WITH few months to exit office after serving UBTH AS Chief Medical Director for two terms of eight years, Prof. Michael Ibadin opens up. In this engagement with the duo of our Editor, Osazua Ivbaze and Deputy Editor Tunde Eigbiremonlen, the fearless and courageous administrator speaks on his achievements and challenges and how he overcame them,
IN 2009 when you were contesting for the position of CMD, you said you were going to build on the legacies of your predecessor and take your achievements to new frontiers. Eight years down the line, how have you fared? If you were to score yourself how would you rate your performance in the face of mounting challenges?
If I was to score myself, I think I have scored 90%?
Yes, first I said I was going to build on the legacies of my predecessor and that is exactly what I did. It’s on record that I never reversed any of his policies. I never did. Then, two, I also made sure that all those structures for governance were left in tact. If anything, I think I improved on them.
But going to specifics, in the area of achievements, I think I would want to view then in various sections.
In the area of physical infrastructure, because that is the one people can see, if you were to go to the right side of the hospital now, which used to be an open field, starting from the rear, we now have a fire fighting unit, we have children emergency unit, we have mental health wards and you have the department of O & G; Department of Anesthesia, then Pathology building, all on that side. As I said, all that area, used to be an open field.
I remember those days, the tractor will go there and clear the entire place, but today, it is something else completely. But the development goes beyond that. If you go to the A & E (Accident and Emergency) wards, you have two or three new buildings, one for sleeping room for doctors whoa are on call, about 24 rooms like an hotel, we have one for NHIS, we also separated the one for medical emergency department. I realized that those days, we had only one emergency unit and that is where you bring in patients who are sick with either stroke or the like. And that is also where you rush in victims who had just accidents. The tendency then was that if you brought in those who just had an accident, the other people will be forgotten. It’s the blood that will attract people to say that oh, this person is dying. Whereas the other man may even be more sick. So, what we have done now is to separate the two. All those who require surgical intervention are on one side and we built a new one for persons with stroke, diabetes, hypertension and those who have fever who are not necessarily involved in an accident.
We also went beyond that. We made sure that something new is done. In the past, we had what we used to call casualty officers; these were doctors whom a patient would first see, before a specialist would see them. But now, we have gone beyond that. We don’t need casualty officers anymore; we now gave that medical emergency to Department of Medicine. So if somebody is brought in, who has a cardiac problem, he is likely to be seen first by a doctor in the cardiac unit, not by another person who will now make a referral. No. That delays care. So, you can have in that unit, about five to eight doctors on call at the same time, each of them manning their specific area of specialty. I think that has improved care in the place.
Then, on the other side, we have a new building for House officers, then we also have the conference centre which we are trying to complete and commission right now. The conference centre has about 60 rooms like a hotel. Then we also have the school; UBTH Group of Schools where we have managed to build about six set of classrooms of three rooms each, we also have the Oba Akenzua Area, where my predecessor worked before he left. Now, what we have done there is to add two blocks of classrooms. We have also added an Administrative Block there. We have also built a students hostel in Ekpoma.
But you may not believe this, the good thing that thrills me in all of these achievements is the fact that 70% of them were done with monies we sourced from within. These are monies sourced locally. You are not likely to see any hospital in this country where people use money from Internally Generated Revenue (IGR) to build houses. But here, in all of these areas I have mentioned to you, that is what we did with monies from IGR.
We have also expanded some facilities outside the structures that were built from foundation by my administration. We have also expanded and renovated quite a number of facilities. I will give you an example. Our delivery suite used to be five (5), but we have added another five (5). The Ante-Natal, ANC, where women deliver, we used to have offices there before, we have moved them away. So, what used to be offices to consultants and lecturers, we have converted them to consulting rooms. Then, of course, the test tube Baby Section has also been expanded and sustained till today.
We still have women and couples who have challenges with child birth who also come in to benefit from that section. When I was acting, and our New Born Babies Section was gutted by fire we had 26 babies on admission that day. We are lucky we survived it and that none of them died. But that incident reminded me that we needed a fire service unit in this hospital. Se we swung into action and today we have a fire fighting unit, fully-kitted. It’s a unit of its own which we have put in place. We also used the opportunity to expand the Baby cared unit. Apart from Lagos, I think Benin has the largest Special Baby Care Unit (SBCU) in the country.
Then, of course you are familiar with the sperm cell transplant issue. Again, this is the only centre in the whole of West Africa where it is done. And all these happened in my time. These are for physical infrastructure.
Then, in terms of training, we have also achieved a lot. Without being immodest, let me put on record that if there is any administration that has centred on human capacity development, I think it is this one. I am not going to bother myself with training within this country. It is on record that I have sent my colleagues, doctors, about 35 of them abroad to train in specialised areas.
It never happened before. Nobody would do it. But we did that. What we did was to identify some areas of need because we needed to expand those areas. Those days, we used to carry patients from here to Ibadan. But we no longer do any of such referrals now. Instead, we have patients coming from other places. Other health workers are not spared in our overseas training. We have also sent some of our laboratory scientists abroad for further training. Like when we were to set up the sperm cell unit, we sent some lab. Scientists abroad. They were not trained here. They were trained in Switzerland.
Then, in terms of plants and machinery for instance, in my time, it is on record that we bought close to eight generators, big generators. We are talking of 2 sets of 500 KVAs, 2 sets of 250 KVAs, 4 sets of 150 KVAs and smaller ones in that range. This hospital also has 2 (7.5 SVA) transformers which I also used my position to attract. We didn’t buy them but one was from BEDC and the other from an agency in Abuja.
That is why we have almost a steady and stable electricity in the hospital. Then, we have equipment, which the hospital cannot do without. I may not be able to give you figures. I have expanded the theatres too. We have added two more theatres, so we have now 15 theatre suites. O & G used to be two, but we have added two more. The way it works is that once you build, you have to equip. So we equip as we build.
The other area we think we have also touched the lives of people is in terms of service delivery. For instance, we have a very viable SERVICOM unit that is accessible. I run an open door policy and when you get to my office you are likely to meet a lot of people who may not be on appointment. I bring in ten people at a time. If it is private, I sort it out privately with you. I found out that you cannot be discussing very intimate matter with someone, while keeping others waiting. They will react. So it helps me dispose off people very fast in that regard.
Then, we have also helped the workers to develop themselves. When I came in, for instance, the Nurses we had with first degree were not more than five (5) and they were not in Nursing. As I speak with you now, almost half of the nurses we have now are in school doing one programme or the other. Up till the moment we speak, we encourage people to go back to school and we also give them in service training. We have trained 4 occupational Therapists in India. As a teaching hospital, training goes on in this hospital on regular basis. Apart from training Doctors and Nurses, we also train others like the Paramedics.
When my predecessor was living, I was his deputy. Then, we had on paper, a number of schools that we wanted to establish. He made pronouncements that they were in place. But really, they were not in place but because I shared in the vision, what I did was that, as soon as I came in, I gave flesh to that vision. What we did was to buy furniture, equip the place, recruit the necessary staff, get accreditation and bring in students and made sure the progrmmes are accredited. As at today, I think, we do not have less than 13 schools training personnel, in various aspects ranging from Paramedics to Biomedical Engineering, and then to other areas.
When I came in too, those who were training in health medical records were just at the level of OND. They have advanced beyond that now. They are able to award HND and the students are mobilized for NYSC. So, I think the students are happy for that. Also, in terms of training for doctors, this is a centre that trains specialists and you need to be accredited as a centre by the various bodies to be able to train. When I came in, we had peculiar challenges. One of them had to do with Dentistry. The Dental unit was not accredited. Because of lack of manpower and equipment. But I can assure you now, we have since overcome that. We also had challenges with mental health. During training, both male and female mental health patients used to be in the same ward, and I don’t think that was tidy enough. That made us to lose accreditation in that regard. We decided to separate them. We have twin wards now, both male and females On both sides.
Then, in the various programmes, virtually all of them are accredited except one. That is Pathology, and we are working on it. So all the programmes in the hospital where we are supposed to train doctors, we have accreditation in all of them. This is taking a lot of money because you have to bring in the team from the various colleges, accommodate and house them for three – four days. They come in to inspect your facilities and give you a verdict. You cannot influence them because they are very senior and experienced people. In our case, some have had to write us back commending us for what we have done. I think our dental centre is the best in this country, some of our senior colleagues on inspection have said they were shocked and testified to that. We have an advanced conservative laboratory. What most dental centres do is to polish and extract teeth. But here, we can conserve the teeth and repair them. So we have that centre here.
Still on training, a lot of our doctors have continued to do well in their exams, because we have a structure that is good. When you come in, you are expected to spend six or seven years as the case may be and we adhere strictly to that. So that is in terms of training.
Other facilities such as vehicles: In my first tenure, I bought 33 vehicles but in this second tenure, we are only able to buy about 4 cars because of the economic down turn. Out of the 33 in the first tenure, we got money from federal government to buy only two. The rest came from within.
You will also notice that we changed the face of the hospital. The hospital used to be pink, but what you will find everywhere now is green and we also did a lot of landscaping because we think that the hospital should be a serene environment where people are supposed to get well.
We have also supported some associations which we have given land to build their secretariats, An example is Nigeria Medical Association, the NMA, and our cooperative. Our cooperative is one of the most viable in this town. It is fully established.
Cancer care – This hospital is designated a cancer care centre. We have only about seven (7) in this country. So, this is one of them. The X-ray department has actually benefited largely from my intervention.
*Again, we needed to put some equipment in place. I give you an example. In that place for instance, we bought ultra-sound machine, we bought 2D, 3D and 4D all from IGR. Then we bought a specialized ultra-sound machine that is with a virgin proof. So if a woman is pregnant, with that virginal proof, you can actually determine the sex of the baby, even if the woman is coming at the age of 16 weeks. So, we also have the ultra-sound in the labour ward. If we suspect for instance that a woman is bleeding from inside, you don’t need to carry her away from there. All they need do is just to wheel the ultra-sound to her bed side and scan her there. So, if the doctors need to intervene, they will do that there. So, those are some of the things we have done.
As for the unions, at a point, we had monthly meetings. Of course the unions are always cantecarious. So each time they had one issue or the other they want to discuss with management and you are not conceeding, they always want to blackmail you.
As for the challenges, of course we are bound to have challenges. Our greatest challenge has to do with funding. Funding had been our major challenge.
When I came in, our overhead cost, what we got from Abuja to run this place was N14. 5 million. Over the years, it has dropped. As at now it is N5.2 million, and we are not even sure we will get it every month. Last year we got it for only nine months. And once you cross over to the other year, you are not likely to get the other months that you didn’t get. So, we have serious challenges with funds. There are a lot of things we would have loved to do, but we are not able to do them because of funds. If you have beautiful plans and you don’t have money, there is nothing you can do.
Right now, a renal unit is being built. We had hoped too that one will be able to build a new ICU (intensive care unit). Our ICU has capacity for only nine (9) beds and it is too small. And so, we are looking at a facility that has capacity for 20 beds, because when somebody requires intensive care, there is no substitute. It’s either you remove one person from the machine and put another person, because it is a moral issue and also an ethical issue to remove one machine from one person and give it to another person. So we need to increase and expand that facility.
We have also built some offices outside the areas I have mentioned. We have the GPC for instance. We have a new office complex. It’s yet to be ultilised. Again, it was built from IGR.
The other challenges we had are related to labour matters which have to do with workers’ mindset. Especially in the last three years, when they hear or see me building structures, they often say oh, if he has money to build these structures, he should give us the money to share. So they became canterkerous. So, they imagine that we have a lot of money, if we can be building so much, and that we should use the money to meet their needs. That is their mindset. And, the other challenge we have with the unions is that once an announcement has been made to the effect that this or that allowance has been approved for you, they do not bother whether or not there is financial back-up, they demand for the money.
Again, some of their actions bother on insensitivity, they also bother on blackmail. They feel they can intimidate you to take decisions you do not want to take. I will give some examples. There are some allowances which government will just make some pronouncements in Abuja, and may be you made the announcement midyear. Of course it cannot be in the budget for that year, but you can be surprised, in the next two or three weeks they come to you to demand for the money. They refer you to the hospitals they think may have paid and tell you to give them their dues. On the basis of that, they can go on strike. That expands mainly the misunderstanding between them and management. It is not because we don’t want to pay. I usually tell them, I am not in a position to seat on anybody’s rights. But also, don’t make demands that I cannot meet.
For the doctors, they too have been the worst in terms of support. If any group has been antagonistic to my cause, they are the doctors. The reason is that the average doctor thinks that he will do it better than you are doing. So, they fail to realize that the best spectator is in the stand. The player should have done it the way they think and not the other way round. Again, it boils down to money too, because their expectations are very high. When you tell them that this money has not been given to you, they remind you how much senators earn. I often do remind them too that it is not my responsibility to find our how much a senator receives and that if you want to be a senator, you resign and go and contest as senator. You cannot be here and expect a senator’s pay. That has caused a lot of frictions in the past. But I think now, we are beginning to understand ourselves, because over the years, they have come to realize that once I say this is what I am going to do, that is exactly what I will do. It got that bad last year, that among the doctors in training, we didn’t pay their two months salaries, and we are not likely to pay, because of government policy of no work, no pay. So the idea that you blackmail me and go the press or social media to say whatever you like does not really matter to me. I am not going to celebrate them by responding to them. Some unions are actually outright mischievous. A lot of their actions are based on tribal sentiments. Of course you know that I am from Esan and a minority among the minority. A lot of people gang-up and of course they want to use the unions to say why should an Ishan man be there. They use the unions as platform to unseat me.
The other issue we have had to contend with is the issue of discipline. A lot of workers don’t really mean well for this establishment. What they are really after is to earn salaries from this hospital. They don’t want to work. If you now have a policy that says if you don’t work you can’t earn salaries, you must justify your pay. They want to kick. Of course in this place, a consultant was sacked. But nobody imagined that I would take a decision that would lead to my colleague being sacked. It jolted the hospital seriously when it happened. But if you know what she did that led to her being sacked, of course, you cannot blame me. After work, they needed her services in the hospital, she was on call. She switched off her phone and told her security guard not to collect any paper from the hospital. And we saw that as unacceptable, because you must do the job you are paid for. Some, people thought we will sweep it under the carpet. We never did. At the end of the day, the board said she has to go and she left. That sent a message.
We have also had to take serious disciplinary actions against those who circumvent the process to defraud the hospital. That is why in designated points, you have notices everywhere that you don’t pay money to any person other than our designated pay points. We brought in UBA and Skye Bank to collect our money. We signed agreement with these banks. They are not our staff. But once in a while, you still see some people conniving with some patients to undermine the finances of the hospital. As a leader, you will not take kindly to those sharp practices. Some people here lost their jobs in the process. We are very intolerant to such actions. If I am aware you are there to undermine the interest of the hospital I will go after you. But these are practices that had been tolerated in this hospital in the past. And so they could not understand why this man is suddenly hard. So they see me as somebody very tough, uncompromising. But that is my other side. Ordinarily and usually, I am a soft person. But I have a goal in this place. I told them this is what I have to achieve. We have been able to achieve so much in terms of finances because we have been able to manage our resources.
When my predecessor, Okpere, came in, the hospital was generating N3.5 million per week gross earning. At the time he was leaving, that money rose to over N8 million. Today, we are talking of N40 million per week. So, if we allow financial leakages, we won’t have that money to spend. You have a situation where some people connive with contractors to undermine the system. What they did not supply they tell you they have supplied. So what I did was to set up a secret police unknown to so many of the staff concerned. I have a unit in my office, unless they see what is being supplied, no payment. The unit generates monthly reports.
The other challenge is the divisive tendencies of some people, who play up tribalism. The other challenge which I consider a very sad story is the tax matter under former Edo State governor, Adams Oshiomhole. He sent us a notice that they were going to audit the taxes we have been paying since 2004. I was here as CMD in 2004. But they insisted government is a continuum. They did the audit and said we owed about N2 billion to Edo State government under the PAYE tax system. During Lucky Igbinedion’s era it was not so. Workers only paid a fix rate to the state government. But, Oshiomhole was bent on sending me to jail and they even took me to EFCC over the matter. Again it bothers on tribal sentiments. If I were from his place, he wouldn’t do that. And I had to get some persons to beg him. Because the tax law holds the chief executive of any organisation liable for over deduction or under deduction or non-remittance of tax proceeds. So, it’s been a mix blessing.
Another challenge was power. Before we got the present 7.5 MVA transformer the one we had before, a 5.0 MVA got bad, it was the one we had from inception of the hospital. It was not even enough, because our systems are very sensitive. The present one we got from BEDC was still been negotiated when Hon. Ikhariale of the National Assembly came to our rescue, using his influence as chairman of House Committee on Energy. It was when I went to present our budget in the National Assembly. The hospital is indebted to him. There are quite a number of people too who have been every supportive. Chief Tony Anenih is one of such persons who have been very supportive. Deacon Vincent Agenmomen every year pays close to N2.5 million to the hospital to settle medical bills for patients who are unable to settle their bills. These are people he does not even know, he tells us to compile the list and send to him, and he pays the bills to discharge them. Then the former governor’s wife, late Clara Oshiomhole used to also support us by paying bills for indigent patients too. The other person is Hon. Ken Imasuagbon, the “Rice Man”. Every year he gives us N1 million. In addition he gave us N3 million to renovate some wards last year.
Servicom concept guarantees efficient, realistic services. Here we provide specialized care and we do so transparently and judiciously.
What to be remembered for
What I want to be remembered for, you will not even believe it. It is the structure of governance. The changes I put in place that are irreversible. They may not be physical. I introduced so many changes to ensure probity and accountability. The vote system is novel. Initially, my people didn’t quite like it. But they are gradually getting used to it.
Another thing is that I stopped the idea of workers taking annual leave both in UNIBEN and UBTH. That is for those who are both staff of UNIBEN and UBTH at the sametime.
So many allowances in the form of duplication were also stopped. This obviously will make me unpopular among my colleagues. But these have been done in the best interest of the hospital.