by Jane Osamor
Hibiscus Female Publishers, an association of female publishers made up of both online and soft sell media platforms recently paid a courtesy visit to Dr. Shakiru Bamidele Mustapha; the Medical Director Lagos State Health Service Commission General Hospital Ifako- Ijaiye General Hospital Lagos. During the media chat, this patriotic and far sighted medical professional and uncommon administrator took us in-depth into the workings of Ifako-Ijaiye General Hospital and gave accountS of his sterling achievements in the last three years as well as the state of the Nigerian medical sector with regards to the acute shortage of medical practitioners in Nigerian hospitals nationwide due to the relocation of a mass of Nigerian doctors abroad in recent times.
EXRACTS:
CAN WE MEET YOU SIR?
My names are Dr. Dr. S. Bamidele Mustapha the Medical Director Lagos state health service commission general hospital Ifako- Ijaiye General Hospital Lagos.
SIR, CAN YOU TELL US HOW YOU BECAME THE MEDICAL DIRECTOR IFAKO-IJIAYE GENERAL HOSPITAL
Well, I was posted here two years ago. When I came in, I was not too happy with the conditions I meet on ground here. The road network was something else. When you come in here, you have to pass through the MCC to the casualty before you can get here. So, I said the first thing is to build a good road network here. I will want to say a big thank you to my management team for their cooperation; they were the one who told me to go ahead with the road and drainage construction. I have the pictures here of how it uses to be and how it is now. Everywhere was flooded.
Now, I was just coming here from Ikorodu which I had turned around too before coming here. You see, I have a friend who came from the US four weeks before I was posted here and he was taking pictures of what we had done in Ekpe When he was about to go back, I had been posted here and he came to see me here. When he saw this place, he was almost crying and he said to me, you must have stepped on some powerful toes for them to post you from like say London to Ajegunle. I said to him; it is General Hospital Lagos State either Ikorodu or Ifako, it is still Lagos, if you give me some time for us to tidy things up here because I did the same thing over there. From their gate inward, we did it to become as beautiful as it is now. We did it with the cooperation of the management team there.
I look at things and prioritize and say this will come in first for the benefit of the patients maximally and that is where we have to start and build on it from there. I improved on the IVR, when I took over there, I meet a revenue of 4. 2. million and when I was leaving six years later, I have increased it to 32.4 million. One thing about hospitals is that if you want to impact, you look at things very well and start improving. For instance, our physiotherapy ward here is on this first floor and I am thinking of moving it downstairs. This is because some of these patients like those suffering from stroke will find it difficult to climb the stairs. But by the time you bring it downstairs, even if they were just ten at the beginning before you know it the ten will become fifty in no time. And that will be our next project for the new year.
What we had in mind before was to enlarge our casualty because what we did was to removed what we saw as an obstruction there. It was not really an obstruction really because it was a lab so we had to disperse the lab; one section was moved to MCC and the three others were scattered around the complex. What we did was to renovate the whole building and take all the sections of the lab in such a way that we created space. The casualty had just seven to eight beds but what we are doing now is to increase it to about twenty at the casualty. So, the issue when you have people coming in and they have to sit down on a chair to take drip will be a thing of the past.
The problem here I will say load and clear is that unlike Ekpe where people are ready and willing to support the hospital. In Ekpe a rural community and here an urban center, Ikeja, there are not ready to support you in any way. All they are interested is in making trouble with you so they can get exceptions. To reduce what you are looking for which is money to improve the hospital, rather, they want to reduce it, ‘They say we should do Ex-ray five thousand, that is not what we have been doing it to see how you can reduce it for us, we are your people. That is what I am getting here. But we are making progress if only we can get the support.
In Epe, we have had people supporting us with ten laptops and supporting it with five hundred thousand naira; Oluwalogbon Motors. Chief Bakare. I have not gotten anybody to give me common twenty thousand naira here for the past three years. It is rough; there is no support. Government alone cannot do it. Those of us that see people who are comfortable outside that they can talk to and say come and help create a more comfortable environment, support us, it is possible. It is not too big.
NOW, WHAT IS THE CAUSE
Well, to say A, B or C is actually the course is like trying to point accusing fingers. We all have our attitude but we keep improving. Those days when I was a swimmer for the state taking cigarette, someone saw me and said now you have finished swimming and now a smoker what kind of rubbish is this and I changed. Till today I cannot even bear to perceive the smell. We can change, we are all human beings. If someone just come and shouted at you, go and ask questions about that person, you might just find five to six people who will say positive things about that person before you can find somebody who will say otherwise. And you will say this is the woman people are applauding and look what she did. But if you get close, you might find out she is going through some stress at the time.
Imaging a nurse having her period and she is going through some pains and she is attending to somebody and the person is uncooperative and she shouted at that person and they will say that is how they shout at people in the General Hospital and they report to me and she now comes and say, oga I am having serious pains. If you want to assist, don’t say I will not because somebody is stubborn. This Hospital belong to Ifako-Ijaiye; it belongs to all of us. It is better than putting blames. As us how we can make it better because this is what we want and we tell you how you can contribute so we can achieve it. And we will expand the scope of the hospital for you and the only way we can do that is to get funds through your support. We are planning to put a small dental section here and where we are hoping to put it is the small space where we removed the lab. So, we keep planning and replanting to get better. He few friends I have here is through this lobbying to get things done. To get people to support in any way they can.
PRESENTLY IN LUTH, THERE IS A HEAVY SHORTAGE OF DOCTORS AS THEY ARE ALL LEAVING AND GOING ABROAD. WHAT ARE THE STEPS YOU ARE TAKING TO ENSURE THAT DOES NOT HAPPEN HERE?
Sincerely speaking everybody know why because when you look at how you work and how you are compensated. Some years back when you see the younger ones go out and they will say I want to do housewarming and all such those who are left here will begin to wonder, this guy left less than three years ago and we have been working here for more than ten years and even if I want to buy a plot of land, Omo onile will deal with you. You start thinking what is happening. People have deferent opinions. You might say because of the exchange rate, what they are getting on that side is ten times more than we are getting here.
Well, the Federal Government did not anticipate that but Lagos State had anticipated that. That is why we have to give it to Governor Babajide Sanwo-Olu. He has instructed the Health Service. On a month to month basis, he wants to know how many people exited so he can give you approval for the total number of those for replacement. That was how we were able to cope. Before the exit replacement.
The only time we had problems was before the exit replacement because you have to make advert and all that ‘the routine you have to talk to people, Interview them. Like yesterday, I was still at HMC, discussing with them about three doctors that will soon be exiting, they said I should put it on paper that as soon as a new set of doctors come in, they know it will go to Ifako-Ijaiye. The problem is the exiting rate is so high; two leaves today and you get three new ones, another five are leaving again. But for now, the governor is actually plugging it in Lagos. It is not as if the rates of exits are not as high as usual, like deficits, the younger ones will be able to cover it up
THERE WERE TALKS SOMETIME AGO ABOUT A GOVERNMENT POLICY TO RESTRIAN JUST GRADUATED DOCTORS FROM GOING ABROAD WHO HAVE NOT PUT IN FIVE YEARS PRACTICE HERE AT HOME, WHAT IS THE SITUATION OF THAT POLICY
For now, it is only hypothesis yet to be practicalized. It has not been put into practice because it has to go through the lawmakers, House of Rep and the Senate. If you want to do it, there are some of them who went through Federal Universities and there are others who went to private universities and their parents had to pay through the nose. You can’t try to hold them down. So, it is a debate that is still ongoing.
I HAVE NOTICED AND IT IS FROM MY OWN ASSUMPTIONS AN AREA OF MEDCINE THAT IS NOT SO UP AND DOING IN THESE CLIMES THAT IS PROSTHETICS, DO YOU HAVE A DEPERTMENT FOR IT HERE AND IF YOU DO, HOW IS IT WORKING
Generally speaking, most of these hospitals were created by now President Tinubu when he was governor of Lagos State so that in every locality, they have at least one or two primary and tertiary institution they can patronize. As time went on, we started having some innovations based on team leads who started adding one or two departments here and there as against what was presented; a general outlook first and foremost; major ailments but as time went on MMC came on board Unit of Medicine came on board for the prosthetics something and for Specialists like Orthopedics. There is an orthopedic hospital nearby here. If you need that we can refer you. To an extent, the Lagos State General Hospital is also gradually coming on board too. Assuming we don’t have a Federal orthopedics hospital here, what can we do in Lagos by ourselves? But as you know, in Lagos, there is always the issue of space, same thing here and same thing at the General Hospital. If you want to expand you don’t expand laterally, and you know the meaning of building five, ten story buildings, it is expensive.
I HAD AN EXPERIENCE AT LUTH. WE PUTT SOMEBODY THERE AND THE PERSON WAS UNCONCIOUS. THEY DID NOT EVEN TEST OR DO ANT CHECK ON THE PERSON THEY JUSTT KEPT TELLING US THERE IS NO BED. SO, I STARTED WONDERING IF HATT IS THE WAY THEY RUN GOVERNMENTT HOSPITALS IN LAGOS STATE
Before your arrival, I was telling my people we need to expand the emergency or accidents wards here. This is because most times, people will not understand when you say there is no space. They will say how can you say there is no space? Where do you want me to get space? Sincerely speaking if you look at these hospitals that are strategically located close to other states, Ogun State is nearby, I want to tell you that over 40 percent of the patients you see are from the other side, Ogun State. Right now, I am proposing fifteen to twenty beds. If I am going to go 20, I cannot think of the normal size of bed. I have to be looking like something like couch that I can just put people on to get them stabilized pending when you can take them to the wards. These are the problems we are facing with this population surge. It is happening to all of us including you. In the old days, you will have some money you budget for miscellaneous and you can say ok fifty per week. In those days in the fifty, maybe you don’t even spend twenty out of it. Nowadays, with the rate that people are calling for assistance here and there, Monday, Tuesday, that is the end of that fifty. Any other person that knew you as someone they can depend on for assistance begins to have a second thought about you. They will say this man that anytime I call him now he will say there is nothing. This was somebody that use to help us. They have forgotten that in those days, it is the same thing that is affecting us here. Left to right, center. I have an example in Ekpe; there was a time the doctor said all anti natal cases and surgery should be treated for free. People were coming from Ondo. If you tell them there is no space, they will tell you there is a bench here, I will sleep on it till I can have my surgery. There is no money, they cannot afford it where they are coming from. But they have gotten the information’ if you get to Lagos, they will do it for you free. That is what is happening almost everywhere now’ LUTH, LASUTH.I should not even refer to LUTH because LUTH happens to be a tertiary institution where things you cannot get be it a private or state hospital cannot get.
You need to be there to know what is happening. People even come there with their camp gas and camp beds and chairs like going for a picnic. When you say there is no space, they will tell you space is here to. They will show the bed and say we can manage here. Things are that bad. The Federal Government has to expand the scope of what we have now.
Look at the issue of ‘japa’. ‘Japa’, if possible, irrespective of what you can get outside, if we think of how we can close up the financial gap between those of them abroad and us here, it is a shame when some of our people are going to Senegal and some other West African countries because they are even well paid than some of us here. But me I have look at it; in the next one or two years I will be bowing out so what am I looking around for? But talking of others if I were heir shows, what will I do? We are talking of comfort and take care of my family.
WHAT INFORMED YOUR CHOICE OF GOING INTO MEDICINE?
I think mine was a divine call. You know, my dad was a Police Officer, we were staying at Ije Police Barracks around Obalende. There was a day I and a doctor were involved in an abortion case and my dad wanted to cover him up and I don’t no. But was later he told me what happened and I left the guy and he said I should follow him out. We went to somewhere around Falomo to buy ice cream. He took me to a three-story building; I think it was a General Hospital. You know Police, the accommodation is room and parlor and, in the parlor, you put about four or five beds there. Our wardrobe are peak milk cartoons where we put our cloths. When you are about to dress you bring it down and say I am looking for this black trouser and one of your brothers will say okpari.
Then when I got to the General Hospital Lagos, it was an organized environment; parlor is parlor, deferent rooms and kitchen is kitchen. The children had a special room and I asked you mean you have your own room and they said yes. To me it was so deferent and coming back home I said, daddy, why are you not a doctor? And he replied immediately and said if you want to be, then go ahead. And I did with God on my side I did.
AT THE MOMENT, WHAT SHOULD WE EXPECT
What are we expecting, in Yoruba Local parlance, if I say it you might not understand? For those who understand; we say when water pass garri the possibility of making eba is not possible; it will look somehow. The population upsurge is too much
WITH THE WAY THINGS ARE NOW, DESPITE PEOPLE LIKE YOU TRYING TO IMPROVE ON THE ENVIRONMENT, DO YOU THINK AN END TO MEDICAL TOURISM IN NIGERIA WILL EVER COME TO AN END
Well, it is a matter of time. We are approaching it slowly but gradually and presently; we are lucky to have his person at the helms of affairs; the incumbent President. We all have different impressions about him. But as far as it is now, he is the one there. He is so passionate about the basic things. Health is wealth. Like this place now, if it was not for him, it would not be here. The only problem I see with our people is that the don’t seem to handle one or two things and hold on to it tenaciously and say this is my own, it was done during my own time.
Obasanjo came as funny enough the man did some things but our people were still complaining. The man did this (telephone) we are using for communication. When you come in and you are given that eight years, hold on to some things and say this is my cardinal achievements while on duty. Hold on to it. It was not as if he was not doing other things. Hold on to health; make sure you satisfy those health personnel who are thinking they have one or two reasons to move out. Go along infrastructure; go into low cost housing schemes for them. All these things we are talking about, is it not all about comfort?
When you have enough money to buy a plot and build it why can’t my government prioritize it and build two, two-bedroom flats and say it is for 13 million, and say doctors should come and buy it, you are wasting time. Civil servants, where are they going to get the money? Why not bring it down? Go and meet in between the rugged car like Toyota and the Mercedes Benz and fashion it out? It will reduce the cost. Give it to doctors who are just coming in and give it to them and say we will be removing thirty thousand from your salary for the next so years till you finish paying. They will say ha, airconditioned car, I have a car to myself so what else am I looking for? It is ok now.
That two-bedroom flat that I can marry into? Where am I running to? But when there is no adequate provision. but the incumbent President will look at all these. Sure, I know; we have had the opportunity to discuss with him when he was not yet president and he said if given the chance, these are what he will do and I am sure at the way I am looking at it, health will be his cardinal achievements too. Lett us be hopeful let us support. It is like people will look at Ifako-Ijaiye and say that one? If we support Ifako-Ijaiye, you will see what it can become. We can have a VIP. If you come in and you don’t want to wait yet want premium service, go in there, pay a certain amount and it is done.
WHAT IS THE COST
It is not much, about five to ten thousand. If you want people will even ask you if you are sure you went to the General hospital and you got your medication in just 20 minutes? It is there. the first building when you come in by the gate., we have done a lot. In fact, the one at the gate my plan is to clear everything here and make it a dialectic center. Look at us now, we are struggling, I can get to a stage now you might not be able to be active as this. Your sons and daughters abroad send you money and your houseboy or house girl siphon it; so why don’t we have a place where these old people can be? They pay and we take good care of them. They are down we treat them and have exercise program for them. Every Wednesday, we come in play games with them.
We have a program that we planned to do but there is no support. Everybody is after money. The little one I wanted to do based on my religion; I once donated a borehole to a mosque that I know most of the time they buy water. Do you know what the leader of the mosque was saying? He said I should donate the money that I should not do that borehole. And I said are you serious/ I am telling you my personal experience.
I was not expecting this money, I got the money and I said, where can I send my own tithe. I am a Muslim, I approached helm, they did the frame and everything but the tankers will every three days to give them water and I said can we put an end to all this? Let us put borehole here. It was he Chief Imam that called me in the evening, somebody that will stand in front of all leading prayers. He said, like how much is our budge and I said I is based on whatever the people want. And he said; what I am thinking is that you can just donate the money and then we see what we can do about it. And I said to him, if I wanted to donate money, I will say I want to donate money. In case you don’t know what, I am proposing, I will take you through it and he said; no, no, no. You have to go and meet one Iya of Asalatu, Iya Isale and I went and meet them and said if you don’t want it, it is ok. There are many mosques here and there.
It is to clear everything that is there and make it a pediatric center; look at us now we are struggling and are not as active as expected. Assuming your sons and daughters abroad send you some money and based on that you turn things around and say why don’t you have a center somewhere where all the elderly will be adequately taken care of but if there is no like we are having now there is not much you can do about it and the little one I do know based on religion is that everybody wants money. I once donated something towards a borehole project in a mosque where I normally would want to pray but do you know what a cleric in the mosque said he stated that I should give out the money to them on a personal basis and should not send it as a form of donation while this might sound strange but I am recounting my own personal but sad experience. I was not really expecting the money at the time but when I got it, I said to myself how do I spend my own ten percent which is my own way of contributing to the financial grid.
I used to see tankers come up every now and then as they pulled up with giving them water and I said to them can we put an end to this situation. It was then that the chief imam called upon me wanting to know how much was my budget and to which I told him the actual amount the project will cost and so I was told I could just donate the money and then they will see how they will go about it.
The imam said that they could assist me in whatever they wanted and from what I inferred they probably did not want the project and I told them point blank that if they did not want the borehole, I could move on the project. He told me that I will need to meet some baba isale for endorsement and I went to actually hold a meeting with them and I told them that if you do not want my intervention it was not by force. The Nigerian President Ashiwaju Bola Ahmed Tinubu is a man of great and lofty heights and we have had the opportunity of discussing with him in the past hence am sure of his aptitude as someone with our nation’s best interests at heart.
He had told us at a forum in the past when he had not yet being elected as Nigeria’s President that if he was elected into office as President he will look in to the health care sector and who knows that could turn out to be his own cardinal achievement too but it is just a question of time and so let us be hopeful. People will support Ifako Ijaiye General Hospital and they will hiss but I want to assure them that all that they need do is support and then the rest is history. But even without the much-needed support we are getting infrastructural equipment here and there. They were frustrating us as when you have dugged today tomorrow they will fill it up and so we had to do a 24to 48 hours en block and we decided to divide ourselves and we kept doing the digging with our men splitted up into shifts just so that we can meet with our set targets. We continued until we struck our target and we were being congratulated for our uncommon feet they never thought that this was achievable in any way.
We had thought that there was a special spirit that was blocking what they were doing a the time but we thank God that the spirit walks with us and also walks with them and so while you are talking to doctors you are also talking to spirits and so you do not disturb those guys at all. Anytime I get to Ikorodu now I still use that water and this gives me so much joy for performing ablution.; I think that they now contributed money that will help in pumping the scheme with the aid of a generator machine. Most of the time the idea we have is usually based on individual self -centeredness ;all we after is money perhaps even if my sister here is crying that there is no bread I can some how look for a space in the refrigerator and keep something for myself after been filled so do not mind her in any way as am less concern.
But if we all develop this attitude that it shall be well and we are willing to share then it is just a matter of time for the issue of medical tourism to turn out a great success especially with the present Governor of Lagos state; the present crop of leaders in the state at the helms of affairs in the health care sector in the state it is just a matter of time
What you have said will be conveyed to the society at large but is there any other thing that you wish to add sir?
Yes, they should assist us as we believe that if we give the much-needed support, we can turn things around in this hospital as I know about three or four angles into expanding our operations. We want to bring in endoscopy; I want to do an intensive care unit [I.C.U.];You see when you need us to reduce money for you while on a treatment and we know that we have other facilities that can aid our work we will reduce the cost of treatment for you but you know that the government alone cannot do it as we desire to have supporters.
The government is trying its utmost best as it has to pay salaries on a monthly basis and where you are working and you are being paid regularly then there is no worry; however, it is the issue of the foreign exchange in the economy right now that has affected the nation totally. There was a drug that we use to buy those days at N4;500 and I could recall that it was called Augmentin. You know what I want to do is to use the syndrome which is based on see and believe and that is why I am taking us to the last question somebody sent to me on Augmentin and It was put at N54.000 what was put at N4;300 or thereabout those days. We are using the same amount of salaries that we have to service all this escalated services so how do you wan us to cope attending to the general public may be it is time we go back to the days of step and strep using such injections like steplopin and streptomycin and both are broad spectrum in nature.
When I came out in 1989 and I was practicing; our medical director at the time will call me and tell me that we drew patronage from the ordinary people hence I had to take things easy and I should take hem through a regime of treatment of five days and after that you will see truly the patient recovers quickly and bouncing. When you ask patients to deposit money, they start to shout on you where you want them to get money and I tell them to let me be because realistically the job has to be done as things are really bad. There is his schematic diagram When you look at the scheme of things everything continues to be on the increase but there is no addition to our salaries and so the question remains how do you survive and he same set of people we will now be asking ourselves. So just do your very best by reducing your spending; in those days I will say 50 per week but now it is 25 per week but the latter will be sucked up even by Monday by your own people.
if you come in the evening of Monday, I always allow people when they come for help to put up all their epistles and then I strike by being very blunt, I tell them Money is not available as I cannot imagine myself suffering for our own situation. In those days they tell you that you cut your cloths according to your size but it is with the size of what you have right now; so rather than put up hope for a miniature monkey jacket which is a sleeveless kind of coat but the fact is known matter how good looking there is no one that does not wish for a full blown coat at all times. Italian suits that we used to buy a Mandilas at the rate of over N70.000 those days will pass for over N350.000 presently which for me is ridiculous and so the question remains how do you survive when salary remains the same.
Before now you could say I will buy this one this month and next month I will buy another one and before you know it you have an array of suit collection .Now you cannot afford to do shakara by buying several suits or coats at the same time hence you will be needing your dry cleaner a lot so that he or she can help you bring out the colour of that your suit but if you get a quack instead of a pro to do your laundry you are done for.
As the financial implications right now is 4 or 5 times what it used to be and not just that I am used to particular brand of perfume; in those days I use four horse when it was still over N80;000 but now it is N250;000 presently. I am still using it but I do not spray it on my body indiscriminately as I only do two sprays or puffs this day and so we have to continue to adjust. if you go close to my purse I will pretend as if I did no see you but if you go close to where I keep it is, I will scream as you will know that it is a known go area.
Before I can get it when it is 50 percent I begin to save for the next rainy day and you start putting he cash aside until it is strong enough to help you to buy and when next you see It on the shelf you go to pick it up.
But for sure it is just a matter of time things will turn around for good
