Nigeria

2014/03/05

Dr Ronke Desalu

“Safe surgery is tied up with the socio-economic status, political participation and education of women.” Ronke is an Associate ProfessorRead more →

2014/03/05

Dr Queeneth Kalu

“They say ‘Abasi Akan uman ikwa,’ meaning ‘God forbid delivery by knife!’” Queeneth is a Senior Lecturer and Chairman,Medical AdvisoryRead more →

2014/03/05

Dr Nneka Anaegbu

“In the coming decade we’ll be on the frontier and at the helm.” Nneka is a Consultant Anaesthetist at LagosRead more →

2014/03/05

Comfort Osagie-Ogbeide

“You have to buy your life.” Comfort works in hospital administration in London. She is originally from Nigeria. What isRead more →

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Dr Ronke Desalu

Dr Ronke Desalu

“Safe surgery is tied up with the socio-economic status, political participation and education of women.”

Ronke is an Associate Professor and Consultant in Anaesthesia at the Lagos University Teaching Hospital. Her sub-specialty interests are paediatric anaesthesia and Training in CPR. She is happily married with 2 grown-up children.

Why is access to surgery essential for women’s health?

A third of the 4500 surgeries performed at my hospital in Lagos last year were related to women’s reproductive health. This is a substantial percentage for one ‘special group,’ and emphasizes the importance of ready access to safe surgery for women.

Yet not all women are lucky to get this professional treatment; the maternal mortality rate in Nigeria is approximately 585 per 100,000 live births.

Why did you become an anaesthetist?
I always wanted to be a doctor, even as a young girl growing up in Lagos in the 1960s. With two aunties showing that women were just as capable as men, and could be doctors, my mind was made up.

I’m passionate about helping the vulnerable and the sick, and it gives me great satisfaction to see the outcome and the value one person’s actions can have on another person.

Can you tell us about one of your most memorable cases?
I’m in a profession that has its fair share of risks, but I like to look on the positive side of my work, the good we do and the relief we bring.

Many years ago we treated a 5-year-old child with a large cystic hygroma [a growth that appears on a baby’s neck]. The surgery was difficult, and afterwards she was unable to breathe on her own. We admitted her to our intensive care unit, which didn’t have a functioning ventilator at the time.

The trainees and technicians took turns to manually ventilate her for 100 days.

The case emphasizes the importance of teamwork, perseverance – and above all, commitment to your patient.

What is the government doing to reduce maternal mortality?

In the last six years, the Lagos State Government opened six specialized maternal and child health hospitals, with full surgical facilities. This means more theatres, more surgeries, more training and better health service delivery.

What is the role of women in the surgical ecosystem?

Safe surgery is tied up with the socio-economic status, political participation and education of women. We need to support groups that advocate for women’s health issues – women shouldn’t have to travel such long distances for basic care.

I take as one of my critical roles in life, to uplift and raise the bar for young women. To show them that it is indeed possible to have both a happy home front and a sky that is the limit in their career.

 What is your goal for women in the medical profession?

I want them to realize that they’re part of a unique team. Many organisations assume that women can’t cope with the top positions and we need to change that mindset. We need to be amongst the counted when it comes to doing our job well.

Women need to be fully involved in the implementation and management of healthcare, as well as in the policy and mapping of future health plans for their community – and indeed the world.

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Dr Queeneth Kalu

Dr Queeneth Kalu

“They say ‘Abasi Akan uman ikwa,’ meaning ‘God forbid delivery by knife!’”

Queeneth is a Senior Lecturer and Chairman,Medical Advisory Committee at the University of Calabar Teaching Hospital in Cross River State, Nigeria.

Do women recognize that surgery can play a life-saving role in safe childbirth?

In my locality they say ‘Abasi Akan uman ikwa,’ meaning ‘God forbid delivery by knife!’ When it comes to childbirth, most Nigerian women prefer a vaginal delivery, meaning going to hospital is a last resort.

This translates to late presentation after laboring for hours in the traditional birth attendant’s home. They commonly arrive with obstructed labour, severe preeclampsia, foetal distress, haemorrhage – conditions requiring surgical intervention to save mother, baby or both.

The importance of safe anaesthesia in these emergency patients, arriving in suboptimal states into our very challenging health service system, cannot be over-emphasized.

What kind of challenges?

As a trainee anaesthetist I once had a patient who needed a Caesarean section at night. As soon as I gave her the spinal anaesthesia, there was a public power outage.

There was no back up power supply in the theatre. W e had no automated patient monitors at the time. We put on the small light of the laryngoscope, checked blood pressure every 5 minutes, palpated the pulse, kept communication with the patient and waited in the theatre till the anaesthesia receded.

We’re familiar with occasional power outages during surgery and will usually carry on with torchlights until power from the generator or public supply is restored. In this case we felt it was too risky, so we returned the patient to the ward and surgery was done the following morning. These are not things we are proud of but the reality in Africa is: we work in a challenging environment.

Does experience of working in other countries change your perspective?

I witnessed a case of placenta acreta [a sever complication of pregnancy that often requires surgery] during my obstetric anaesthesia fellowship at Wolfson Medical Centre in Israel.

The early diagnosis and preparation of equipment, blood availability, personnel – obstetricians, anaesthesiologists, interventional radiologists, perfusionists, nurses…it was amazing. Such a sharp contrast to what’s available in our environment when we see the same condition.

I realised why our maternal mortality rates are so high and theirs so low. I realize that saving a woman’s life in an obstetric emergency situation, especially where there’s bleeding is more or less a warfare and must be treated as such. All hands must be on deck.

What are your goals for women in the healthcare profession?

My joy is that I have found my passion for public health being fulfilled along my career path, and I encourage women to rise to professional excellence.

They should strike a work life balance. Make the most of the opportunities that come their way, engage in community development projects. Share their knowledge through health education programs in churches, market places, media houses.

I pray that in the coming decades, women will not be looked upon in terms of gender but will be seen as too relevant to be ignored.

 

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Dr Nneka Anaegbu

Nneka Anaegbu

“In the coming decade we’ll be on the frontier and at the helm.”

Nneka is a Consultant Anaesthetist at Lagos State University Teaching Hospital, Nigeria.

Why is access to surgery essential for women’s health?
The woman’s role is vital in the maintenance of the family. Since the family is the smallest unit of the society, their function is essential for society at large.

Inability to get access to safe surgery can lead to unnecessary demise of a woman, a tragedy and a great disaster to her children and husband. Children who lose their mothers are negatively affected psychologically, which may affect their behavior in the society.

Does a woman’s role in society affect her ability to get surgical care?
There are various challenges that women face while trying to access health care. They include financial, educational, cultural, gender inequality, poor governance and religion.

In my culture the young girls are usually at a disadvantage due to gender inequality – their parents may not send them to school because they believe it is a waste of resources. Girls are soon married out to end up in a man’s kitchen, seen and not heard.

This leaves women financially dependent on their husbands for every need, including healthcare support. A woman whose husband does not provide money for her to access healthcare when needed is a woman at risk.

Is surgery seen as a safe option?

Education about safe surgery is vital, and sometimes lacking.

In our environment some women run away from Caesarean section for various reasons. Some believe they may die during the surgery, others feel that their family and friends will look down on them for not delivering naturally. Others feel that it means that they are not prayerful enough.

I remember a woman who was pregnant and attended antenatal care at the hospital. The doctors noticed that she had pre eclampsia, therefore she was told that she would require surgery to deliver her baby. Instead she went to a traditional birth attendant to deliver.

She eventually developed eclampsia, and by the time she came to the hospital the baby was dead. She still had to have a Caesarean delivery and died in intensive care after about 10 days.

What can women around the world do to support safer surgery?
Women should strive to educate their girls to enable them have a brighter future and be independent. Many of the young girls I know want to be professionals in various fields, and have a passion for healthcare. But there are many barriers –parents lack the financial capacity, while some girls get pregnant in secondary school and can’t further their education.

Women should be supported by other women to achieve their goals. My aim for women in the medical profession is that in the coming decade we’ll be on the frontier and at the helm of activities in the industry. Taking decisions that will favor women, in order to improve women health and prevent avoidable eventualities that may affect women.

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Comfort Osagie-Ogbeide

Comfort Osagie-Ogbeide

“You have to buy your life.”

Comfort works in hospital administration in London. She is originally from Nigeria.

What is your experience of surgery?

Well it saved my friend’s life. She needed a caesarean section for her second baby, and she survived. But it was very difficult.

Why is that?

The attention she needed wasn’t really there, due to lack of financial resources and unavailability of the right equipment in Government hospitals. She decided to go private but lacked the initial deposit. If you don’t have the money, you don’t get the treatment.

There’s so much pressure on the family. The price they may charge is huge, and of course if she’s pregnant the lady hasn’t been working. It pains you to see this happening – women dying from illnesses that are not supposed to take them. You have to buy your life.

So is it hard to trust in surgical care?

Recently I heard about a young lady who died from an incomplete operation. Not immediately – she went for a surgery to deliver a stillbirth and they left some products behind. She kept going for follow up, kept complaining that she had pains. She wasn’t wealthy, and her life didn’t get enough attention. She was neglected until she developed sepsis, and she died.

From a stillbirth. A tragedy followed by a tragedy. It is really difficult to trust surgical care.

Surgery is that line between life and death, and it’s the common belief that if you go into surgery you’re not likely to come back.

Has your attitude changed since you moved to the U.K.?

Here at least they’ve got the right equipment to look after the patient. I’ve come to realize that there’s nothing inherently dangerous about surgery when you need it and you do it safely.

It’s when you need it and they don’t have the resources for that. My friend and her baby almost wasted away. It’s just a nightmare. You don’t want to talk about it.