel abroad for medical tourism because we lack facilities in Nigeria, or as a result of lack competent experts. Some of our leaders who go for treatments overseas do so not because of medication, but because they want rest. They have this notion that they would have a better time to relax in the developed world. But, if we are talking about care only, I would say that a number of them travel out for sickness and diseases that we can attend to locally here in Nigeria. So, they go there to catch fun. No matter how equipped this hospital might be, those who are hell-bent on travelling abroad will still do that because they have other reasons for their actions.
What are those spectacular feats that you have attained or recorded in the institution?
I pioneered mental health and it was surprising to the people in Lagos and other parts of Nigeria. Many of them were asking where is Ido-Ekiti on the map of Nigeria? Many confirmed that residents doctors from our hospitals who who go coming for examinations do excel with high grades ahead of their colleagues in bigger and older hospitals. We are doing a lot of exploits here which is not known to the public and that is why we are seeking the assistance and corporation of all, including the media, in this regard. By law, we are barred from placing advertisement but we can only do it in a subtle manner.
Right now, we have not less than 66 full-time consultants. I am talking of those who have attained the peak of their chosen careers in medical discipline. With that alone, it is obvious that we have the manpower here. We have the gadgets but we will still need more, even the Lagos University Teaching Hospital (LUTH), the University College Hospital (UCH) and others need more.
If you go round the hospital, you will see our dialysis centre. It can match any within and outside the country. We have no fewer than six dialysis beds here and we have a separate one for HIV patients. And we charge paltry fees. We also have a cardiac centre.
