TELL Magazine

Dr. Abali Chuku. Medical Director Federal Medical Centre, Umuahia.

The health component of President Goodluck Jonathan’s Transformation Agenda seeks to achieve a number of objectives. These include the enhancement of the professional capacity of medical personnel towards specialization. Upgrade of facilities especially in Federal Government’s health institutions so as to ensure best professional practices in the management and care of patients of diverse cases and complications. Among the purpose of the later is to minimize medical tourism that has tended to diminish the state of medical practice in Nigeria even when many Nigerian-trained doctors are practicing in first-rate hospitals across the world.

At the Federal Medical Centre, FMC, Umuahia, Dr. Abali Chuku, the Medical Director, MD, who is driving President Jonathan’s transformation in the health sector, has turned the medical facility into a Centre of Excellence and a reference point in health care services going by the testimony of Honourable Minister of Health, Professor Onyebuchi Chukwu and other stakeholders. On his appointment as the MD, FMC, Umuahia on May 16 2011, Dr. Chuku thought of a strategy to deliver on both his mandate and Government’s Transformation programme on health services.

His preferred approach was to:

• Enhance the capacity of medical doctors in critical health care areas through specialist training.
• Improve facilities through the procurement of state of the art medical facilities.
• Improve the hospital environment to make it conducive to both patients and staff.
• Ensure industrial peace in FMC through the practice of good labour relations.
• Personalise care in nursing practice.

This futuristic approach has largely defined Dr. Chuku’s service at FMC, Umuahia. He identified diabetes and heart disease among others as ailments that will continue to challenge medical practice in Nigeria.

Under the Seek an Area For Excellence (SAFE) programme, Dr. Chuku embarked on intensive overseas training exercise for his medical personnel. One of the early beneficiaries is Dr. Ignatius Ezeani, now a consultant physician, endocrinologist and diabetologist. Dr. Ezeani was exposed to a multi-national training in the United States, Spain and Ethiopia. He trained in the areas of Endocrinology, Diabetes and Metabolism. The training was necessary because the MD realised the compelling need for doctors to be abreast with current trends in the management of diabetes. On the return of the doctors that was sent abroad for specialist training, Dr. Chuku evolved the Team Arrangement that has deepened the SAFE project. A major benefit of the Team Arrangement that has brought in its wake so much innovation is that the FMC, Umuahia today functions with the precision of an automated vehicle assembly plant. Dr. Ezeani explains how the Team Arrangement works using the Diabetic Team. This team according to him is made up of a diabetologist, an ophthalmologist, a dietician or nutritionist as well as a diabetic nurse. In the Diabetic Team also are a pharmacist and a medical social worker. The main aim of setting up the team, Dr. Ezeani explained, was to enhance patient’s outcome especially given the many complications that can arise from diabetes. Such complications could involve the eye, the kidney, the nerves among others.

Minister for Health Prof. Onyebuchi Chukwu

Because a patient wants the best, what the Diabetic Team does is to provide a holistic treatment. According to Dr. Ezeani, the patient on entering the consulting room sees the Diabetologist, from there, the patient is sent to the next consulting room to see the Ophthalmologist for the eye to be examined. Thereafter, it will be the responsibility of the Nutritionist to counsel on dietary requirements. Next will be the Pharmacist who will advice on drug intake and finally to the nurse who will inform the patient on what next to do and also the date for the next appointment.

Because of the quality of care provided and modern technological equipment available, FMC Umuahia has become a leading centre for the treatment and management of diabetes in Nigeria. It has also become a reference point for research into diabetes through the establishment of Endocrinology Diabetes Metabolism Research Laboratory which is domiciled in the department of medicine. The laboratory has all the equipment for effective research into the various challenges which emanate from diabetes for which new understanding for the disease and its treatment is required. The laboratory is equipped with the following equipment: Biothesiometer, Ankle Brachial, Index Analyser, a computerised Body Mass Index, BMI, Analyser as well as a Glycated Hemoglobin Analyser that meets the National Glycohemoglobin Standardization method of the United States. It is significant to note that FMC, Umuahia is the first hospital to procure Glycated Hemoglobin Analyser in the whole of South-east geo-political zone. Experts are of the opinion that the availability of the equipment is one of the best things that has happened in the area of diabetes because the analyser will give an idea of the patients’ condition. It is therefore, not surprising that challenging diabetic cases are being referred from places such as Uyo, Port Harcourt and of recent Lagos to FMC, Umuahia.

Urology is also a field of medicine that Dr. Chuku is striving for excellence. According to Dr. Okwudili George Achor, a consultant urologist with the centre, before Dr. Chuku assumed office as MD, there were challenges in treating patients with diseases of the urinary tract mostly among male patients because they were being treated in what Dr. Achor called the ‘traditional way’.

Asked to explain what he meant by ‘traditional way’ he said it was the cutting open of a patient with, for instance enlarged prostate or stones in the kidney. One of the ways the MD addressed this problem was to send Dr. Achor for training in Muljibhai Pathel Urological Hospital as well as to Nadiad and Saifee Hospital, Mumbai, India to acquire the needed expertise in Endo-Urology services and also in Laparoscopy.

Since his return, FMC, Umuahia, now treats patients with prostatic diseases and stones in the modern way as is done in other parts of the world. What this means is that patients with enlarged prostate are no longer cut open to remove the prostacy. What obtains now is referred to as trans-urethral resection of the prostate during which the medical doctor introduces instruments from the penis into the prostate and reset the enlarged prostate. A major outcome of this procedure is that at the end, the patient will not have any scar. The same applies for patients with stones in the kidney, urethra or bladder. FMC, Umuahia has the capability to treat such patients without giving them incisions. The centre also performs percuteneous nephrolithotomy for stones in the kidneys and usospopic for stones in the erectile and also uses endoscope to treat stones in the bladder. These modern procedures practised in advanced countries are now obtainable in FMC, Umuahia.

There is also a Cardiac–Thoracic Team. Most of the team members are trained in medical facilities in India. FMC, Umuahia is about the only hospital in Nigeria where a Cardiac–Thoracic Team is operational. All the specialists with professional interest in cardiac care are bonded together to form the team. To move cardiology to a higher level at the centre, one of the cardiologists, Dr. Kelechi is at present in India training to provide the service of pacemaker implantation. Dr. Chuku said that on Dr. Kelechi’s return, the equipment to practice the new skill he had acquired will be made available.

The infertility clinic in the centre has become fully functional. Dr. Agwu Felix who trained on that aspect of medicine in India under SAFE now provides along with his team in vitro-fertilization, IVF, treatment for needy patients. Furthermore, FMC, Umuahia has made its mark in the field of family medicine. Indeed, the Department of Family Medicine has grown astronomically to a point that, today it ranks as one of the best in the country.

Another notable achievement of the centre under Dr. Chuku is the remodelling of its theatre and practice. FMC, Umuahia is among the few establishments that are paying close attention to World Health Organisation Standards on surgical safety. The attainment of this milestone is so significant that Professor Onyebuchi Chukwu, Honourable Minister of Health, during a recent visit to the centre was initially doubtful of its veracity. It was not until he saw the documentary evidence that he was convinced and commended the MD and his Management Team for a job well done.

Also, nursing services is being re-engineered so as to provide optimal service to patients. Until recently, FMC, Umuahia practiced duty-based nursing. That practice now belongs to the past. The method now in place is what Dr. Chuku called individualized-based nursing. Nurses at FMC, Umuahia now ‘own’ patients. They can identify patients that they can call their own. By this new practice, they are expected to know everything about those patients. For instance, in a hospital ward with about five nurses and 25 patients, each nurse will ‘own’ five patients. They are expected to have as much information about each patient as to enable them provide total and effective care. The innovation already in practice in the United Kingdom creates a better bond between the patient and the nurse, which brings about a better care.

At FMC, Umuahia, there is so much emphases on patients’ rights. Out of the nine patients’ rights that are emphasized, two cannot be compromised. They are the right to information and the right to emergency care. This gives rise to an emerging culture at the centre encapsulated in what Dr. Chuku call The AIDET Protocol. This protocol which has been used by the Star Buck Chain in the United States from where it is borrowed stands for Acknowledge, Introduce, Duration, Explain and Thank (AIDET).As Dr. Chuku explained, AIDET is an acronym for these stages of customer care areas.

The entire 1600-member of staff of FMC, Umuahia are being trained so as to comply with the AIDET Protocol. In fact at FMC, Umuahia, it is mandatory for newly employed staff to undergo training on AIDET Protocol before the recruitment processes is finalized. The objective is to make staff, patient friendly and customer oriented so as to change the perception of patients positively so that they can regard hospitals as a hospitality industry.

The pursuit of excellence has also impacted greatly on the centre’s Department of Obstetrics and Gynaecology. The labour ward has undergone a lot of improvement and modernisation. Today, the ward is much neater, friendlier and a lot more convenient for the doctors to work in. For instance, the labour rooms are all air-conditioned and very comfortable. In the paediatric area more facilities such as incubators and radiant warmers have been provided. All these are at no extra cost to the patients.

At FMC, Umuahia, Dr. Chuku has enunciated a process that if replicated in major tertiary health institutions in Nigeria could significantly slow down the rate at which wealthy Nigerians embark on medical tourism abroad. The acquisition of specialist medical skills abroad through training and procurement of state of the art medical equipment have been extensively highlighted. The next logical step is to provide an in-patient accommodation facility comparable to those Nigerians enjoy abroad.

In this regard, FMC, Umuahia can now boast of a new eighty-eight bed facility. It is indeed a three-star in-patient facility, tastefully furnished and operational. The life saving facilities provided include, piped oxygen, piped suction machine. There are also TV monitors in each of the private rooms. The environment of this facility is so conducive that it has been likened more to a luxury hotel than a hospital.

“You have done well”. A visionary always strives to achieve the best. He is very innovative. He also works hard to be ahead in any competition. Perhaps it is these attributes that prompted Professor Chukwu to declare in an interview that he is very proud of the accomplishments of Abali Chuku at FMC, Umuahia. According to him. “The Medical Director is one of our best, his staff here are co-operating with him, you know when you are doing the right thing, people will naturally follow you. They are doing wonderfully well”. All these are the minister’s verdict on Dr Chuku’s scorecard at FMC, Umuahia.

They will remain a lasting testimonial to the good work a man with a sagacious mind and penetrating vision, like Dr. Chuku is doing at FMC, Umuahia. The Honourable Minister of Health is not alone in his commendation; another stakeholder who is happy with what Dr. Chuku is doing is Dr. Achor, a consultant urologist with FMC, Umuahia. According to him “he has been moving our hospital along in different directions he has trained a lot of us in modern services, how to render modern services in different areas of the hospital. He has also provided different infrastructure like you can see the new ward complex which is now a standard ward complex which can compete with any ward in any part of the world and from the things he is doing and things he is yet to do we are sure that by the time he finishes as the MD of the hospital, the hospital will not be the same again. The hospital can compete with any hospital in the world”

Speaking in the same vein, Dr. Ezeani, a consultant physician, endocrinologist and diabetologist in the Department of Medicine, FMC, Umuahia said, “I can confirm and I can tell you that of all the Chief Medical directors I have come across or worked under, this is the most innovative, this is the most focused, this is the most humble and in fact this is one of the most competent medical directors. He has been a motivator to us. He has been like a father to us. In fact he is like a mentor to every doctor in this hospital. In fact the Endocrine Unit, the Endocrine Research Laboratory was just set up about 18 months ago and that is courtesy of Dr. Abali Chuku so I can tell you that he has done exceptionally well”.