September, 2021 will mark the third year of the Chief Medical Director (CMD), Professor Ahmed Ahidjo, on the saddle as Chief Executive of the University of Maiduguri Teaching Hospital – UMTH. He is not a man known for too much celebration amidst mounting problems, considering the fact that he came in from the academic background as the Provost of the College of Medical Sciences. Among many other issues, SAM KAYODE writes about the CMD’s doggedness in trying to fix the Kidney Center which like others has not enjoyed the best of times since the inception of the lingering insurgency
Amidst the myriad of renal problems affecting the residents of Borno State, the commencement of the extension of the kidney Centre of the University of Maiduguri Teaching Hospital (UMTH) marks a big milestone in the history of the North – East region of Nigeria. All things being equal, the center should be ready to bring hope back into the lives of many patients before the end of this year and beyond.
Indeed, the current extension of the kidney Center of the UMTH is a big plus to the management led by Professor Ahmed Ahidjo, a consultant Interventional Radiologist. As a matter of fact, it is one of the greatest achievements that has ever happened in the history of the institution since inception in July, 1983. The advent of the lingering insurgency into the North East region however has brought to the front burner the need for the current extension going on in the center. Many watchers on the development of the institution and stakeholders who spoke with this reporter on the development in the institution cannot wait to benefit from it.
It is an achievement to humanity, says Professor Babatunde Omotara, a Don of Community Medicine who started his career in the hospital and witnessed the first transplant supported by some experts in UMTH and Obafemi Awolowo University Teaching Hospital OAUTH. But its growth has not been very smooth from then because from the eyes of other partners in the health sector like the Head of nursing in the facility, Innocent Mamza, enough attention has not been given to the training of nurses with nephrological background over the decades which is why their number is negligible years after the first transplant. He commends the center but warns that there are only sixteen nephrological nurses in the center now making it grossly inadequate.
This is why it is heartwarming that the administration of Professor Ahidjo has come around to update the facilities in the institution including that of the kidney center that was almost running into a comatose state. Before the assumption of Professor Ahidjo in September 2018, there were lots of setbacks in this center but it is obvious now that there is light at the end of the tunnel. It is expected that by the time the extension is completed, the synergy which Mamza is praying for between the partners in the sector will be enhanced and a bigger headway will be opened in the process of management of the sick. Commenting on the extension, coordinator of the center, Professor Ibrahim Ummate, a Nephrologist in an exclusive interview told this reporter that he has been waiting patiently for the completion of the physical structure so that vital equipment can come in.
With the completion of the physical structures, he expects a lot of collaboration with colleagues from all over the world during his tenure as Coordinator so he can implant his expertise on patients. He is also looking forward to transplants and research which have been long overdue. This reporter recalls that Governor Babagana Zulum of Borno state had challenged the experts in the region to produce a practicable solution to the prevalence of kidney challenges in the region. By the time the funds for the research are released and the results start trickling in, there would be an urgent need for the setting up of an institute to train nurses who will complement the doctors in bringing succor to the people.
Presently, the major challenge of the entire facility is severe shortage of manpower and modern equipment for operations. And this was occasioned by the massive exodus of trained personnel in the last decade of insurgency as regretted by the Chairman Medical Advisory committee CMAC Prof Mala Bukar Sandabe in one of our chats with him.
Sandabe who is also a problem solver believes that this matter can be sorted out as soon as the new extension comes on stream. The center has two Nephrologists, three Urologists, and Resident doctors ready to take it beyond just dialysis and some tests which are carried on in the side laboratories. There is also a workshop for engineering technologies which supports the sophistication of the dialysis machines. Repairs of the machines are done locally now to keep the service going and to avoid regular invitation of the manufacturers when they malfunction.
However, to transit from this present status of needs to the expectations of transplant centers, there is a dire need to increase these consultant specialists to stand up to the daily challenges that goes with such a modern center, said Professor Ummate. This is a lacuna that must be handled by the management team led by Ahidjo and supported by CMAC Professor Sandabe. With the present financial stress, the Hospital is going through, spiced with choking insurgency which has led to lack of electricity to power these machines it’s obvious that management needs quite a lot of support from its proprietor, the Federal Government. To ensure that lack of electricity does not continue to act as a clog in the wheel of progress, they are spending as much as ten million naira on diesel on a weekly basis to keep services going on serving the very humanity it was meant for.
OVERCOMING THE CHALLENGES
These are trying times indeed, says Professor Bashir Tahir, Deputy Provost of the College of Medicine, a former CMAC who is now involved in training doctors. No matter how many they train yearly as long as there is insurgency, most of them move out to greener pastures. And that affects the center badly too. For Prof. Ahidjo, this project should be commissioned today and Nigerians should begin to benefit from the structure since he is a man who seems to be running faster than his generation noted one of his nurses in the facility who took this reporter round the old structure.
As a matter of fact, this is just one of the myriads of structures that Ahidjo has been able to use his influence also to bring into existence in the UMTH Community since he assumed duty. The CMD has shown from the first day he stepped into the institution’s Chief Manager’s seat that he had one mission, and that was to move this tertiary facility to the next level in terms of infrastructural developments. A feat, sources say he must have inherited from his father who was a mortgage business man. Before the CMD, the facility had suffered from almost thirty years of infrastructural deficit.
Indeed, the UMTH which has been involved in several kidney management issues such as dialysis with only thirteen functional machines left out of an initial eighteen, will soon join the league of big tertiary facilities involved in kidney transplants.
EXTENSION OF THE CENTRE
The extension of the center has been seen as a blessing not only for the staff like the Head of Department, Professor Ummate, whose office looks like a makeshift facility to get more space to operate with staff and residents. It’s a leeway to bring increased professionalism in the current training going on in the facility. Also commenting on the extension further, Professor Omotara, concerned about the prevalence of kidney complications particularly in the entire Borno community described the introduction of the extension of the kidney center this way: “The kidney Centre is the first in the northeast region. The purpose for its existence was to provide treatment for patients with kidney disease to reduce its prevalence and severity.
The first kidney transplant was carried out at the center over a decade ago. The new extension will help to improve services and increase the number of patients that would benefit from the services.”
It is also expected that the contractors who would be involved with the sale of drugs and components for dialysis would be much more comfortable and organized in serving the people. Patients will come directly to the center as a one stop shopping port and leave satisfied.
Although the consultant engineer to the project could not be seen on site during the visit of this reporter, a physical examination of the building shows that it has been roofed and windows space created. The building is plastered and is almost completed.
When completed, the center will have eighty-four bed spaces, two adult female and male Nephrology wards, a sludge and sterilization center, scrub area, nursing section, adult and Pediatrics (consisting of male and female Urology and Nephrology) wards, conference room, library, a massive records section and an impressive reception. Others will include the counsellor’s office and waiting room, several offices for medical workers, two big theatres for advanced operations. The dream of the Kidney Center Extension was actualized as a result of efforts made by Senator Mohammed Ali Ndume representing Southern Borno and Chairman House Committee on Army. We gathered that in the past he assisted the hospital with many other projects.
EQUIPPING THE CENTRE
The building, when completed, will house sophisticated equipment worth N750m from TET funds obtained through the assistance of Kashim Imam.
It is also believed that kidney treatments handled by the surgery unit of the hospital already would be more improved with the new equipment supplied by the efforts of Alhaji Kashim Imam, who is the chair of the TET fund. Kidney stones with a high prevalence here would soon be nipped in the bud because several researches would be launched to investigate further the intricacies of this vital body organ. Some of the equipment that are already waiting to be installed are 100 watts Lithotripsy laser machine, complete set of Upper and Lower Endoscopic equipment, -86 degrees centigrade freezer, four fully equipped Operating Theaters 2 of which are for transplant, basic diagnostic laboratory including a chemistry analyzer, a fully equipped HLA typing laboratory, consumables, etc. Professor Ibrahim Ummate who is very happy that Alhaji Kashim Imam, a Borno son has contributed to the
equipping of the Kidney Center.
On training of doctors, head of center Ummate said that the exercise is ongoing. “We have a consultant that has been trained here too. His name is Dr. Suleiman Mohammed Maina. We have two senior registrars currently training under us. Their names are; Dr. Umar Loskurima and Dr. Mustapha Lawan. There is no serious challenge with the training of doctors,” he posited.
On training of desperately needed nurses to complement the extension, he went on: “We have trained nurses that are currently rendering services in Federal Medical Centre Yola, Abubakar Tafawa Balewa University Teaching Hospital Bauchi, State Specialist Hospital Maiduguri and Federal Medical Centre Nguru. We will continue to train nurses that will render service to us and other centers in need.” He assured.
The head of Center however regretted that the challenges they are facing with training of nurses is getting accreditation from the nursing council which he maintained will be pursued in due course. It is the accreditation that would enable UMTH to join the league of Teaching Hospitals already with an accredited institute on Nephrology.
“Only Kano, Abuja and Lagos have such full-fledged accredited one-year training institutes for nurses in the country as at present,” noted one of the staff of the center stressing that it is high time management fights for the desired accreditation for Maiduguri to join the list. “Despite that we are still training our nurses in house. We have competent hands to train nurses. Biomedical Engineers in our center also train our technicians in-house. They are also competent,” he stressed.
The Chief Medical Director disclosed that the Extension and Equipping of the Kidney Center comes along with a training of staff both within and outside the country.
KIDNEY PROBLEMS IN BORNO AND NORTH EAST NIGERIA
The extension of this facility is coming at a time when kidney complication issues have become a major challenge of the people of the north east corner of Nigeria. In as much as kidney dialysis is about 30,000 naira per session averagely in the region and a patient with a failed kidney may need treatment for about three times a week, it is high time the preventive therapeutic emphasis is placed on the front burner so that a lot of people do not have to go through that path before they lose their lives ultimately due of lack of a compatible kidney to bring them back to normal life.
KIDNEY TRANSPLANT SUPPORT FUND
Professor Ummate noted that other centers have a pool of support through one foundation or the other but they do not have it in UMTH.
He equally hopes that they do get access to funds from philanthropists to be able to support residents who cannot afford the cost yet they need the services. Such a facility, if approved, would be known as Kidney Transplant Support Fund. And it would be another first for UMTH and the North East region of Nigeria.