INTERVIEW: Why I’ve remained in Ekiti practising as a doctor for decades – Ayodeji Aturamu

Ayodeji Aturamu
Ayodeji Aturamu

Ayodeji Aturamu is a native of Ekiti State, South-west Nigeria. He had his early education in the local area and his higher education in the urban areas of Western Nigeria. Instead of migrating to the cities or going abroad after his medical education, like many of his peers, he went back to Ekiti to practice medicine. He had a brief interlude as the Medical Superintendent in the Pacific Island of Fiji where he delivered medical care for a few years. Here is his story.

PT: Where were you born?

Aturamu: I was born in Igede-Ekiti, in Ekiti State, to the Aturamu family. I am the sixth of the seven children of Chief Otolorin Aturamu Bamisile and Chief (Mrs) Esther Jemimusiyin Aturamu – both of blessed memory. My father was a peasant farmer while my mother (Eye Siyin Alabari) was a small-scale manual dry cleaner and the most famous “Abari” (Bean, Corn and Plantain pudding) maker and seller in the village and its environs.

PT: Tell us about your primary and high school education. Who were your favourite teachers and why?

Aturamu: My primary school education was at Baptist Day School (Awolowo) Igede-Ekiti between 1961 and 1967. My favourite teachers in the primary school were Mrs Fadelu, Mr Akeju, Mr Fatunla, Mrs Falua, Mr Babatunde, Mr Fajemilehin, and Mr Ayeni. Right from primary one, each of them discovered the potentials in me and encouraged me to be the best among my peers. They recommended me for prizes and awards for academic excellence and this motivated me to work harder. One of my vivid memories about my primary school days is about a day I had to solve an arithmetic question for one of my friends who was in primary three, a year ahead of me then. It was quite embarrassing to both of us because the teacher made me flog my friend five times. My friend was ridiculed. He later retaliated by cajoling his other friends to beat me up on our way to the farm the following Saturday.

My high school education was in two stages. The West African School Certificate Examination (WASCE) – January 1969 to June 1973 and Higher School Certificate (HSC) – September 1973 to June 1975. My WASCE was at Aquinas College, Akure and HSC at Government College, Ibadan both in the then Western Region of Nigeria. My high school days were memorable. I had the opportunity of travelling out of Igede-Ekiti to the envy of my friends and old classmates. My teachers at Aquinas College were majorly Irish Catholic priests and Reverend Sisters and the others young Nigerian graduates from Nigerian Universities. My favourite teachers were Fr. Whelan, Fr Evans and the late Mr Babalola who taught me Mathematics, Chemistry and Biology respectively. Aquinas college opened my eyes to the ‘telephone box’ that I had never seen in Igede. The curriculum helped groom me especially in the sciences and I was able to get admitted into Government College Ibadan (GCI) on merit. This gave me the opportunity of travelling out of Ondo Province to Ibadan where I saw a television set for the first time in September 1973 at GCI. I managed to find the courage to turn it on after 72 hours. Thinking back now, that was quite an adventure for me. I thought I would be electrocuted because of the ‘flashes’ emanating from the TV. I eventually got a hang of it and spent my leisure time in the common room listening to music and practising the latest dance steps. GCI inspired my love for music till date and that love led me to become a disc jockey. I was at GCI with a bosom childhood friend, Ayodele Faromika, who is now a successful private medical practitioner in Lagos. He and other friends gave me the nickname ‘ATUU’, which is what a lot of people call me today. Together, we would share our GCI experience with our friends during the Christmas holiday back home in Igede. Our friends envied us because they believed we had been transformed into city boys and would listen to us go on about our school and its wonderful gadgets.

PT: What university did you attend? What was your experience there?

Aturamu: My first degree was in Medical Physiology at the University of Ibadan, Ibadan, from September 1975 through June 1978. I was the commissioner for Socials and Common Room for Kuti hall during 1976/77 session. The country was so encouraging and supportive during my university days. We had good food, decent utilities and there was no fear of cultism. The government was supportive in awarding scholarships. Federal and State bursary awards were regular. It was a wonderful experience and I enjoyed it. My Bachelor of Medicine and Surgery (MBBS) degree was at the College of Medicine of the University of Lagos, Lagos (LUTH) from September 1979 through June 1985. Back then there were a number of students from Europe, South Africa, the Caribbean, Ghana and other West African Countries in the school. There were exchange programmes between our medical school and British/European medical schools.

The zeal to study medicine stirred in me as a child. I had pneumonia and was on admission at the Maria Assumpta Catholic Hospital in Ado-Ekiti, the nearest town to my village. There was only one Irish Catholic Missionary Medical Doctor there then. I would observe him keenly as he attended to me and other patients. Little me made up my mind after one week at that hospital that I would become a medical doctor so that I would be able to communicate better with mothers like my own dear Mom who was scared of the “white-skinned” doctor and would only watch from a distance.

PT: Who were the major influences on your life as a young man?

Aturamu: First and foremost, my parents of blessed memory, then my siblings, especially the first older three siblings: the late Chief Adeleke Aturamu , a retired grade one high school principal, the late Mr Abiola Aturamu, a retired Commissioner of Police and the 1st commandant general of Nigerian Civil Defence Corps, and Mrs Omolola Awolokun, a retired class teacher. All of them took care of me as if they were my biological parents. My dedicated teachers in primary, secondary and tertiary institutions all have a profound influence on my young life.

PT: You have been practising medicine in Ekiti for almost 40 years. Why did you choose to stay when most of us migrated to cities or went abroad?

Aturamu: Yes. I have been in Ekiti practising medicine for a long time. I decided to stay in Ekiti because of my passion, which is to give back to my people in the environment that gave so much to me. When I graduated in 1985, Nigeria was a country to live in with abundance and satisfaction then. There was societal appreciation and respect for medical doctors. It is, however, a rollercoaster of joy and serious challenges practising medicine in Nigeria, and worse still, in the rural area. Unfortunately, there has been a steady and dangerous decline in the quality of medical practice in Nigeria because of a lack of maintenance culture in the country. Because of the very selfish, myopic and corrupt leaders we have at federal, state and local government levels, 8 out 10 Nigerians do not have access to affordable and equitable medical care. Since 1990 till date, it has been an avalanche of challenges such as the brain drain of doctors to greener pastures diminish the doctor-patient ratio with the attending consequences, no constant power supply to work and keep the cold-chain of the vaccines, substandard environmental sanitation, a very meagre budgetary allocation on health at all tiers of governance, and no motivation and support for the medical personnel in terms of salary package that is ridiculously and unrealistically meagre and irregular. Also, there is the common usage of native and unrefined medications of ungraded dosage with the attending pathological consequences including preventable deaths, and there is non-regulation of pharmacy practice. Most Nigerians patronise unregistered medicine stores and vendors that are not manned by qualified personnel.

PT: What have been the joys and challenges of practicing medicine in a rural area?

Aturamu: Some of the joys of my practice include achieving good results and progress in the management of my patients. Practising in this kind of clime makes you innovative. I have had to perform surgeries using hurricane lantern or lamp at times when the electricity goes off while I’m in the theatre. I have also treated premature babies with improvised incubators as well just to mention a few of my experiences where improvisation became a necessity.

PT: You were in Fiji for some time to practice medicine. What was that experience like?

Aturamu: Between 1998 and 2001, I was employed by the Government of Fiji Islands as the Medical superintendent of BA Mission Hospital, a 52- bed hospital owned by the Methodist Mission. Fiji Islands is a popular tourist destination. Fijians are amazing people with impressive health planning, promotion, education and surveillance systems. The Government respects the World Health Organisation’s prescription of adequate budgetary allocation for health annually. Therefore, every Fijian enjoyed absolute free health services in terms of laboratory and pharmaceutical services. The health care in Fiji was easily accessible, affordable and with adequate community participation. Drugs were delivered to the aged by courier throughout the country because of the comprehensive medical records keeping and up-to-date epidemiological survey on schedule and appointment.

In Fiji Islands, I saw many medical equipments that I had not seen before in Nigeria. In fact, I was not trained with them. Some of them are basic medical equipment like glucometer for blood sugar estimation, nebulizer for acute asthmatic patients (this saved my son who is a medical doctor now), Oxygen concentrator, patient’s monitor, defibrillator and diathermy for bloodless surgeries.

My experience in Fiji was like going for postgraduate training in all the major specialities. It was a wholesome educative experience and it opened my eyes to the shortcomings of Nigerian healthcare. I could not leave without getting some of this equipment to help me provide adequate care for my people back home. I was the first medical officer in government and private owned hospital to practice medicine here in Ekiti State with glucometer, nebulizer, oxygen concentrator, patient’s monitor, and diathermy as at 2001.

PT: You came back to Ekiti to resume your practice. Why?

Aturamu: I came back to Ekiti to resume practice with a zeal to share my experience in Fiji for the betterment of medical practice in Ekiti. These days, I question my return because the Nigerian health system has failed us. Shamefully, the situation is getting worse on a daily basis.

PT: What are the challenges of practising medicine in Nigeria today?

Aturamu: The challenges of practising medicine in Nigeria today are inexhaustible. Some are: a brain drain- because of poor remuneration, health workers seek better offer overseas in drones on daily basis, poor working environment because of unstable power and water supply, medical tourism by the leaders at the expense of equipping the hospitals and employment of qualified medical personnel, no legislation on medical practice in Nigeria hence we have a lot of quackery and fake medicine stores. Nigerians go to pharmacy stores without doctor’s prescriptions and there is a proliferation of illegal, incompetent and unregistered clinics/drug stores/vendors with fake drugs in our pharmacies. 80 per cent of Nigerians cannot afford orthodox medical care by paying out of pocket and religious fanaticism vis-à-vis faith healing is a wild calamity and serious tribulation in the country and for the profession. Shamefully, there is no government health policy or plan for the elderly, people 65 years of age and above.

PT: Do you have any new professional goals?

Aturamu: Yes, I am planning a new goal professionally and this is core to my present mission and vision for the medical profession. The Medical and Dental Council of Nigeria had just incorporated Traditional, Complementary and Alternative Medicine (TCAM) into the medical curriculum of medical schools. I have decided to go into research towards the use of Phytochemicals and plant products in the management of myriads of illnesses confronting Nigerians by having an affordable, accessible, acceptable and equipotent alternative drugs in the management of diseases like malaria, diabetes mellitus, and hypertension. My vision is to research drugs that can be used as the main therapy or adjuvants to the present orthodox drugs being used to manage the listed ailments above by using diet from phytochemicals and plant products. This shall take me to the medical schools as a researcher/lecturer. I plan to collaborate with pharmaceutical companies, orthodox medical practitioners, schools of pharmacy- department of pharmacology/pharmacognosy of universities and traditional practitioners both in Nigeria and internationally towards the production of medicaments made of phytochemicals that are affordable, accessible, equipotent with orthodox medicines and of low or no side effects in the management of the listed illnesses that are of alarming health burden in the country. I shall support researches in natural products and production of plant-based drugs taking a cue from China and India (where Arthemisinin Containing Antimalaria Therapy (ACT) are researched and manufactured from the plant Qinghaosu and artemisinia annua respectively). I fervently hope for local and international financial support in form of research grants towards this goal. The actualization of the goal will bring succour to the numerous citizens of Sub-Saharan Africa (SSA) who have no access and cannot afford the treatment for these prevailing illnesses that are of great health burden out of their pockets, especially now that foreign medical aid to SSA countries had dwindled drastically. I have just concluded a Masters degree in Human Physiology from Afe Babalola University Ado-Ekiti, Ekiti State, Nigeria. I researched the HYPOGLYCAEMIC EFFECT OF VERNONIA AMYGDALINA (BITTER LEAF) IN MALE WISTAR RATS. Apart from confirming the blood sugar lowering effect of the plant, I found out that the root is the most potent part. Interestingly, the literature on this comparison is very scanty. I still intend to do more research on the plant focusing on its antimalarial possible properties. Vernonia amygdalina (Bitter-leaf) plant is a valuable household shrub in East and West Africa. In Nigeria, especially in the South-east and South-west, the plant is used for food and medicinal purposes. In Nigeria, daily diet is dominated by starchy staple food and vegetables that are the cheapest and most readily available source of important proteins, vitamins, minerals and essential amino acids. Hence, the acceptability of the plant. I shall soon research its hypoglycaemic properties in human beings in collaboration with dieticians and diabetic physicians in specialist and teaching hospitals during my intended PhD programme.

PT: What do you like most about living in Ekiti and what would like to see improved?

Aturamu: Living in Ekiti has been partially fulfilling. As expected and respected by our culture, I was able to pay back into the family what was invested in me. I took care of my dear mother till her last breath. I have been supportive to my other siblings too. I have been able to touch the lives of so many Ekitis in terms of mentoring and charity. Ekiti people are very pleasant, loving and hardworking. They deserve more from the government in terms of empowerment, provision of basic utilities and amenities like electricity and water supply, housing, communication, transportation and road networks. Healthcare should be equitably universal and affordable. There should be health insurance cover for all Ekitis. Every citizen must receive the comprehensive health services they need. Distance should not be a barrier to accessing the health services, especially in remote areas. Education should be free, qualitative, and compulsory from primary to secondary level. More attention should be placed on Technical and Vocational Education. Tertiary education should be affordable with scholarship and bursary support from the government. Local Government should be made autonomous with better budgetary support to enhance rural development. Government should encourage fresh school leavers towards agriculture by providing equipment and farm inputs at subsidised rates to promote food production and reduce hunger, cultism and “yahooism”. There should be enforcement of registration of every birth and death with certificates to facilitate health planning and promotion.

PT: Thank you.

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