Dr. Azubuike Onyebuchi is the new Chief Medical Director (CMD) of the Federal Medical Centre (FMC), Umuahia, who has only been in the office for 100 days.

In this interview with Emmanuel Ifeanyi, he talks about several ongoing plans to transform the hospital into a transplant centre, and other medical and administrative measures being put in place to make the hospital one of the best in the country. Excerpts:

Can we get a little of your background history?

My name is Doctor Azubuike Onyebuchi, the Medical Director Federal Medical Centre, Umuahia. Before my appointment by President Muhammadu Buhari, I was a consultant, obstetrician and gynaecologist of the Federal University Teaching Hospital, Abakaliki for 11 years. While there, I served as the Chairman Medical Advisory Committee of the hospital for four years. I’m a senior lecturer of Faculty of Clinical Medicine, College of Medicine Ebonyi State University. I’ve lectured medical students for eight years and I’ve been assessed as an Associate Professor of the faculty, although it’s not yet out. I’m also the Assistant Secretary General of the Society of Gynaecology and Obstetrics of Nigeria (SOGON), which is the parent body of all doctors that look after women.

You’ve spent over 100 days in office, what could you say about this place so far?

As you can see, this is a Federal Medical Centre, and I came from a Teaching Hospital background. So, basically that concept of training of medical students and other health professionals might not just be as it is in a Federal Teaching Hospital. However, the core functions of a tertiary hospital, which include service delivery, training and retraining of health manpower and research, are also in FMC Umuahia.

What are the things lacking here, and what have you done about them?

What I’ve done first is to re-motivate the staff. Before I came on board, most of the service delivery points lacked things they required to work. I understood from them that that was a major problem and they required me to change the narrative and make sure that all the things, logistics, consumables and supports that they needed to work with are provided for them to work with and that I’ve tried to do. I also noticed that working environment in most of the workplaces was dilapidated and the staff were not working in a conducive environment and did not have job satisfaction that I’ve also tried to address. I also noticed that their moral was low because most of them had been denied some form of promotion, sponsorship or things like that that will motivate them work better. I’ve also tried to address that by sponsoring some health professionals to both local and International for conferences and promoting some people who have some backlog of promotion through the help of the management of the hospital.

What are the major challenges you’ve encountered so far?

The place needs more modern medical equipment to function. Like the CT-scan which you know is a very good radiological investigation that you can use to diagnose almost anything is not working at the moment and we working very hard to put that in order. The Intensive Care Unit where you take care of very sick people is not properly established and the equipment you require to monitor people who are critically ill are not there and we’ve decided to work on those aspect and try to bring in as more modern things as we can to help our people. If you go to the Intensive Care unit now, you’ll notice that we have new ventilators, new string pumps, new infusion pumps, new modern monitors that you can use to monitor patients who are critically ill. We’ve also tried to provide for the cardiology unit a state-of-the-art 2-D Echo machine that can look at you and tell you how your heart is functioning, and that has brought a lot of relief for our cardiac patients and also job satisfaction for the cardiologists. They had to come here as a group to thank me for doing that for the department and it has helped them to save a lot of cost for patients who were formerly managed by not looking at their hearts. One had to tell a story of a patient who had massive pericarditis and was been treated as a case of cardiomyopathy, but with the aid of that 2D Echo machine, they were able to look into the heart, pick the fluid and the patient got well and went home, but they were initially thinking it was cardiomyopathy. So, without that machine, they would have been treating the wrong thing. So, we need more modern diagnostic machines to be able to make correct diagnosis and of course treat. We are also trying to renovate places that are bad. If you go to the maternity ward complex now, both the Obioma and Nkasiobi wards, where incidentally I was born, and my mother told me that the place had been like that since I was born and it was still like that for some time.I’ve completely renovated the Obioma and the Nkasiobi wards within my first 100 days in office. If you go there, you’ll be impressed and be happy to send your wife there to get delivered of your child. We’ve also renovated the dental and ENT complex. It was about collapsing when I came on board, but if you go there now the story has changed. That has motivated the staff as they’re now happy to work. We’re pushing ahead to lobby the necessary people both at the National Assembly and the Ministry of Health to get things here. I’ve been able to attract in the budget, a building of a modern Accident and Emergency Unit (A&E) and an Intensive Care Unit. If you go to our A&E, you’ll feel sorry for the patients there because the place is overcrowded and overburdened by cases that hitherto should have been managed at the primary and secondary healthcare facilities.

But because those systems of health care facilities have collapsed, the whole pressure is now on tertiary hospitals.

The previous administration was applauded for organ transplant, what do you intend to do in that area?

Yes, we’ve sustained what was done by the previous administration. I’ve had a renal transplant done after taking over as the Medical Director. Though we did not use the American partners, we used our own Nigerian partners and that reduced cost. So, we intend to consolidate that and bring in more plants. Part of my long-term plans for this hospital is to have a transplant centre here, not just renal transplants, but for other areas. It will include renal, cornea, liver and whatever things that can be transplanted will be done there.

What do you want FMC Umuahia to be like at end of your tenure?

I want FMC Umuahia to be transformed from a Federal Medical Centre to a Federal Teaching Hospital. That’s what I’ll want to be remembered for and by the grace of God; we’ll get it from this President (Buhari) who listens to genuine concerns. I want the narratives to change from when people say if you are going to FMC, you are going to die to a situation where people will now say, if you are going to FMC, you are going to get healing because the staff would have been motivated, retrained and their attitudes changed and the hospital known for patient centeredness and patient friendly hospital. That will be my overall aim.

Are you comfortable with your staff strength, especially the medical health workers?

I’m not comfortable. Basically, we’re lacking resident doctors. And that’s one thing we’ve tried to change. I’ve made the case for a waiver to take more health professionals and that waiver is getting attention at the Head of Service’s office and I’m very sure that soon that waiver will be granted and we’ll employ more health professionals. The health workforce is obviously inadequate.

How do you tend to handle the issue of nurses and patients’ relationship in terms of the way they take care of patients?

It will be very unprofessional of me to stick out nurses for the attitude of our health professionals on patients. We’ve already started retraining our health professionals both nurses, doctors, other health professionals and non-health professionals who are also working here to change their attitudes towards the patients. Without the patients, every one of us medical professionals will be in the labour market. I’ve made this clear to them throughout my interactions with them. So, whatever we have to do to make our patients comfortable, we all have to do that. I’ve made them to institute regular training and collaborations with institutions abroad, so that they come down here and have some in-house training for them to see the international practice of how a nurse should relate with his or her patients. So, I don’t want the nurses to be picked singularly on this issue because it’s a general thing that all health professionals must be retrained on their attitudes to work and attitude to their patients.

What you intend to do to improve the Internally Generated Revenue of the hospital?

With money, you can do almost everything you want to do. And increasing the internally generated revenue of every organisation what every CEO must tried to do. First thing is to improve services. Make sure that clinical services you’re rendering are of high quality so that more people can access that. That’s why I said we have to get the CT scan back to functionality, get our labs back to functionality which we have done. The radiology section we’ve refurbished all the x-ray machines, we’ve provided backups for the ultrasounds, we’ve resuscitated the mammograms so that all those services will be functional and once they’re functional and people knows, they’ll access them and your IGR will grow. Second, we’ve tried to block up all loopholes, automate our revenue collection system. If you look round you’ll see wires and computers going round the whole hospital. The whole idea is to automate our revenue collection and reduce physical involvement of individuals and block loopholes where people mismanage funds that we naturally should have gotten. So, with automation, I know that our IGR is going to go up. We also aim at creating more services for our people. The things that we’re not doing regularly, like the (intro fertilization) we intend to make it more regular and let the public know that these things are done in FMC and not only in private settings.

What are you doing to checkmate the issue of diversion of FMC Umuahia patients to private hospitals by some doctors?

As we talked about the automation of revenue collection, we are also trying to automate the electronic medical records. With that, you are going to reduce the physical contact between health professionals and the patients who had worked into this hospital willingly. Because everything you’re doing is going to be through the computer. If I see a patient, he is entered into the computer. He wants to go and get his drugs, the doctor keys in his prescription in the computer and he goes to the pharmacy, so there will be no prescription sheet to take away. That’s one diversion that will be reduced. In terms of doctors diverting patients, once your name is keyed in the system, the doctor who is following you will also be keyed into the system. So, we’re thinking about that, we are also talking to the doctors that anybody who is caught diverting patients that have willingly walked into this hospital will be dealt with according to public service rules. Whether you’re the highest consultant or lowest doctor, you’ll be dealt with according to public service rules. I’ll be having interactions with the often so that they’ll know I’m always available for them. We’ll keep dialoguing often. And with that this inter-professional rivalry will end. (New Telegraph)

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