Chief Medical Director of the Federal Medical Center, Owo, Akure, Dr. Olufemi Omotoso, speaks with JULIUS ALABI on the spread of Ebola and HIV/AIDS, among other medical issues in the country.
There is so much hype about the Ebola Virus Disease (EVD) which has caused several deaths in Africa and more recently in Nigeria. Do you think the contagious nature of the disease is being exaggerated?
Olufemi Omotosho
It depends on how you look at it. Like you pointed out, the contagious nature of the EVD is exaggerated. There are certain diseases that are transmitted by sneezing. We call them droplet infections. Ebola is not a droplet infection. If you don’t touch somebody who has Ebola, you cannot contract the disease. When Ebola came in 1976 in Uganda, they used to tell children not to touch the adults who had contracted the disease. They would still sleep in the same room, but won’t touch. It was then rare in Uganda for a child to have EVD. There are diseases that are so terrible that common sneezing will spread. If Ebola is a droplets infection, all it would take was for Patrick Sawyer to have sneezed inside that plane, and everybody would come down with it. So, it is not a touch thing. Even at that, unless somebody is having the symptoms, you can’t contract it from the person. The person must be symptomatic already. By the time somebody is symptomatic, he will likely be on the bed. Patrick Sawyer just managed to travel. He was sick. All those who contracted the disease had contact with him.
Consciousness is a very important factor. The truth of the matter is that if you get protective equipment, everybody still has to be trained; even doctors have to be trained on how to use protective equipment because there are procedures for using them. We have seen somebody who wore protective equipment and still got the virus, simply because he/she doesn’t know how to remove the gloves. I have actually seen somebody at the airport when I wanted to catch a flight from Abuja to Lagos. The person was wearing gloves, handling all sorts of things and at the same time wiping his face with the gloves. The person was not conscious of such things. Knowing how to handle cases is also an important factor, especially for health workers.
Some people had contact with Sawyer and escaped been infected. How did they survive it?
Somehow, some people have some forms of immunity. We are different. If one disease walks into this place now, it may attack two people and leave two people. Nobody can really know why. So far, the kind of research done on Ebola is not such that can provide us with such answers yet. If it can provide us with such answers, we could have got the cure.
The federal government is doing more to educate Nigerians on Ebola. How prepared is your hospital in the area of prevention of the disease?
We have procured infrared thermometers which our doctors will be using. We are in the process of procuring personal protective equipment that each staff who will be handling suspected Ebola cases will wear, and we are talking to the federal government to see if they can help us; so that we can have one isolation centre here because we know the kind of people that we serve. Part of the problem is that we are a fire-brigade country, so to speak. It is when something comes up that we begin to run up and down. We don’t have anything yet that can give us a full confirmatory diagnosis. If we suspect any patient, we will send him or her to centres that have such things, like the University College Hospital (UCH), Ibadan.
How would you assess the state of the health sector in Nigeria?
In fact, if we need to talk about the health sector now, it is a big problem. The whole health sector is a mess right now because there are doctors on one side; others are on the other side. Today, doctors will ask for something; but tomorrow, others will say no, we want our own too. It shouldn’t be so. It is the patients’ lives that we are playing with, and it is not too good. But then, the state of the health sector is something that can be improved upon.
You realise that, in Nigeria, not everybody will come to the hospital. When I resumed, we had to open up two places for primary care. The first one is at Ikaram Akoko. Before we got there, doctors were seeing about 26 patients in a month. By the time we started there, we were seeing over 80 patients per day. That tells us that people don’t want to go too far for their care. We opened up one in Emure-Ile. The place has been doing very well, but finance and personnel were our handicap. We have an FMC annex at Oda Road, Akure. Like I said, not everybody can come to the hospital in Owo. Not everybody will want to go far. So, it is vital for us to take healthcare to the people. If we can have more places that are well staffed, well stocked in terms of drugs, in terms of infrastructure too, our health will be better in this country. We’ve sent proposal to the federal government to help us.
So, if you look at the healthcare situation in Nigeria, it could be improved upon. That is what one can say. I know the federal government has primary health facilities all over the country, but not all of them are actually working as at now. If the federal government could do something serious about that, I believe it will help the people so much.
Don’t you think it is unethical for doctors to go on strike?
It is true that health is wealth. But one thing people don’t understand is that doctors are human beings too. It was in those days that people used to look at doctors as gods. I am a doctor who is at the management level. Of course, I don’t want anybody to go on strike, because I know the implication for the general public – some people will die. But it is a two-way thing. Doctors will make their demands; government is also there to answer to their demands. The question is whether the government is answering them the way it should answer them.
If you look into what the doctors are asking for, they have a number of genuine reasons to actually go on strike. We thank God that they are back and pray that they don’t go on strike again. Doctors go on strike abroad. So, it is not something that is totally new. When doctors go on strike abroad, the government strives to ensure that it looks into their demands very quickly and see how they can meet them. If doctors had not been on strike when this Ebola came, more of them would have died. But as professionals, we must do our work. Be as that may be, I believe that doctors in this country are still a very responsible group of people. I know about my staff; they are responsible people.
What is the prevalence of HIV/AIDS in Ondo?
There are no official records. Unofficially, it is about 4.5 per cent. Because of the high stigma attached to people living with HIV, they still hide. We have free treatment and drugs for them, but they won’t come because they don’t want to be stigmatised. People even fear Ebola more than HIV now. Everybody knows that who contracts Ebola can only last for maybe a week or two. But with HIV, one can still live for a long time. It underscores how people look at these diseases. The behaviour of the people doesn’t suggest they are afraid of HIV.
What has been your experience since you became the CMD of this hospital in 2009?
This is a 300-bed hospital. Since 2009, we have noticed that our patients have been on the rise. And we have opened up Ear, Nose and Throat (ENT) department. We have expanded the scope of our ophthalmology department. There was a lot of old equipment before I came on board. When patients started increasing, we found it difficult to cope with the number of patients. But somehow, we have managed to replace almost all the equipment in the hospital. We have even added what is called CT (computed tomography) scan to our equipment. That is something that a lot of institutions, even some teaching hospitals, do not have.
