‘Some Nigerian hospitals now equipped to handle complicated surgeries’

You said there isn’t really any reason why people should travel abroad for medical attention? But the lack of confidence in the sector still persists. What is your take on that?Because the administrators of health in Nigeria have forgotten one thing which is that medical care is a business; it is more than just social […]

You said there isn’t really any reason why people should travel abroad for medical attention? But the lack of confidence in the sector still persists. What is your take on that?
Because the administrators of health in Nigeria have forgotten one thing which is that medical care is a business; it is more than just social service, especially tertiary healthcare. For primary healthcare and secondary healthcare, those can be left in the hands of government but tertiary healthcare, the private sector should drive it. Teaching hospitals should concentrate on training and research. I tell you something, over 95 per cent of the hospitals in Europe and India where Nigerians go for treatment are run by private hands and a good number of the owners are not even doctors.
They are investors but the government of India has made the environment so conducive for them. People will lose confidence in the Nigerian health sector when there are incessant strikes in public hospitals, when the spirit of public service is not there – people think more about themselves than others. That discipline is not there and there is no ownership. Everybody does what they like and nobody cares about what happens to the patient and then the patient looks like they are begging. People have options and they want to seek medical care in places they can be treated well – where they know there will be no strikes, their surgeries will go on as planned and that the best hands are taking care of them.
As we speak, there seems to be a drift of attention from public hospitals to private hospitals and these are improving everyday to cater for that chunk of people who really want good services and are ready to pay for it. I can say that the health system has improved on the side of the private establishments; I don’t know what is happening in the government but I think that more people are preferring the private hospitals.
If the National Health Insurance Scheme (NHIS) is strengthened and we are having money released in the insurance system and more people are enrolled in the scheme, people will not care about government hospitals if they don’t sit-up because nobody will care because you are not paying; the insurance is paying. If government can encourage private individuals to build mega hospitals, guarantee loans at very low interest rate and a very long moratorium period, we would have mega hospitals in this country and people would come from other African nations to patronise them.
But for now, you cannot stop people from making their choices but what we want to do is to create awareness that before you get into the plane and go out, why not look for viable alternatives within the country and that is exactly what we are saying.
For people that are suffering from severe osteoarthritis, people who have problems walking with their knees and it is so hurting that it is taking away their life and their comfort, there is an alternative and it is a safe alternative. You can take away the pain through a knee replacement surgery.
Generally, for health seeking Nigerians, it is not over everything that you need to go out of the country even if you have the means.  Find out about hospitals, about their surgeons and what they have done in the past and then you can make a decision on who to submit yourself to locally. It is not everything that you need to travel for. Once you travel, you will always travel because you need to follow up. But there are too many advantages of getting yourself treated in a Nigerian hospital that knows what it is doing.
 What common ailments make Nigerians throng hospitals abroad?
One of the reasons Nigerians go abroad to seek treatment especially in India is orthopaedic care, especially joint replacement like total knee replacement surgery. This is actually the solution to severe osteoarthritis of the knee. Good enough, we have acquired the competence and the skills; we have acquired the equipment and the technology to do those surgeries in Nigeria. Here in this hospital, we’ve done quite a number of knee replacement surgeries.
 What does this knee replacement surgery entail?
 First, the cartilage that has become damaged is carefully removed, the surface is shaved away and then there are artificial components that are put to replace what has been removed both for the femoral and tibia components. Then, the knee regains function. Soon after the knee replacement surgery, the patient is able to walk with support; by means of crutches usually for three days after the surgery when the pains must have subsided and in six weeks, the patient is able to bear weight on the limb.
 Following the successful surgery, there should be no pain anymore. The patient goes back to his or her normal activity. Now the knee replacement prosthesis is supposed to remain in the patient’s body and can last for about 20 years but after 20 years, we expect that it starts loosening. So there is an interface between the prosthesis and the bone and at that time, it is expected to be revised. So we take away the component that has been there for 20 years and we replace it with a new one and it is expected that the new one can go for another  20 years. That is why we don’t rush to do a total knee or hip replacement for young people except it is absolutely necessary.
We try to push it until the patient is around 45 years and above. Except the knee is so bad, we can do it earlier but we try to push it forward. If we do a total knee replacement at 45, and in the next 20 years, that would be 65 and by the time they are due for the second revision, it will take them to about 85 years. Most patients don’t live to do their third revision. This is how we manage our knee replacement programme here in Alliance Hospital.
 Since you started your knee replacement surgery, how many have you done and how successful were they?
Quite a lot! In the last couple of weeks we have done joint replacement surgeries like two a week. The success rate is one 100 percent. Though we have not experienced any complications yet, it does not mean it cannot occur. Complication is not necessarily the surgeon fault. Some are unavoidable even in the best centres. The more procedures you do, the more complications you would record in your lifetime as a surgeon.
 How much does it cost for an average person to undergo a knee replacement surgery at Alliance Hospital?
Here, the implant alone is about N600,000 and by the time you add cost of hospitalisation, surgery fee, drugs, physiotherapy and investigations, it will turn to a neighbourhood of  N1.1 million or N1.4 million depending on the patient’s factors. No two human beings are the same but this is the range. Meanwhile, in some countries, you can have these surgeries done for $20,000 and some for $30,000 and you’ll have to transport yourself there.