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Wrong diagnosis, fallout of facilities’ shortage



Wrong diagnosis, fallout of facilities’ shortage

Dr. Anuma Kalu Ulu is a Nigerian–born medical practitioner based in the United States (US). In this interview, he discusses the importance of medical doctors ditching profiteering in medical practice as against saving lives, the problems of incessant strikes in health system, factors driving misdiagnosis, among others. APPOLONIA ADEYEMI reports



In a country like Nigeria where practising doctors are struggling to survive. How do we help them?
Nigerian doctors need reorientation. I mean there has to be reorientation within the doctors because if they see medicine as a profit-oriented thing, then I don’t think they would go far. In my own situation, I am not putting profit as the foremost thing; but if it comes then it becomes a consequence but not the reason.
They have to reorient themselves to think that they can serve first and along with the service, they can also better their lives.
I don’t believe in government thing. I have been neck deep into this. I have been trying to get sponsorship. I have approached many corporate organisations and governments but they are not friendly.
They are not amenable to this kind of innovation. And that is why I decided to start on a smaller scale, to show what I can do before going to somebody’s doorstep to I say I am the one that did this and can make it better with your financial support. That is my main trust right now.

What is your take on migration of doctors abroad and implication on the health system in Nigeria?
With the recent migration, the fragile health system will actually become comatose if the trend continues. But I am praying that more people would return to the country.
There are people who have similar intentions to what I have but they want the system to be holistically complete before they would come down. They want a better security, the kidnapping and armed robbery to stop. However, even America is not a perfect system but they want a better system.
They said they want good roads, stable electricity but if they keep looking at all these things, they will never come back.
This will continue to promote brain drain and there would come a time that everybody wants to go and the people left would just try to do any ad hoc thing to survive and then, the health system would become comatose.
Like in my village, when I started my medical mission programme in 2004, over 90 per cent of the people had hypertension and we used to have stroke like 10 to 15 people a year, which was attributed to somebody not killing goat before laying foundation and all sorts of traditional beliefs.
Over four years of my programme, it reduced to like 20 per cent because the people were compliant. Six years down the line, there was only a time that we had two strokes and one of them happened to be my mother. My mother died at 84 years and she was taking blood pressure medications for over 20 years.

What’s your take on the incessant strikes by doctors in Nigeria?
It is not right for doctors to go on strike because when two elephants fight, the grass suffers. When they go on strike, it is the people that suffer. Many people might die.
Although the medical care is not optimum, the little they do has been able to sustain some people to some extent. So, when they go on strike people lose that little ability to sustain life.
I really don’t understand the root of the problem, but this also dovetails to my initial statement that when it comes to health care government is missing in action; they are not living up to what they are supposed to do.
Also, doctors have to have a system whereby they absorb this kind of shock so that they can continue to provide continuous medical care. At the end of the day, it is not the government officials that would suffer.
Most of them would travel abroad for their medical care, even for something as little as ear pain. So, I do not subscribe to them going on strike.

What could be done to improve medical diagnosis in the country?
I trained here. During our training, we had little It is not right for doctors to go on strike opportunity to be exposed to some of the diagnostics equipment. We call most of the diseases like heart problems western diseases.
We only read about them, but we never used equipment like ECG to train. It was actually the first time I went to Trinidad to work that I started experiencing these things and practising them.
Infrastructure is a problem and then the scope of training is also a problem because there isn’t equipment to diagnose.
Apart from abject lack of facilities there is also dishonesty. In Nigeria, people talk about scan and it is only ultrasound they are talking about and it is the least we use over there now for diagnosing pregnant women.
We have CT scan, bone scan, MRI scan, etc. In Nigeria when somebody is sick, he goes to the hospital and they do HIV, full blood count, they do ultrasound and they will say they have finished all the investigation but found nothing.
Misdiagnosis is really a big problem because of lack of facilities.
Do you know that as a doctor in the U.S., we refresh every year.
There you have to get certification. But in Nigeria, somebody after graduation would go to Mbaise in Imo State and open a hospital and start being imperialistic. There is no checks and balances.
Similarly, there is no improvement in career improvement because he or she is not doing even continuous medical education.
Another thing about misdiagnosis is that doctors will not admit that they are not God here in Nigeria. In America, the ability to be employed as a doctor depends on when you know your limitation.
So, when our doctors learn their limitation and treat patients like people who are not just pedestrians but people who should have minimum idea of what they have, the misdiagnosis would be history.

From your experience in practicing medicine abroad, could you tell us what Nigeria is not doing right?
There is really no basis for comparison, everything we are doing here is wrong. I have to be frank. Some of you may have had the opportunity to travel and see what obtains in other climes.
I trained here before I travelled, and since I travelled and got my further training, I have been coming here to practise.
So, I stand in a better stead to actually compare and say based on world standard, we really don’t have anything here that is called a hospital or medical delivery system. The system is rippled with many practices that would land a medical staff in any other clime in jail or a situation where he or she would lose license.
There are no checks and balances here and I believe that some people might know what to do, but because of self-aggrandisement or the need to make profit beyond the need to serve, then they get derailed. However, as I said earlier, I mean I can expound this if you want; there is just no medical care in Nigeria.

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