Can we meet you?
I am Chris Bode, Professor of Surgery with the College of Medicine, University of Lagos and Consultant Paediatric Surgeon at the Lagos University Teaching Hospital (LUTH). I did my basic training in Nigeria with occasional stints outside the country. I was at the University of Ife (now Obafemi Awolowo University) Teaching Hospital for my medical school and later came to LUTH for my post graduate training from 1973 -1980. Upon completion, I joined the College of Medicine of the University of Lagos as a lecturer in November 1992 and I have steadily risen to the post of professor. Currently I am the Chairman Medical Advisory Committee (CMAC) of LUTH. In my position, I am in charge of clinical services and training. We have about nine (9) schools here: School of Midwifery, School of Nursing, School of Health Information & Management etc. We are an accredited institution for post graduate training of doctors - the residency (specialist) programme. We train the doctors to specialist standard and external Colleges examine and certify them. That is basically part of what I do, besides other clinical and research activities.
What would you describe as your guiding principle?
I am an incurable optimist. There is little I call work in life. I enjoy and love doing everything I do. I see life as one big fun. Also, anybody that opens my door and comes to my office is not an idiot; that is my own principle. They must have left where ever they are coming from for something. The essential thing is to put a smile on each person's face by being as useful as I possibly can to accommodate their wishes without breaking the law.
Why are there long waiting times for some patients at LUTH?
Lagos with a population of twenty million has just two Teaching Hospitals- The Lagos State University Teaching Hospital (LASUTH) and LUTH. Abidjan the capital of Ivory Coast, with a population of six million has three teaching hospitals. So if you establish two or more teaching hospitals in Lagos, the megacity will still be undeserved. That doesn’t mean we can’t do better. We can always improve and we will improve. We will also need to improve on packaging the image of LUTH so that people will see many good things we are doing every day. Furthermore, the primary healthcare services are still rudimentary in Nigeria. These should normally treat simple ailments such as diarrhea, malaria, vomiting, headache, common cut, circumcision and all common ailments. Secondary levels which are supposed to be general hospitals in Nigeria have also failed. It is only the tertiary health care services- Federal Medical Centre’s and teaching hospital’s that are up and running. So they have to take care of the primary and secondary problems in addition to the tertiary problems that they were set up for. Even when we finish treating them and we say go back to your primary healthcare givers, most patients still want to come here. They don’t want to go. But we can’t turn anybody back.
What is your take on LUTH doctor’s recent strike?
It was all so much of politicization of the medical services that we all swore to give to Nigerians. There was really nothing that couldn’t have been discussed in a civilized dialogue that democracy calls for. I find it irreconcilable to say you are a medical personnel and you walk away from work, stop treating patients and giving care to those who need you in the name of protesting. It is not in the interest of the larger public. I don’t subscribe to the notion of punishing a third party for a dispute with anybody. Patients cannot continue to die while we walk away from work. It is not part of the medical creed.
What is LUTH doing to stem Medical tourism?
Medical tourism started as a fad in Nigeria. Once something becomes fashionable, everybody wants to do it; whether it is relevant or not; but that is Nigeria for you. For us, it is chic for you to say I am just coming from India, even when what you went to India for was flimsy and a silly way to have spent your money. Many return to still require to see local doctors for followup. While on the average such person may spend about four million naira and be happy, many such treatments are readily available at eminently cheaper prices in Nigeria. It takes a very good leadership to reverse that. It will pass as we become more efficient, make people aware of what we are doing very well and as we continue to improve. Medical tourism can't continue indefinitely as it is not sustainable. We can’t carry the whole of Nigeria to India. By the time our top leadership starts showing the correct example and adopt appropriate policy guidelines, it will stop. So to stem medical tourism we need to believe in ourselves, let people know more of what is available here. In LUTH for example, we have started open heart surgery. We are already doing renal transplantation surgery. We have one of the best surgical skills training centers in Africa. We will commence stem cell transplantation. We have specialists in diverse areas that are doing wonderfully well. Doctors don’t care too much about advertising themselves. We need business managers to start packaging us well for publicity. We are not packaging ourselves for people to see all the many good things we are doing very well. LUTH is a recognized centre for laparoscopic training- that’s advanced keyhole surgery. We have just been awarded the regional training centre for West Africa by the World Gastroenterological Organization.- That’s a big thing. We have just been given that position in the whole of West Africa. We carry out top neurological procedures here. We have a fantastic Intensive Care Unit (ICU). Our Urology center is excellent. We have the latest CT scan machine in West Africa. We are the only one with it in the whole of West Africa. It is a 126 slice CT- scan. Our Department of pediatrics will have over two hundred (200) beds by the time we finish the new building. We have the largest newborn unit in West Africa with over 60 incubators all working; we take care of more than four hundred babies every month. These are newborns with challenges that would have died if such dedicated newborn treatment centre were not available. Many parents go home happy.
What one thing would you do to improve the health sector?
I will gradually increase the private sector participation in healthcare and broaden the coverage of the national health Insurance care. If we do these two things, we would bring the powerful managerial experience of the private sector to bear on this healthcare system. There will be improved efficiency, increased customer satisfaction. There will be a lot of money unleashed into that sector. We will be able to meet demand with supply. That model will come gradually into healthcare delivery in Nigeria too because whoever is funding it will ask at some point what is the return on my investment. That is why those who are heating up the polity should be careful. It has happened in this country in a number of sectors and it can happen in health.
What is your advice to young and upcoming doctors?
It is for them to believe in themselves knowing they have had good training. They should continue to improve on their skills. They should devise inventive ways of being relevant by raising the bar each time. They should domesticate whatever skills they acquire in other places so that Nigeria as a whole can benefit from such knowledge. It will continue to be a sad day when people train with hard earned national resources, finish, take everything and then go to better climes that did not spend a penny on training them. With proper guidance from our leadership cadres no doctor should suffer in Nigeria. There is much work to do. We don’t all have to stay on the coast. The whole of Nigeria is yours for the taking. That should go hand-in-hand with government providing proper infrastructure, transportation, communication, housing, water supply and electricity in the hinterland. Doctors should go there, live and work there to serve the people and they will also make a lot of money too. If the countryside becomes more developed, you will live where there is a lot of nature's freshness and away from the pollution of the cities and discover the hidden opportunities waiting to be unearthed there.
