Chairman, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Matthew Urhoghide recently spoke with reporters on new development in the institution and its potentials for Nigerians in need of kidney care services and transplantation. WOLE OYEBADE was there. Excerpts.
WHY is the institution regarded as ‘complex’?
OAUTHC or Ife is peculiar as the only teaching hospital in Nigeria that is not located in one place. It is complex because it has about six health facilities
that are scattered all over in a landmass of about 65 kilometres. We have three facilities here in Ife, two in Ilesa and the other facility in Imesi-Ile, a rural community. All these facilities offer comprehensive healthcare – primary, secondary and tertiary health care.
Besides the complex nature of the hospital, what would you describe as the area of strength in terms of services?
The Federal Government has a transformational agenda for health; instead of our people going to access healthcare abroad, we should have specialized services in our hospitals. For instance, OAUTHC has the best facility in the area of kidney transplant.
Nobody is aware that the teaching hospital as far back as early 2002 has done successful kidney transplant. There are other institutions that do kidney transplant in Nigeria, but they either depend on this teaching hospital or access foreign assistance. But for us, we are 100 per cent indigenous in kidney transplantation. Like Ilorin Teaching Hospital that does transplant, we take our specialists there to assist them.
Again, ours is the only place where we have organ transplant theatre. Kidney transplant is not just taking someone to the theatre and harvest the kidney. The process that is required is that you’d use the right theatre and the specialists required are kidney surgeons. Before they can remove a kidney and replace it, there are other specialists, like the Nephrologists that must be present.
We also have a Tissue Typing Laboratory where you first have to do some preliminary work of taking a part of the tissue, not necessarily the kidney, to match it with other person’s to see if the donor kidney will be compatible. Ours is the only hospital that has the Tissue Typing laboratory in Nigeria.
Today, we’ve developed ours. We used to send samples to Egypt, but since our technology had improved and the specialists are in place to render such services, we have stopped sending samples abroad; rather, people send their tissue samples to us.
More on daily basis, we now see Nigerians complaining of kidney diseases and asking for help. They would say they have opened an account and in need of N8 million to go to India for kidney transplant. The truth is that renal disease has become so rampant in Nigeria that we are looking at a statistic that one out of every 10 people has a compromised kidney. So, because of that problem, the government wants us to help Nigerians.
People are trouping to India, but they are not better than us. Our experts are everywhere including the United States where we have over 4000 Nigerian specialists. People who have gone to India would tell you that even the environment is not better than what we have here.
How affordable is renal care services and transplant in OAUTHC?
In this place, it actually cost less than N3 million to have a kidney transplant. The cheapest in India is about N7 million. The problem that goes with transplant in India, unlike when at home is that the patient has to be accompanied there. There is need to buy ticket for the person. By the time you are through, you have spent close to N10 million. But this is what we offer here. Medical services forbid advertising, but we need to create awareness on services that we now have here.
Since 2002, how many transplants till date?
We have done 12 successful transplants. We have done two this year. Others are coming up, now that we have a brand new organ transplant theatre. There are other renal services. It is only the kidney that is totally bad that will need transplant. There are others that have lesser problems and in need of dialysis. We do renal dialysis.
Cost of hemodialysis
In every hospital in this country, up to University Teaching Hospital (UCH) Ibadan, it cost between N30, 000 to N40, 000 to do a session of dialysis. Here, we charge N15, 000. Why we charge that low is because of an existing tradition here to charge the locals low to help them afford it. Again, we know that majority of the people who use this facility are not from here but attracted by our lower prices.
Besides transplantation, we also do endoscopic surgery, with minimal incision on the body. It is highly specialised surgery and we have had 100 per cent success rate. What we do in teaching hospitals, unlike private hospitals, is that we don’t want a doctor to manage a patient; rather a full complement of the medical team. This makes wrong diagnosis impossible. Teaching hospital is indeed the place to go.
In line with the objective of President Goodluck Jonathan’s transformation agenda in the health sector, we want to try as much as possible to reduce medical tourism because capital flight is involved. With overseas medical care, a patient spends up to two or three times of what is require here. It is no longer an excuse that the health facilities are not available here, actually they are.
Instead of our political appointment holders going abroad or sponsoring people for foreign treatment, they can spend small fractions of the money and get the same services here in Ife. The benefit is not just in the wellness of the patient, though not less important, but also the wellness of the nation. Again, it can improve the economy of this whole community, Osun State and Nigeria as a whole. But before we can do that, people must be aware of what we can do. It is not the money we can make from it that is important but the value that we can add to human lives.
Challenges of sustaining the kidney programme
The first challenge is raising the cost for transplant; N2.5 million is much but N8 million for Indian care is far more traumatic. Second, we don’t have kidney donor readily. This is because the procedure has not been done rampantly. By the time people come in and see what we are doing, it will get better.
There was a time when people were so afraid to donate blood. But now, people freely walk to the Hematology department to donate blood. We believe that after sometime, people will have the awareness and the humanitarian disposition to donate their kidney, because it can save anybody’s life.
Somebody told us a pathetic story of how a young man was having kidney problem. The father wanted to donate his kidney, but after the tissue typing, they found that his kidney would not be compatible being far older than the young man. They tested the mother, and found that her kidney is just perfect for the patient. But the mother refused to donate her kidney. The marriage eventually collapsed because the boy died.
Our people are ignorant that they can survive on one kidney. Someone can have one functional kidney that will carry him or her throughout life. We believe that if we are able to increase the public awareness, we will reduce kidney-related death rates in Nigeria.
The other aspect of it is on training. Our departments here are over-subscribed, because residency here is a different field of medicine. The specialist doctors that qualify here are the best in the country. For instance in Obstetrics and Gynaecology (O&G), we are the best in the country. That is why when we ask for application into residency, we always have applicants pouring into Ife. Today, we have 876 applications for residency, when the people that we need are not more than 31. It tells you the quality in Ife.
Tissue-typing and DNA test were done overseas in the aftermath of the Dana plane crash in Lagos last year. Could it have been handled differently in Ife?
What happened in the Dana Air crash was very unfortunate. Lagos has a state as well as Federal teaching hospitals. Even if they don’t do tissue typing there, their professors over there know their colleagues are here who are doing tissue typing. So, instead of sending the samples abroad, they could have send them here for matching. Even on DNA test, the technology is already here.
Endowment plans for the indigent
Now OAUTHC can care for all instead of them looking for N8 million to go to India. Illness does not know financial state. In fact, the more indigent people we have, the more of philanthropist and charity fund that should take care of them. Even in the advanced countries, the system pays for the indigents. Tomorrow, a Dangote can walk in here and choose to endow kidney transplant at particular percentage or offset the entire bill of any poor Nigeria.
Not only in renal care. A lot of our centres have several patients at the point of discharge but don’t have the money to pay. And if they are from this State, the Governor can come to their aid, so we could continually render the services to the people. Even if it is at certain fraction of the cost, it will encourage us and we will be able to get the records back to the governor.
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