- WHY AND HOW WE SUCCEEDED IN OUR FIRST CONJOINED TWINS SURGERY
- WE WILL SOON START BRAIN AND HEART SURGERY
- WE ARE ONE OF THE BEST FMCs TODAY, PACE SETTER IN ELECTRONIC RECORD
By Muhammad M. Garba
Before Dr Yahya Baba Adamu took over mantle of leadership of the 20 year old Federal Medical Centre Keffi, Nasarawa State , in 2018, as its Medical Director and Chief Executive Officer, the Centre, though popular and reputed for hard work and excellence, had never contemplated or attempted a risky surgery like that of Conjoined Twins.
However, on July 10th, 2020, Dr Baba Adamu took the bull by the horn and rolled out his team of Surgeons, within and outside the Centre, to attempt the 9-hour historic separation of Conjoined Twins conceived by Malama Tasalla, a resident of Mararaban Udege in Nasarawa local government area of the state
Following this first successful and historic surgery, team of Journalists from Health Monitor, one of the titles of Education Monitor, sought for audience with the Medical Director to know what motivated him to embark on this risky but successful and ground breaking medical exercise.
The Medical Director who gave a surgical analysis of the reasons that motivated him and his team to attempt the surgery, stressed that he was largely encouraged by the Minister of State for Health, Senator Adeleke Mamora.
Health Monitor: Sir, we want to, first of all, thank you for the audience, despite your very busy schedules. For the benefit of the public, may we know who is Dr Yahaya Baba Adamu?
Medical Director: Dr Yahaya Baba Adamu is a Nigerian Citizen from Nasarawa State, basically a medical doctor. That has been my major trade or practice. After graduating as a medical doctor over 25 years ago, I spent most of my time training as a surgeon and eventually became a Cardiothoracic Surgeon. Meaning, I specialized in surgery involving the chest and the heart. I can remember very well that as at the time I graduated as a Cardiothoracic Surgeon, I think by all records I’m the first from Northern Nigeria to be a fellow of the West African College of Surgeon in cardiothoracic surgery. And we thank God over the years so far, we’ve had so many other of our colleagues who later joined us. We have a number of them in Sokoto, Kano, Zaria, Ilorin and in different other locations around the northern part of the country. Generally, in cardiothoracic, we are not really so many in the country, even in the southern part of the country, we all know ourselves and where each and every one of us is. We are not so many that we don’t know where the other person is. But as compared to the south, I think, we are a bid behind, because I happened to be the first in the West African College of Surgery from Northern Nigeria.
Health Monitor: Congratulations for these exceptional and unique achievements. Sir, how is it like, heading FMC keffi, which is arguably, one of the crowded hospitals in the country?
Medical Director: We want to thank God seriously for this, because it is a challenge but I think every challenge is supposed to be taken up by somebody, and so when I was asked to come and take the mantle of leadership of this Hospital, being my home, I considered it as a challenge that I should take, and it doesn’t matter what it takes to do that, I was willing to do that, and I did not see it as something that will give me a sleepless night. So, I was ready to come in.
On coming in, we had to look at what were the things on ground, what needed to be done, who needed to do it, and how do we do it. For over the last two years that we have been here, for those who know the place before now, I do not think I need to praise myself because that is not my job, but I believe the system itself is around for anybody who wants to take the judgment to do it for him or herself.
We have been trying to see how we can improve on the system. we had to modify some of them, beside the infrastructure that we have to improve some, and then of course we also had to make sure that certain things that ordinarily were not working, we had to put them back to work. We tried to also energize the staff to have a sense of belonging, so that we can all move together. We tried to unify even the management and work closely with the Board of the hospital. Since we are all on the same page now, because of the harmony that had been created so far, even with the unions, we have been having very smooth relationships.
For those who know this place before, you will agree with me that since I came in the last two years, we have not had any serious industrial action in the hospital. The few times we had some of these challenges, were when the Union’s national body declared a nationwide industrial action; and our union had to obey directives of their national leadership to join the strike.
Health Monitor: What other major challenges can you say you inherited?
Medical Director: When I came in, the first thing that really struck me that we felt was the primary challenge that needed to be tackled immediately was that, most of the services like in laboratory and investigations were being procured outside. Even drugs, when prescribed to patients, most times these drugs had to be procured outside the vicinity of the hospital. We felt that was not the best for both the institution and our patients. So, we had to come in, and with very good collaboration and cooperation of other management staff, we were able to turn that for the better, and this happened within the first two or three months of our coming.
As at today, basically, all services that were supposed to be rendered at the hospital including some others that we’ve added are going on concurrently. Then, I also discovered that we had to carry several massive works on our source of oxygen supply.
Before we came on board, the oxygen that was used in the hospital was procured from Abuja to meet the oxygen needs of our patients. When we came in, we said, No, this had to stop because it was not in the best interest of our patients and image of the hospital, because when we go out of stock, somebody’s life may be at stake. So, to address this, we decided to set up our own oxygen plant within the hospital so that we can produce our own oxygen 24/7. Oxygen is not something that you can say wait for me to go to Abuja and come back. The holdup at Mararaba can hold you for another two or three hours and you may not be able to come back on time.
Again, you see, this Oxygen is more like a bomb. If you carry such massive cylinders of oxygen in your vehicle and God forbid, if there’s an accident, that will be several bombs exploding, and I do not think it’s something we should toy with. So I felt that one of the first few things we should fix immediately was to recover our oxygen plant and also to improve its capacity. At the time I came in, I was told that the capacity of the oxygen plant was such that it could produce four to six standard size oxygen cylinders a day. That’s not enough to cover one unit, so we had to quickly upgrade the oxygen plant and reactivate it. Even the four to six it was supposed to produce, it was not producing, it was producing zero a day; and for over two years it was like that and we had to bring it back.
So, within the first few months of our administration, we succeeded in reactivating the oxygen plant to the extent that it has the capacity of producing about 40 to 48 cylinders a day, but because we have to ensure that this is not overrun beyond its capacity, we decided not to go beyond twenty cylinders in a day so that the machine can have some time to rest. So, we put it at an average of twenty. Though occasionally we go above that but at least we have capacity to produce not less than twenty standard size cylinders of oxygen on a daily basis.
This is what we have been maintaining until recently when we had a short period of down time because it needed servicing and the routine servicing coincided with the COVID-19 period, and the importation of those service parts was not easy, so we had to close down for a few months during the COVID, just to make sure we keep the machine alive; because if you keep running it, it will just collapse completely. So, we suspended its production for a while but now it’s back. As soon as there was ease on the lockdown, we were able to bring those things, serviced the machine and we are back on production. So these were the major areas that we felt had to be corrected immediately then, but of course there are many other areas that we’ve touched either in terms of policy, in terms of change of structure, addition of equipments, and all that.
Health Monitor: Did you have knowledge of these challenges before you came in or until when you took over before you discovered them?
Medical Director: To be very candid with you, before I came in, I just knew I’m from this town. I would have said I knew a lot of FMC Keffi, because I’m from Keffi. But I think I knew nothing. When I took over, I realized that my knowledge of the hospital is not what I used to think it was. But, be that as it may, it doesn’t mean that when I came in everything was just not there. No! There were many things we should be very proud of that I met here. Indeed, before I came here, I came to realized that this hospital was a Centre of reference for electronic medical records. We have people from all parts of Nigeria coming here to learn. People coming all the way from Abakiliki in Ebonyi state, from Ebutemeta in Lagos state.
I think if am not mistaken, we are probably one of the first public health institution in Nigeria to go fully electronic in medical records.
I think that side has great feat for others to refer to. The only thing that the hospital tried to do, unfortunately, was the technical issues. It was trying to go onto solar which was something that would have served as a reference point. But the equipment and other things ran down too fast, so that it lasted not more than two to two and a half years and everything was no longer functional. I tried to see how we could salvage it back because of its importance, but the cost of bringing it back was very exorbitant. In fact, I don’t have the resources to do that now. So, I just had to let it be for now because the quotation was above N40m, and if it is just to recover it for two years, or thereabout, where would I even get the N40m from? And how soon would I be requiring another N40m? for this reason therefore, we had to begin to revert back to our backup generators. When I came in, I was told that there were two transformers that were serving the hospital.
But in reality, it was only one that was working because the other one was literally dead.
I thought AEDC would readily come in and give us a replacement but unfortunately that was not to be after all my advocacy. So I had no choice than to go and source for funds to procure a second transformer for ourselves. So far so good, I think the two transformers have been working and the hospital has been enjoying relatively stable power supply with the backup from our multiple generators that are within various service points within the hospital. With this, I can say that we’ve been able, to a great extent, solve the issue of electricity.
Another major issue is water. We’ve been doing our very best to make sure that there is portable water supply in the hospital. We have done this by improving the source which is by increasing the number of underground water sources (boreholes). So far we’ve added about three more boreholes since I came in.
Then there came the issue of how to store the water. In this case, we eventually came up with two reservoirs of water.
One is a surface tank of not less than one hundred thousand litres capacity and the second one is an underground tank which is also not less than one hundred thousand litres capacity.
We also tried to recover the overhead tanks that had always been in existence from the inception of this hospital that were otherwise thought to be out of place and could never be used. We decided to look at them for what it may be and luckily for us they didn’t require so much renovation to get it back to full use. We succeeded in recovering the overhead tanks that had been there for sometimes times, and today they are in use. That is part of what we are using to pump water to wards. To a large extent, we have tried to solve the problem of water.
With the coming of Gov. A. A. Sule, the public water supply that was not in existence for a while, suddenly has resurfaced, and we decided to quickly take advantage of that and reconnected ourselves back to the public water. So we are now taking advantage of both our underground water (Boreholes), and we are also taking advantage of the public water. To a large extent, we cannot complain of source of water. Of course just like in any system, from time to time you may have one problem or the other that is preventing water from reaching one area of the hospital or the other, which is not lack of water. We always have water in the hospital.
Health Monitor: In the course of our investigations we discovered that before you became the MD of this Hospital there were cases that were usually referred to other hospitals, like the National Hospital Abuja and other more advanced hospitals, but with your coming, you decided to change that practice. What informed your decision?
Medical Director: Well, I have only one conviction that is spurring me to thinking that we have outgrown referring cases all over the place. I’m not saying that the case that is required to be referred, should not be, but the training that is obtained for the consultants and specialists that are in this hospital and those in other hospitals outside Keffi, is not different. They were all trained by the same college. Every Specialist, if he is a doctor, is trained either by the National Postgraduate Medical College or the West African Postgraduate Medical College. If you attended the same training, and write the same exams and got the same qualification, I do not see why, except you want to query the training by the College that they are giving one type of training for some people in another location and another type for other persons in another location. I think their training is basically the same. They just need to get the right encouragement and the right equipment. So what we needed to do was to give them that push and then make them believe they can do it because they can. And where they have challenges of equipment or instruments that they need to do this job, they bring it up and we try to put them into batches.
I am happy to say that we have been buying all the equipment that we need to handle any kind of patient, and those that are obsolete, we try to replace them gradually and slowly. That has helped us to a great length. To undertake complex surgeries, depends on what you have in your theater, what you have in your Intensive Care Unit, what type of personnel do you have, what is their level of training? If all these are answered positively, then you should be ready to do anything. It is not the location or name of the hospital that determines what you can do.
So, when we came on board, I looked at the theatre, as a surgeon, I am at home with theatre; I can see my left from my right when I go to the theatre. I didn’t have to wait for the staff to tell me So, some of the things, first before I do them. I just knew what needed to be changed if we need to do what we have to do. I knew some of these things in this theatre since I was a medical student more than 25 years ago; I still come here and see some of them still in existence. So, we started a program of gradually replacing most, if not all of those equipment. Recently, we even changed the headlamps that we use to lighten the operating table and we have changed the operating table, we have changed anesthetic machines, introduced monitors that were not available and are needed in such a high theatre like this.
The same thing also happened in the intensive care unit. When I came in, we had no single functional ventilator there. We had to bring in the ventilators, bring in monitors, bring in the syringe drivers and all the things needed to have a functional ICU. Today we have a functional four-bed ICU and we still hope for improvement. We hope that when the Covid situation improves, we are going to improve the personnel capacity by sending the staff to places where the best of training is received such that we are sure they can be measured with any other person in any part of the world because I don’t think we deserve anything less.
I am not in competition with any hospital, but I believe we deserve the best in any of the service areas. It is not about where you are located, but if this is our hospital, then it has to be the best it can be. And that is our target and that is what we are focusing on.
Health Monitor: Sir, can you, in clear terms, also take us through your infrastructural achievements in the hospital, if any?
Medical Director: Frankly, since we came in, I am not sure there is any place I would look at now and tell you that we cannot show you our signature in this hospital. If we want to start in series, then we can start from where we are sitting now. Starting from here to the Board Room, the way we met it is not how it is today. Every sit in the Board Room now has a speaker; we also have convenience there too. We dug bore holes as I mentioned earlier, we replace the city scanners in the radiology department, we bought new ultrasound machine, we have put up a library for them, and have done many other things in that department. For the first time they have gotten accreditation to train postgraduate students there.
For the sake of emphasis, In the theatre, like I told you earlier, we have changed so many things to a standard of what a hospital should have. We changed the operating table, the anesthetic machines, headlamps, etc. Before, they used to carry oxygen in the cylinder to the theater before they connect to the machine and use.
Today, we piped oxygen to the theatre. What you need to do is just to turn the tap and then you are able to run your machines in the theater. We have also pipped the oxygen to the Intensive Care Unit, and Special Care Baby Unit, all within this period. In fact, in maternity ward, at the time I came, behind the labour ward, you cannot stay there without covering your nose. Even if you cover your nose, your eyes are also a problem. The mess you will see on the ground is something else because it was overflowing and overflowing into the delivery room. So, we had to completely dig a new suck-away. The obstetricians even threatened that they were not going to receive any delivery from the unit again.
But, few weeks after our coming, we quickly rescued the situation. If you go there now, if you like, you can spread your mat at that place now without anything. We also expanded the Labour Ward Theaters. They had a two-suit theatre which we expanded and made it a four-suit theatre. We brought additional air conditioners and made it more conducive. The ACs were all down, we repaired some and replaced some. We also fixed their ultrasound and so many other things in that ward. We were also able to get them full accreditation for training too.
In fact, in some wards, back then, maggots were seen moving all over the toilets because they were full, due to lack of proper drainages. Everywhere was full of messes. Relatives of patients or whoever wished to, used to defecate in the open, around the area of the wards. But today, you cannot see those things again. We have changed all of that. Once I get a report, I go myself, I follow it and take immediate action and we make sure the necessary decisions are taken to do all that immediately.
Health Monitor: With all these Achievements, how do you get money to do all those things, when Chief Executives of many hospitals always complain of lack of money?
Medical Director: Well, some of these things, we have a very good understanding with my staff, we deal in direct level, from our IGR, whatever we get, we try to put some of them directly by using direct labour. Some, we allow contractors to do them, and we owe them and eventually we pay them back. In fact, sometimes we don’t pay at once. There is a good understanding that we can even pay some of them in batches. We pay you probably first 30% of first 50% and later we pay the balance. Because there is a good understanding, we have been enjoying this good relationship, and we are able to go through. Of course, at one point in time there would always be some people that we owe, but we try to clear the logs as soon as we get some money.
When I came in, there were three major capital projects that were ongoing, but all of them were at foundation stage. So far, in the last two Years, we have succeeded in being able to start and complete the new laboratory building. The only thing that is remaining now is to equip it, which is not part of the budget now. We have to make a new budget for that. But it has been delivered and submitted to the hospital.
The second one is the Ward Extension A B C and dialysis. That, too, is almost completed. The few things remaining is the piping of their oxygen in the new amenity ward that we want to create in that particular building, and that is what is holding the whole project to a standstill at the moment. That needed to be imported, but, unfortunately, the COVID-19 pandemic is not allowing things to move as expected. However, we hope that as soon as they are able to fix the background oxygen equipment they needed to put in there, they would be able to complete and deliver that as well.
But, if you go there now, from outside you may think the job is done but it’s not there yet. We need to fix that and be sure that that is 100% delivered. The third one I met also on the same similar level of DPC is the Specialists Clinic. As at today, we have taken it up, decked it and started building the top one which is at the level of lintel now. The expectation is that very soon we will roof that place and continue with other development within the place.
Again, where we are treating COVID-19 patients today was a building that was already done but not in use because there was nothing there. We had to scamper around to get beds to make it a Ward. Of course it was purposely built to be our isolation centre so we had to make sure we quickly put it into use immediately.
I didn’t know COVID-19 was coming, but we were used to having things like Lassa fever; so I don’t have to wait until Lassa comes that we had to lock our wards. So, we had to quickly activate the place. We started using it for Lassa patients before COVID-19 came and overtook Lassa. Thank God that Lassa has gone on break too, as well. So, we are now using it fully for the treatment of COVID-19 patients. Like I said earlier, if we keep moving from Unit to Unit there is always something I can say we have done in this period.
Health Monitor: Could this, drive to boost the hospital’s IGR base, have been what prompted you to hike different charges in the hospital, which you were accused of by some patients sometimes ago?
Medical Director: I think there was a misunderstanding. It may appear like we hiked our charges sometimes ago, but we did not really hike anything. What we only did was we tried to be very objective and told ourselves the reality which if we do not, then we will continue to deceive ourselves and live in a fool’s paradise. You see, when I came in, the situation I met was such that, for instance, if a lady came to deliver at night and it was discovered that she required a Cesarean Section, they would have to write for her to go and buy all the things required for the CS, outside the hospital. If she comes in at 1 am when all the Pharmaceutical shops have been closed, where will she then go and get those things from at 1.00 am? Or if one comes in with an emergency of chronic abdominal pains and the surgeon decided that he has to undergo an operation, and then a long list is written for him at 3 am, where do you expect him to go and get those items from? I don’t think that system was right.
So I said, No! Let us not deceive ourselves and say we are charging twenty thousand naira for this operation when in the real sense, this operation is sixty thousand or fifty thousand naira. Because the things you have written for this person, he has paid twenty thousand naira for operation but by the time he goes and buys other things and comes back, the total cost of the operation is now fifty or sixty thousand naira. I said ok fine. Let’s put this together. They put everything and came back and said this is how much it costs to buy those things. I said ok put it in the charge of the operation and then the patient doesn’t have to be sent out to go buy those things. So, all you need to do is, if it is Cesarean Section, you just ask them to go and pay fifty thousand naira, your own is just to take the patient to the theatre and the operation is done and your baby is out. So, I don’t know what they mean by saying that we have increased cost of operation.
Then the second thing which was a completely untrue was that we increased the cost of delivery. What we did was downward review of the cost so that we discourage people from going to quack places to deliver. Even circumcision that was done for ten thousand naira, I said No! We will be encouraging people to go to the wrong places for circumcision. We reviewed it down to five thousand naira. But the next thing I saw on the news was that we have increased the cost of circumcision, we have increased this and that.
Sometimes, I wonder who is benefiting from this kind of news. I think these are some of the challenges we are going through. The only thing we need to realize is that this place used to be a General Hospital and today it is a Federal Medical Centre; and if it is a Federal Medical Centre, then, it is supposed to be a tertiary hospital; and a tertiary hospital is supposed to give minimum standard that is supposed to deliver and we cannot achieve that if we insist on having the conditions of General Hospital that it used to be.
This is part of the challenges we are facing; and up till now we had to let go, but we will come back to it. If a patient comes in, and you ask him to make admission deposit. They said this man has come to kill us. Deposit is a deposit for God’s sake. Did he tell you to make admission payment? It is admission deposit. If you don’t do a deposit, I don’t know how you will even enjoy your stay on admission. It then means that for everything we need to do, you will physically have to come and do the running for yourself.
Worried by this strange development, I invited all relevant stakeholders and told them that this has to change, because I had never seen this in any tertiary hospital, throughout my practice life, apart from one or two years when I was a bit out before I returned to the tertiary hospital. Everywhere you go, people make what we call admission deposit to make your stay easy in the tertiary hospital. And when you pay this admission deposit, it is distributed among the services for easy access.
However, I said let’s start with something minimal. Let’s say five thousand naira each for the four units, which is twenty thousand. They said hey!! He has come to kill us. He is asking us to pay twenty thousand naira before we are attended to. Even when we made this statement, we said those who come into emergency should first be received, resuscitated, at least within the first 24 hours. If the patient is stabilized, he should go and pay.
However, some people took it upon themselves to frustrate the whole program. they went and started saying that we said if you have not made deposit, they shouldn’t even receive you in the emergency. That created unnecessary tension around town and around the hospital which was unfortunate. Eventually, because there were too many problems people were coming with, I wanted to get a little breathing space, we suspended that. And now some people are complaining. Because you can imagine you come in at 1 am and they need to do something for you, and they say go to the cash point and pay, when you come back, go to the laboratory come back, go to the pharmacy, it doesn’t make sense. But if only the deposit was there in your name, the ward attendant will be sent to just go and collect the drugs or take the sample to the lab, you know, in all these things we will not need you. Well, that was what our people were used to during the general hospital days. You know, change is always a difficult thing for people. People don’t want to change.
Health Monitor: Sir, Federal Medical Centres are established in almost all states, but why is it that FMC Keffi is always crowded with patients?
Medical Director: well, I want to say that if people are not satisfied with what we are doing, they will not come around. Even those who come around will run away. That is one possibility. Again, our location is very strategic. We are like a corridor to many places. We are very close to Abuja, and at least two of the Area Councils of Abuja are adjoining us closely. We have Abaji Area Council coming through Toto, we have the AMAC coming through Mararaba and coming all the way here. And we are very close to Kaduna state here; we have our neighbours from adjoining Local Governments of Sanga, Jaba, Jema’a. They find us as the closest tertiary hospital they can easily reach; so, they tend to come this way. We also have people coming in from all parts of the state, and by so doing, we tend to have many patients coming and over stretching our capacity. Because of this we are really focusing on how to improve the capacity of the hospital to meet up with this. We hope that very soon we should be able to widen our capacity on what we can do in this respect.
Health Monitor: Your hospital recently successfully separated conjoined twins. What gave you the courage to embark on such a risky venture or mission?
Medical Director: Well, like I said, I believe my specialists are not second hand trained. They were trained from the same colleges others were trained. So, when these babies were brought in or when they were delivered about fifteen months ago, the first thing was whether we should refer them or not. This was because few months before then, similar conjoined twins were brought here, and they had to be referred to the National Hospital Abuja. Then I was just coming, so I did not see reason why I should stop that. So the babies were referred. When this second one came in, and they were planning a referral, I stopped it. I said No, you can’t refer. I know we can do it. And the question was like he was a joker, how can he be talking of separating conjoin twins? But I said well, I don’t see what is there that is going to stop us from separating the conjoin twins here. But the question is, would we be doing a disservice to the children by keeping them here just because we want to try? But the question is, what do you need? When is the best time for them to undergo the Operation? Even if we had referred them, and even the one we referred to the National Hospital, had to be in the Hospital for about nine months before they were operated. I think they were almost one year at the time of operation. Because everywhere you go the children had to be well prepared, and the optimum time for surgery is between six to nine months. That way you have a chance of higher and better output. So, I said well, since I know the optimum time is six to nine months, which means I had been given my question paper before entering the exams hall, I know that I can prepare for the next six to nine months. So, that makes it not an impossible job. If you are telling me to do that in six to nine weeks, it’s a different thing, but you are telling me to do it in six to nine months which is almost a whole year to prepare. So I felt it was something that was doable.
I told them, look guys, let’s sit down. We are able to do this and we should be able to do it. So, they set up a committee. Then we started looking for different facilities from different locations that we would need to use for this procedure. Then, they came up with their list and we started following them one after the other.
We fixed this, we fixed that. Of course immediately I assumed office, one of my major focus was to improve the critical care of this hospital. So, because I had already started that, it was easy for us to build on it. So, we built up our ICU, we started improving the infrastructure in the theatre. When all was done, we were now left to buy other consumables that needed to be used, which we gradually bought, fixing them as we buy them. We also had some trainings where it needed to be done.
But just while that was ongoing, like they say where there is a will there is always a way, in the course of this preparation, His Excellency the Governor of Nasarawa State got wind of the news that we were preparing to separate conjoin twins here, and he decided to come in and pay a visit. When he heard about our level of preparations, he decided to put in his own contribution, which came in handy, because it helped in speeding up our preparations to the finish line.
We were actually ready to do this surgery when they were nine months, but, incidentally, COVID-19 was at its highest peak of scare and everybody was not sure and nobody wanted to take any risk. Should we end up infecting the children or vice versa? So, we took a break trying to understand more and more of the COVID-19. Along the line, we came round and we were able to develop more confidence on the COVID-19 matter. Then we eventually concluded that we were going on. Then, we planned that every person who will participate must be COVID-19 free. So, everybody was screened and all the people who were screened, almost all were negative. The few that were positive, we were lucky none of them was a key participant. They were people that could be done without. So we excluded those people who were found to be positive and send them for treatment and then fixed the date for the surgery.
As God would have it, with adequate preparations, with everybody on ground, the surgery was undertaken. It was done on the 10th of July, 2020. It was a 9-hour operation. As God would have it, the operation was very smooth. We never had areas of anxiety, and we thank God there was no single complication, and it was successfully completed. Again, when the children were separated, it then became two surgeries; so two tables were running. When the first table finished theirs, the baby was brought out. As the parents saw the baby, as they had already been primed that they may lose one, they started crying. But they were counseled properly that nothing was wrong and everything was under control and that the second child would be out any moment.
Few minutes later the second child was also brought out and everybody was quiet happy. We took them to the Intensive Care Unit, and typical of the twins, when the first one was doing so well we thought the other one was more challenged but along the line, when the one that was apparently having more problems decided to wake up, she became faster than the one that was even better at the beginning. Both of them really recovered quiet fast.
There were some interesting and spectacular moments during the whole process. Firstly, in fact, it’s about having a good Boss. It is good to have a good Boss. Also, we didn’t have trouble with the Board; the Board was very cooperative and willing to let us go on with the procedure, and of course our direct Supervisor, the Honourable Minister of State for Health, Dr. Olorunimbe Mamora, was quiet caring, very interested in the whole development of what was going on.
When I met him, his fears were not farfetched. It was unexpected that a Federal Medical Centre like Keffi wants to consider doing such an operation. When I told him sir, we want to do a separation of our conjoined twins, he said ahh! Don’t you think you should refer them to the National Hospital? I said, Sir, I understand your fears but I think we have all it takes to do it. Like I told you there is nothing more interesting than having an understanding Boss. He said in that case, I wish you all the best; I know you can do it. His encouragement added to my confidence and we thank him very much.
When everything was done, I sent the pictures to him and in fact, his excitement knew no bounds. That’s why I told you that all that he said from the beginning was out of deep feeling of concern. He called me and said we have to organize a Press Conference immediately. But along the line, because of the same issue of concern for the children, we felt we should allow the children to be strong enough. Within few days later when I snapped the children and forwarded the pictures to him, he said the children are okay. So, we should go ahead and organized the Press Conference. He personally took the responsibility of organizing the conference in Abuja. All that we needed to do was to take the babies to Abuja.
Health Monitor: With this great achievements, Sir, don’t you think you should pay more attention to such risky ventures so that the hospital may eventually become and be recognized, globally, as Centre of Excellence for Conjoined Twins?
Medical Director: Already, this is the beginning. We didn’t do a one shot thing. The experts will remain here, they will not go away, and that’s why I wanted it to be done here in the first place. The expertise and the equipment will remain, and that would mean that if there is similar case of conjoin twins, there won’t be need to go to the National Hospital, they will come to FMC Keffi. Because we have a record of having done this successfully, just like it was done in the National Hospital as well. So I think that that has already been established.
Before I came here, there was a Neurosurgeon that was supposed to be a Visiting Consultant in this hospital. But at a point he felt there’s no point for him to come because he cannot operate. We needed the environment for him to be able to operate. As at today we have put up an advertisement for a Neurosurgeon because the environment is quiet suitable for us to operate on the brain in this hospital. On the same line, we have started doing chest surgery here already. We are set to do one now but we don’t have a Neurosurgeon and we want to employ one. We are already quiet advanced in that line. Once we employ a Neurosurgeon, we are going to commence brain surgery in this hospital. And since we have started chest surgery, part of my next plan, hopefully, within the next twelve months, we should also record a pitch of the fact that we can do heart surgery in this hospital. And that should not be long from now.
Health Monitor: Government was excited over your recent achievement. Is there any encouragement or support from them?
Medical Director: Yes, at least our Honourable Minister of State clearly mentioned that day that FMC, Keffi, is going to be recognized as Centre for Specialists Surgeries. I see that as a challenge and we will try to make sure we take it on ourselves and take it with the ministry as well. We have to stand on it and try as much as possible to make it thrive on highly specialized things that cannot be gathered in every hospital that we have to be referring our patients out, rather we would want to have a reverse tourism of people coming back here instead of going out.
Health monitor: Are these experts all staff of this hospital or they came from other places?
Medical Director: Just like I said earlier, every aspect of the specialization was here but we had support from our colleagues from the National Hospital, Jos University Teaching Hospital, and other locations. Sometimes we do that. I remember when they did the separation at the National Hospital, I and the pediatric Surgeon from here were part of that team. And of course we had a very great support from their pediatric surgery team too. Their cardiothoracic surgery team also came to take part in what we did. So it’s a question of a cross fertilization of specialists.
The Head of the Surgical Team is a Pediatric Surgeon. He is Doctor Charles. We had different Heads of different units, the Pediatricians, the Anesthetics and Intensivists, we have the Nurses in the different locations and Plastic surgeons and many others who participated.
Watch the full interview https://www.youtube.com/watch?v=0z6pHezuzVY#action=share