Today, I witnessed how the vision and commitment of an entrepreneur – in this case a doctor – opened up access to essential maternal healthcare for a whole community of people. Meet the Doctor, Founder and Medical Director at a hospital in North Western Nigeria.“Entrepreneurs do not come to community meetings” said Ernesto Sirolli in his recent TED Talk. This got me thinking. Entrepreneurs are everywhere in Nigeria. Here, there is an almost national optimism that anything might really be possible.
It almost literally emerged from the ashes of the religious crisis in 2000. He recalls: “standing there, amid the refuse from the fires next door, I realised that this community needs a maternity clinic. I felt that the people within the community needed my service.” At that time he was running another hospital, which he left and devoted his energies to founding this maternity clinic. It runs independently, without any support from the government, “except for the air we breathe and the relative security we are enjoying now” he explained, with some gratitude.
The clinic was converted from shopfronts and then extended further back to add more rooms. The hospital now offers 24 hour services, and there are plans for further development. Today, there are 23 staff at the hospital – 14 permanent and 9 casual, including doctors, nurses, community health workers, medical record keepers, cleaners, a laboratory technician and scientist, an environmental health officer, cashiers and an accountant. The clinic offers a range of services including obstetrics, ante-natal and post-natal care for mothers and their babies, prevention of mother-to-child transmission of HIV and general HIV services, and tuberculosis diagnosis and treatment.
Today the clinic was full – almost overflowing. The noise was deafening as women jostled amongst each other to be at the head of the queue for cervical cancer screening. The community mobilisation officer, who gave a talk to a crowded waiting room, was clearly very effective at her job. Within seconds of her ending her public counselling session, the women rushed to get in line for a screening. Today, because it was the first time the service was offered, that service was being offered for free. Beyond the raucous of the waiting area, all the beds were full with mainly mothers and their children, some receiving treatment for malaria, others as part of a child immunisation drive, and others to deliver and register new births.
It is a private clinic and there are small costs for all clients for all services, with the exception of HIV testing and treatment for tuberculosis. The charges are there but they match the affordability of clients in the surrounding community. For example, to deliver a baby at the hospital costs 3,000 Naira (USD $6), 300 Naira (60 cents) for a blood or Malaria test. The most expensive drug is Augmentin (at 1,500 Naira or USD $3 for a dose) and the cheapest is paracetamol (at 2 Naira or 0.004 cents a does). The most expensive service offered is a hysterectomy, at 60,000 Naira (approximately USD $120).
The number of people at the clinic spoke for itself. “They come. If they were not appreciating the services then they would not come” said the doctor, even though he thoughtfully did engage in the quality of care review taking place at the hospital. He contemplated suggestions and agreed to add a suggestion and complain box for client feedback.
He has spent 30 years living in this community, and he is also trying to tackle wider issues about male health and also a man’s responsibility for family planning. He wants to “take away that shyness” he has observed among men in talking about health and sexuality, and open up their minds so that they can come and take a service.
Towards the end of our meeting, I check that the doctor is OK with the amount of time we have been taking from his day. Someone else responded, “we are Nigerian. We ask for 30 minutes but we really mean 2 hours,” and everyone laughed. The doctor beamed as he intently continued the discussion about quality of care at his facility, and it seemed that the queue of women waiting for their screening was starting to thin out as the other clinical staff continued undisturbed.
The spirit of volunteerism is alive and very active. Not only is the doctor a passionate and professional medical director, he also volunteers with a local family planning organisation. Apparently he drops in there at least 3 times a week, to say hello and let the staff know about any recent policies or changes within the community.
Perhaps there is a new wave of entrepreneurs who are also community minded and embody the values of volunteerism (the kind that would come to community meeting)? Without a doubt, this doctor is a role model for both.