What Makes Ondo Health System Strong, Says Adeyanju

Ondo State Commissioner for Health, Dr Dayo Adeyanju, explains the proactive roles of the state government to curb the recent strange disease and the giant stride of the Mother and Child Hospital in an interview with OLUWASEUN AKINGBOYE in Akure. 

TELL us about the outbreak of the strange endemic recently in the state?  The strange disease, which came up precisely on April 12, this year, was strange to every member of the Irele community and led to the death of about 10 persons.

The time our outbreak control team got to know, it had occurred for 24 hours, because the death was not reported and there were hurried burials of the victims, linking the death to the anger of the Malakun deity.

But when we got to know, we quickly dispatch our State Rapid Response team to the affected area, and they promptly swung into action, trying to determine whether it was an infectious disease or poisoning, because as at time, we were not too sure what we were dealing with.

The team met at the emergency operation centre, which we quickly had to put in place, and we discussed. We had to dispatch them again to go back to get samples, which we dispatched to Lagos and Federal University of Technology Akure (FUTA) for us to ascertain what was going on.

Apparently, after the third day, we had a report that ruled out infectious disease, non-viral, not hepatitis, Ebola and all of that. We were quite glad at that, because that meant it was not contagious and as such, the containment would not be as challenging as if it were infectious.

Of course, I had to lead the entire team on Saturday to see what was actually going on in the community and it was later clear to me during our active case finding that one thing that was peculiar to all of them was the fact that there was consumption of the Ogogoro, which is the locally brewed gin, and samples were then taken of these locally brewed gin they consumed, the patients and survivors were referred to the University College Hospital (UCH).

About five days later, it was clear to us that there was high concentration of methanol in the blood and samples that we took, which confirmed that it was methanol poisoning we were dealing with, and, of course, our strategy changed.

What is the state of the 10 survivors now? Nothing is wrong with their health; they only lost their sight. About six of them were the ones who did not really have sight, as two of them regained their sight at the UCH and another two at the General Hospital, Ode Irele.

It was clear to us how to manage it and we also had to develop the management protocol, because we realised that early diagnosis and prompt treatment actually aids the prognosis, which is the outcome.

The truth is that it was neuronal damage, which even depends on the quantity you consume, that would determine the manifestation. If the quantity is so much, the concentration of methanol becomes more and the damage to optic nerve is more.

As regards their wellbeing, they are absolutely fine. Although some have blurred vision, others have complete blindness.  By the time we were rounding up after 14 days, we realised that we were not having any new case, so we had to call it quit and handed them over to NAFDAC, as well as the DSS for further investigation.

We have been calling meetings to know how far they have gone, because there is need to standard the production of Ogogoro, possibly give them some label, for those who are able to produce and know how to produce, so that they don’t produce the wrong one.

The fight against fake and counterfeit drug is a fight that is essential, so that all our investment in health wouldn’t just go down the drain.

We were able to put in all those gigantic facilities, renovate, upgrade and put in personnel. By the time the patients consume your drugs and find out they are fake, work done will be zero, because it wouldn’t translate into any improvement in their wellbeing.

In order for us to completely be assured of quality health care delivery for our good people, there is need again to pay attention to what they consume, which informed the establishment of the state task force, where we have the state ministry, NAFDAC, police and NDLEA.

After putting all these together, we decided to procure a True-Scan machine to enable us scan these drugs at their outlets. The moment we scan and find out they are fake and counterfeit drugs, such outlets would be shut down.

Also, anyone we scan and we find out to be completely potent and reliable, we would announce to the public that the facility is good and we would put a guarantee-seal on that outlet, so that people would know where to buy their dugs, both public and private facility, including the government-owned facilities.

Tell us about the Mother and Child Hospital? The Mother and Child Hospital is the apex maternal and child health care for the state and is actually poised to offer critical paediatric and obstetric emergencies, because one of the greatest ways to reduce maternal mortality is to attend to the emergencies when there is prompt referral, and that will be saving a whole lot of life.

For us in Ondo, we are actually trying to decongest all our primary health care delivery centres and reducing the complications that will go to the Mother and Child Hospital. As a result, we are going to have one in each senatorial districts of the state.

The facilities are big and good, but what is more about the hospital is the software, which is the service we provide. We are able to organise ourselves to have what is called task shifting, using a clinical guideline and following a protocol management, which is improving greatly the outcome on the output and then impact of the hospital.

We have again been able to ensure, using the packing system, a result-based financing, so that when we dole out money to them, we do so based on performance.

We have been able to give out average cost for delivery of a pregnant woman, which is N5, 000. So, when we release N5 million to them, we expect 1000 babies.

These are the things promoting efficiency, because they too are able to get the pack system, normal delivery pack, caesarean session pack and the blood donation, which ensures that everybody and patients who need blood are able to get it.

These are the things that make the hospital great and very unique. Another thing is that we have good referral linkage, which ensures that from the primary, secondary to tertiary cases.