Prof. John Obafunwa is a professor of Forensic Pathology at the Lagos State University College of Medicine and a Consultant Pathologist to the Lagos State University Teaching Hospital, Ikeja, Lagos. In this interview with OLABISI ALAUSA, the two-time provost of LASUCOM, and former Vice-Chancellor of the Lagos State University, Ojo, explains how private partnership can help to boost the health care system. Excerpts:
As a former provost of the Lagos State University College of Medicine, what can you say about the quality of medical education in Nigeria?
We still need to do a lot in terms of medical education. The whole structure has to be re-organised – the time put into it, the sacrifice and people being recognised for work done. I feel, perhaps, we have come to a stage where Medicine should become a second degree. That is, anyone that wants to study Medicine would have done a first degree in any of the sciences before coming into Medicine.
But if we are saying that it should be a second degree, then the society must recognise that the remuneration must be in tandem with that. You don’t want to come out, after four years of doing basic science, another four years or five years of Medicine, and you are still placed on Level 8. We should still have it in mind that the person is still going back to do a post graduate, which will take another five years before he or she can become a consultant.
Also, I feel this will allow us to know the good ones, who can proceed to study Medicine, after the first degree in basic sciences, because we need quality students for our medical schools.
Government invested in LASUCOM, but many of these so called medical schools don’t enjoy the same level of funding and that is impacting on the quality of medical training. Many of them shouldn’t have survived accreditation, but you have a lot of politics being played
Sometime last year, some medical schools were established in the country. With that, do you think the universities can absorb the number of students willing to study Medicine?
Yes, we have some medical schools that came up recently. Some of them are private medical schools like the one we have in Babcock or Madonna universities. But the proliferation, particularly by the state governments, is not the solution to medical education in Nigeria. For example, we are particularly lucky in Lagos. We are able to get some money from government. Government invested in LASUCOM, but many of these so-called medical schools don’t enjoy the same level of funding and that is impacting on the quality of medical training.
Many of them shouldn’t have survived accreditation, but you have a lot of politics being played and that is why you have one lecturer in one medical school and an associate lecturer in four or five medical schools. This is not right, but such medical schools still get accreditation.
Even at that, do you think our medical schools have the required facilities to train doctors in the country?
I would say we still need a lot of facilities for teaching in our medical schools across the country. Things have changed from the time we were trained. That is why government needs to re-orientate itself. Government needs to provide the environment in terms of facilities, in terms of infrastructure, things that people will work with. And by so doing, students will work within the environment and assimilate more. Apart from this, there is the issue of personnel, because if you don’t have committed personnel, this may affect what is being taught in the medical schools.
I was reading sometime ago, I hope it is not true, that one of the medical schools in Nigeria was advertising for lecturer 2, assistant lecturer in certain fields of Medicine, and I was like, wait a minute, you cannot be an assistant lecturer or lecturer 2 in Surgery or Medicine or Pathology. You need a particular level of qualification to teach the subjects. In basic sciences, Anatomy, Physiology and Biochemistry, you need to have your MBBS and Master’s before you can say you are applying for lecturer 2 in those non-clinical fields. And by the time you want to get to lecturer 1, you must have had your PhD in those sciences, basic medical sciences.
So, when you have some states advertising for teachers in particular areas, seeking to have people only with MBBS, it is shocking. And that goes back again to the Medical and Dental Council. They should not approve such medical schools. So, it’s interwoven. Even if we have enough academics to teach in all these places, we will still not meet up the doctor-patient ratio of 1 to 1000 patients.
It is said that we have about 25,000 doctors in the country and when you work the mathematics, you will see the ratio we are dealing with. There is still a long way from there.
Let’s look at ethical issues. Recently, we heard about some doctors not handling their patients well, resulting in their deaths, even in private hospitals…
I try to tell doctors, don’t say because you don’t have all the equipment that you need, you will not do what you have to do for a patient. With very little, you can still improvise, you can still do what you have to do because I try to put myself all the time in the shoes of the patient. Would I love to be treated this way? Would I love the situation where doctors say I don’t have this, I don’t have that, so I can’t do anything for you? No. I don’t believe in that.
I say to people: when you take a job, do what you have to do, don’t complain unnecessarily about that thing, because nobody has forced you to take that job. You have a choice, you can leave and go and do something else; something that will reward you better. But I’m not suggesting that doctors should not be taken care of. Attitude to work is quite different and I must say that it is right from the medical school.
That is why I’m an advocate of Private-Partnership arrangement. Doctors might be attracted to work or to stay in the country, because the condition of work will improve. The truth is that certain things are lacking even with regard to the so-called specialists, and you cannot give what you don’t have. That is why government should invest more. But above all, health insurance, PPP arrangement, give it to consortium, they will be forced to bring in the right equipment and then move things forward.
Let’s now divert a bit to LASU matters. Some of the things you were trying to do during your tenure as the vice-chancellor of the university were done last year, like the issue of the Chairman of the Academic Staff Union of Universities, ASUU-LASU, who was sacked last year. Is it that you didn’t handle it well during your time?
I can tell you, I know I played my part with regard to LASU. The infrastructure you have in LASU, from a secondary school appearance to a university, starting from the gate, the old auditorium, I started the refurbishment. We demolished the student union building and put a fantastic building there. The new Faculty of Science Complex, LASU Radio, I got it functioning. There were some that were ready, but the former governor, Mr. Babatunde Raji Fashola, didn’t have the time to commission them before his term ended. I brought in the Department of Aerospace Engineering and I also got the approval from NUC to start the School of Agriculture.
So, when I look at the whole space now, launching and inaugurating this and that, and nobody talks about me, I just laugh. But the good thing, after all these things, is that I can go home and sleep without the Economic and Financial Crimes Commission coming to knock on my door. Nobody can say Obafunwa stole one kobo, either as a provost, four years in the medical school, or as VC for
four years.
But there are moments in life, you just sit down and ask yourself, don’t you deserve a little thank you? Throughout my stay as provost for four years, I did not use university money to sponsor myself, while as VC for four years, I did not use the university money to sponsor myself on any conference or whatever. That is why when ASUU-LASU was trying to look for one thing or the other against me, they went to the Audit Department. I said they should go ahead because they would never find anything. When I signed cheques, I didn’t bother to chase it because it had to go from table to table before it would finally get to the bank. So, many people had the opportunity to photocopy it and see what it was meant for. So, I don’t bother myself about certain things. I don’t have money, but thank God, I’m contented.
