In this interview with The News Chronicle (TNC), Dr Biodun Ogungbo, a consultant neurosurgeon, talks about his clinic, Brain and Spine Surgeries Ltd, the use of surgeries to reverse some of the problems created by spinal injuries, the state of medical training in the country, the food supplement Cellgevity … and many other issues.
TNC: Thanks a lot for agreeing to this interview – despite your obviously very tight schedule. You are a consultant neurosurgeon, with special interest in stroke and spinal cord injuries. Can you tell us a little bit about yourself, why you studied medicine and why you chose to specialize in neurosurgery etc?
DBO: Thanks for asking me to participate in this interview.
When I was growing up, I was actually interested in the arts and engineering. My father convinced me to study medicine instead. However, he also wanted me to become an obstetrician and gynaecologist. My way of rebelling against that was to go as far away from women’s affairs and become a brain surgeon instead.
Also, I met a great neurosurgeon in my first job, Mr Christopher Adams. He demystified neurosurgery and showed that contrary to what people think, great outcomes can be easily achieved after brain surgery. You just have to be good at what you do and work with a great team.
TNC: Tell us a little bit about your clinic, Brain and Spine Surgery Ltd. When was it set up? What are the challenges it faces? And what are its major accomplishments or breakthroughs?
DBO: The Brain and Spine Surgery Ltd (BASS) in Abuja started off as a special purpose vehicle to make spine surgery acceptable in Nigeria. We came into the picture in 2015 to promote spine surgery and reverse medical tourism to Abuja. The business was called SPINE FIXED IN ABUJA. This was essentially to demonstrate quite clearly that spine surgery can be performed safely in Abuja and in Nigeria as a whole. We have achieved that purpose as spine surgery is now attractive and many more surgeons have joined in providing exemplary services to the Nigerian patient. We made spine surgery sexy!
BASS is focused on improving outcomes in brain and spine surgery through collaborations with other hospitals and specialists. We regularly publish our outcomes, morbidity and mortality with emphasis on doing better through this simple audit of practice. Many hospitals in Nigeria do not collect or report such outcomes data and we are hoping to blaze the trail. It is vitally important and the transparency will improve local confidence.
TNC: Can surgeries really reverse some problems of spinal injury such as strokes that confine one to a wheel chair or are they just to help a patient to manage the condition?
DBO: Surgery can often reverse the damage to the spinal cord or nerves if performed in time. It has to be very timely and efficiently performed to maximize the chances of recovery. If the damage is not permanent then nature perfects the healing and full recovery can be expected. However, if delayed and permanent injury has already taken place, then the outcomes are poor. The key is to operate expeditiously
TNC: You did post-graduate studies in the UK and worked in various hospitals there. At a time when many experienced doctors are voting with their feet, do you have any regrets remaining and practising in Nigeria? Do you have moments when you feel really fed up with things – like lack of enabling environment and insecurity – and feel like relocating? What are the pull and push factors for you?
DBO: Working long term in the UK was never an option for me. I never intended to travel out in the first place but was forced to because of the conditions in Nigeria at the time I left. Similar conditions of poor service and a hostile environment is in play again now forcing many young doctors to seek greener pastures. The government of the day also does not care about the healthcare industry otherwise they would actively discourage foreigners from coming here to conduct interviews and spirit away our trained healthcare practitioners.
We have pitched our tent in Nigeria and will continue to deliver care of international standards locally. We firmly believe we can resist and thrive in the difficult business environment because quality will always be in demand.
TNC: What is your assessment of medical training and medical practice in Nigeria? What do you think are the specific challenges facing both fields? And how do you think they can be remedied?
DBO: Medical training is poor and rudimentary in Nigeria. I can confidently say that from my assessment of the quality of the products from our universities and training institutions in recent times. There is a lot to be desired and many need finishing touches to their reasoning capacity, skill levels and attitude to patient care. Of course, since many hospitals are in dire conditions with lack of drugs, equipment and poorly remunerated consultants, you get what you pay for. Patients paying out of pocket do not allow young doctors to see good outcomes or develop compassion necessary to be great practitioners. All they see is the misery which deadens their humanity.
What can be done? We should keep engaging the government and make healthcare a priority. The private sector is trying to fill the shortfall but the same government creates obstacles every step of the way with multiple taxes and hostile government agencies like the customs and immigration service. They simply have no clue on how their actions or inactions deliver effects of tsunamic proportions down the line.
TNC: Nigeria is a very religious country, with several religious groups hawking miracles – so to say. I believe I have read something from you where you were critical of people who believe that prayers can miraculously heal them of their ailments. Do you see a role for religious faith in medical practice? I ask this question bearing in mind the aphorism that ‘doctors cure but God heals’. Some say that what doctors call ‘placebo effect’ is itself evidence that faith plays a significant role in individuals, including the effect of medical treatment. How do you react to these?
DBO: Pastors and Imams, faith healers should not meddle in the physical but stay within the boundaries of spiritual healing of the patient. Under no circumstances should they delay, restrict or hamper access to medical services by abrogating healing powers to themselves. Doctors cure but God heals, not pastors!
TNC: Now let us talk about alternative therapies. You have traditional African systems, for example bone setting, the herbalists, the ‘babalawos’ (or juju men). In several Asian countries you have homeopathy, acupuncture and even yoga. It seems that in Asian countries, alternative medicine and formal Western medicine co-exist symbiotically while in Africa the relationship between traditional and Western medical practice is mostly antagonistic – medical doctors like you tend to look down on traditional medical practices while the latter often believe that the efficacy of Western medicine is overhyped or that it is not geared to understanding African peculiarities such as their belief that some forms of illnesses are ‘spiritual attacks’ or remotely controlled by one’s enemies. How would you respond to these?
DBO: Traditional healers are closer to the people and we should foster close relationships with them. I think we need to empower them with information and education so they can appreciate their limits and limitations. I do believe we can work together in a way that delivers better care for the Nigerian. But, we need to work synergistically and in a way that focuses only on providing a good outcome. Often, only money motivates traditional healers and they keep patients who are visibly deteriorating!
TNC: What do you think of the current brain drain in the country, especially in the health sector? Former Minister of Labour and Productivity Dr Chris Ngige was quoted as saying that the country has excess medical personnel and that those who need to vote with their feet to other countries can do so (he later clarified that he was misquoted). What is your take on that?
DBO: The Former Minister is sorely misguided.
TNC: There is a new supplement craze in town – Cellgevity. While most doctors and pharmacists hail it as a wonder supplement, you recently wrote an article called, ‘Cellgevity: An Accident Waiting to Happen’, in which you were critical of the craze for the new food supplement. Can you tell us more about this?
DBO: The food supplement Cellgevity is the rage at the moment in Nigeria. The company marketing the ‘drug’ is also using doctors to promote and sell it to patients. This is often at the detriment of their health as the drug is touted as a cure for all.
I am deeply against the idea of turning doctors into drug peddlers and hope that the Medical and Dental Council of Nigeria (MDCN) will look into this. Our doctors are in a privileged position, and it is unethical to use the lure of money to engage doctors in illicit business practices. Patients and relatives should also be encouraged to sue if they or their relatives come to harm.
TNC: What do you see as the future of medical practice, including your clinic in the country?
DBO: The future of health in Nigeria is in the private sector and many hospitals and specialists are coming up. The diaspora is also interested and only require an enabling environment. Many well-trained specialists and healthcare practitioners all over the world, especially from the UK and USA, are looking to return to Nigeria.
The future is great as private medical practitioners and hospitals improve quality of care and health care delivery. The future is bright and we look forward to building on the confidence and trust we enjoy locally. We intend to build a new hospital specifically for brain and spine diseases in Abuja.