Amidst a series of health workers strikes and other challenges in the health sector in Nigeria, significant developments are being recorded at the Olabisi Onabanjo University Teaching Hospital, OOUTH, Sagamu in Ogun State. The tertiary health institution is silently but steadily making strides in pediatric surgery.
In recent times, surgeons at the hospital have been successfully diagnosing, treating and managing a host of complicated paediatric surgical conditions.
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In this interview with Sola Ogundipe, Dr. Ibukunolu Olufemi.Ogundele, an experienced Consultant Paediatric Surgeon sheds light on exploits of the health institution in the area of paediatric surgery.
Ogundele, who obtained his medical degree from the University of Ilorin and did his residency at the OOUTH, successfully carried out 26 laparoscopic paediatric procedures in less than 20 months.
He insists that Nigeria has what it takes to make the delivery of health services work if only the loose ends are tied up by the government. Excerpts:
We do all types of surgeries especially for newborns and small children. Before we started doing the surgeries, many of the patients had to be sent to other Teaching Hospitals and some had to go as far as Obafemi Awolowo University Teaching Hospital Complex, OAUTHC, which was our main referral hospital. Some other patients went to hospitals of their choice, but the reverse is the case now because patients are coming from those hospitals to us.
The patients that we used to refer are now being taken care of here. Other patients have also started coming to us as soon as they get to know that we are doing these procedures. For instance spillover patients from the Lagos State University Teaching Hospital, LASUTH, and the Lagos University Teaching Hospital, LUTH, have started coming to us.
As much as 40 percent of the patients that come to us for surgery are from Lagos. Several patients are on the waiting list, this is why we need to start expanding our services.
We are doing different surgeries in OOUTH. As long as that surgery can be carried out successfully in Nigeria, we are doing it here. The paediatric surgeries vary and are carried out on newborns and babies in the first few months of life that have conditions that are congenital or acquired after birth.
In addition to paediatric surgery, there are different specialties including neurosurgery, cardiothoracic surgery, and orthopaedic surgery. Paediatric surgeons are like general surgeons for children, but some of us go-ahead to further sub-specialize. Generally, paediatric surgeons can handle some of the more complex cases.
For instance, cardiothoracic surgeons may need to do a drainage around the heart. We can do that but in certain instances, we may need to refer the patient to see a particular sub-specialist that we do not have in the hospital.
Taking care of complex surgeries
Some of the surgeries that we undertake include the correction of congenital deformities such as esophageal atresia that occurs when the esophagus or gullet is not continuous. In this abnormality, there is a break in the esophagus such that whenever the baby swallows, it cannot go down into the stomach.
What should be done in these cases is that the esophagus needs to be repaired when the babies are still very small. That is what we do. This is a condition that usually would have led to the death of the affected baby if it is not corrected in time, but we take care of these cases and the babies survive after the surgery. We have done several of these cases as well as other surgeries that a number of hospitals in Nigeria cannot handle.
We have carried out surgeries on babies with spinal cord deformities. Some babies are born with a problem with the secretion of bile. Babies with jaundice have a blockage somewhere in the gall bladder and it needs to be fixed. For the past two years, we have done a good number of surgeries on babies with obstructive jaundice. About 10-12 of such surgeries have been successfully carried out.
However, the challenge is that majority of the patients would still require a liver transplant because the liver has suffered injury and no hospital in Nigeria is doing liver transplant in children or adults for that matter.
We are looking at the possibility of Ogun state taking up the challenge of carrying out liver transplants and we are ready for that, as long as the resources are made available. It is something that we can take up and we are working on it to happen in the state.
There are children with kidney problems that manifest through the inability to excrete because there is a blockage. An example is the Ureteropelvic Junction Obstruction which occurs when part of the kidney is blocked, most often at the renal pelvis. We have a list of patients waiting for this particular surgery now, and we have done an average of six of such surgeries successfully in recent times.
The argument here is that we need to create awareness about these things so that people know and when they come across potential patients, they can refer them to us.
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We have started doing laparoscopic surgery also known as keyhole surgery. With laparoscopic surgery, there is less pain, the patients recover faster and can go home earlier and even resume work quicker. Laparoscopic surgery came into being in OOUTH through a collaboration of Ogun State under Governor Dapo Abiodun with Rotary Club. It is very expensive equipment, and this is a call on the government to rise up to the challenge of appropriately equipping the hospital as a tertiary health centre.
Shortage of equipment
We need certain equipment, among them is radiological equipment. There is one in particular known as an image intensifier. When we are working on the liver or the intestines, sometimes we need to outline the organs with an image intensifier. We also need basic instruments for laparoscopy and open surgery alike.
Holistically, the whole infrastructure could benefit from overhauling and there is an urgent need for serious investment and complete turnaround.
Dearth of specialists
Quite often, our patients need to be seen by specialists such as neurosurgeons, cardiothoracic surgeons, plastic surgeons, maxillofacial surgeons, amongst others, however, we do not have all these specialists currently at the OOUTH. So I do a lot of collaboration, looking for the specialists that we require. Sometimes whenever I am to do some procedures, I need to go in search of some specialists from outside and this may not always be achievable. As a result, I would not be able to offer my services to the patient.
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