A Little Sunshine
In a country where the health sector is well below world standards, a modest clinic in Lagos is struggling to shore up the wide gulf and deliver quality healthcare to as many people as possible, especially in the area of providing intensive care medicine, writes Solomon Elusoji.
According to a report by the Amsterdam Institute for International Development (AIID), “Nigeria’s health indicators have stagnated or worsened during the past decade. Life expectancy is 44 years, lower than the African and developing country average, and infant mortality is almost double the developing country average. An estimated 3.5 million Nigerians are infected with HIV and access to prevention, care and treatment is minimal.
The burden of health care financing lies mainly on individuals, with private expenditures equalling 70 percent of total health expenditures and out-of-pocket expenditures (OOPs), totalling 90 percent of private expenditures.”
The situation is dire. The sector is in need of massive investment in infrastructure, as the ones available are either obsolete or not functioning properly. Then, with the incredible growth of modern medicine, it is high time the country’s health sector gets upgraded.
These were probably some of the things that motivated Paelon Memorial Clinic, nestled in the quiet opulence of Victoria Island, to invest in an Intensive Care Unit (ICU). An ICU, also known as Intensive Therapy Unit or Intensive Treatment Unit (ITU) is a special department of a hospital or health care facility that provides intensive care medicine.
ICUs cater to patients with severe and life-threatening illnesses and injuries, which require constant, close monitoring and support from specialist equipment and medications in order to ensure normal bodily functions. They are staffed by highly trained doctors and nurses who specialise in caring for seriously ill patients. ICUs are rare facilities in Nigerian hospitals, despite their constant need by patients across the countries.
“ICU is in the early phases,” a partner at Paelon and consultant in charge of the ICU, Dr. Sylvia Cole, told THISDAY during the facility’s launch recently in Lagos. “By the time you are flying somewhere, you’ve lost 12 hours. Nigerians going to the U.S for treatment first need the ICU here in Nigeria, or they get to the U.S with no kidneys or no liver or no brain. So, ICUs need to be on ground.” This is, undoubtedly, a fillip for the resurrection of the sector, in terms of investing in infrastructure.
“Health care in Nigeria is not where it should be,” the founder and current Managing Director of Paelon, Dr. Ngozi Onya, said. “There is a very wide gap to fill. I remember when my daughter, Patricia was born 21 years ago, she required life-saving surgery. At her third year, we had to take her to U.K for this life-saving surgery. This was surgery I had watched being performed as a medical student in Nigeria, in the seventies and early eighties. But in ’94 when Patricia was born, I had to take her to the U.K. In that period, between ’84 and ’99, healthcare suffered major reversals. When the Queen came to Nigeria in the ‘50s or thereabout, she didn’t need to come with any healthcare because UCH Ibadan was the third best hospital in the Commonwealth of Nations. Today, no Nigerian university, I think, ranks among the first 100 in the world. Unfortunately, at the same time when we were having a reversal, healthcare was improving in the world. Now, there is a huge gap to fill.
“And this is why we have something like Paelon. In our own little way, we are trying to see how we can make things better. And it can be done; little pockets of excellence here and there will, at the end of the day, give us an excellent healthcare system.
“I will love to appeal to the government and other individuals with deep pockets to please invest in the healthcare sector, because we all need healthcare. And no matter how much money you have, sometimes you only have one hour to make a difference between living and dying, or to make a difference between living as a vegetable and living a normal life.”
The hospital itself is a testament that true health care can be practised in the country. They have quality in-house paediatrics, intensive care and obstetrics/gynaecology specialists. They also possess in-house competence and capability for minimally invasive (laparoscopic) surgery and a rich network of visiting specialists in cardiology, psychiatry, neurology, general surgery, ophthalmology, orthopaedic surgery, paediatric surgery, endocrinology, gastroenterology, urology, oncology, radiology and physiotherapy.
Some of the facilities in the clinic include: 6 adult beds, 2 paediatric beds, and 2 ICU beds, a labour room, well-equipped operating theatre with laparoscopic surgery capability and a surgery room, a radiant warmer, and two neonatal incubators.
Speaking on the challenges in running the ICU facility, Cole said: “I take every challenge as an experience. I try not to look at them as challenges, but as learning phases. So, whatever happens, I find out how I can surmount it.
However, she noted: “I would like for every hospital to have ten bed units. I would like for every hospital to have ambulances. I would like for the whole of Nigeria to have a directory, so that if I have a patient I want to refer, I know where the beds are, in every speciality. I don’t like the fact that people have to carry their loved ones in the car in the middle of the night, driving round, looking for hospitals that can look after them. “And it takes we the professionals coming together; it takes the private sector and the public sector coming together and building bridges.“ Since medical services in the ICU are very expensive, health insurance is one sure way of ensuring that every Nigerian has access to such facilities, and Cole believes it is a growing phenomenon, although she would like the insurance companies to place more value on ICU services.
“Health insurance is growing,” she said. “But what I would like the insurance companies to pay attention to is that intensive care is more expensive than they actually feel it is right now. Right now, they put as very cheap. What’s needed for intensive care is more expensive. So, if we are actually going to give the care that’s required, they need to invest more.”
Talking about some of the challenges she faces in running the clinic, Onyia cited several anomalies such as power problems, getting people to do their jobs, and collecting receivables.
“Because we operate in Nigeria, there are many issues that we contend with. There is power. In other parts of the world, you will not have a noisy generator. But we do the best we can.
“The major challenge we have as an institution – and I think this affects anybody who runs a business in Nigeria – is human capital – getting people to do the right thing and do their jobs well without being watched over the shoulder.
“The next biggest challenge is getting patients to pay their bills. Our receivables are very high. Because of the kind of profession we are in, a lot of people in need come to us, and it becomes very difficult to turn them away,” she observed.
Noting that they (Paelon)want to bridge a gap in the critical health sector, in the next ten years, Onyia sees “Paelon in our own purpose-built hospital. We are trying to raise funds, because there is no more room to expand in our current premises. So, I see us as a thirty-bedded hospital in our own premises, somewhere in Victoria Island. Also I see Dr. Cole heading Paelon, and myself taking a backseat.”
One interesting facet of the clinic’s management is the palpable chemistry between the founder, Onyia, and her partner, Sylvia, who joined in 2014.
“Ngozi’s vision is very close to mine,” Cole told THISDAY, “She’s very passionate about what she does. She’s very serious about giving a particular kind of care. I’m not interested in going into a practice that is very dirty, and I’m very clean. And my speciality requires cleanliness, because without it my patients become infected. So, I walked into Paelon; it was a lovely atmosphere. It didn’t feel like I was in a hospital. It didn’t have that jik smell. So, you need to be in a hospital and feel like you are not in one, it also helps the sensorium.
“You should come to Paelon because we are passionate about giving you the quality healthcare that you deserve. We are here to give you quality first time and every time. We have here doctors that care about you, no matter how much is in your pocket.”