We are Fully Equipped to Manage COVID-19 – Dr Ugboaja

In this concluding edition, we continue from where we stopped in our interview with Dr Joseph Ugboaja, new CMD of Nnamdi Azikiwe University Teaching Hospital, NAUTH, who was recently promoted to the cadre of associate professor.

In this interview with Fides’ Rev. Fr Martin Anusi, Mercy Hill, Alexander Johnson Adejoh, Precious Ukeje and Adejumoke Alebiosu, he reveals a number of things about him and his trajectory from clinical practice to hospital administration. The new CMD, who was Chairman, Medical Advisory Committee, before his most recent appointment, also shares his vision for the institution, noting that the teaching hospital is aiming at being among the first five in Africa.

Excerpts below:

Let’s go back a bit. Did you choose to study Medicine or you were pushed into that?

I came into Medicine by accident. What I wanted to read was Pharmacy. So, when I finished my secondary school, I got the JAMB form and wrote the exam for Pharmacy, but I didn’t meet the cut off for that year. I missed it with five marks. That was in the University of Nigeria, Nsukka. When I now got the JAMB form for the next year, an uncle of mine told me that I am brilliant and that people that are brilliant go into Medicine while Pharmacy was meant for the less brilliant people.

He mentioned few instances and I sat back and looked at it: all my mates in the class that are at my level were opting for Medicine. I was in the science class and was also part of the top. So, all of them opted for Medicine while those opting for Pharmacy were actually little below us. What he said made sense to me and I filled Medicine in the JAMB form. Because Nsukka had denied me admission the previous year, I decided to fill Nnamdi Azikiwe University. That was it and I got it.

You see, originally, when I was in school, pharmacy was my point of call. When I saw a person in pharmacy, I would be going close to the person to see what I could learn. Thus, medicine is actually by accident; nobody inspired me. But when I came in, I fell in love with the course. Again, when I finished undergraduate courses, I wasn’t too sure what was going to happen in terms of post graduate. At a point, I felt it will be Ophthalmology. So, I started reading Ophthalmology textbooks before I went for service and all of that.

But along the line, instead of Ophthalmology, why not Obstetrics and Gynecology? Since everyone around me thought I should better do an engaging course, I thought it was Obstetrics and Gynecology. I opted for it.

I dropped the Ophthalmology textbooks and picked up the O & G, went for primaries and passed, and then got admitted into the residency training. Again, I did very well in Obstetrics and Gynecology. When I finished and passed my exams one hand, I also loved it when I started practising it.

Two years into being a consultant, the former CMD with whom I had a close relationship, was looking for who will be the Deputy CMAC in the hospital to help him. He called me to his office one day and he gave me an envelope containing an appointment letter as the Deputy CMAC.

I was relatively quite young, and I didn’t think I could be considered to fill in such a responsibility. That’s how they carried me to the position of the Deputy CMAC and I started. And I did that job well. You know you don’t access yourself, but I knew I did well when I came to contest for CMAC. When I came out to contest for CMAC after four years on that job, I ran against very senior people: three professors and one associate professor.

We were 106 consultants and professors that voted and I got 81 votes. That was when I looked back and said perhaps, I did very well as the Deputy CMAC that I could exude this level of confidence among my colleagues. I didn’t plan to be the DCMAC but once I became, there is what we call ‘committed sperm cell’ in Biology; I became committed to management. Not like I sat down one day and said I wanted to go into hospital management, but here I am, Acting Chief Medical Director.

Where do you see the health sector in Anambra in the next ten years and what role do you think NAUTH will play in contributing to that vision?

See, we are preparing NAUTH to be a national player, not a statewide player. We are talking about ranking among the top five in the country. So, I don’t like discussing state; we discuss Nigeria, discuss Africa and the world in the sense of where NAUTH will be in the scheme of things. That is the vision.

We are not looking around the state, because if you look around the state, you drop your vision. The vision is larger than the state. It’s a federal tertiary institution and so, it cannot be serving just the state. It’s positioned to serve the south east at the minimum and to serve Nigeria at the general, because what we want here is that you will be in Abuja and require a particular service and they will say go to NAUTH.

All the way from Lagos and Abuja, they will say go to Nnewi. And you come here and we sort you out. And what it means clearly is that you will go there and get the skill. Medical practice is all about the skill and the knowledge. It’s a service driven art. What you don’t have, you don’t give.

What I have to do with my people just like India did is find a way to send them to India, let them stay as long as it requires getting the skill. And they will come back, where you will provide them with enabling environment to explore. Those things our people go to India and UK to access, they will come here and access them.

Once they come here to access them, your centre has become a centre for medical tourism. And so, that is where we are headed in terms of where we want to be. It is not a one-day thing. Like I said, we are building a ten-year strategic development plan that will guide us all the way with timeline. We are developing that document. Once we develop it, it is my duty as the Chief Executive Officer to mobilize the entire community to key into the vision.

When will the document be ready?

It will be soonest, and I am sufficiently prepared to do that. I am an apostle of transformational leadership. I believe that everybody has got something to offer in this system. All they need to do is to bring it out, because that’s leadership.

The transformational leader is the one that brings out the extra in everyone. That is the way we want to approach it. So, we have to transform the system and get us to that place. In terms of the health sector in Nigeria, it’s a third world country; it has its high times and has its own low areas.

But, the current Ministry of Health has actually tried, especially in terms of managing coronavirus. You see, we’ve never been this challenged, but I am happy with the response mustered by the federal government, the Ministry of Health and other agencies. So, if you want to use response to COVID-19 as a yardstick, I will tell you that they are doing well.

Given that the money allocated to the health sector is not up to the 15% of national budget stipulated by the Abuja Declaration. There are many things competing for the scarce resources, but I think the ministry has done well. However, what we must know is that the largest room in this world is the room for improvement, so, you keep encouraging them to improve on what they do. But, what people keep forgetting is that upholding the health status of the people is not a one-man show.

It is not for the government alone, because even if government gives the 15% stipulated by the Abuja Declaration, people at the receiving end may not receive the money. You may give me the money in this hospital and I will eat all of it, and this hospital will remain like this. It’s, therefore, about everybody being committed to improving the health status.

It’s not the governor, not the president, not even the CMD. It’s about all of us committing to uphold the health status of the people, especially, the most vulnerable, that is, women and children. The press is also a part of it, if you mount your health campaign from time to time, even in this COVID-19, give lectures and sensitize people. It’s a duty for all of us.

And I believe if all of us work together, the health indices will improve. That’s just the truth of the matter. So, we are looking at a bigger picture for the institution and not Anambra State.

What is the most significant breakthrough you’ve had as the CMAC that came through research; and what is the quality of the reviews of your papers before they are published?

Let’s start from the first one: you know using products of research is time dependent, because if you do problem-solving research, what you want to do is when you identify the problem, you try to sort it out and if you try to sort it out, the only way you know you’ve sorted this problem is to go back to the field and conduct end analysis again.

The SHIP was our flagship product, then the Patient Satisfaction Survey (PSS) was also key to us. Now, after that PSS, which showed that our people were not doing well, we mounted attitudinal change workshop; we trained over 3000 staff. We spent money.

We were meant to go back to the field after six months to conduct an exit interview to find out how many of them are satisfied, because the expectation was that after the trainings and getting the qualified people to talk to them, their attitude would have changed. But the only way to objectively find out is going back to the field and administering your feedback forms again, but COVID-19 caught up with us.

However, anecdotal evidence, observational evidence did suggest that there was change in attitude as evidenced by the patient disposition, but we could not objectively ascertain that. But we think that if we had gone back to the field, perhaps, we will have noted some positive responses.

In terms of the review, reviews are journal based. We have internal reviewers, professors. We have people who write, we have editors and people who belong to the Editorial Board. I brought these people together. Then, we have an Internal Review Committee.

After you’ve done your research, you’ve presented to us in a conference and you now want to publish, you direct it to that Committee and they will do an internal review. Once they’ve done that, they point out to you what and where to effect changes. Whether the journal you are sending to accepts and publishes it is entirely the prerogative of the journal. It becomes an external process.

When you send it out and it’s reviewed, it could be sent back. Some will modify it. Some will also publish as sent. But, what we did was to get a very good internal review mechanism. In fact, we start from the level of development of the manuscript: when you conceive the idea, that this is what you want to do, we also channel it to that committee to help you put the idea in order; in a way that is researchable.

Look at your methodology, work with you. And if you see what has come out of that effort, you will be marveled because our people started writing. Not writing for the purposes of writing, but they had interest in research. So, our creative output rose. In fact, it is the university that is enjoying because in assessing the university globally, they look at the creative output from their staff.

We don’t have any direct benefit as a hospital outside using it to solve our problem. But in terms of ranking, Unizik got some serious ranking. For some time, professors from Nnewi topped the Google Scholar ranking, even as we speak today. I don’t know what it will be tomorrow.

So, our professors keep topping the ranking and people keep wondering. It’s because of the kind of interest we’ve generated here in research. People are writing, researching and all of that. And that’s how it’s been.

You seem to have been into a number of things, even though there were no initial plans, yet you do very well in them. How do you work this out?

I don’t know. You know there are certain things you don’t know in life. I don’t know how I would have also fared if I had gone into Pharmacy. Perhaps, the thing would have been the same and all of that. I think it’s all about applying yourself to where you find yourself.

Now, there are things you decide to do and there are things that come to you by opportunities. But I think the bottom line is: wherever you find yourself, apply yourself to do the job very well. The CMAC, I didn’t want. I considered myself very young to do the job; I had other plans for myself, but I was convinced that I did a good job out of it. So, it’s all about applying yourself, then planning. From the DCMAC moving forward, the choice was mine.

I decided that I would run for CMAC, I also decided to run when the position of the CMD became vacant. So, I think it’s about application of yourself to where you find yourself. For me, my motto is “determination is key to success”. Once you are determined and focused you will get to your goal. Now that I am doing the Acting CMD, I don’t know what I will do tomorrow. Other opportunities may come; I may also choose other opportunities.

What do you think stood you out from other contestants despite having similar experiences in the DCMAC and CMAC positions by some of them?

I wouldn’t know. I don’t like assessing myself, and in this contest, I don’t like discussing people, because there are other CMACs who were also in the race. So, what I believe in life is in whatever position you find yourself, do your best, be sincere and be visionary. Leave other mundane considerations. Now, when you do those, both God and man will find you suitable for opportunities.

That’s the truth of the matter. Because some of the things that may happen around you, the truth is that you may not be in control; you may not even know why. That’s my belief in life. Do your utmost best in whichever situation you find yourself. Help humanity, and then, leave the rest to God and man. It will happen. That’s how I do. I don’t know whether or not I am outstanding.

All I know is that you give me the job and I apply myself to it in all sincerity and strive to achieve the result for the institution; every other thing will fall into place. But one can’t come into a position and start having mundane considerations for other pecuniary things. I don’t think both God and man will align behind you.

People might associate with you for pecuniary reasons for their selfish interest, but even those people know that when push comes to shove, they will point somewhere else, and say that this is the man. That’s leadership. Peter Obi is not the governor of Anambra State anymore, but all over the country and the world, people are talking about Peter Obi because of the way he ran the state.

Do you see the difference? So, aim to be like that. It’s a lesson even for people who are coming up. Whichever place you find yourself, do your best so that people can recommend you, but more importantly, so that God can recommend you and find you suitable for more opportunities.

May we know your plans for taking NAUTH to the height of being among the first five hospitals in Nigeria?

In strategic leadership, you start from the vision, develop your vision and your vision should be large as to frighten you. When they say that this particular leader is visionary… if your vision is common place and it looks ordinarily achievable, then it’s not a vision, it’s not a dream.

Your vision must be likened to a dream, and might be likened to something that is not achievable. So, you start from your vision and then you develop your strategic objectives. For instance, we are saying that we want NAUTH to be among the top five in the country, that’s a very big and vague statement.

But you break it down to objectives. How? In any hospital, you have lab, pharmacy, theatre where people do surgery, you have clinics where people come to consult. For it to be topnotch, these areas will have to be developed to an extent they also become one of the best in the country. And so, you might say that one of your strategic objectives towards achieving your vision is to make your radiology centre the best in the country.

That is a strategic objective. You also go on to break it down. What does it take to make your radiology the best in the country? The building will have to be very fine; you have to have CT scan, MRI, X-ray, Ultrasound, etc. You now have to train your people. Now, these you also have to break down: when are you building the structure? When are you getting the equipment?

When are you training these people? So, as you make your vision, you break it down to strategic objectives in thematic areas, you give yourself timeline and you start working with that. It’s, therefore, this: have a timeline, break it down and use the timeline to work. There is what we call Performers Indicators, PIs. So, I say, this radiology I am talking about will have been ready by the last quarter of this year.

People will ask you: what are the key performance indicators? Say, by June, I must have bought CT scan, by July, I must have bought MRI, by September, I must have acquired this so that by December, the centre is ready. So, when you get to June, you look at your scorecard and know whether you bought CT Scan or not. If you did not buy it, you look at the activities before CT scan; whether you’ve gotten the money, whether you have called on the vendor.

So, you break it down. If you follow the key performance indicators, you will know whether you are doing well or you are not doing well. All those ones are going to be contained in that document. It is left for us as managers to be disciplined and follow that religiously. You may not achieve everything you want to achieve, but your strategic and development plan will give you a roadmap and show you where you are so that you will be able to assess what you’ve done.

What are your security plans for the institution? And what contribution has NAUTH made with regard to fighting coronavirus and what plans do you still have in place to curb the spread of the deadly virus?

This is a contemporary issue, but before I go on, let me correct an impression that we are recovering from the pandemic; the second wave is here. If you go to our Isolation Centre now, it’s filled to capacity. So, the second wave is here. It’s when you are done with the second wave, you now talk about recovery so that the public will know.

In terms of the NAUTH response and activities in curtailing the spread of the deadly virus, we are an institution and I have told you our three thematic areas, all of these are very pertinent to curtailing the spread of the deadly pandemic. When the issue of COVID-19 came up, I was the CMAC then and I knew it was purely in my purview. So, what we did was that we quickly put up a task force on COVID-19 and I was the Chairman of the taskforce.

I am still the Chairman even as the Acting CMD. That’s how important it is to us. So, we quickly put up that task force because it is our duty to sensitize the public in terms of preventive measures as a foremost tertiary health institution around the communities.

But more importantly is to prepare ourselves to be able to manage the cases that will come to us eventually because, serious cases will catch up with us. Here is the place. We had that task force and we started.

We had about seven committees in the task force: we had the Rapid Response Team; their duty is to safeguard the hospital and safeguard the patients. So, anybody who has symptoms that are suggestive of COVID-19, i.e., fever, cough, and all that, you stop him or her at that point and move the person over to the Isolation Centre, so that you don’t contaminate the hospital and get other people infected.

They are called the Rapid Response Team. If we cannot take you to the Isolation Centre, we put you where we call a Holding Place; isolate you from other people and take it from there. Once they’ve done that, their job stops, and the Case Management Team will take over. That’s the second team. This team has people who have been trained on how to manage cases of COVID-19: respiratory physicians, infectious disease physicians, infectious disease nurses, hygienists and so on and so forth.

So, they will take it from there and take you to the Isolation and Treatment Centre. We have a committee on surveillance and case identification. The Surveillance Committee was charged with making sure that people in the community, the hospital, observed the preventive mechanisms and ensure you are wearing all you need to for work. If you are not wearing your face mask, they ask you to leave.
They ensure that you have water for washing hands, hand sanitizers and all of that. So, they go round every day to ensure that both the patients and staff are all putting on their face mask. Then, we have the Public Sensitization Committee who goes to radio, television and newspapers, to pass the messages. They are largely public health physicians. So, they educate the public.

We equally have a committee on logistics. That was headed by my deputy. That committee ensures that at each point in time, we have what we call the protective kits; personal protective equipment in adequate quantity and quality. So, they keep giving us the stock levels and all of that. At a point, it became very challenging to procure. Then, we now have the Collaboration Committee, whose work was to collaborate with the stakeholders to ensure that we have what we need.

One of the major things that came out of that committee is the building of the progressive Isolation and Treatment Centre by the Anambra Progressives. I attracted that project because I heard that they were interested in building Isolation and Treatment Centre. So, I pushed them to that committee.

Then, we’ve also made some presentations in NTA and Channels, trying to sensitize and call the attention of the government on what we are doing. So, as a result of our engagement with stakeholders, NCDC appreciated our efforts, gave us PPEs and now, they are building a very standard isolation centre for us at the permanent site.

At the isolation centre at the last count, we’ve managed well over 150 patients; we’ve taken well over 300 samples for testing. So, we manage positive and negative cases. Some of our staff have had to test positive and we managed them. We have also responded very well and we are hoping that the second wave will wane with time so that people can go back to their normal activities.

The hospital was thrown into a kind of controversy few weeks ago about a doctor who died here. How’s the hospital managing that controversy and what is the situation now?

I am sure you are referring to the death of Dr Martins. It’s an unfortunate thing. He was a personal friend to us. What actually happened in the case of Dr Martins is one of the things that come up in our practice, and that’s why medical auditing is an integral part of the medical practice, because it must come up. Somewhere along the line, a mishap will happen because individuals are not robots.

People who work are human beings and they have their feelings. People on the other side also have their feelings; you may put in your best and the other person feels you’ve not done well. So, the best thing to do is to put up a panel of enquiry. The essence of the enquiry is: to strengthen your system using what you find, not really in punishing but collaterally, people who are found wanting must also have a case to answer. But for us in health management, that is not even the major aim.

The major aim is to use what we find from the investigation and enquiry to strengthen your system so that you don’t have a future occurrence. When Dr Martin died, there were accusations; some people were not happy with the way he was treated. So, for us as a management, the only way to resolve the issue was to set up an independent investigative panel and we had to make sure that members of that panel are people who can give us an objective and sincere report.

That panel is headed by a forensic pathologist, Professor Ani Orah and assisted by the team. We are expecting that when they turn in their report, we now look at the system to see. We are not afraid. As a healthcare administrator, I’ve told them clearly, do your job because the finding will help us strengthen the system.

The truth of the matter is that we don’t know who the next patient is. If the system is functioning well, then tell us the system is functioning well; if the system has got some loopholes, you should also show us so that we can use the information and strengthen the system. The panel is ongoing and because the panel is ongoing, it’s not good to make comments on this or that. So, we are waiting for the report of the panel.

What timeframe has the panel to submit its report?

We gave them a time frame but they asked for more time and we said they should do their thorough job. We don’t want to sacrifice efficiency on the altar of expediency. So, I am aware they invited the family; they’ve spoken with some stakeholders and all of that. I’m sure very soon, that report will be ready. And I assure you, as a manager, once we have that report, we are going to implement it to the letter because it is what is good for the institution.

Some people are afraid of coming to the hospital perhaps for two reasons: fear of being infected and security. How do you intend to manage these fears?

We have a security network. This is a public health institution and it is our duty to secure the lives of people and property, not just our staff but also people who come into the institution. So, we have security here.

If someone should ask if Nnewi is secure now, what would you say?

That will be on a personal opinion. Prior to now, just like the state, what I know was that the state was very secure initially and all of us enjoyed it, but recent activities in town do suggest that the security is coming down because we’ve been hearing of kidnappings here and there. Like I said, that is a personal opinion; I am not in a position to say whether Nnewi is secure or not. That will be left for the security agencies; I am just giving you the layman view.

Are your married? Have you kids?

(Flaunts his wedding ring) I don’t have kids yet. We do at the appropriate time.

In this concluding edition, we continue from where we stopped in our interview with Dr Joseph Ugboaja, new CMD of Nnamdi Azikiwe University Teaching Hospital, NAUTH, who was recently promoted to the cadre of associate professor.

In this interview with Fides’ Rev. Fr Martin Anusi, Mercy Hill, Alexander Johnson Adejoh, Precious Ukeje and Adejumoke Alebiosu, he reveals a number of things about him and his trajectory from clinical practice to hospital administration. The new CMD, who was Chairman, Medical Advisory Committee, before his most recent appointment, also shares his vision for the institution, noting that the teaching hospital is aiming at being among the first five in Africa.

Excerpts below:

Let’s go back a bit. Did you choose to study Medicine or you were pushed into that?

I came into Medicine by accident. What I wanted to read was Pharmacy. So, when I finished my secondary school, I got the JAMB form and wrote the exam for Pharmacy, but I didn’t meet the cut off for that year. I missed it with five marks. That was in the University of Nigeria, Nsukka. When I now got the JAMB form for the next year, an uncle of mine told me that I am brilliant and that people that are brilliant go into Medicine while Pharmacy was meant for the less brilliant people.

He mentioned few instances and I sat back and looked at it: all my mates in the class that are at my level were opting for Medicine. I was in the science class and was also part of the top. So, all of them opted for Medicine while those opting for Pharmacy were actually little below us. What he said made sense to me and I filled Medicine in the JAMB form. Because Nsukka had denied me admission the previous year, I decided to fill Nnamdi Azikiwe University.

That was it and I got it. You see, originally, when I was in school, pharmacy was my point of call. When I saw a person in pharmacy, I would be going close to the person to see what I could learn. Thus, medicine is actually by accident; nobody inspired me. But when I came in, I fell in love with the course.

Again, when I finished undergraduate courses, I wasn’t too sure what was going to happen in terms of post graduate. At a point, I felt it will be Ophthalmology. So, I started reading Ophthalmology textbooks before I went for service and all of that. But along the line, instead of Ophthalmology, why not Obstetrics and Gynecology? Since everyone around me thought I should better do an engaging course, I thought it was Obstetrics and Gynecology.

I opted for it. I dropped the Ophthalmology textbooks and picked up the O & G, went for primaries and passed, and then got admitted into the residency training. Again, I did very well in Obstetrics and Gynecology. When I finished and passed my exams one hand, I also loved it when I started practising it.

Two years into being a consultant, the former CMD with whom I had a close relationship, was looking for who will be the Deputy CMAC in the hospital to help him. He called me to his office one day and he gave me an envelope containing an appointment letter as the Deputy CMAC. I was relatively quite young, and I didn’t think I could be considered to fill in such a responsibility.

That’s how they carried me to the position of the Deputy CMAC and I started. And I did that job well. You know you don’t access yourself, but I knew I did well when I came to contest for CMAC. When I came out to contest for CMAC after four years on that job, I ran against very senior people: three professors and one associate professor. We were 106 consultants and professors that voted and I got 81 votes.

That was when I looked back and said perhaps, I did very well as the Deputy CMAC that I could exude this level of confidence among my colleagues. I didn’t plan to be the DCMAC but once I became, there is what we call ‘committed sperm cell’ in Biology; I became committed to management. Not like I sat down one day and said I wanted to go into hospital management, but here I am, Acting Chief Medical Director.

Where do you see the health sector in Anambra in the next ten years and what role do you think NAUTH will play in contributing to that vision?

See, we are preparing NAUTH to be a national player, not a statewide player. We are talking about ranking among the top five in the country. So, I don’t like discussing state; we discuss Nigeria, discuss Africa and the world in the sense of where NAUTH will be in the scheme of things. That is the vision. We are not looking around the state, because if you look around the state, you drop your vision.

The vision is larger than the state. It’s a federal tertiary institution and so, it cannot be serving just the state. It’s positioned to serve the south east at the minimum and to serve Nigeria at the general, because what we want here is that you will be in Abuja and require a particular service and they will say go to NAUTH. All the way from Lagos and Abuja, they will say go to Nnewi. And you come here and we sort you out. And what it means clearly is that you will go there and get the skill. Medical practice is all about the skill and the knowledge.

It’s a service driven art. What you don’t have, you don’t give. What I have to do with my people just like India did is find a way to send them to India, let them stay as long as it requires getting the skill. And they will come back, where you will provide them with enabling environment to explore. Those things our people go to India and UK to access, they will come here and access them. Once they come here to access them, your centre has become a centre for medical tourism.

And so, that is where we are headed in terms of where we want to be. It is not a one-day thing. Like I said, we are building a ten-year strategic development plan that will guide us all the way with timeline. We are developing that document. Once we develop it, it is my duty as the Chief Executive Officer to mobilize the entire community to key into the vision.

When will the document be ready?

It will be soonest, and I am sufficiently prepared to do that. I am an apostle of transformational leadership. I believe that everybody has got something to offer in this system. All they need to do is to bring it out, because that’s leadership. The transformational leader is the one that brings out the extra in everyone.

That is the way we want to approach it. So, we have to transform the system and get us to that place. In terms of the health sector in Nigeria, it’s a third world country; it has its high times and has its own low areas. But, the current Ministry of Health has actually tried, especially in terms of managing coronavirus.

You see, we’ve never been this challenged, but I am happy with the response mustered by the federal government, the Ministry of Health and other agencies. So, if you want to use response to COVID-19 as a yardstick, I will tell you that they are doing well. Given that the money allocated to the health sector is not up to the 15% of national budget stipulated by the Abuja Declaration.

There are many things competing for the scarce resources, but I think the ministry has done well. However, what we must know is that the largest room in this world is the room for improvement, so, you keep encouraging them to improve on what they do. But, what people keep forgetting is that upholding the health status of the people is not a one-man show.

It is not for the government alone, because even if government gives the 15% stipulated by the Abuja Declaration, people at the receiving end may not receive the money. You may give me the money in this hospital and I will eat all of it, and this hospital will remain like this. It’s, therefore, about everybody being committed to improving the health status.

It’s not the governor, not the president, not even the CMD. It’s about all of us committing to uphold the health status of the people, especially, the most vulnerable, that is, women and children. The press is also a part of it, if you mount your health campaign from time to time, even in this COVID-19, give lectures and sensitize people. It’s a duty for all of us. And I believe if all of us work together, the health indices will improve.

That’s just the truth of the matter. So, we are looking at a bigger picture for the institution and not Anambra State.

What is the most significant breakthrough you’ve had as the CMAC that came through research; and what is the quality of the reviews of your papers before they are published?

Let’s start from the first one: you know using products of research is time dependent, because if you do problem-solving research, what you want to do is when you identify the problem, you try to sort it out and if you try to sort it out, the only way you know you’ve sorted this problem is to go back to the field and conduct end analysis again.

The SHIP was our flagship product, then the Patient Satisfaction Survey (PSS) was also key to us. Now, after that PSS, which showed that our people were not doing well, we mounted attitudinal change workshop; we trained over 3000 staff. We spent money.

We were meant to go back to the field after six months to conduct an exit interview to find out how many of them are satisfied, because the expectation was that after the trainings and getting the qualified people to talk to them, their attitude would have changed. But the only way to objectively find out is going back to the field and administering your feedback forms again, but COVID-19 caught up with us.

However, anecdotal evidence, observational evidence did suggest that there was change in attitude as evidenced by the patient disposition, but we could not objectively ascertain that. But we think that if we had gone back to the field, perhaps, we will have noted some positive responses.

In terms of the review, reviews are journal based. We have internal reviewers, professors. We have people who write, we have editors and people who belong to the Editorial Board. I brought these people together. Then, we have an Internal Review Committee. After you’ve done your research, you’ve presented to us in a conference and you now want to publish, you direct it to that Committee and they will do an internal review.

Once they’ve done that, they point out to you what and where to effect changes. Whether the journal you are sending to accepts and publishes it is entirely the prerogative of the journal. It becomes an external process. When you send it out and it’s reviewed, it could be sent back. Some will modify it. Some will also publish as sent.

But, what we did was to get a very good internal review mechanism. In fact, we start from the level of development of the manuscript: when you conceive the idea, that this is what you want to do, we also channel it to that committee to help you put the idea in order; in a way that is researchable. Look at your methodology, work with you.

And if you see what has come out of that effort, you will be marveled because our people started writing. Not writing for the purposes of writing, but they had interest in research.

So, our creative output rose. In fact, it is the university that is enjoying because in assessing the university globally, they look at the creative output from their staff. We don’t have any direct benefit as a hospital outside using it to solve our problem. But in terms of ranking, Unizik got some serious ranking. For some time, professors from Nnewi topped the Google Scholar ranking, even as we speak today.

I don’t know what it will be tomorrow. So, our professors keep topping the ranking and people keep wondering. It’s because of the kind of interest we’ve generated here in research. People are writing, researching and all of that. And that’s how it’s been.

You seem to have been into a number of things, even though there were no initial plans, yet you do very well in them. How do you work this out?

I don’t know. You know there are certain things you don’t know in life. I don’t know how I would have also fared if I had gone into Pharmacy. Perhaps, the thing would have been the same and all of that. I think it’s all about applying yourself to where you find yourself. Now, there are things you decide to do and there are things that come to you by opportunities.

But I think the bottom line is: wherever you find yourself, apply yourself to do the job very well. The CMAC, I didn’t want. I considered myself very young to do the job; I had other plans for myself, but I was convinced that I did a good job out of it. So, it’s all about applying yourself, then planning. From the DCMAC moving forward, the choice was mine.

I decided that I would run for CMAC, I also decided to run when the position of the CMD became vacant. So, I think it’s about application of yourself to where you find yourself. For me, my motto is “determination is key to success”. Once you are determined and focused you will get to your goal. Now that I am doing the Acting CMD, I don’t know what I will do tomorrow. Other opportunities may come; I may also choose other opportunities.

What do you think stood you out from other contestants despite having similar experiences in the DCMAC and CMAC positions by some of them?

I wouldn’t know. I don’t like assessing myself, and in this contest, I don’t like discussing people, because there are other CMACs who were also in the race. So, what I believe in life is in whatever position you find yourself, do your best, be sincere and be visionary. Leave other mundane considerations. Now, when you do those, both God and man will find you suitable for opportunities.

That’s the truth of the matter. Because some of the things that may happen around you, the truth is that you may not be in control; you may not even know why. That’s my belief in life. Do your utmost best in whichever situation you find yourself. Help humanity, and then, leave the rest to God and man. It will happen. That’s how I do. I don’t know whether or not I am outstanding.

All I know is that you give me the job and I apply myself to it in all sincerity and strive to achieve the result for the institution; every other thing will fall into place. But one can’t come into a position and start having mundane considerations for other pecuniary things.

I don’t think both God and man will align behind you. People might associate with you for pecuniary reasons for their selfish interest, but even those people know that when push comes to shove, they will point somewhere else, and say that this is the man.

That’s leadership. Peter Obi is not the governor of Anambra State anymore, but all over the country and the world, people are talking about Peter Obi because of the way he ran the state. Do you see the difference? So, aim to be like that. It’s a lesson even for people who are coming up. Whichever place you find yourself, do your best so that people can recommend you, but more importantly, so that God can recommend you and find you suitable for more opportunities.

May we know your plans for taking NAUTH to the height of being among the first five hospitals in Nigeria?

In strategic leadership, you start from the vision, develop your vision and your vision should be large as to frighten you. When they say that this particular leader is visionary… if your vision is common place and it looks ordinarily achievable, then it’s not a vision, it’s not a dream.

Your vision must be likened to a dream, and might be likened to something that is not achievable. So, you start from your vision and then you develop your strategic objectives. For instance, we are saying that we want NAUTH to be among the top five in the country, that’s a very big and vague statement.

But you break it down to objectives. How? In any hospital, you have lab, pharmacy, theatre where people do surgery, you have clinics where people come to consult. For it to be topnotch, these areas will have to be developed to an extent they also become one of the best in the country.

And so, you might say that one of your strategic objectives towards achieving your vision is to make your radiology centre the best in the country. That is a strategic objective. You also go on to break it down. What does it take to make your radiology the best in the country? The building will have to be very fine; you have to have CT scan, MRI, X-ray, Ultrasound, etc. You now have to train your people.

Now, these you also have to break down: when are you building the structure? When are you getting the equipment? When are you training these people? So, as you make your vision, you break it down to strategic objectives in thematic areas, you give yourself timeline and you start working with that. It’s, therefore, this: have a timeline, break it down and use the timeline to work.

There is what we call Performers Indicators, PIs. So, I say, this radiology I am talking about will have been ready by the last quarter of this year. People will ask you: what are the key performance indicators? Say, by June, I must have bought CT scan, by July, I must have bought MRI, by September, I must have acquired this so that by December, the centre is ready.

So, when you get to June, you look at your scorecard and know whether you bought CT Scan or not. If you did not buy it, you look at the activities before CT scan; whether you’ve gotten the money, whether you have called on the vendor. So, you break it down. If you follow the key performance indicators, you will know whether you are doing well or you are not doing well.

All those ones are going to be contained in that document. It is left for us as managers to be disciplined and follow that religiously. You may not achieve everything you want to achieve, but your strategic and development plan will give you a roadmap and show you where you are so that you will be able to assess what you’ve done.

What are your security plans for the institution? And what contribution has NAUTH made with regard to fighting coronavirus and what plans do you still have in place to curb the spread of the deadly virus?

This is a contemporary issue, but before I go on, let me correct an impression that we are recovering from the pandemic; the second wave is here. If you go to our Isolation Centre now, it’s filled to capacity. So, the second wave is here. It’s when you are done with the second wave, you now talk about recovery so that the public will know.

In terms of the NAUTH response and activities in curtailing the spread of the deadly virus, we are an institution and I have told you our three thematic areas, all of these are very pertinent to curtailing the spread of the deadly pandemic. When the issue of COVID-19 came up, I was the CMAC then and I knew it was purely in my purview. So, what we did was that we quickly put up a task force on COVID-19 and I was the Chairman of the taskforce.

I am still the Chairman even as the Acting CMD. That’s how important it is to us. So, we quickly put up that task force because it is our duty to sensitize the public in terms of preventive measures as a foremost tertiary health institution around the communities. But more importantly is to prepare ourselves to be able to manage the cases that will come to us eventually because, serious cases will catch up with us. Here is the place. We had that task force and we started.

We had about seven committees in the task force: we had the Rapid Response Team; their duty is to safeguard the hospital and safeguard the patients. So, anybody who has symptoms that are suggestive of COVID-19, i.e., fever, cough, and all that, you stop him or her at that point and move the person over to the Isolation Centre, so that you don’t contaminate the hospital and get other people infected.

They are called the Rapid Response Team. If we cannot take you to the Isolation Centre, we put you where we call a Holding Place; isolate you from other people and take it from there. Once they’ve done that, their job stops, and the Case Management Team will take over. That’s the second team.

This team has people who have been trained on how to manage cases of COVID-19: respiratory physicians, infectious disease physicians, infectious disease nurses, hygienists and so on and so forth. So, they will take it from there and take you to the Isolation and Treatment Centre. We have a committee on surveillance and case identification.

The Surveillance Committee was charged with making sure that people in the community, the hospital, observed the preventive mechanisms and ensure you are wearing all you need to for work.

If you are not wearing your face mask, they ask you to leave. They ensure that you have water for washing hands, hand sanitizers and all of that. So, they go round every day to ensure that both the patients and staff are all putting on their face mask.

Then, we have the Public Sensitization Committee who goes to radio, television and newspapers, to pass the messages. They are largely public health physicians. So, they educate the public. We equally have a committee on logistics. That was headed by my deputy. That committee ensures that at each point in time, we have what we call the protective kits; personal protective equipment in adequate quantity and quality. So, they keep giving us the stock levels and all of that. At a point, it became very challenging to procure.

Then, we now have the Collaboration Committee, whose work was to collaborate with the stakeholders to ensure that we have what we need. One of the major things that came out of that committee is the building of the progressive Isolation and Treatment Centre by the Anambra Progressives. I attracted that project because I heard that they were interested in building Isolation and Treatment Centre. So, I pushed them to that committee.

Then, we’ve also made some presentations in NTA and Channels, trying to sensitize and call the attention of the government on what we are doing. So, as a result of our engagement with stakeholders, NCDC appreciated our efforts, gave us PPEs and now, they are building a very standard isolation centre for us at the permanent site.

At the isolation centre at the last count, we’ve managed well over 150 patients; we’ve taken well over 300 samples for testing. So, we manage positive and negative cases. Some of our staff have had to test positive and we managed them. We have also responded very well and we are hoping that the second wave will wane with time so that people can go back to their normal activities.

The hospital was thrown into a kind of controversy few weeks ago about a doctor who died here. How’s the hospital managing that controversy and what is the situation now?

I am sure you are referring to the death of Dr Martins. It’s an unfortunate thing. He was a personal friend to us. What actually happened in the case of Dr Martins is one of the things that come up in our practice, and that’s why medical auditing is an integral part of the medical practice, because it must come up. Somewhere along the line, a mishap will happen because individuals are not robots.

People who work are human beings and they have their feelings. People on the other side also have their feelings; you may put in your best and the other person feels you’ve not done well. So, the best thing to do is to put up a panel of enquiry. The essence of the enquiry is: to strengthen your system using what you find, not really in punishing but collaterally, people who are found wanting must also have a case to answer.

But for us in health management, that is not even the major aim. The major aim is to use what we find from the investigation and enquiry to strengthen your system so that you don’t have a future occurrence. When Dr Martin died, there were accusations; some people were not happy with the way he was treated.

So, for us as a management, the only way to resolve the issue was to set up an independent investigative panel and we had to make sure that members of that panel are people who can give us an objective and sincere report. That panel is headed by a forensic pathologist, Professor Ani Orah and assisted by the team. We are expecting that when they turn in their report, we now look at the system to see.

We are not afraid. As a healthcare administrator, I’ve told them clearly, do your job because the finding will help us strengthen the system.

The truth of the matter is that we don’t know who the next patient is. If the system is functioning well, then tell us the system is functioning well; if the system has got some loopholes, you should also show us so that we can use the information and strengthen the system. The panel is ongoing and because the panel is ongoing, it’s not good to make comments on this or that. So, we are waiting for the report of the panel.

What timeframe has the panel to submit its report?

We gave them a time frame but they asked for more time and we said they should do their thorough job. We don’t want to sacrifice efficiency on the altar of expediency. So, I am aware they invited the family; they’ve spoken with some stakeholders and all of that. I’m sure very soon, that report will be ready. And I assure you, as a manager, once we have that report, we are going to implement it to the letter because it is what is good for the institution.

Some people are afraid of coming to the hospital perhaps for two reasons: fear of being infected and security. How do you intend to manage these fears?

We have a security network. This is a public health institution and it is our duty to secure the lives of people and property, not just our staff but also people who come into the institution. So, we have security here.

If someone should ask if Nnewi is secure now, what would you say?

That will be on a personal opinion. Prior to now, just like the state, what I know was that the state was very secure initially and all of us enjoyed it, but recent activities in town do suggest that the security is coming down because we’ve been hearing of kidnappings here and there. Like I said, that is a personal opinion; I am not in a position to say whether Nnewi is secure or not. That will be left for the security agencies; I am just giving you the layman view.

Are your married? Have you kids?

(Flaunts his wedding ring) I don’t have kids yet. We do at the appropriate time.

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