The immediate past Chief Medical Director of the University College Hospital (UCH), Ibadan, Prof. Temitope Alonge, in this interview with Southwest Bureau Chief BISI OLADELE reflects on his eight-year tenure which ended February, 2019.
HOW has it been in the last eight years?
Well, I think it’s been more of a mixed lesson and a lot of challenges having been thrown up and for me, the mindset prior to assuming office has been well articulated. There are few things that I probably would have loved to put in place but I couldn’t. But in all, I think I feel fulfilled.
At the start of your career, what were the things you desired to accomplish as the CMD of UCH and looking back today, how much did you accomplish?
I must begin by stating categorically that I have seen the good, the bad and the ugly times of the University College Hospital (UCH). I began my medical career as a student at the University of Ibadan 1977/78 session as it was called, and I moved over to the University College Hospital in 1980. Those for me were the days when there was excellence in practice, attitude, and Medicine was exciting as a profession. Subsequently, after my internship, I proceeded to serve the nation and then I began my postgraduate studies in 1987. Between 1983 and 1987 when I graduated, there was huge defect that I found when I came in to start my postgraduate studies. Technically, I saw the good and I saw the bad when things were not the way they should. And then when I went to England to train as an Orthopaedic surgeon, I came back in 1995 and I saw the ugly. My understanding of the funding principle of the UCH was still registered in my mind, from my initial clinical days in 1980. So, my mindset was to try not re-enact the good old days because if you look at the good old days, it means you’re retrogressive. I wanted to bring about the changes that would reposition the UCH as a centre of excellence in clinical service delivery, and also as the reference point in healthcare in Nigeria. And I adopted a theme called REBIRTH OF EXCELLENCE.
The UCH was established on a tripod – training, research and service delivery. On assumption of office on the March 1, 2011, the deficiencies that I saw in the system prior to my assumption of office were quite frightening. So, my mindset was to try and address those defects. I, therefore, set about wanting to know what has gone wrong with the training. It was apparent to me that most of the healthcare professionals had not even gone for refresher courses, or update courses for up to five to 10 years and the aftermath of that is that they were deficient in new technologies, new methods of treating patients, new investigations and all of those things. They were living on past glory. I then embarked on the 3B principles of management. I wanted to build the people, get every professional group to up their game by engaging in training of all sorts – some postgraduate, some courses, and then when these people are trained, my perception was that they would come up with new ideas, then they can set up what I call a system. That is the second B – building system. Any institution that does not have a system or a structure is bound to fail. The system that is dependent on individuals just popping up now and again is bound to fail. And so I wanted these people that have been built up in their various professional callings to come and build me a system and a structure that will outlive everybody. So we began the building of standard operating procedures. You have to be knowledgeable enough in what you’re doing for you to be able to give a standard operating procedure for various techniques – whether clinical, surgical or laboratory. Building infrastructure was the third B. Those 3 Bs I have, by the grace of God, been able to put together.
We now have a training centre that allows courses to be run in the hospital, to bring the courses home. People will technically be forced to go for the training because this time they’re not travelling to Maiduguri or going to Rivers State. The first training centre is called Professor Olu Ajebo Continuing Development Centre. We established a training centre for every cadre. We have a dry lab, we have a wet lab, we have the lecture theatre. We have toilet facilities attached to a generator, cooling system so that when you’re having your lectures, you have a very conducive atmosphere. And till date, that training centre has been the bedrock for training in UCH.
We instituted the cardio pulmonary resuscitation course. It is a mandatory course in any health institution. You must know how to resuscitate somebody who collapses. You don’t have to be a medical doctor. We teach them the basics. So, almost one third of UCH staff, as I speak, have been trained in Cardio Pulmonary Resuscitation that we call CPR. Then we began to run the basic trauma course. The basic trauma course is for every newly employed medical doctor, whether as a house officer or as a resident doctor. Outside of medical emergencies, the second commonest emergency in the Emergency Department is actually trauma-related. So, you must know how to handle the patients who come in. The Total Quality Management (TQM) was established primarily as a policeman for me and the management. They were to look at issues in the hospitals for which there are complaints, they are to address them or proffer solutions. So the TQM Department, which is the first of its kind in Nigeria, has actually instituted 105 processes. They have numerous processes. One of them is patient compliance with medications, attendance in clinics, waiting time in clinics, water supply to the clinic, and the kind of food patients eat, the quality of the food, the taste of the food etc.
In 2012, the commonest causes of death were hypertension-related diseases like stroke and other cardiovascular diseases. Of course, we made so much noise about cardiovascular diseases, people should check their blood pressures, we had outreach programmes, we offered free treatment for patients with hypertension and diabetes. Two years after, we looked at the mortality, the deaths from cardiovascular diseases had been overtaken by trauma and as at 2015, the commonest cause of death was cancer. Interventions may not show up immediately. But over a long period of time, we can see the effect. We didn’t treat all of them but the fact is that there was an awareness going on in the 11 local governments in Ibadan and four local governments in Oyo where we found that the commonest disease among the people above the age of 40 was hypertension-related. We believe that our intervention is having effects.
What would you describe as your most anxious moment as the CMD?
It is when we have industrial actions and there are many patients in the ward at the Emergency Department. My mindset or one of the guiding principles that made me to apply for the job was to reduce the incidents of preventable deaths. So, I get very anxious when there’s a strike. What that means is that patients are not going to be looked after. The chances are that some of them will die prematurely on issues that are preventable. So, those are the only times I get a little bit agitated. Otherwise, I take this job as personally as I can.
How did your immediate family receive the news of the end of your tenure as the CMD of UCH?
Well my wife is excited, very excited. She is happy that she’s going to have more time with me. I love farming, I usually go to the farm every Saturday unless we have restrictions like the election or there is an important wedding I have to attend. I’m not a very sociable person, so I’m family oriented. I like to stay with my nuclear family. So, she is very happy that this burden of being in the hospital all day, all night is over. I only see my wife on Sundays. We prefer to go to the farm, she also loves farming. So, we play golf together on Sundays. We spend about four hours just talking to each other and playing golf.
You’ve been here for decades; you’ve reached the pinnacle of your career both in practice and administration. Are you going back to the classroom or looking forward to contesting as a politician?
(Laughs)…Well, contest is not in the making at this moment but the truth of the matter is that I still love research. I’m going to be 60 years old next year and my retirement at the university as a professor is pegged at 70 years. So, I still have 10 active academic years to run. I’ve been embarking on a research activity for almost 20 years. I’ve been working on bone infections. I may do a little more research on antibioticarial system, this time not treating bone infections alone but also treating chronic bone cavities and also treating infected wounds. I hope to work with my son who is currently studying for his Master’s in Biotechnology and he has produced a particular material that I think I might work on and he said if I need to be taught, I should come to his lab. So, I’m looking forward to that. And if an offer of a job that I think might impact lives comes up, yes I will take it but for now I will be more than happy to go back to what makes me deep. That’s to teach and to operate patients. I had a patient that accosted my secretary while I was the CMD. He said “I’ve never seen your boss this happy. He’s smiling, laughing…” I just operated on him. They told him that the happiest day of Professor Alonge’s life in the week is when he goes into the operating room and he comes back. This is because all my attention is focused on getting somebody getting better, aligning the bone and treating infection. That’s what makes me happy. Otherwise, I am open to a lot of things but I am not contesting.
While doing your research, would that mean that you are still a member of staff of the UCH?
Well, I will be part of it as an honorary consultant. I’m going to resume back at the University of Ibadan on March 1 because I was loaned by the University to the hospital. So, I took leave of absence for eight years. I am going to be appreciating the Vice Chancellor for allowing me to serve as the Chief Executive of UCH and I will be more than happy to teach my students. I’ve got a mentee, a medical student attached to me and I’ll still teach my resident doctors. I read their proposals, give them topics for their parting dissertation, I’ve done that as a CMD. My books and scrups are in the rest room. So, I will be back to the College of Medicine as a member of staff.
