Nigeria: IVF, open heart surgery our priorities -LUTH CMD

Nigerian Tribune: Part of the missions and objectives of LUTH is to provide quality health services using highly skilled manpower and deploying technology to ensure safety of patients and ensuring quality of services. In this interview by Sade Oguntola, the hospital says that in line with the FG’s transformation agenda, it had commenced care in various disciples of medicine such as Invitro Fertilisation, IVF. What activities is the hospital undertaking to achieve its goals of training, research and treatment? THE Lagos University Teaching Hospital (LUTH), Idi Araba has a triple mandate; service, human capital development for health care services and to conduct research. Different cadres of health care providers are provided as well as different services in all sub specialities of medicine as well as research in different aspects of health. And of course the hospital has come a long way since its establishment in 1962. Just last year the hospital was 50 years old and we were able to celebrate it, looking at what the hospital has been able to do in those years. The hospital started with less than 300 beds and today the hospital has more than 800 beds, making the hospital one of the biggest in Nigeria. When the hospital first started, we did not provide antenatal care services, that was way back in 1962, but as of today, we do not only provide antenatal care services, we have a labour ward theatre where we perform all kinds of super-specialised gynaecological and obstetric services and we are commencing our In Vitro Fertilisation (IVF) programme again. The first IVF baby was produced in this hospital by the duo of Professor Giwa Osagie and Professor Dapo Ashiru around 1984 to 1987. Then everything went quiet since that time. But with the support of the Federal Government, we are restarting that programme so that we can put smiles on the faces of people with challenges of having babies. How pocket friendly is it going to be? It will be reasonable because it is supported by the government and in any case, it is going to be in-country. So definitely, it will be cheaper than going for it abroad. The equipment for this have already started arriving. We are training our staff now, we are commencing all sort of programmes. Professor Giwa Osagie is also going to be helping us. Is this a way of bringing back the hospital’s past glory? LUTH has remained the glorious and leading hospital in the country. But what we are trying to do is to keep on raising the standard. LUTH remains and has always remained one of the leading hospitals in the country. Let’s delve more into activities and services LUTH offers? We cover a broad area of medicine. Of course there are different sub-speciality of medicine and laboratory medicine. We have capability of diagnosis in our laboratory medicine. We have a fully automated haematology, clinical pathology and histology laboratories. Of course, we have introduced new equipment into our medical laboratory. In our radio diagnosing department, we have CT scanner, MRI and digital X-ray equipment, all functional. Shortly, the hospital is acquiring the latest 128 slides CT machine. It will be the first in the country. Is this under a Public-Private–Partnership arrangement? Yes, it is. We have linked the laboratory medicine with radio-diagnosis to boost our capability to make proper diagnosis and to do so promptly. It also ensures quality result. With prompt diagnosis, treatment is half way through. In addition, with the assistance of the Federal government, we have also been acquiring sophisticated equipment. For instance, the hospital can boast of laparoscopic towers that can help us to do minimally invasive surgery. We also have equipment to carry out total hip replacement Have you started the hips replacement surgery? We have done them in the past and we are restarting them and the equipment are on ground. So we can start any minute from now. We have the manpower to do this surgery. What other services are offered? Our Guinness Eye Centre remains one of the best eye centres in the country and as a mark of corporate social responsibility, every year; we perform up to a 100 of free cataract surgery for members of the public. We are, perhaps, the first hospital to deploy the technology of small incision cataract removal in the country. We have trained people for other centres in the country and the technique is now commonly used in the country now. How about kidney transplantation? In 2011, we were able to carry out our first renal transplantation, an indication that we have moved beyond renal dialysis to also providing kidney transplantation. Are people coming in for this service? There are challenges of getting suitable donors. And as a matter of policy, we do not accept or encourage commercial donors, thus slowing down our activities on kidney transplantation. We can offer renal transplantation for about five million naira, if they can bring a suitable donor. Is every step involved in the kidney transplantation done at LUTH? Oh yes, but we still send some part of the investigation out, particularly, the HLA typing. But by the middle of the year, we would have solved the problem of HLA typing because we are setting up a DNA laboratory in the hospital with some support from the private sector. Which other services are just coming up or that are being reinvigorated at the hospital? The FG provided us with the latest technology in cancer management, which is the linear accelerator. This equipment helps us to provide treatment. It is precise and helps us to be able to direct the rays specifically at the tumour with little or no collateral damage. How about heart problems? Our cardiothoracic surgeons do pacemaker insertions into the heart and before the end of the year we would be able to do direct repairs on the heart. We are strengthening our cardiac surgery department. We have a cardiac programme that we are developing. Heart repairs, are the equipment and staff on ground? We are training people on this and some of the equipment that will be required to do it are here already. But we need additional equipment and are already working on that. It is going to be a total package before the end of the year. Of course, we have a paediatric hospital. With the help of the Federal government, a new children emergency centre is being constructed. It is going to be a unique centre on it own. It will have its own operating theatre, radio-diagnostic centre and space for admission of additional 100 babies. So the capability of our paediatric department will go to between 250 and 300 babies. Increasing patronage of LUTH The patients are here. In 2005, when things were really down, the number of surgeries was down. But between 2005 and now, we have increased the number of major surgeries from about 1,000 to over 5,000. That is roughly, over a 100 surgeries per week. So the patients are back. Of course, there are challenges particularly from the perspective of the patients. Patients assume that it is a government hospital and as such they should not pay. However, somebody has to pay. It is a shared responsibility and the government is already meeting part of the cost. Individuals and families should also meet their part of the cost. Specialised care and its cost Specialised care must be more expensive. In fact, teaching hospitals are more expensive than general hospitals and primary health care centres all over the world. Their supper-qualified personnel and equipment make them more expensive than the other tiers of health care facilities. We are talking of equipment that cost hundreds of millions of Naira. There is a huge capital outlay that goes into teaching hospitals in order for it to provide these services. Of course, many medical conditions if treated early could be managed at the primary healthcare centres, thus reducing what is spent on accessing health care. If we desire health and if we want health services, then families and individuals must be prepared to play their own role in securing the health of the people. Research activities I will just give one or two examples because we have a multiplicity of studies going on at the hospital. For example, we have been looking at development of drug resistance in HIV in partnership with other centres in Africa. It has serious implications for management of HIV. Social and corporate responsibility of the hospital Every year, we do over a hundred cataract surgeries, freely. This is announced, they come in and we do the surgery. We also do free cleft palate repairs in babies with lips or cleft palates with some assistance from the Smile Train Foundation. Periodically, we do free screening within our neighbouring communities. We screen for diseases such as hypertensive diseases and diabetes. Also, we have an outreach centre in Pakutu in Ogun state, where we provide health services to about 30 communities. Challenges faced by the hospital. Power supply is the major challenge, not only for us, but most organisations. However, we are coping with the support from the generating sets that the FG had provided for us. But the other challenge is the delay by patients before seeking health care. For instance, if it is cancer, when such is detected early and nipped in the bud, it is always better. But then, many of our cancer patients are seen when there cases are advanced. People should get to do periodic checkups, for instance, we have a unit in the hospital that offers periodic screening. All these will help to ensure early diagnosis and treatment. We must face some realities. If you take your car for regular checks, why is it that individuals never take care of their bodies before things get too bad?

Nigeria: IVF, open heart surgery our priorities -LUTH CMD

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