The Chief Medical Director of the University of Nigeria Teaching Hospital, Enugu, Dr. Christopher Amah, tells OZIOMA UBABUKOHaboutthe open-heart surgeries at UNTH
UNTH just commenced another round of open-heart surgeries; how did it start?
Last year, precisely March 2013, we were able to reactivate the open-heart surgery programme, which disappeared some 10 years before. The very first open-heart surgery done in sub-Sahara Africa took place in this hospital in January 1974.
Nothing happened in the 10 years before the last surgeries probably because we moved to the permanent site where there was no purpose-built facility for the open-heart surgery. Between March last year and now, we have carried out several open-heart surgeries in four missions. The ongoing one is the fifth mission and we have operated on 40 persons. The last one was in December 2013, and we did 11. For this current one, we have shortlisted about 18 persons, both adults and children, and there are many more patients pressing to be enlisted.
How long will this current mission last?
This is going to end on April 6 (today). The ultimate objective is to make sure that our people completely take over. If you go there now (theatre), expatriates do it along with our people and there is a plan that towards the end, they will guide and stand by our own local team.
Who are the people conducting the present mission?
We have a local team and there are cardiac surgeons here, but we also have partners from overseas. For this current mission, the surgeons came in from the United Kingdom and Northern Ireland. A non-governmental organisation is managing the programme, which was formerly under VOOM Foundation. VOOM is an umbrella NGO that we are collaborating with. Right now, the NGO has registered a separate and stand-alone NGO in the UK called Save-a-Heart Nigeria. They call themselves Friends of Nigeria and their goal is to save lives of those who suffer from heart diseases. It is based in St. Victoria Hospital, Belfast, which is one of the major cardiac centres in the UK. That is where the leader of the team, Dr. Onyekwere Nzewi, is based. He is the one carrying out the surgeries and he trained here – University of Nigeria. He is an Igbo man from Nnewi. But as a way of giving back to his country and supporting the healthcare service, he raises the team that performs the surgery on charity basis.
When will the local team take charge of the programme?
By the end of this year, we would have completely achieved that, because the more frequent you do the surgery, the more experienced you become. We want to be doing this every two to three months. We have the equipment. We have the consumables; and we have procured enough to be able to go on. These missions come as a booster when quite a number of people come. The people that come are not only from here. People come from other hospitals from Abuja, Umuahia, Port-Harcourt because a lot of teaching is going on. By the end of this year, the target is that our people should be able to take over. For the doctors coming from overseas, it is not as if they would completely withdraw, they could now come less frequently or maybe two or three persons.
Are you able to take care of the number of Nigerians who need this service and who approach you?
We are not, especially when you check the population of Nigeria and the disease burden. With westernisation of lifestyle, heart diseases, cancer, and all that, are predicted to be the next issue of concern when you talk health, even of more concern than malaria and infection. So, the burden is there, but because of ignorance, poverty, and non-availability of this service, nobody would want to seek for cure. If we didn’t have this programme, nobody will come for open-heart. Also, if you came here to check patients who come to UNTH, you wouldn’t see anybody with heart disease, so you may assume that it doesn’t exist. With this service and with awareness, the number is enormous.
What is the cost of carrying out the surgery?
For adults, it is between N750,000 to N1 million. But for children, it is N500,000. This is just about half or less of what it would normally cost. It costs between N1.8m to N2m to do open-heart surgery. It is highly subsidised because we want to create awareness. We are getting quite a reasonable amount of support from our collaborators in terms of consumables. Most of the heart valves we use are donated. In fact, this particular team paid for their flight tickets to Nigeria. They did fundraising to get the money. When they raise funds, they use it to buy what they need like drugs and the kind of things we need for this. When they arrived here, they came with about 24 cartons of consumables. We allow the surgery charity to rub off on the patients.
Do you have cases of failure?
That is one thing good about surgery. If you go to hospital and your condition is a surgical condition, most times after that surgery, if it is successful, you are almost done. It is not like hypertension or diabetes; you keep coming to take medicine. Once you remove it, put an artificial heart valve, the person is home and dry. If there will be complications, it will be within the operating period. Some artificial heart valves require one taking constant medications.
How do you feel having this happening during your tenure?
I want to see it from the point of just the patients and those that are benefiting from this. Yesterday, one of the patients that we operated in August last year came around. Nobody recognised her because she was then very smallish. Stunted growth is caused by chronic conditions of the body like heart, kidney, especially part of the heart. This girl was stunted but six months after the operation, nobody recognised her again. She was so happy. She was almost moved to tears, but my day was made. That is what is important to me. This programme has been able to bring life and hope to people whom by now would have been dead because they wouldn’t be able to go to wherever Nigerians go for such surgeries like the US, the UK or India. There was one we did last December — a farmer from Nsukka. Immediately he woke up from sleep, the question he asked the surgeon was, ‘would I be able to farm now?’ When we said yes, he started crying. My joy is that we have saved lives. That is what we signed to do. Somebody that could have been dead lying in the mortuary is alive happy and walking around. That gives me joy.
How did all these begin?
The issue of medical tourism to even India has become an embarrassment to this country. There should be a situation where Nigerians have a home-based alternative of the same quality and standard. I travelled to the United States and met with the president of Voom Foundation. Immediately I got there, he called a meeting of medical equipment foundation, talked about Nigeria and talked about the donation they wanted to start in Nigeria and all that. In addition, most medical equipment companies started filing in. That was how we started. With their support, and with what we were able to put on ground here too, the first trial started. Then the UK-Northern Ireland branch came in. Right now, the UK branch is as strong as their US counterparts are.
You were able to resuscitate this programme with the collaboration of foreign partners, is there any way the government can assist?
The bottom line is funding. Government must come in because all what we are doing is through internally generated revenue. This is not a capital project. There is no special subvention anywhere. Anything you see in this programme is something from within, and then the help we are getting from outside. For this to be sustainable, government must come in. Non-governmental agencies could also get involved. People could have an endowment or a trust fund where people can donate money so that Nigerians can have free treatment. The call is for well- meaning Nigerians to save a life today. This is the only way we can sustain this because there is no cheap way of doing open- heart surgery. It is an expensive undertaking but there is no alternative to it for now.
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