As we observe another Independence Day celebration, our focus in this Edition is Health Care Delivery in Nigeria. Critics have reported the following as percentage of Federal Government’s spending on Healthcare Delivery in recent years: 2019, 4.75 percent; 2020, 3.83 percent; 2021, 4.18 percent; 2022, 4.76 percent; and in the current year 2023, 5.75 percent.

Those who are clever with figures say that this budgetary allocation provides N9,000 only as cost of health care for each Nigerian in the year 2023 budget. Just one diagnostic test can wipe off the entire amount, even requiring more, especially if you are dealing with a major health crisis.

In a document titled ‘Situation of Women and Children in Nigeria,’ the United Nations Children Emergency Fund reported that there is 576 child mortality per 100,000 live births in Nigeria. Former Nigerian Minister of Health, Dr. Osagie Ehanire, once tried to explain the cause of the high maternity and infant mortalities in Nigeria. He admitted that, “the area where you have this maternity mortality is in the rural areas, where they have zero access to healthcare and that many people are actually excluded from the healthcare service delivery (facilities).”

Other reports indicate that Nigeria loses 140 pregnant women every day, just as yet another report indicates that, out of 195 countries, Nigeria occupies the shameful number 163 position in Global Health Security Index.

Our crew was privileged to have a one on one discourse with the Medical Director of a leading reproductive Health Care Delivery Practitioners in West Africa, NORDICA FERTLITY CENTRE in the person of Dr. Abayomi Ajayi, a thoroughbred Gynaecologist, who has been involved in putting smiles on the faces of couples with difficulties in conceiving in their marriages. He spoke with COUNTDOWN’s Taiyelolu Ojo on factors that lead to infertility; the successes achieved so far in the past 20 years of establishing the Fertility Centre as well as his commitment towards reversing the current trend of medical tourism in Africa. Unrelenting, the group has also just recently opened a highly sophisticated Fibroid Centre in Lagos, where every aspect of fibroid issue is being taken care of without necessarily having to go through any form of surgery (minimally invasive and the non-invasive). It is indeed good news and a relief to patients who hitherto couldn’t access such facility without going abroad.

 

COUNTDOWN: Good to meet you sir. Congratulations on the 20^th anniversary of NORDICA putting joy and smile on the faces of distressed couples all over and around Nigeria. Not to waste your time sir, as we rightly said, we are aware that your Fertility Centre just clocked 20years recently and by the grace of God, we would like to document some of your achievements, some of your aspirations and possibly your life conviction from inception. As we go by sir, we would want you to start in form of introduction, to meet you personally, your early life, education and career progression. Maybe we should start from there sir, for the benefit of some of our readers who are not too conversant with your ministry, so to say.

DR. ABAYOMI: Yeah thank you, it’s really a Ministry. Did you say early life and life convictions, did I hear that right?

COUNTDOWN: Yes sir

DR. ABAYOMI: Oh, good, thank you so much. My name is Abayomi Bolaji Ajayi. I’m a gynecologist. I attended CMS Grammar School in Lagos and the University of Lagos for my First Degree and of course studied medicine and specialized at the University College Hospital, in Ibadan, to become a gynecologist. That was a few years ago, I worked in Lagoon Hospital for a couple of years, and then came to start Nordica in Lagos. About life conviction, Personally I believe that Nigeria is the best country on planet earth, and that Nigeria and Nigerians deserve the very best, and that you and I have the responsibility of making our country better, and that has been my driving force all along, to make sure that we’re able to give our people the very best in terms of healthcare and that is what Nordica has been trying to do since it was established.

COUNTDOWN: Thank you very much sir, that is brief enough. So we’ll go straight to the main reason for the interview; we want to know what really led to the establishment of Nordica.

DR. ABAYOMI: Practically all my life now, I’ve been a doctor and I have seen that the kind of   healthcare delivery we have had in Nigeria a few years ago was not the best we can offer as a system. The patients were not getting the required attention. We had some good hospitals but they were not listening to the patients enough. The doctors seem not to know what is wrong with the patients, and I thought this was not a great thing, that patients need to be listened to more and empathized more with, because we know that the lack of well-being is not just being physically ill, sometimes emotionally, a lot of illnesses can be cured on the emotional level as well, and so, that’s what made me to say, look apart from the physical illness fact, that we were also trying to meet more of the emotional needs, which are wrapped up in childlessness or having struggles to have children. So, based on that, we thought, there is a lot that we could still contribute then and that’s what gave birth to Nordica. Technology was of course, rather new in Nigeria then in 2003, Majority of the clinics that were available then, were also more like ‘hush hush’ and so that was the picture about 20years ago. If you spoke about anything IVF, people did not understand what you meant by IVF. So that was the background which we started Nordica from. Nordica from the ‘go’ was meant to let people understand, take away all these ‘hocus-pocus’ about IVF and put it on the front burner of discussions, the only way you can meet peoples’ needs, that is the way they can tell you about their own expectations and then you see how you can meet possibly it. That’s the background under which Nordica was established.

COUNTDOWN: Thank you very much sir. Bearing in mind that this edition of our publication actually coincides with our National Independence celebration, we would like to go a little bit into national discourse from the health sector, but before we go into that, we want to find out sir, having operated the Reproductive Health Center facilities in over 2 decades now, what can you say is the major cause or causes of infertility in couples in Nigeria, from your experience?

DR. ABAYOMI: Well, I guess male factor infertility is probably the biggest elephant in the room now, because worldwide, we see that sperm count appears to be decreasing, and that also has been the case across the world, In other climes, for example, in America, in Europe, they’ve seen that in the last 40years, sperm count seems to have reduced by about 50%. So, Nigeria is no exception too and we did research studies here in Nordica, we saw that, in the last ten years sperm parameter seems to have deteriorated about 30%. So, there is no doubt that male factor is becoming a stronger factor. Of course, the female factor is also there, and some of the things that we did not know that contributed to female factor such as endometriosis that we thought was not very common in our environment was discovered and, we were one of the very few professionals who started pointing out to the people that endometriosis is as common among whites and blacks, and Nigeria is not an exception. So, you see, that’s the truth and then of course, there’s the other part which I will call the unexplained factor. So, all these factors are just here in our environment and one of the things we are also observing is that infertility might be even more than the one in four, that we used to say was like the prevalence of infertility in our environment, because there are some results of studies coming out now that are showing that it might even be as much as one in three. So, we can all see the causes and prevalence of infertility in our environment as they are unfolding. 

COUNTDOWN: Can you tell us in details what your experiences have been like over the years, your successes and frustrations alike?

DR. ABAYOMI: [laughs]. Yes. I think it’s been more of joy than frustration [laughs]. We’ve been able to create a massive impact. God has been able to use us to bring smiles to many homes, thousands of homes. We’ve been able to also introduce many things to the healthcare industry. When people ask me about my frustrations, I just say they are like every other person who runs a business in Nigeria. Infrastructure, power especially, is a nightmare, and of course, the foreign exchange again recently is also is a nightmare. But like we say, we thank God in everything and for everything, but I think it’s been more of joy than frustration.

COUNTDOWN: Okay. So, if you want to count the joys, like how many, {if you can still keep count), families have you been able to directly touch, putting smiles on their faces.

Dr, Abayomi; How many? We have over 5000 babies now, and still counting, so I think we’ve been able to achieve this by the grace of God, through our facility outlets spread across the country, we’ve been able to touch thousands of families.

COUNTDOWN: Okay. And that is including, both those from within and outside Lagos. Can you tell us more about the main cities in Nigeria where you predominantly get patients from?

DR. ABAYOMI: Yes, we have clinics in 3 cities in Nigeria, but patients come from everywhere, even outside the country, we have a diaspora unit that deals with people who come from abroad, because we have quite a large number of people who come from England, U.K, U.S, Australia, Canada, you know, so we have a large entourage of diasporas’ who come to the Clinic. Of course, because Nigeria is cheaper now than any other place in the world when you have to convert your currency to naira, it’s much cheaper.

COUNTDOWN: We were informed that you established a fibroid center at Lekki recently too, can you tell us about it

DR. ABAYOMI: Oh yeah

COUNTDOWN: And we’re asking why a fibroid care facility again?

DR. ABAYOMI: Yeah, because fibroid is probably the commonest reason why women have surgery in Africa. And just like every other person, if I have a choice, I won’t have surgery done. And you know that this surgery is not an easy one both for the doctors and the people who are undergoing it because the uterus naturally is very, very vascular, so loss of blood is one of the greatest complications. A large number of people after the fibroid operation will need to have blood transfusion and for some it might even be worse than that. Of course, we know that fibroid surgery is one of the ones that we medically know to have been associated with quite a number of deaths among our women. So, we are on the lookout to see, since it’s a very common condition among our women, if there is any way it can be treated without surgery, so that was what led to this quest, to acquire a machine that really treats fibroid without surgery. And so, that machine is called HIFU, High Intensity Focus Ultrasound. But when we now got that machine, but before then, we have been treating fibroid in other ways, either laparoscopic method or even for the open method. So, we just thought it was better to have the whole gamut of fibroid treatment under one roof, so that’s what led to the establishment of the Fibroid Care Center. And right now, I think as at today, the number of people treated will be 371 that have had HIFU in just about 2years. So it’s a very safe and very non-evasive way of treating fibroid. So, many of the people who have done it can testify to that and they are embracing it as a community of our women.

COUNTDOWN: Okay. So just like my question concerning the causes of infertility too, can you tell us a little bit, in form of advice for women, causative factors of fibroid?

DR. ABAYOMI: Unfortunately, we don’t know exactly what causes fibroid, but we know that there are some risk factors for fibroid. The strongest probably being the family history, but we also know that a woman who starts menstruation early might have fibroid, if a woman’s periods are longer, she might be predisposed to fibroid, if she is obese, she might be predisposed to fibroid, and then, of course we think some food items also might predispose a woman to fibroid. But these are things that might predispose, we’re not saying that they’re cause consecutive straight-up, but family history is a very strong one because we all know that genes, genetic predisposition might be one of the things that lead to fibroid. So yes, what I will advise women who have fibroid, is that they should know that is not only the knife that can cure fibroid now, we can treat fibroid without the knife, and that is the alternative that we offer, apart from the laparoscopic surgery that we can do, that’s still surgery, but HIFU, it’s so simple that on the day of the procedure, the doctor doesn’t even touch you at all. So, you just lie on the table for about one and half hours - two hours, and you are not sleeping, and then after one and the half hours – two hours, they tell you that the procedure is over, and then we observe you for another 2 hours and you go back home that very day. So, it’s as simple as that, and that every day, you start eating some light food, and by the next day, you can eat almost anything. And so, it’s so easy on patient and also easy for the doctor. So, I think that’s it.

COUNTDOWN: That sounds out of this world, but we’ll like you to tell us more on this light sir, what makes your facility unique in the country. Can you tell us more? 

DR. ABAYOMI: Yeah, one of the things is that there is no cutting, so there is no risk of blood. You’re not having blood transfusion, there’s no need for anesthesia, your recovery period for you to go back to work is faster, and there is no scar at all, so it’s a very safe method of treating uterine fibroid.

COUNTDOWN: Okay. Like the Yoruba adage goes sir ‘Obe to dun, owo lo pa’ which is, tasty soup is made possible only with money. How applicable is this adage to your service affordability, is your facility’s technology just an exclusive of the rich, can you tell us of the cost implication? Can the average income earners or even the poor walk in and get access?

DR. ABAYOMI: I guess it’s affordable because what we say is that, you get it for the price of what you use for something like laparoscopic myomectomy in a standard hospital, that’s what you pay also for HIFU, about that price. It’s actually maybe a little bit lower but yeah, it’s affordable. We always talk about cost effectiveness and it’s very, very cost effective if you look at all the advantages that it has. But I must say that it’s not everybody that qualifies for this procedure, so the main work is for us to identify the patients who qualify and those who don’t qualify, so that we may be guided.

COUNTDOWN: Well, one other major challenge we have as a country right now, is the issue of personnel. You’re aware that there’s this ‘japa’ syndrome that is hitting the country. How have you been able to manage to assemble your personnel and also tell us about their competence, their professional qualifications and how they’re able to manage your patients to meet up with the standard that is acceptable all over as best standards as we see in Nordica today?

DR. ABAYOMI: Well, one thing I always tell people is that Nigerians, especially healthcare Professionals are reluctant immigrants. It’s not as if they want to leave their country, most of the time they leave because, either they feel they can get better conditions outside, or they don’t have fulfilment in what they’re doing. So, I think we’ve been very lucky, in the top echelon, I can say we have not lost anybody at all; nobody has ‘japad’ in the top echelon. Yes, some nurses have ‘japad’ in the center but we’ve replaced them and we have a good training system in place, so that if someone leaves, he/she is replaced, a comprehensive point of entry intensive training is mandatory to keep our standard. You know we’re also in the Diaspora window and we’re ISO certified, so our processes are established, it’s easier for us to replace and change man power when the need arises. So, I think that has helped us and we’ve been able to maintain the standard that we have today.

COUNTDOWN: Thank you very much sir.  Concerning healthcare delivery in Nigeria, do you think the government has done or is doing well in Nigeria’s health sector? So far, is the standard we have as a sector good enough? And if not, how best would you advise a change in the sector? Peradventure, the government gives a listening ear to your advice, what is the major thing that needs to be done in improving healthcare delivery in Nigeria?

DR. ABAYOMI: Well, what do we need to do? One, we need to devote more money to healthcare. I think for the first time in a long time, Nigeria has started well by electing qualified people to run the Ministry of Health, however it is, not only from the point of view of the Minister, but they need money in order to be able to make the necessary impact. No matter how much they mean well, if there’s no money to do anything, it’s going to be tough. Then again, even government can give them enough money, they should also choose a good team to help them in fulfilling whatever expectation they need to fulfil. We know that there is no place for a one-man riot squad anymore in the world, you need a good team around you to be able to fulfil whatever dream you need to fulfil, so, I think that these guys are likely to do well but they’ll need a lot of money. And then of course, the biggest challenge, which is corruption (chuckles) should also be reduced to a barest minimum.

COUNTDOWN: Thank you very much sir. Talking more now about Nordica, sir, thank God for the accomplishments so far, but they said the reward for a good work is more work. If you are to wish or aspire to dream bigger, what would you say are your aspirations, prayers and dreams in the coming years for Nordica?

DR. ABAYOMI: Yes. We want to make an impact, not only in Nigeria but in West Africa. We want to be able to contribute our quota. You see what we’re doing, because it’s based on technology, therefore we need a lot of training, so we believe that we have a place, not only in Nigeria but in west Africa. I’ve travelled round the West African states, just to limit it to West Africa, and even East Africa, and I’ve seen that there’s a big place that we can take up in this continent, making health care delivery more accessible to our people, thereby reversing medical tourism. That’s one of the ways that we know that we can save the country quite a large chunk of foreign exchange if we offer very good services. So we need to scale whatever we’re doing now, so that many more people can benefit from our services. That’s what we intend to do in the next couple of years, to be able to scale whatever we’re doing, not only in Nigeria but other parts of West Africa, at least to start with.

COUNTDOWN: How much have you been able to move your services to your consumers nationwide viz a viz what is required to reach out to West Africa sub region as you just said?

DR. ABAYOMI: We’ve tried our best to do that. Don’t forget that of course we’re a private company, not a public entity, so access is determined by maybe at least two things; awareness and affordability, so, yes, what we talk about more, is to make people aware of the possibility, and then we leave access and the affordability to each individual. So, we’re trying on a daily bases to reach more and more people, but of course, a lot still needs to be done.

COUNTDOWN: Can we know where the facilities are presently in Nigeria?

DR. ABAYOMI: We have clinics in Asaba, Abuja and Lagos

COUNTDOWN: Okay sir, that is for the Nordica Fertility Center, what of for the fibroid?

Dr.Abayomi: The only machine in West Africa is in Lekki, Lagos, Nigeria.

COUNTDOWN: West Africa, that’s a very big one sir. So, anybody from Abuja or from Kano that wants that, they have to come down to Lagos?

DR. ABAYOMI: For now, yes. We’ve had so many people coming down from Abuja and Kano just like you mentioned

COUNTDOWN: And on a final note now, we want to know what are your past times outside or aside from Medicare, what do you enjoy doing?

DR. ABAYOMI: I watch football, I play golf, and I try to keep fit (smiles)

COUNTDOWN: So, we want to know, on a last but not the least note now, is there any information you feel like letting the world know, about you, about Nordica Center or Fibroid Center

DR. ABAYOMI: Well, we tell people that we don’t think that there’s any reason to travel abroad now for IVF, because we can do anything that is possible anywhere in the world now in Nigeria, but of course, if you have your money, you can spend it anyhow, nobody can stop anybody, but if it’s just the service, there’s really no reason. There are a few clinics in Nigeria that can stand anywhere in the world, and I think one of them is Nordica.

COUNTDOWN: Thank you very much, it’s been a pleasure speaking with you.

DR. ABAYOMI: The pleasure is mine.

By:Countdown