How I helped improve healthcare in poor American community – Nigerian Paediatrician Afolabi Oguntoyinbo

Nigerian Paediatrician Afolabi Oguntoyinbo

A few years ago, I visited Oyotunji Village in South Carolina, an intentional community founded by African-Americans in 1970, modelled after Yoruba culture. They speak fluent Yoruba, worship Yoruba gods, and you could easily mistake them for Nigerian Yoruba with their tribal marks and sartorial styles.

During a conversation with the new king, Adejuyigbe Adefunmi II, the son of the late founder, Efuntola Adefunmi I, he spoke of a Nigerian doctor who took care of him and his siblings when they were young. This, no doubt, pricked my interest and curiosity.  I asked for his name and to my shock and pleasant surprise, I discovered it was a man from my own town in Ekiti who left for the United States a long time ago to study. He was one of the academic legends of our youth, held up by parents as examples to follow, even though most of us had never met him.  He is about to return to Nigeria after a long sojourn in America.  I caught up with him recently and he was gracious to share his wisdom with us on living and working in the United States as a doctor.

Afolabi Oguntoyinbo  has lived in South Carolina and practiced medicine there as a pediatrician for over forty years, taking care of some of the most impoverished and distressed children in America. South Carolina is ranked as one of the poorest states in the U.S.  One little known fact is that about twenty-five per cent of American doctors are foreign-born, and many of them practice in rural America and urban neighborhoods, places with high poverty rates where American doctors do not want to go.  But for the services of people like Dr. Oguntoyinbo, such places will be bereft of medical care.

Here are excerpts of my interview with Mr. Oguntoyinbo.

Bunmi: Where were you born?

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Dr. Oguntoyinbo:  I was born in Igede-Ekiti and I had my primary school education there. My father was a farmer.  He liked being a farmer, but he wanted me to go to school.  I attended Christ’s School, Ado-Ekiti and I did very well.  After finishing from Christ’s School in 1960, I taught briefly at Ekiti Baptist High School, Igede-Ekiti before attending Olivet Baptist High School, Oyo, for my Higher School Certificate (HSC).

We were the first set to do HSC at Olivet. I went back to Igede again to teach after which I was admitted to the University of Ibadan. I spent one term there and left because I couldn’t afford the school fees.  I then went and taught at St. Joseph’s School, Ondo, with two of my friends.  From there, I learned that you could attend the University of Lagos’ College of Medicine free, so I applied and I was admitted.  My set was the third set but by the time I got there, they were charging tuition.  I paid my tuition with the money I saved from my teaching job at St. Joseph.

In the third year, I and nine others were asked to leave because we couldn’t pay.  I went to seek assistance from my former Chemistry teacher in Christ’s School who was a friend to the Vice Provost at the university.  The Vice Provost was his professor at the University of Ibadan.  After his intervention, I was allowed to stay and finish my studies. The Biafra war broke out in our third year, in 1967, and five Igbo classmates left.  We had three foreigners in our class, one Pakistani, one Ghanaian, and one Canadian.  I finished medical school in 1969 and did one year of internship with the Lagos Ministry of Health at Randle Avenue Health Center in Lagos.  In 1970, I took the Examination for Foreign Medical Graduates (EXFMG), which allows foreign doctors to do residency in America.


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Bunmi: Why did you want to leave Nigeria?

Dr. Oguntoyinbo: Because there was no post-graduate opportunity in Nigeria then.  You can either go to Canada, England, or the United States.


Bunmi: You did your residency in pediatrics.

Dr. Oguntoyinbo:  Yes, I wanted to take care of children.  I used to take care of them at Randle Health Center in Lagos.  I was a bachelor then, so I used to go to the wards to work late into the night, even when I was not on duty.  I saw many suffering mothers waiting for their children to get better.  I spent one year in New Haven as a pediatric intern in a hospital affiliated with Yale Medical School.  Then I decided to go to South Carolina for Pediatric Residency Training at Richland Memorial Hospital in Columbia, South Carolina.

Bunmi: Why there?

Dr. Oguntoyinbo: They had the kind of training I wanted and the weather was conducive. Also, when I talked to the director and assistant director of the program, they were very nice.  I got married on my way to South Carolina on June 24, 1972.   I met my wife at the Randle Avenue Health Center in Lagos.  I spent two years doing residency at Richland.

Bunmi: What was life like as a foreign-born black doctor in the South?

Dr. Oguntoyinbo: I experienced racism and discrimination but I just considered them obstacles to be overcome. Some asked silly questions like “Do you live on trees in Africa?”  I had an objective and I was there to fulfill that objective.  I knew where I was coming from and I knew where I was going.  Thinking about racism was not a part of it.  I call it healthy avoidance because if you dwell on it, it could be destructive and become an obstacle to progress.

You know, at times, people thought I was the cleaner because of the color of my skin.  I had cases where white patients refused to be treated by me because they thought I didn’t know what I was doing.  The training I received in Nigeria was excellent so I was doing very well in my residency.  One patient refused to be treated by me and suffered a heart attack.  I had to revive him.  He opened his eyes and I was standing right there beside him.

You can imagine what young black people here go through, being told they are not smart enough, that they can’t do it.  It’s terribly destructive, psychologically.  That is why many of them quit school, act tough, and don’t have high academic goals. Unless one understands the situation, there is a tendency to blame the parents.

Bunmi: Are there any differences or similarities between your upbringing as a poor child in Ekiti and poor children in South Carolina.

Dr. Oguntoyinbo: You know, we had the support of our families, communities, and school. We didn’t even know we were poor.  Like many children in my town, I followed my father to the farm at 5 a.m. and worked for six straight hours before taking a break.  You still had to study and do very well in school.  Parents drilled into us a very high work ethic and set very high standards of performance.  Parents wanted their children to do better than them.

My father wanted me to go to school, even though he loved farm work.  He couldn’t read.  When my school report came, I was the one who read it to him.  If I came third in my class, he would ask why I did not come first.  Our teachers encouraged and supported us.  You had to study, do your homework, and follow school regulations or you were punished.  We had boys from well-to-do families in Christ’s school but we poor boys did just as well academically.  Your being poor did not determine your performance.  One of my friends in Christ’s school, also from a poor background, became a urologist.

Here, poor children have more challenges.  Many of them don’t have the home or school support because of racism. Those who are doing well do so because of the same factors that made us succeed at home. Family and community support. When you look, you’ll see that some adults in the family have the vision and determination to see the child succeed. The grandmothers are especially important.  Educated adults in the family also act as role models.

Family togetherness is critical for the survival of the child.  Poor children here attend bad schools where academic performance is not very high, those who are doing well are moved to other schools.  If a child is not doing well but he is with other children who are doing well, he is likely to do better.  Sharing and mixing with other children and families who are doing better contribute to development, but when a struggling child attends school with only children like him, the chances of success become very low.

We never had this kind of segregation at home, and thank God, our parents never experienced racism and discrimination, which create a lot of barriers and setback for families and children. Poor families here have huge mountains to climb because of centuries of racism that is still ongoing.

Bunmi : You also earned a Masters degree in Public Health (MPH) from the University of California, Berkley.

Dr. Oguntoyinbo: Yes, I applied to Johns Hopkins and I got in but they wouldn’t give me a fellowship so I waited for a year and applied to Berkley where I got one.  I wanted to do Maternal and Child Health. After I finished, I practiced in the Neighborhood Health Center.

Bunmi: Why?

Dr.Oguntoyinbo: I didn’t want to go into private practice that depends on the ability of the patient to pay in order to receive care.  Poor kids need care, they need to be seen.  I was a poor child. I go to Nigeria now and I see many cases where patients are not seen unless they pay upfront. This is not right.

Bunmi:  You were the first doctor for Oyotunji Village.

Dr. Oguntoyinbo: Yes, I was very impressed with them, trying to build a community that replicates life in a Yoruba village.  They started at a different site.  I met a couple from New York who had come to be a part of the community.  They said they wanted to be taught how to live. They had to pay $1000 to join the community.

Bunmi: How is life in Beaufort generally?

Dr. Oguntoyinbo: You know when I first got here, the situation was severe.  There was no sanitation, no indoor plumbing, no toilets.  There were infections and infestations.  It was a third world country really.  We had to buy air conditioners for old people in the summer because it was too hot.  Some of them died in the summer of heat, and in the winter of cold.  The condition was so bad they had a Congressional hearing on the harsh poverty in certain communities in the state. Things did get a little better, but what I’ve noticed lately is the use of drugs.  When I first got here decades ago, we didn’t have a drug problem.  Now, it has become a problem that devastates families.

Bunmi: Did you give medical care to white children and are their circumstances better?

Dr. Oguntoyinbo: No, they are just the same as black children in this area.  There is a lot of white poverty here as well. I’ve always said, poverty is a world disease. It knows no race.  Everyone needs access to food, good housing, good education, and a safe environment.

Bunmi: What do you think poor families can do to improve the lot of their children?

Dr. Oguntoyinbo: Families have to work together to encourage and support the children.  When the child is told “you can’t do that”, the family must emphasize he can. The child must be taught coping skills on how to overcome hardship and also have good work ethics. These were the skills we were fortunate to be raised with.  Even if a child is doing well, he can always do better.  Young or old, we all need improvements in our lives.  One of the children I took care of became a doctor, a pediatrician, and he came back to the area.  I’m planning to invite him and another doctor to a program in Nigeria once I settle.  They’ll expand their knowledge by working on cases in Nigeria.

Bunmi: What are you most proud of in your long career?

Dr. Oguntoyinbo: To see the children I took care of doing well, growing up to be healthy and productive adults.

Bunmi: After over forty years here, why are you going back?

Dr. Oguntoyinbo:  I’ve always wanted to.  I made two determinations when I got here.  One, I’ll take care of my children and support them financially until they finish their education.  The other is that I’ll go back home to contribute.  Nigeria educated me and gave me opportunities.  My parents and my community supported me.  I owe them deep gratitude.  I want to go back and work with young medical students.  I came from a poor background.  I feel a deep obligation to serve people. We used to have a good health care system at home, but we slipped back.  There is so much corruption.

Bunmi:  You are a father of three grown sons. What is your experience of parenting in America and what advice will you give new immigrant parents?

Dr. Oguntoyinbo: I would advise new immigrant parents to keep the home language.  Speak it to children and make sure they learn it.  I regret not doing that.  I didn’t want the children to have an accent.  What is wrong with having an accent?  Maintain home culture and take the kids home periodically for visits.  Also, pay attention to what is happening to them carefully in school.  They had complaints about my first son, that he wasn’t performing, that he was always drawing pictures.  I found out he was bored, he was not challenged enough. So I withdrew him and his brother from public school and sent them to private schools where they thrived.  In their public school, some black kids called them “whitey” and ridiculed them because they spoke proper and grammatical English.  It was a class issue.  They were children of professionals attending school with mostly poor children.

Bunmi: What do you think of the relationship between African immigrants and African-Americans?

Dr.  Oguntoyinbo:  It’s not bad but there could be misunderstandings on both sides because of lack of information.  People believe what they see on television about each other leading to questions that are ridiculous. In my time, before we got here, we never read any book about the discrimination and violence visited on African-Americans here, so we could not understand why they were not doing so well. Things have improved since I arrived in 1971, and I’m hopeful for the future.

Bunmi: Nigeria has mega-churches with a lot of wealth, the likes of which we did not grow up with.  The traditional churches used to manage education and provide a lot opportunities for children to be educated.  Are mega-churches serving the same purpose now?

Dr. Oguntoyinbo:  No, they are not.  They are buying jets.  It was the Baptist Church that gave me a scholarship to attend Olivet Baptist High School. But for them, I wouldn’t have been able to attend.  I think the American Gospel of Prosperity, acquiring wealth at the expense of members, has distorted the true meaning of religion and the teaching of Jesus. He served the poor and gave, never accumulated any wealth.

Bunmi: Thank you. I wish you all the best.

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