Wahab Dele Owolawi is a consultant and professor of Audiology at the King Saudi University, Saudi Arabia. He has been practising for 30 years in a line of medicine where there are only a few Nigerians. As a result of a dearth of professionals, he set up Decibel Hearing Consultants in Nigeria. In this interview with GBENGA ADERANTI, Owolawi talks about the hearing challenges many Nigerians are facing sometimes without even knowing it, why he remains in Saudi Arabia and how government can revive the health sector
At what point did you decide to leave Nigeria for Saudi Arabia?
I decided to go to Saudi Arabia in 1999, partly because of the appalling situation of things in the country, particularly with respect to medical practice and our area of specialization, which is Audiology. When I got an offer in Saudi Arabia, first and foremost, it was financially rewarding. Secondly, they have the tools one can utilise to do the job effectively. That prompted me to take an appointment with the Saudi government.
You talked about appalling situation. What are you really talking about here?
You would realise that we were under the military for quite some time. During that period, there were a lot of problems in the country. Lots of agitations and attention was not focused on medical practice. I was working with the Lagos University Teaching Hospital (LUTH) before I decided to go. We were in the state where we could not get the basic equipment for the diagnosis of problems and treatment of people who had hearing disorder. One could not do so much and one’s training abroad was being underutilised or not even utilised at all. That was the situation.
We didn’t have the requisite equipment. We didn’t have what could be regarded as the standard audiological centre in the hospital, and all efforts to make them understand were not heeded in a way. So, I decided to take my leave.
That also enriched my experience outside the country. It also enhanced my capability to be able to see what obtains elsewhere and to be able also to improve my skill working with other colleagues from other parts of the world.
In Saudi Arabia, people from the US, UK and India, all of us were working together and that also added to my experience beyond the local environment of Nigeria.
I want you to compare the situation you left behind during the military era with what obtains now. How positive has been the shift in terms of medical facilities? Why is it that people still go abroad for treatment, especially when they are being treated by Nigerian doctors abroad?
I wouldn’t say things have not improved. It has in a way. But looking at it from holistic perspective, we still have a very long way to go. Bcause if one visits some of our hospitals, one would still feel sad with regards to what obtains in terms of facilities. But I think to some extent, things have improved. I wouldn’t say significantly, but not yet to the standards that is required for a country like Nigeria. So we still have a long way to go.
I can’t imagine people going to India for medical care. It baffles me to see that. I believe that with the rate at which we were during the colonial and post-colonial period before the military came, I think we were doing excellently well. For example, the University College Hospital (UCH), Ibadan was rated 5th in the whole of Commonwealth. And from the information we had, even some Saudi royals were attending UCH Ibadan for medical care. But today, the reverse is the case. People go to Dubai, India and so on. So we need to put our act together and focus on health care for our people. It is very essential.
We have the experts, the professionals are there and I think if things are made available and we improve on medical education in the country, things will be much better than we have at the moment.
If we once had a robust health sector, where did things go wrong?
I think that is a question I can’t conveniently answer because that has to do with our political system. When there is no accountability, when people think whatever belongs to the government belongs to nobody; when people do not have the mindset of service above self, you have to serve without taking from whatever you are doing. When I talk of politicians, well we all know what is happening in terms of self-aggrandizement, corruption, and so on.
Corruption kills a nation and I think to a certain extent that has been our Achill heel. We have to re-orientate ourselves. By reorienting ourselves, I think we can get there. Nigeria is a great country; there is no doubt about that. But what actually confers greatness on a nation is the ability to take care of its people. When our health system is up to standard, when we have a system that cares for all, I think things will be better. It started before or during the military period. You can’t question what they do. But today, we have democratic political system. At the same time, graft and corruption is killing if it has not already killed the nation.
Let’s assume you are the current health minister; what are the reforms you would embark on?
First and foremost, we need to restructure our educational system. Whether health sector or other sectors, we need to reform that. Because with sound education, I believe we will go a long way. We all know where we were in the past and we know what obtains these days with respect to our educational system. It is a holistic thing. It is something that requires total overhaul. It starts from kindergarten.
We also have to be competitive. In Saudi Arabia where I am, we have people from different countries. There is competition. You are bound to put up your best. But here, we have a lot of professionals around, but we need to be competitive.
The question on becoming the minister of health, forget about it.
There are different areas of medicine you could have specialized in. Why audiology?
Yes it is based on one, passion and compassion. Compassion in the sense that people who have hearing problems are hardly heard. What we call hidden disability. People don’t see it, so it does not evoke sympathy. It does not involve care as such, unlike the eyes. The eyes are very visible. People can see them, and that can elicit sympathy. But auditory problem, it is very difficult. And I also had a lot of information about some of the children who were easily knocked down by cars, particularly at Wesley School for the deaf when I was in the university. They were knocked down by cars because they could not hear when a car was coming, and that actually prompted me to say, ‘Why can’t we do something about these children who have hearing challenge?’ That motivated me to choose audiology.
So what are you doing about it?
Like you rightly said, there are very few in the country, and because we’re trying to do our little best, we need training institutions for audiology. In Nigeria, we don’t have a single institution that trains audiologists in the clinical field. South Africa has about five or six universities, they have less population in comparison to Nigeria, but Nigeria does not have any.
We are trying to push that forward to some of the universities. One university, Obafemi Awolowo University, Ile Ife, has indicated interest, and we are trying to see that we have a training institution where we can train more hands so that people can take over from us. If we don’t put that in place today, we might regret it in the future. And if you look at our society, a lot of people are actually going about without realizing that they have hearing problem. Some people have wax blocking their ears but they don’t know. Some people go about with noise all over the place. They would go to pharmacy and purchase drug that could damage their auditory system. They don’t know where to go and those who know where to go sometimes go to quacks and they are misdiagnosed and a lot of problems arise from that.
So, these are some of the things we’re trying to put in place so that Nigerians can also benefit like others in the developed world.
Many would wonder why you chose to come back to Nigeria after spending 15 years in Saudi Arabia as a teacher and a consultant…
I work in King Saud University in Saudi Arabia and on my own volition decided to come and establish a clinic because hearing healthcare seems not to be well known in Nigeria. There are so many people who are in search of solution to their hearing problems. As a result of that, I decided that it was worthwhile to come and establish a state-of-the-art audiological clinic. People go to the UK, US, Dubai, but I have decided to provide the facilities and expertise that is required so that Nigerians may stay here to have the best hearing aid.
I felt that the best thing I can give back is to come back and offer services so that everyone can afford it no matter what, and give the best of service that is available in any part of the world. That is why we are here.
How was life in Saudi Arabia?
The statement that whether east, west, north or south, home is the best applies here. At the end of the day, you just have to come back home. Initially, because Nigeria is western oriented and Saudi Arabia is purely Middle East and Islamic oriented, even though I am a Muslim, there was an initial culture shock, a lot of restrictions which to some extent infused some sort of discipline into one’s life. I didn’t really find it obnoxious because those restrictions are put in place so that there will be order in the society. The only thing one misses is one’s friends. Sometimes you socialise here in Lagos. You go to parties. Where I am, we don’t commonly see Nigerian foods. We are always eating rice. These are the things.
Averagely, it is a sane society. It is well developed. Where I am, particularly Riyad, I can call it 21st Century city. And what impresses me the most is the care they give to their citizens. They give 100 per cent care to their citizens. Health care is free. They pay their students for being in the university. They pay them on a monthly basis. Absolutely, there is safety. There is a bit of sanity. You can drive your car at any time of the day or night without being molested or challenged by anyone.
The only down side is that most people speak Arabic. And for those of us who don’t speak Arabic, sometimes, we have little challenges. I ought to have returned home fully. I was expected to have returned five years ago but they kept renewing my contract. They are not prepared yet to release me because of the services I’m rendering to their citizens. I lecture in the university. I also consult in their hospitals.
Do you think this policy of retiring medical doctors at certain age is healthy?
Actually, officially, they are supposed to retire their doctors at 60. But they have a proviso that you can still stay beyond 60 because of the experience and particularly because they don’t have a citizen of Saudi who is a specialist in the field. You may still stay till 70. I’ve been practising in Saudi for 15 years now.
Most Nigerian doctors excel when they go abroad. What could be responsible for that?
The facility and the conducive environment. Over there, they provide you with necessary facilities to do your work effectively. If we have something similar, we will do better. Our professionals are good. We have good doctors, but when the facilities are not there, what would they do? So it is difficult. We need to improve on our trainings. I remember in those days some medical students were sent abroad to have one year or two years exposure, and when they returned, they would deploy the experiences they had acquired to the services they were rendering here.
Such programmes should continue because we are not an Island. A lot of development has occurred over the years, particularly in the western world.
We need to be conversant with this development. We need to acquire the skills that are required so that we can bring the skill and experience back home to impact positively on the people of the country. Saudi Arabia tends to send her own citizens outside to US, Canada and UK to acquire experience and higher degrees, and when they come back they do very well.
I think if we can put some of these things in place for some of our doctors, even if it is just for one year outside the country, and come back and provide them with the necessary tools to work with, things will be better
How often do you think Nigerians should visit audiologists?
It is very important that every Nigerian should be aware of their hearing status. Why? There’s noise all over the place, particularly in Lagos. People walk into the pharmacy and buy any medication, antibiotics which are dangerous. We have drugs that we call autotoxin drugs. They are not friendly to the auditory system. Some damage the vestibular system that gives us opportunity to have a balance. And all these things, people don’t know that they have to check. There are drugs that actually destroy the cochlear, the inner ear. There are some that destroy the vestibular system.
And people who are also undergoing cancer treatment, they give them a particular type of drugs that destroy the auditory system. Yes, life is paramount. The first thing that the physician thinks about is survival. But the secondary effect of some of these medications is auditory compromise. It compromises the auditory system. So we need to see such people. We need to monitor them and if necessary, we need to dialogue with the physicians if there are alternatives that are less destructive to the auditory system.
In short, every Nigerian has that opportunity, at least once a year. It’s an annual thing. In the western world, when a child is born, before the child is discharged from the hospital, the child will undergo hearing screening programme. We call it neonatal hearing screening programme. In some countries, it is blanket. Every child must have it. For example, in Germany, it is very general. In some other countries, they select some children who have suffered from measles, low birth weight (less than 1500g), birth asphyxia (they didn’t cry spontaneously after birth); children who were kept in intensive care unit for 29 days and above; babies who have crimo-facial abnormalities: you see their ears are deformed, the head is deformed; children that were born with prolonged labour that the mother suffered for so long that their mother suffered from rubella (German measles). They need examination. It is very crucial.
We always talk about deaf-mute. But we do not realize that if a child is detected on time between the time of birth and six months and we are able to figure it out and we fit them with what is called hearing aid, the child will acquire speech exactly like a normal hearing child. But when the child is left for one or two years, it takes a very long time for us to be able to do therapy and make the child come back to normal.
We have had numerous situations where a young person is wearing an earplug while crossing the road and a vehicle is honking only for an accident to occur. Is there any form of enlightenment for these situations?
On the wearing of earplugs, most of our youths are not aware of the damage that is being caused. Some of them are listening to music, the volume is high and they do not realise the volume is high. All they think about is ‘I am enjoying myself’. But with the enjoyment comes something else. And that something is the damage to the auditory cells. It is better if the earplugs are not worn.
So it’s a trend that we need to educate people on. People need enlightenment and this is the only thing that can liberate this behavior, which is detrimental to them and to the society generally. So we would continue to talk about it, continue to propagate the gospel of safe hearing.
One of the best things they could do is to put it on their speakers. If you want to listen to music, put it on speaker and listen to it. But popping out the earphones all the time causes not only fatigue to the ears it causes a mild hearing loss at that point in time. If somebody who is talking to you does not raise his voice higher you might be missing a lot of things.