Dr Damilola Akinsulire is a Consultant Public Health Physician with Lagos University Teaching Hospital (LUTH). She runs a medical outreach programme (breast and cervical screening, family planning, counselling & services) for women prisoners and the underprivileged. . She has touched more than 5,000 lives through her initiatives. Akinsulire, a recipient of the prestigious Mandela Washington Fellowship, was the Best candidate in Principles and Practice of Public Health, 2017 at the National Post Graduate Medical College. In this interview with Omolara Akintoye, she speaks on her experience and how government can ensure fairness in the allocation of resources.
ELL us about your work at LUTH?
My work involves implementing effective programs in communities to ensure that the health of the community is optimal. I chose the field of Public Health and Community Medicine because it is a field that emphasises prevention, focusing on not just the health of one person but of the entire populace. Our focus is on prevention, because if you are able to identify and prevent the root cause of a disease, it is more cost effective than when complications have set in.
Here in LUTH, we run a “Well Woman Clinic, immunoprophylaxis clinic and an endemic clinic. The beautiful thing about the well woman clinic is that it is run alongside the immunoprophylaxis clinic, which allows mothers get immunisation and care for their babies and still have an opportunity to care for their own health, thereby reducing frequent visits to the hospital and lost time at work. The well woman clinic provides cancer screenings, family planning counselling, HIV counselling, to mention a few.
There are lots of myths and misconceptions surrounding infertility and family planning, at LUTH, we try to dispel these myths. These women get information about their reproductive health and the choices to make on family planning. I’m also into quantitative and qualitative research, which guides policies and allocation of resources for health programs. Research and health needs assessment is key to implementing effective programmes.
Do you do anything outside LUTH?
Yes, I am actively involved in health outreaches and mentorship programmes for young persons. Outside my work in LUTH, my focus is on marginalised communities. I am very passionate about connecting marginalized women and young persons to reproductive health information and services. Take for example market women, these are also a marginalized group.
Have you ever wondered how this group get information and access health care considering the fact that they spend long hours in the market. This curiosity prompted me to do a Research work on “Birth Preparedness and Complication Readiness amongst market women” This was to serve as a baseline and guide to future programs for this group. It is a fact that maternal mortality is high and we can only tackle this problem by leaving no one behind. If we don’t consider marginalized groups of people including adolescents and young persons, we will keep having worse health indices. I was at different markets in Mushin local government area to find out how these women get information about their health and some of my findings were interesting.
Can you please share some of your findings?
These group of people had little or no information about the concept of birth preparedness even though they were able to relate with some of its components. The “Birth Preparedness and Complication Readiness’ concept emphasizes getting prepared for Pregnancy and Delivery. This involves saving money for delivery, identifying a blood donor, identifying a skilled birth attendant, making arrangements for transportation to the hospital when labor starts and having information about danger signs in pregnancy and postpartum.
My findings revealed that most of these women wait till last minutes to make preparations for their delivery; they wouldn’t register for Antenatal care until they are fifth to sixth month gone. Not being prepared for birth and delivery contributes to maternal mortality. A lot of women still deliver at homes or with unskilled persons. It is very important that women know about the danger signs in pregnancy such as swollen legs, excessive bleeding, frontal headache and heartburn. Such a woman should see her doctor immediately.
An effective strategy to tackle maternal mortality is to look at the health of the woman right from the womb to the tomb. I mean using the Life course approach.” This is why I am interested in the health of women, children, adolescents. An unhealthy fetus from a malnourished mother may have intrauterine growth restriction, which in turn affects brain development and her grades in school. An uneducated woman is more likely to engage in unhealthy habits and delay in making the right decisions for her health.
Ignorance and inability to make prompt decisions when emergencies arise in pregnancy contributes to maternal mortality. It will interest you to know that the nutritional status of a mother in pregnancy has been linked to the development of non-communicable diseases in her child. Recent researches are beginning to link malnutrition in the mother and fetus to be associated with the development of hypertension and diabetes in the baby in future. This is called metabolic programming. There is so much to talk about concerning the health of women and children. The health of these group are intricately linked. A healthy woman equals a healthy nation.
Tell us your experience with female prisoners
The government needs to pay attention to the state of the prisons. The problem identified in the prison I visited recently was overcrowding and we know that this puts the inmates at risk of respiratory tract infections, skin diseases and other contagious diseases. The free medical outreach to the prisons was to create awareness on breast cancer and empowering the inmates on conduct of self-breast examination. I also treated ailments and skin infections and provided the women with toiletries and sanitary towels.
How do you get funds for these projects?
I’ve been leveraging on family and friends who have been very supportive as well as my personal funds. I am also collaborating with organisations to generate funds for future projects.
As a beneficiary of the prestigious Mandela Washington Fellowship, what was the lesson learnt?
It all started in 2014 by President Barack Obama. The fellowship is the flagship program of the Young African Leaders Initiative (YALI) that empowers young people through academic coursework, leadership training and networking. It provides young leaders from Africa with the opportunity to hone their skills at a U.S. college or university, with support for professional development after they return home. The competition was keenly contested that in the whole of Africa, there were over 64,000 applicants and out of this, 22,000 of the applicants were from Nigeria. But only 100 of us were selected. It’s been a life changing experience exposing me to how the American health system runs and most importantly my leadership skills were sharpened. It was a rigorous 6 weeks coursework at the Ohio State University, where I studied Public Management and Policy. I will be applying the trainings and experiences gained to my public health work here.
Tell us some of your success stories
My success story is that I am impacting the lives of women and young persons and putting smiles on the faces of the indigent and impoverished. Career wise, a recent success was an award I received from the National Postgraduate Medical College as the best candidate in Principles and Practice of Public Health in Nigeria. It’s quite humbling for me, and it is no doubt a call for more service to humanity. I’m grateful to God, my teachers and my mentors.
What is your advice to other doctors?
It’s very simple. Be humble, stay focused, and have mentors, because a mentor will allow you to see the hope inside yourself and bring out the best in you.
What is your final word?
Reducing inequalities in health is achievable. Nigeria can achieve universal health coverage if there is strong political commitment and fair allocation of resources; and of course evidence-based research should be a driving force for policy formulation.
