Below is the Executive Summary capturing the activities of ANPA’s Team during the 2017 ANPA Week of April 22-29, 2017.
The 2017 ANPA Week took place at three locations namely:
1. Lagos for medical and surgical missions from Saturday, April 22 to Tuesday, April 25, 2017
2 Abuja for advocacy meetings on Tuesday, April 25, 2017
3. Calabar for Continuous Professional Development (CPD) in conjunction with the Nigerian Medical Association (NMA) as part of NMA’s 57th annual Convention.
1. Dr. Clifford EKE (Chair of ANPA’s Medical Missions’ Committee and Leader of the Surgical Team)
2 Dr. Jide Bamigboye (Chair of the ANPA Disease Intervention and Prevention Team otherwise known as ADIPT and Leader of the Medical Team)
3. Dr. Johnson Adeyanju (ANPA President)
4. Dr. Charmaine Emelife (ANPA President-elect)
5. Professor Ajovi Scott-Emuakpor (Chair, Programs Committee)
6. Dr. Barbara Onyia (Houston Chapter’s Chair-elect)
7. Dr. Abraham Osinbowale (Chair, Advocacy Committee)
8. Dr. Stanley Okoro (Chair, Atlanta/Georgia Chapter)
9. Dr. Dr. Tokunbo Etomi (Volunteer)
10. Dr. Adanna Anyikam (Volunteer)
11. Dr. Dr. Toks Macarthy (Volunteer)
12. Dr. Dr. Nkem Ezeamama (Volunteer)
13. Dr. Kingsley Agbeyegbe (Volunteer)
14. Anthony Okolo (MS3, Albany, Volunteer)
15. Dr. Nnamdi Maduekwe (Chair, Psych sub-Committee)
16. Dr. Wale Sulaiman ( Chair, Consultancy Committee)
17. Dr. Udo Asonye (Chair, Maternal and Child Health Committee)
18. Dr. Teresa Pounds (NAPPSA, Pharmacy Volunteer)
1. Dr. Benjamin Ohiaeri (CMD, First Consultants Hospital)
2. Dr. Rowland Ifeanyi Osuoji (Consultant Pediatric Surgeon)
3. Dr. Moruf Abdusalam (Pediatric Surgeon)
4. Dr. Abimbola Abolarinwa (Consultant Urologist)
5. Dr. Dapo Asiyanbi (MOH, Lagos Island Local Government)
6. Dr. Akinwande Fadipe ( Consultant OB/GYN)
7. Dr. Kayode Osunlaja (Consultant Anesthesiologist)
8. Dr. Mary Gbolaro (Resident House Officer)
9. Dr. Fred Adekola (Consultant Anesthesiologist)
10. Dr. Ochi Igbolo (Consultant Anesthesiologist)
11. Mr. William Iwuoha (CRNA)
12. Dr. Adewole Coker (Consultant Anesthesiologist)
13. Dr. Idowu (Consultant Anesthesiologist)
14. Dr. Ibukun Odeyemi (Consultant General Surgeon)
15. Dr. Nkoyiren Ajie (Dentist)
16. Pharmacist Kayode Aiyegbajeje
This year’s ANPA Week kicked off with a reception and pre-mission briefing at the Adadevoh Resource Center, First Consultants Hospital on Friday, April 21, 2017, with Dr. Ohiaeri welcoming the ANPA Team, going through the logistics for the medical and surgical mission work and highlighting the importance of teamwork and safety. Drs. Jide Bamigboye and Nkem Ezeamama who arrived on Thursday, April 20, 2017 ahead of the other volunteers had been in discussions with Dr. Ohiaeri and they both visited the sites earmarked for the medical mission work. All surgeries were scheduled to take place at the First Consultants operating rooms. Dr. Ohiaeri invited Professor Afolabi (former Secretary to the Federal Government of Nigeria and Head of Civil Service) to the Friday evening reception. Professor Afolabi welcomed the ANPA team to Nigeria, commended ANPA’s efforts and implored ANPA to be actively involved in making its presence and expertise more visible in Nigeria because the unique expertise obtainable from ANPA is needed in Nigeria now more than ever before and he promised to help make the necessary connections to help ANPA.
On Saturday, April 22, 2017, the first leg of the medical mission started at St. Gregory’s College, Obalende, with health education talks by Dr. Bamigboye on diabetes mellitus, Dr. Oinbowale on smoking -related diseases and smoking cessation, Dr. Toks Etomi on women’s health, Dr. Teresa Pounds on appropriate use of medications. We then started seeing patients who had been recruited by our partners at the Junior Chamber International, Nigeria Chapter (JCI) from the Eti-Osa Local Government of Lagos at St. Gregory’s Health Center. We saw pediatric, adult and geriatric age groups who presented with various diagnoses including hypertension, diabetes, heart disease including congenital heart disease, rickets, different pediatric and adult hernias, GERD, peptic ulcer disease, old fractures with dramatic malunions, respiratory distress syndrome with atypical pneumonias, bronchial asthma, chronic kidney disease, dysfunctional uterine bleeding, uterine fibroids, multiple lipomata and other skin masses, varicoceles, goiter, anxiety state, depression and a host of other medical problems. We did accucheks and vitals right on the site and kudos to the Medical Student Anthony Okolo and the nurses for an excellent job in performing the on-site testing, taking of vitals and triaging of cases that enabled us to see 147 cases on that first day of medical outreach. Surgically-related cases were sent to the First Consultants Hospital for surgery and the very sick patients were sent down to the General Hospital stat. Medications were dispensed by the team assembled by Dr. Teresa Pounds of NAPPSA from the United States and Pharmacist Kayode Aiyegbajeje, a local community pharmacist who recruited about six local pharmacists to assist in drug dispensation and education of the patients on safe drug usage. Dr. Ajie, the local dentist assigned to the mission appeared briefly for the day but due to logistic reasons, she was asked to report to First Consultants Hospital on Sunday. The surgical team headed by Dr. Clifford Eke with the active participation of Dr. Stanley Okoro, Dr. Rowland Osuoji, Dr. Abdusalam with the assistance of Dr. Nkem Ezeamama, Professor Ajovi Scott-Emuakpor, the operating room nurses and anesthesiologists performed circumcisions, pediatric hernia repairs, myomectomy, adult inguinal and ventral hernia repairs with mesh, breast biopsies/lumpectomies, lipectomies, excision of “lumps and bumps”. Other cases seen but not operated on due to lack of adequate equipment included huge goiters and acute cholecystitis which Dr. Odeyemi (local Consultant Surgeon) agreed to take care of at the Lagos General Hospital. Postoperative care was provided by the Consultant Surgeons and the two residents and staff at the First Consultants Hospital. Unfortunately, the surgical team also saw some advanced cases of breast cancer and carcinomatosis and they were referred to local oncologists for further care. The surgical team donated 5 pulse oximeters, many surgical instruments and numerous medical and surgical supplies to the hosting First Consultants Hospital after completion of their surgical mission.
On Sunday, April 23, 2017, patients were seen at the First Consultants Hospital and we had more doctors in attendance because Dr. Adeyanju (ANPA President) and Dr. Nnamdi Maduekwe (Psychiatrist) joined the medical team which made our mission work easier as we were able to see all the 86 patients who presented by 5 pm, just in time to attend the 6 pm reception organized by Attorney Geroge Etomi (Dr. Mike Etomi’s twin brother) to welcome the ANPA team. The reception was co-sponsored by George Etomi and Mr. John Momoh (Chairman and CEO of Channels TV) according to the information provided by George during his welcome speech. Unfortunately, John Momoh was out of the country and could not attend but his crew was present to record the event. It was a lavish party with enough to eat (including dessert) and drink and although the surgical team was working late but there was enough food and drink when they finally arrived at 8 pm. A lot of the movers and shakers in the medical community in Lagos were present at that reception and it was quite a fun night.
On Monday, April 24, 2017, the medical mission work shifted to freedom Park in the center of Lagos Island where JCI working closely with Dr. Asiyanbi, the Medical Officer of Health (MOH) for the Lagos Island Local Government (recruited by Dr. Ebun Sonaiya who is a very good friend of ANPA) had assembled 167 patients for us. We saw all the interesting cases listed for the mission work of Saturday, April 22, 2017 above but we also saw some unique cases like gut eventration after failed colostomy years after surgery for Hirschsprung’s disease in a 6 year old child and a lumbar meningocele the size of a watermelon in a multiparous 35 year old woman! Again kudos to Drs. Agbeyegbe, Etomi, Maduekwe, the medical student, Anthony Okolo, Pharmacist Kayode Aiyegbajeje and his team of Nigerian pharmacists, the 6 nurses, 2 pharmacy technicians and medical officers provided by the Lagos Island Local Government for assisting the ANPA team complete the day’s mission especially when Dr. Adeyanju (ANPA President), Dr. Emelife ( ANPA President-elect), Dr. Abraham Osinbowale (Chair, Advocacy Committee), Dr. Clifford EKE (Chair, Medical Missions’ Committee), Dr. Jide Bamigboye ( Chair, ADIPT) , Dr. Barbara Onyia (Chair-elect, Houston Chapter) and Dr. Teresa Pounds (NAPPSA Pharmacist) had to leave for Abuja at noon for advocacy meetings scheduled for Tuesday, April 25, 2017. The medical team saw 400 patients during the three days of medical mission and the surgical team did 37 cases. It is pertinent to mention that ADIPT was newly set up as the medical arm of ANPA’s medical mission and the fourth area of ANPA Week to provide information on preventive health and organize a ready-to-go group of medical professionals as a rapid response team during disease outbreaks or any medical crisis of regional or national proportions. Prior to leaving for Abuja and exploratory to ANPA’s quest for competent local collaborative partners, ANPA’s advocacy team met with the Director of Training for the Lagos State University Teaching Hospital (LASUTH), Dr. Adedokun, on the advice and coordination by Dr. Rowland Osuoji who worked with the surgical team as a member of ANPA’s surgical mission. Present at the meeting were also Dr. Abdusalam, Dr. Osuoji’s Pediatric Surgical Regsitrar and Dr. Abimbola Abolarinwa, Consultant Urologist. The Director was very enthusiastic about collaborating with ANPA. Dr. Adeyanju and Dr. Eke will explore this opportunity further.
On Tuesday, April 25, advocacy meetings were held starting with the National Universities Commission (NUC) at 9:30 am with discussions on the ANPA/MANSAG curriculum for medical students which was still awaiting implementation and addendum on “culture of caring and medical ethics” for development of compassionate patient-oriented physicians and dentists in Nigeria’s Medical and Dental Schools, progress report on the implementation of the telemedicine and internet facilitated practicum teaching program between ANPA and Nigeria’s Medical and Dental Schools through the NgRen Technical Center, development and enrichment of a Universal National Examination for graduating Medical and Dental Students to ensure uniform standard for practicing physicians and dentists and those entering into the postgraduate residency programs for specialty training and any other topics that may arise from the discussions during the meeting. The new Executive Secretary of NUC, Professor Abubakar Adamu Rasheed talked at length about the statutory role of NUC in the regulation of higher education in Nigeria and advised ANPA to revise the document noting what is presently in place for the various levels 100 to 600 in medical education incorporating the “culture of caring and medical ethics” and whatever ANPA is proposing so he can have his team and faculty of existing Medical and Dental Schools review the document with a view to adoption and implementation. He also stated that the issue of PhD as an equivalent or requirement for postgraduate training and appointment as Consultants and/or University Administrators has now been resolved and it is now an option for those who want to go into medical research or who want to become medical scientists in addition to their fellowship training in the various specialties. Dr. Adeyanju and Dr. Emelife promised to follow-up on his suggestions. Dr. Joshua Atah, the Officer in charge of NgRen stated NUC was waiting on ANPA to identify ANPA Specialists who are willing to participate in telemedicine for the one Medical School that is ready for the program. The ANPA team promised to bring this to the attention of ANPA’s IT Committee Chair for next steps.
At 11:00 am, the ANPA team met with Dr. Chikwe Ihekweazu and his team at Nigeria’s Center for Disease Control (NCDC) for discussions on facilitating a working relationship between NCDC and the ANPA Disease Intervention and Prevention Team (ADIPT), enhancement and participation of ANPA members, NCDC and Nigeria’s Primary Health Agency in Nigeria’s Primary Healthcare delivery system with prevention as priority, discussions on enhancement of a working relationship between NCDC and ANPA towards the engagement of local governments and community leaders for better outcomes in population health in Nigeria, involvement of Nigeria’s National Youth Service Corps members and other unemployed but employable youths in disease prevention programs and any other items that may come up during the meeting. Dr. Ihekweazu talked about the history of NCDC and their active working relationship with America’s CDC. He expressed his agency’s willingness to work with ANPA and expressed a request to enlist ANPA’s support and active participation for student mentoring for National Youth Corps members NCDC is sponsoring for careers in public health. Dr. Adeyanju (ANPA President) promised to explore the initiative further with Dr. Ihekweazu.
At 12:50 pm, the ANPA team met with the Senior Assistant Secretary (SAS) to President Buhari on Diaspora Affairs. She welcomed the team and introduced ANPA to another non-governmental organization that is working actively on population health and would like to work with ANPA on disease surveillance. Honorable Abike Dabiri-Erewa (Presidential SAS) then spoke about the need for an Emergency Response System that will be part of an Integrated Health System, structured medical mission that will be integrated into Nigeria’s health system and the formation of a diaspora commission that will leverage the expertise of Nigerians in the diaspora to accomplish these objectives. She implored ANPA to look into these initiatives and work with the diaspora office in making these objectives a reality.
At 3:00 pm, the ANPA team met with the Health Minister, Professor Isaac Folorunsho Adewole and top officials of his ministry. The Director of the PPP/Diaspora Desk read the minutes of the previous meeting of March 2016 during the first ANPA Week and the issue of rotatory 11/1 (one month of work in Nigeria) consultative program in the different specialties. He then briefed ANPA about the ministry’s challenges during the present meningitis outbreak and the 4 cases of polio recently discovered in the northeastern part of the country despite the fact that Nigeria was declared polio-free in 2015 without paying close attention to the northeastern part of the country which is in turmoil. He outlined the efforts his ministry is undertaking in controlling the problems including the issue of massive immunization for meningitis in the face of shortage of funds to acquire the necessary vaccine. The Minister was asked about ANPA’s previous discussions with him on ANPA’s ready-to-go projects, capacity building for Radiation Physicists for Nigeria’s Oncology Centers and capacity building for cutting edge oncologists for Nigeria’s Oncology Centers. He stated that the ministry was limited by lack of funds because the budgetary allocation to health was reduced from 51 billion naira to 35 billion naira and may even be reduced further, hence they are unable to do many of the projects they would like to pursue. He implored the ANPA team to take up the issue of funding with the Senate when we meet with them.
Mr. Chris Maiyaki, Director of Protocol, NUC, was gracious in giving the ANPA team a very lavish reception in his home in the evening of April 25, 2017 followed by another dinner/reception for ANPA and our JCI partners hosted by the Presidential SAS on Diaspora Affairs, Honorable Abike Dabiri-Erewa.
Finally at 10:00 pm, ANPA team met with Senator Lanre Tejuoso, Chair of the Senate Committee on Health to discuss sponsorship of legislation to improve infrastructure in Nigeria’s healthcare system, improvement of Nigeria’s health expenditure in line with WHO’s recommendation, sponsorship of legislation to facilitate availability of funds through the Bank of Industry for private public partnership (PPP) and any other matters that may arise from the discussions at the meeting. He spoke at length about the challenges facing the country at present especially lack of funds. He agreed with all our major positions but bared his mind about the difficulties of passing the relevant legislation at the moment. He implored ANPA to remain proactive in Nigeria’s health affairs and he promised to work with ANPA in our quest to improve quality of healthcare in Nigeria.
The ANPA team left for Calabar on Wednesday, April 26, 2017 for NMA’s 57th annual Convention and we were joined in Calabar by Profesor Ajovi Scott-Emuakpor and Dr. Adanna Anyikam who were from Lagos. Dr. Udo Asonye also joined the ANPA team in Calabar on Wednesday, April 26. There was a grand pre-Convention reception in the evening of Wednesday, April 26, 26, 2017 and our team was well attended to. We later met with the Acting Registrar of the Medical and Dental Council of Nigeria (MDCN), Dr. T.A.B. sanusi, in our hotel on facilitation of registration and practice requirements for ANPA members who come to Nigeria for medical missions and medical staff development/capacity building on a rotatory basis, renewal of medical licenses for fully registered ANPA members who are practicing in the United States and are in good standing with the US regulatory bodies, facilitation of payment of renewal fees from the United States into MDCN’s Federal TSA system, discussions on the “culture of caring and medical ethics” as an addendum to the ANPA/MANSAG curriculum earlier submitted for updating training in Nigeria’s Medical and Dental Schools to ensure compassionate and patient-centered care and any other matters arising during the meeting. The Acting Registrar reiterated the Act establishing MDCN giving it the sole authority to approve and regulate the training of physicians and dentists in Nigeria and not the NUC. In the light of this, he asked ANPA to submit the revised curriculum to MDCN and not NUC for further action. He stated that MDCN is in the process of updating its IT system and that the issues raised about electronic payment of license renewal fees will be eventually addressed by the IT upgrade. He promised to work closely with ANPA and implored ANPA members who may be visiting Nigeria at the time of MDCN’s Council meetings to feel free to attend the meetings. We advised him to inform ANPA about the meetings in time so we can send representatives among our members who may be visiting at the time of MDCN’s Council meetings. On Thursday, April 27, ANPA participated in a joint Continuous Professional Development program with NMA with lectures on “A Preventive Approach to Coronary Artery Disease” by Dr. Abraham Osinbowale, “A Novel Approach to Evaluation of Chest pain” by Dr. Johnson Adeyanju and “Uremic Pericarditis” by Dr. Charmaine Emelife during the morning session which was moderated by Professor Ajovi Scott-Emuakpor. Dr. Udo Asonye gave a talk about his four decades of pediatric practice in the United States and the need for collaboration between Nigerian physicians practicing in the United States and physicians practicing in Nigeria during the morning session also. During the afternoon session, Dr. Johnson Adeyanju presented “A Culture of Caring and Medical Ethics” while Dr. Adanna Anyikam presented ” Post Partum Hemorrhage”. Other lectures on medical tourism and etiology of coronary artery disease- the Nigerian experience were given by the Nigerian faculty. On the advice of Dr. Asonye, some members of the ANPA team (Dr. Emelife, Dr. Eke, Dr. Onyia and Dr. Osinbowale) visited the Maternal and Children Hospital in Calabar to assess the potential of the Hospital as a collaborative facility. During the Convention, ANPA team also met with other doctors who are running 30 to 50 bed hospitals and doing laparoscopic/minimally invasive surgeries in various cities in Nigeria who are interested in partnering with ANPA members in Nigeria to advance quality healthcare in Nigeria.
The team returned to Lagos on Friday, April 28, 2017. On Saturday, April 29, 2017, Dr. Johnson Adeyanju and Dr. Abraham Osinbowale participated in Channels TV Sunrise program to discuss the activities of ANPA Week from April 22-29, 2017 and how ANPA plans to contribute to quality healthcare in Nigeria by availing our members the opportunity to practice alongside Nigerian physicians thus building capacity and easing access to healthcare for the Nigerian populace. The interviewers asked whether ANPA is planning to do more that one week in a year due to patient need and success of the two programs so far. We agreed with them for the need to have more than one ANPA Week in a year but we also reiterated the challenge of funding such missions due to the fact that the service is free and participating volunteers take time off work and are not paid while serving.
Overall, ANPA’s second ANPA Week is a huge success and an improvement on the maiden 2016 ANPA Week. There is no doubt in our minds that it will even get bigger and better considering the number of volunteers this year.
Abraham Osinbowale MD
Chair, Advocacy Committee
Clifford Eke, MD
Chair, Medical Missions’ Committee
Jide Bamigboye, MD