“Why UCH at 60 is Still Nigeria’s Best Health Institution”

On Monday, November 20, the University College Hospital (UCH) Ibadan will be 60 years old. It is the first tertiary hospital created by an Act of Parliament in 1952 to serve the Faculty of Medicine and Surgery, University of Ibadan which was founded earlier in 1948.

Speaking on why the UCH has continued to maintain its leading enviable position in spite of the establishment of new and modern healthcare institutions, its Chief Medical Director, the seventh since inception, Professor Temitope Olugbenga Alonge in this chat told Healthstyleplus Online  “In spite of all the challenges the hospital has gone through in six decades, UCH Ibadan, remains the first and preferred choice for training in Residency and the most preferred for healthcare delivery. We are indeed top heavy in terms of expertise and we have departments that do not exists in other hospitals”. Excerpt of the Interview:

OUR UNRIVALED EXPERTISE:

It would be on record that at inception, the College had only the departments of Medicine and Surgery but it gradually evolved to over 60 specialty areas. The high point in our practice was in 2006 when the former Health Minister, Professor Eyitayo Lamb commissioned the first Department of Nuclear Medicine in any Nigerian Tertiary Hospital. Here, we offer both diagnostic and therapeutic treatments using nuclear medicine techniques.

Let me explain a little about how uniquely the Nuclear Medicine department works. Although it is still under the supervision of the International Atomic Energy Agency (IAEA) and until it is fully in the hands of the Federal Ministry of Health when in turn it will be handed over to the UCH, we have very little input. However, there is at the moment a graduation of the Nuclear Medicine Facility; which presently has a single-headed gamma-camera. We really need a triple headed gamma camera or a double-headed gamma camera to complement the work that goes on at the Nuclear Centre.

. Prof Along explaining a point at the Card-Lab

A triple-headed or dual headed gamma camera will reduce the length of exposure of patients and would cut down the length of time of procedures and double the number that you might particularly put out especially for our cardiac patients.

Now, before our patients go into the Card-Lab to have an open heart surgery done, we do a procedure called Cardiac CT-Graph which shows the perfusion and area of deficit where there  is obstruction of blood flow. The colour codes the muscles in the heart and then, we are able to know exactly where we are going to operate. The procedure shortens the length of time we do a cardiac catherisation and we can tell the length of time our patients can be on the machine and predict the outcome of the cardiac surgery.

But until we have the handing over of the Nuclear Medicine Unit to the Hospital, through the IAEA to FMoH, we can only refer our patients to the facility (located in the Complex) and work only with the results ; we do not have a hold on what happens at the centre.

A triple-headed Gamma Camera is the ideal , says Alonge

Besides the Nuclear Medicine Department which complements services at UCH, we are proud to have the first Card-Lab and Card Intensive Care Unit of modern day pattern; which was opened in 2012 and only just overtaken by Babcock University Teaching Hospital.

THE GERIATRIC CENTRE & REHABILITATION COMPLEX:

Aside various other firsts known in the College, we are ever proud to showcase how we have taken care to the the next level. UCH is the first Teaching Hospital to have a hospice and palliative care looking at end of life care proficiency both within and outside the hospital. Our teams go out to visit patients that are terminally ill and offer them care in their bedrooms until they finally pass away. This service is second- to -none and I believe this has given us an edge over many other competitors.

Sir Tony Anenih Geriatric Centre

Sir Kensington Adebutu Geriatric Rehabilitation Centre

 

Head, Tony Anenih Geriatrics Centre, Dr. Lawrence Adebusoye explaining the plight of a 65-year old Diabetic to Prof. Alonge

It was in 2012 the first Geriatric centre was opened in Africa and it is situated here in UCH- the Sir Tony Anenih Geriatric Centre. In its five years of existence, the centre has treated 13, 000 new cases and has attended to over 30,000 follow up cases.
The Centre is unique in so many ways because it provides care for people above the age of 60 and it has entertained the high and mighty in the society including Ambassadors, past Presidents, Professors, Kings among others. And, on Monday, November 20, the first Geriatric Rehabilitation centre, which is to offer long-term care, is to be commissioned-This is the Sir Kessington Adebutu Geriatric Centre situated within the UCH.

No

The Kessington Adebutu Rehabilitation Centre is equipped with solar panel, while the old Sir Tony Anenih Centre has a stand-by generator. We intend to alternate between generators and solar system for the two centres. Now, the cost of accessing care at the centre by those who are 60 and above is 50% of the total cost for those below sixty years. To make it lot easier, there is insurance cover at N16,000 per year which comes to N1,500 per month. UCH already has 100 of the elderly who cannot afford to pay and these ones are registered on NHIS and all their drugs including cataract are done

Within 60 years, we have attained a lot of accolades in many areas of expertise-We have the best Neuro-surgery department in the country and indeed in West Africa with 80% of all the Neuro-surgeons in the country trained in UCH and we We have advanced beyond the  conventional craniotomy and advanced to the awake craniotomy– in which the patient is wide awake while they are doing the surgery. (This is a preferred technique for operations to remove tumours close to, or involving functionally important (eloquent) regions of the brain).
We also have gone to Day-case Neurosurgery practice in which a patient could have his surgery done in the morning and by evening, patient can go home.

WHAT NEXT?
We have come around to evaluate who we are and what we have in the past sixty years. Now, what we intend to do in the next 60 days:
We intend to go into Paediatric intensive care unit which would be established before the end of the year. Here, we intend to commence what we call fetal surgery.

We intend to send some of our young doctors to train on how we can exteriorise the baby in the womb leaving the placenta connected to the mother especially when they have life-threatening congenital problems; we can operate on the babies and put them back in the uterus, the stitch it up and still have normal safe delivery.
Why do I say that, we have experts in the Radiology department, Dr Janet Akinmoladun, experts in anomalies and has state of the art machine that can scan the babies in the womb to analyse all the defects that are possible including heart defect, brain defect and facial defect. You can see the baby and determine the way the baby is going to be born. With this technique we can pick up babies who cant survive outside the uterus and then offer them surgical interventions so they can survive when they are delivered

We believe our Arthroplastic unit where we do knee and hip replacement surgeries –done about a hundred in the past four-five months; we intend to intensify on our practices and look beyond primary hip or knee replacement to become the centre of excellence for Revision Surgeries. This is more technical more demanding. There are quite a number of centres doing knee and hip replacement surgeries in Nigeria but we believe in a few years’ time, they would need them to refer to us for revision surgeries. This is what we are doing to be the edge over others.

Cancer Unit:

Until about three months ago, only UCH had a functional Cobolt 60 cancer machine. Nevertheless, the Cobolt machine unfortunately is old in the sense that the design was made in India and unfortunately, the company has not been truthful in helping us to replace the pat that is faulty. However, whilst we had this challenge two years ago, we set in motion to have another machine called the Bran-Therapy machine. You have to not cut your coat according to your size, but to be innovative and pro-active. First we had to look at the commonest cancers that we have in men which are Prostate, followed by liver and in women, the breast and followed by cervix. Therefore, we needed a machine that can treat these particular organs and so we got the bra-therapy machine—which will cost close to N250m.
We have gone into discussion with a Bank hoping to have a PPPI on this because the number of patients that we have that would be accessing care for prostate, breast and cervical cancers, 90% of them will be successfully treated with the machine. The beauty of that is that it is nt an external radiation but it is an internal radiation therapy. You get close to the tumour an put all the radiation of the tumour including the surrounding area and then, you have an excellent result with patients doing excellently well. It is direct intermittent treatment. We are n the middle of discussion with the major supplier from South Africa and we are also discussing a Public Finance Initiative with a Bank to acquire the machine. However, we have approached the federal government through the federal ministry of health to assist us in the procurement of a new cobolt 60 machine which would be needed to complement the other cancer types which are not easily treatable using the Bran-Therapy machine. But I believe with these new budget, UCH has been listed as one of the seven hospitals to have investment in cancer care.

The Geriatrics team of Drs. Lawrence Adebusoye and Femi Olowokere with the CMD and the Nursing team

 

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