In continuation of our series to highlight innovative interventions across the Nigerian health sector, Nigeria Health Watch team member Ada Ezeokoli recently visited the ObiJackson Children’s Hospital in Okija, Anambra State, to learn more about how this island of modernity is being positioned to challenge a culture of low expectations in maternal and child health.
Across Nigeria, hospitals face the challenge of finding new strategies to address capital needs in an era of shrinking operating margins. The era of small 2-3 bed hospitals are failing to deliver the healthcare needs of an expanding middle class that is beginning to ask for more. The capitalist model with rapid financial returns as seen in other sectors in Nigeria does not have the patience for the healthcare sector. Can a bridge to this problem be found in philanthropy? This is a question that will be explored intensively in Nigeria and beyond. The Dangote Foundation is completing a N7B hospital in Kano, the Didier Drogba Foundation is building not one but five hospitals in Cote D’Ivoire, so when pictures were shared on social media about an ultra-modern hospital in the otherwise quiet town of Okija, in Anambra State, we decided to visit to see things for ourselves.
The driver navigates his way through a series of winding roads and circumvents a few potholes, commonly called “gallop”, in what he must proudly think is a James Bond style move. “Nwayo nwayo,” I mutter as I try not to cringe. We are headed to the town of Okija, in Ihiala Local Government, Anambra State. It’s 11:30 on a Sunday morning, and as we drive, the faithful are trickling out of church, ladies with head wrapped and decked in traditional wear clutching bibles and hymnals, or “akwukwo ukwe,” literally “book of songs”. You can almost smell the Sunday rice. We breeze through a number of towns, Nawfia, Nnokwa, Nnobi, Nnewi. I lose track of the borders between towns, but what stands out to me is that without fail, each town is home to more than one towering, majestic, and sometimes uncompleted, church edifice.
We get to Okija junction and ask for directions to the ObiJackson Children’s Hospital. We are not far from it, and soon we are entering the well landscaped grounds of the hospital campus. It looks brand new, well built, and today it is fairly quiet. I am here to meet with Dr. Chinwe Muomalu, a consultant pediatrician who is also the Chief Operating Officer of the Hospital. Her office is in the middle of the vast administrative wing, in front of which is a lawn complete with colourful swings and other recreation facilities for children.
Dr. Muomalu greets me warmly, and introduces me to her colleague Chika Ndu-Okonkwo. I am curious and they are ready to show me around. The hospital was founded in early 2014 by Ernest Obiejesi, founder of the ObiJackson Group of Companies, which includes Nestoil. “He had a vision to help indigent children, people who could not afford health care, and he felt the best place to start off was from home,” Dr. Muomalu tells me. “So he brought in experts from all over the world, who had established similar facilities elsewhere, and they built it from scratch.”
The three of us make our way around the campus, and Dr. Muomalu explains that “the idea was that children living in the rural areas could come here and access excellent world-class healthcare, and the ObiJackson Foundation, a non-profit organization also founded by Ernest Obiejesi, would take care of their bills. The Foundation does not just wait for sick children to be brought in, but has been going into the communities and identifying children from indigent families who cannot afford health care, and who may not have the courage to come on their own, inviting them in.”
The hospital is equipped with pretty much everything a children’s hospital can need… and then more. Dr. Muomalu and Chika walk me through each room, and I’m struggling to keep up with the long list of equipment in the breath taking campus. “We have an oxygen generating plant here which has the capacity to supply the state, and the plant pipes oxygen directly to the conduits in each ward,” Dr. Muomalu says.
“We have about 15 incubators, and three life support machines for ventilator support, in addition to CPAP machines and a state of the art diagnostic centre,” she adds. The campus also has its own water treatment plant, a theatre with the latest in telemedicine facilities, a fully functioning pharmacy, an ambulance retrieval system, and even a canteen that provides affordable meals for patients.
I’m immediately worried though about staffing, about maintenance, about how this hospital will continue to run at full operational capacity, given the challenges so many other hospitals, public and private, have when it comes to even just keeping equipment running and staff retained. I ask Dr. Muomalu these questions. The hospital has about 90 staff, she says, including three consultant pediatricians, four medical officers, a team of nurses including a neonatal intensive care trained nurse, and many others, all trained in Basic Life Support, with senior staff also trained in Advance Pediatric Life Support. “They are extremely committed to our mission,” she says.
“We also have social workers, because we don’t turn anyone away, we treat, and then the social worker finds out if they can or cannot pay. Once the social worker investigates and talks to the family, and minutes to say, this patient is indigent, the Foundation automatically takes care of that.” The system was put in place to make sure people don’t abuse the process of free medical care. Social workers also work alongside the Local Government Authority’s Child Welfare Unit to make sure that the child’s rights are protected.
We make our way to the neonatal unit, and each ward is lined with beds, over which a plethora of gadgets to monitor and treat patients hang. Dr. Muomalu says, “The idea and mission is to be able to give the people in Okija and around Anambra State and in Nigeria, affordable but excellent health care”. The founder is committed to the project and has signed long term maintenance agreements for all the equipment. At the heart of the hospital is the mission of its founders, boldly written on the side of the hospital ambulance; “Giving Back to the People”.
Dr. Muomalu herself left Lagos to join the ObiJackson hospital team because she felt fortunate to be part of a very special project. “People go from here to India for healthcare because they think they are going to get quality care. Whether they get it or not, that’s another story. But, this is in Nigeria. So we are saying to ourselves in the next three, four years, let this be a place where people from all over Nigeria come when they have a child that needs excellent care, irrespective of their ability to pay. This is just the beginning.”
As has been demonstrated in other sectors, philanthropists are motivated by many factors, and each person has his or her own reason for putting his/her money into a specific sector. Naturally, we would wish that they all invest in the health sector. There are five Nigerians on the Forbes list of 1,000 billionaires across the globe. Ernest Obiejesi is not one of them. Imagine the potential impact of more of them turning to the health sector instead. More than simply funding infrastructure and operating expenses, funds raised through philanthropy are an ideal way to fund innovation.
The ObiJackson Hospital has a real opportunity to challenge conventional wisdom on the viability of healthcare provided for the poor, but subsidised by a combination of fee-paying clients and philanthropy.
It takes time to identify philanthropists that are interested in healthcare, cultivate their knowledge of and interest in healthcare, and motivate them to take action. But, this should not be the case. It is unlikely that there is a single adult Nigerian who has not been asked to support the hospital fees for a relative or friend. Maybe it is time for us to aggressively build a culture of philanthropy in the Nigerian health sector. Maybe we can even aim for a best-case scenario where the funds from philanthropy ultimately lead to innovation in financing and delivery that will improve the sector over-all.
As I leave ObiJackson Hospital and exchange pleasant goodbyes, I know it is not the last time I will make my way to Okija. There is a lot on my mind. I hope that Ernest Obiejesi will bring the same spirit of entrepreneurship with which he built his businesses to grow this hospital while maintaining a focus on the poor. The win-win situation would be for the hospital to be a successful enterprise on its own, serving as a tertiary referral centre, while the Foundation independently supports the care of the patients in need of financial support. Likewise, the communities around Okija will do well to organise themselves for their children to access the care provided at ObiJackson.
I know there are many more beginnings to hear about here, and history waiting to be made. I look forward to visiting again and seeing the campus bursting at it seams with children getting the care they deserve… and a shot at life.