Like the religious missionaries of
the yore, a new missionary have entered into Nigeria with low charge medical
service to a rural community in Abia State. The missionaries from the United
States of America are declaring emergency in the health sector of this
community with new brand quality health care system that is revolutionary and
things are happening in the rustic- sleepy town of Ozu Abam in Arochukwu Local
Government Area of Abia State. The man behind this medical mission is doing it
to pay back to what his community has giving to him. James Ogbuka Umekwe, an engineer based in the United State told Emeka Ibemere and Ada Dike why he wants to change the state of
health care system in his community. Excerpts
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Tell us the whole story of how UPON
THIS ROCK project started?
I will start
with my name is James Ogbuka Uzoekwe; I’m from Ozu Abam in Arochukwu Local
Government Area of Abia State. I lived in the United States of America and I
have lived there for more than 20 years and by profession, I’m a Civil Engineer
and i worked for Maryland Highway Administration.
I manage one
of the sections there as truck inspection manager but apart from being an
engineer, I have another passion in the health sector and that is to mainly
bring back something good to my community and that was the reason why about two
years ago, I had an encounter with some body that was actually very good to me.
We had a discussion and he was asking me if there was a way that she can help
us or help me do a medical mission.
So, she
accepted that she was going to help me do a medical mission. She is from
California. So she agreed to help me do a medical mission.
Basically,
she was going to give medical supply that would help us do the medical mission.
In that same question, I ask her if there is any doctor she knows that can
accompany us do the medical mission. So,
she directed me to somebody who happens to be a Professor of surgery, at George
Washington University in Washington DC. So, I gave a call to him and then we
had a discussion and there was another guy; his name is Zack Smith, this man
Dr........., he runs Mission to Heal. So, when we agreed that we are going to
do a medical mission, they challenged me and said ‘if you build a clinic and a
hospital in your community, that they will help me, so that was when I started
thinking about building a clinic or hospital, where I can now bring in experts,
doctors and nurses coming in to help. So a year after that, I was able to build
a clinic in Ozu Abam.
So, right
after that we brought in a team of about 12 experts that came in; we have
doctors, nurses, including medical students who are in their final year, who
also were at that trip in December 2012 and that were the inauguration of the
hospital.
We called it
Upon the Rock Medical Centre. At the
inauguration, we had the community people, the traditional rulers, the chiefs
and everybody came and after the inauguration, we started the clinic in 2012 to
2013. So we had our first medical mission in two weeks and we had successful mission.
We were able to do lots of surgeries.
We took care
of about 55 operations, hyena, fibroids, and glaucoma, just name it; we saw
about 1,700 patients on that particular mission, so we did that for two weeks
and went back to US.
Then in May/
June, it was so good that we have to come back again because there were some
patients that we didn’t get to see their cases. So we came back again with
about team of 10 experts; three of them were medical students, four nurses and
three doctors. So we did the same thing and this time we had more than 55
surgeries. We saw more than 1,400 patients.
Then last
December, 26 2013, to January 14, we came back with a team of nine medical
personnel; two medical doctors, nurses and medical students. We had 64
surgeries and we saw over 1400, patients. But the good thing about it is that
we have the Federal Medical Centre in Umuahia and the director is a very good
close friend of mine and he has been very good to us.
Dr Abani
Chukwu, for the first time we came in 2012, he gave us the FMC theatre so that
was where we did all the major surgeries. Any operations that need major work
that require the patient to sleep, we take the patients to the FMC medical
theatre. When we came back in May, he did the same thing and he gave us the
theatre and we did the major operations there.
This past
December into January, 2014, he did the same thing and we were able to complete
for one day work, we carried out four surgeries. These where children and then
we went to FMC with 13 patients, four of them were children for hernia and six
women for fibroids and we had two with tumour and one has disfiguration of his legs.
He was born
with both legs just like that. His legs were disfigured from birth. Right now,
he has been undergoing physical therapy and we have put a cast on the legs. But
one good thing is that every time we go to the FMC; not only that they give us
theatre, the doctors there also help in the operations working along with
doctors from the USA and they have formed a team where they learn from each
other.
We have a very interesting case this year, so
we were in Portharcourt, and there was a guy who came to the hotel where we
were staying and he had what is called AVS, he was involved in an accident and
he has a very big scare on his face and because the blood was flowing all the
way into his brain, so it keeps expanding and getting bigger and bigger.
So I saw him
and asked him how we can help him and one of the doctors said maybe we can
bring him to the hospital, so we gave him a number and he came to the hospital
but that day, the chief surgeon was not around because he came on the 2nd
of January but we came on the 27 January. So, when he came and it was a very
complicated surgery because you have to go to the nerves. We went to the FMC
because we wanted where we will sleep. FMC weren’t sure of the operation
because it was very intensive and major one and the guy said we cannot do it
and somebody came in from nowhere and said that before we can even attempt to
operate him that he was going to lose a lot of blood and that we don’t know
what was going to happen, that we rather go to the blood preservation and that
they have not done this kind of surgery before. So, our doctor said he has done
it seven times before and that he was going to do it. They refused and said we
must have blood preservation and that he must go for blood test and HIV test.
So our doctor said okay, we must go back to the Upon this Rock Medical Centre and
do it. So the FMC doctor decided to come with us to see how it’s going to be
done. Because I would say, first they didn’t believe that it could be done
while the person is still awake. So we took him to the hospital and it took
about two hours and the surgery was done and he left the next day. And it was a
very touching story because, we went with the FMC doctors and it was good proof
to him that it can be done without the blood bank, without blood test, HIV
tests and it can be done without the patient having to stay in the hospital for
six weeks.
So these are
some of the things we do. When we do medical mission, it’s not just coming to help
the community but there are exchange of ideas, experience, knowledge and
transfer of some technology that may help doctors here. Right now, we are on
our fourth medical mission and the team just arrived yesterday. The seven man-
team is comprised of two doctors, one surgeon, who is very good in vascular surgeon;
we have one Neuropsychiatric, two nurses, two surgeon and one Para-medics and
one agricultural consultant, an area that we are gradually delving into.
Health otherwise,
we have started for this year and its going to end in April 8. Again, we are
going to be doing for the first time, something that has not been done in our
state or in our community. We intend to put an Ambulance, so we are doing
integrated emergency medical system which we basically called mobile clinic,
just to persuade people not to think that it was only for the corps. I have
come to realise that when people get sick in the rural areas and villages in
the midnight and they probably die from the sickness that can easily solved.
Somebody can collapse into coma in the midnight and there are no medical
attentions, the person can just die. Even ordinary malaria can kill somebody because
there is no doctor, no medical services, so one of the things we are doing now
is to have medical emergency from where people can call the clinic. We have a dedicated driver, nurses, we have a
doctor, so that people in the remote area of the community is safe in the night
no matter the time, they can pick the person up and bring him to the hospital
and if something that we cannot do right away, then we can take the person to
the FMC. So the ambulance as you call it has arrived and that is one of the
reasons while I’m here in Lagos to pick it and take it to the village. But it’s
going to be ready on Monday. In this team, we have a Para-medics, who works
with California Medical Service, well trained and he is also an instructor. So,
he is going to be providing emergency medical response training to the FMC’s
doctors. So we have a team of doctors from FMC that will be receiving this
training on the 3rd and 4th of April in Umuahia.
So, we have all the teaching materials and
that is going to be part of re-training and continuous education for the
doctors. But now that our medical mission is on, we have already started
separating those that would be doing surgery from those that would not need
surgery. We are providing everything we are giving, medications. We do all our
surgeries in Upon this Rock but
because we don’t have full theatre and machine, so local administration we do
it at Upon this Rock but full, we go
to the FMC.
Let’s
look at the funding of this very big project. Who are the financiers?
To be honest
with you, I put down the seed money. Nobody gave me any money to build the
hospital. I build it with my money. The help that I got was from the
organization that provided medical supplies which we use. The organization is
in the US, they gave me medical equipment and supplies that we are using. That
was the lady who said, ‘if you build clinic, I will help you’. So after
building the clinic, then she supplied the medical equipment that we are using.
Who takes care of the medical team
coming from the US?
The doctors
pay their fares and for their tickets. They voluntarily come here at their own
expenses and they have been doing that since we started.
How were you able to convince your
community in accepting medical missionary you just embarked on and what was
their views. Did they see it as having political undertones?
And that is
one of the reasons I never wanted to be involved in politics. The land the
hospital was build was on my private land. So I bought the land and use the
land to build the hospital. I try as much as possibly to stay away from
politics.
Did you register the hospital with
the state government?
Of course,
yes. The Ogbuka Umekwe Hope Foundation is a fully registered non-government
organization. So the foundation is registered here in Abuja; Upon this Rock is operating under the
foundation.
Who takes care of the patients when
the team goes back to the US?
I can say
that one of the biggest challenges we have had is to realise that you can have
a clinic and equipment and patient but one of the challenges is the trained
personnel. It’s a major challenge. It’s
very tough to have a permanent doctor to live in a rural community and that is
the problem. If you want to see a good doctor, you have to leave your village
and go to the town where all the hospitals are. So what we do is that we have a
doctor that comes to visit when we are not around. We have a doctor that visits
when we are not around. We have a team of one registered nurse, trainee and a
doctor who visits when there is surgery and he will come and do surgery. We
also have doctor, who comes every other week because we are unable to keep
doctors in the village. But one good thing that has just happened is we from
the United States have engaged a doctor who will be coming from Southern Sudan,
to stay in Nigeria. He is making his first visit on Monday, March 31st
with the Para-medics from the US. I will leave before them and they are going
to stay until the end of April to do some other certain things that we need.
Have there been any recorded
casualties during those operations since you started the medical mission?
No, in all
we have carried out we have not had any casualties.
On the area of specialization; are
you people on general medicine or on some specialized areas?
When you
talk about specialization, you talk about those who come, because it’s not easy
for us to specialize and say with this kind of disease we cannot treat you. The
doctors that come are the ones that are specialists in one area. So, now the
doctors that are coming are the general surgeons and they have been into all
kinds of surgeons. But then, the family physicians that have also come are all
into the general medics, so they can do prescription, do consultations.
Health care system in Nigeria is seen
as the privileged rights of the rich and the wealthy. What is the charge like
and or is it free-health care system project?
The first
mission we did was totally free. Then, we realize that anything free is doesn’t
have valued as such. So, we decided to charge N200, for a card and all our surgeries
across board is N7000, no matter the degree of the condition of the patient, so
that is what we have done. We just had case where the same surgery that we
would have done while we were here, but because it was the time for us to
leave, we couldn’t see the patients and we send them to the FMC. Usually, the
FMC doesn’t charge them to treat them but we have a case where they charge N70,
000, for the same operation we would have charged N7, 000. So, we just put that
little money to attach value to it.
What is the general response of the
villagers to the treatment?
The whole
place is always flooded. There is always crowd. You can never see the last
patient. The day we will leave, we will have a crowd. The day the team leave,
we still have crowd outside and sometime it hurts because, you look at them and
tell them we are leaving and there is nothing we can do.
Do you come with your drugs or do you
buy them here?
We bring
them from USA.
Don’t you think that the crowd of
people is because of the mentality of the fact that; it is ‘Oyibo hospital’ and
not necessarily because of the charges?
I will tend
to honestly agree with you, that first when they see ‘White people’, they will
give more value to the treatment they are receiving and developed faith in it
than what they get from here and you cannot blame them because, we are trying
to emulate those ‘white people’. Some of the things they try to do and do it
well is what we are trying to bring into this community. They know when they come to the clinic, they
see what they want and see the different between the ‘white people’ and what
they have been getting from their own local everyday hospital. So that I will say, yes! First, the response
is very intense because they see ‘white people’ and they also get the benefits.
WE are not trying to sound negative
with this question, but do you perceive any clash in
future with the FMC management or government agents over patients or in the
running of the exchange training programmes or blackmail on the facts of
grounds that you are charging low bills and pulling away their patients, which
will make the government or the regulatory bodies to come with heavy taxations,
that would lure you into dropping the ‘missionary’ focus of the organisation;
so as to be charging higher bills and discourage patients from attending to
Upon this Rock Medical Centre or close down the hospital on flimsy political
reasons?
I have not
thought far in that direction, may be because I’m not really familiar with what
goes on here. I come in and I go back to the States. But so far, I can say I
have not seen any sign that there will be any conflict between the FMC and Upon this Rock. Let say, we are helping
each other, when these people come in, the FMC brings in their doctors as they
provide the training and it’s something the FMC has not done before and nobody
has done it in Nigeria before. This is the first medical mission in Nigeria;
international trauma and life support training. This is the first time the training is taking
place here. So, I think our relationship with FMC is very professional. They
see the benefits, their doctors learn when our doctors come here and perform
surgery and their own come and learn certain things.
Corruption in Nigeria and how are you
going to stop it from taking place at the Upon this Rock project?
That is one
of the challenges. Should I say, getting the right personnel? And it’s not that we have not had the right
personnel. We have been having right
personnel but it’s like a revolving door. As they are coming; they are leaving.
Either they are leaving because we are not money-making organization; where you
come in and get paid hugely or they leave because I sensed that there is a foul
play.
Some nurses
will come in and they will corner the patients to their house and try to treat
them at their homes. So, we just fired one of our nurses that were there
because of that. So, for corruption, even when we talk about it, it looks as if
we have developed thick skin about it. We don’t talk much about it because and
if you say much about it nobody will listen. So far, we have done very well.
Each time we have a medical mission, we have a team to feed, we have generator
that runs for 24 hours, because the team stays in my house and leave the house
to the clinic and when they live the clinic, they come to my house, so the
generator runs 6-8 hours in the house in the morning and 8am in the morning to 6.
30pm in the evening in the clinic. We leave the house 6-8am and go to the
clinic and the generator runs the whole night. It is the little fund that we
raise that we use to run it. But I’m not looking at the money because there is
no money in there.
Let’s look at the next ten years of
this organization in Nigeria and how are you going to sustain it?
Things are
really unfolding in a very positive way. This is a very big story. Last year,
somebody send me a message and said, ‘there was a nurse lecturer who wants to
talk to me but I was not sure of what it was. That there was nursing student
killed by truck driver and I don’t know how they manage to get my name but
perhaps they have seen me build hospital, they late student’s dream was to go
to Africa to work in any of the rural hospitals. So somebody called me and said
somebody wants to talk to me and gave her my number and my name. So she called
me and said ‘James it looks like you have a proven record and you has done
something people have seen and that there is an area I want to work with you.
There is this girl killed in an accident and her dream was to go to Africa and
help the rural community and I want to work with you. Do you want to expand Upon this Rock or do you want us to
build a new hospital’?
So, I said
okay, I want us to build a new hospital and I know why I said that because we
want to expand in the same location but we want to make sure that the name of
the girl that was killed is memorialized.
So we said
we want to build a sister hospital. So, we are going to build a new hospital
with the name Christina Cherstermane Memorial Clinic next to Upon this Rock
Medical Centre and both are going to be at the same location. So in this new
hospital, we are going to have high technological operating theatre. We have
already done the design and we are to start this year. It is going to be full
eye centre, full operating centre, and full dental centre, there will be full
OBJY where the pregnant women will be taking care of and lastly, we are going
to have Ex-ray and laboratory. That will make the sister clinics to sustain
each other. Where we are now, we built Upon this Rock to do eye, dental,
surgery, ex-tray and laboratory, but we didn’t prepare very well for the
inpatients. So, when we finish
Christiana Cherstermane Hospital, that is going to be where all our resources
in terms of medicals while Upon this Rock is where we will have inpatients. So, all the patients after surgery and
everything are going to stay there. So we are going to have these two hospitals
team up and grow. And not only that, I see sign of growth from the new hospital
that will be added to this. But still, Upon this Rock functioning as a medical
centre. We are going to be building a new lab in the much more of general lab.
We are also going to be bringing in more international medical doctors because
we think when we build the new hospital because the girl that was killed in an auto
accident was a nursing student and all the nurse students that are from her
University will be doing their exchange programme in the hospital. So, it’s going to be a rotation because they
also want to memorialize the hospital in her name. So, we are going to have a
kind of dormitory style where there will be continuous rotation of doctors,
nurses and students that will come every two months. That is one of the ways
that we think both hospitals could be sustained.
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