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‘How insecurity, economic realities trigger mental disorders’

By Michael Egbejule, Benin City
15 May 2021   |   4:02 am
Most times, we forget people with mental illnesses, even though studies have shown consistently that we have mental symptoms in society. We’ve been facing economic hardship even before the pandemic...

Dr. Imafidon Agbonile is the Medical Director, Federal Neuro-Psychiatric Hospital, Uselu, Benin City. In this interview with MICHAEL EGBEJULE, he spoke on the challenges of the COVID-19 pandemic, as well as issues bothering on mental health in Nigeria among other sundry issues.

Having peculiar patients, how did you cope in that one-year of COVID-19 lockdown occasioned by low funding, because these patients need adequate medical attention?
Most times, we forget people with mental illnesses, even though studies have shown consistently that we have mental symptoms in society. We’ve been facing economic hardship even before the pandemic; the pandemic worsened the situation. The general insecurity in
the country has escalated the mental disorders in society. As I speak, we have purchased new beds to increase the bed spaces for patients due to increase in mental illness. We coped because we have to cope. This is a country where we have been trying to adjust to things for a long time.

The resilience of my staffs, the professional staffs; the doctors, the nurses and other health workers and the support of accounts and administrative staff has helped a lot.

During the COVID-19 lockdown, the internal revenue also went far below expectations, but patients were being brought in and some of them
didn’t have money. We have cases of people we saw by our hospital gate with both surgical and mental illness. We brought them in, cleaned them up. We sent some to UBTH, which we are even paying for. Today, they are stable; we have pictures to back up our claims.

Also, every month, we deduct an amount from the salary of member-staff; we call it ‘Friends of Uselu Clinic Society.’ With that money, we help indigent patients, because government alone cannot handle everything.

You run Psychiatric Nursing programmme in the hospital. What is the level of enrolment considering the perception about the study of mental health disciplines?
On the contrary, nursing generally is a hot cake. As I speak, I have three requests of nurses who want to resign and go to the UK and other countries to further continue their profession. The competition for psychiatric nursing is increasing. Looking at JAMB presently, nursing score is beginning to chase medicine. You know nursing is a specialised area; we just increased our capacity.

Before coming here to study, you must possess a general nursing certificate or a Bachelor of Science Degree in Nursing. Our advert for new intake just expired, in two weeks time, we will have an interview for students’ screening. For the last few years, we have had enough capacity. The reason for the screening is because we have lot of people coming to enroll; that’s why we conduct screening exercise. We have more than expected applicants; that is why we conduct screening exercise. Nurses get job easily both locally and internationally.

With the number of persons enrolling in psychiatric nursing, do you have the capacity and facilities to take all of them?
With accreditation, we are given a particular number of students to be admitted; we have to stick with that number. Presently, we are given 50 students. But after building other facilities, in the next few years, I believe it will be increased to 200-300 students.

When coming for this job, you go through very rigorous interview, and one of the things you have to do is to present a strategic plan for four year; that’s exactly what I did, I wanted to expand our carrying capacity. It was 30, but within my 100 days in office, it has increased to 50; have set a goal of two years. My second goal is to increase the carrying capacity to 100 before my tenure of 4 years ends. With the way we are going now, I’m quite optimistic that before my first tenure ends, we will be able to achieve that.

There’s a building that was abandoned by the former administration. When I assumed office, I called the contractors and we renegotiated on payment by installment so that they can keep working. Once we complete that facility, which is suppose to have lecture halls and
offices for the lecturers, then we can call for reaccreditation for a bigger number. For now, we stick with the number we are given by the nursing council.

Talking about staff welfare, how do you manage to boost staff morale?
As part of my agenda, welfare was a major issue in my plan. In my presentation, I said any
organisation is defined by its quality of staff. The quality of staff, their productivity will define the service rendered. When staff welfare is well attended to, it will boost their morale and they will be more productive. When I came onboard, we were owing staff three years arrears; 2017, 2018, and 2019. I became substantive Managing Director in October 2020. By November, I went to Abuja and we were able to pay two years arrears; 2017 and 2018. Then by December, I was able to pay the one of 2019, alongside the promotion we did.

So, within my few months as a Director, I have been able to clear three years arrears, remaining 2020. In the school, there was a particular payment they were requesting for; I effected the payment and that has boosted their morale. Also, we paid uniform allowance for the nurses that have been pending. We attended to staff who have been stagnated; we upgraded those that has gone to school to upgrade their career. When they bring their certificate, we effect their upgrade. We have also converted quite a number of staff. Some on the lower rank that has requested to go for further studies; I have approved their request. So, these things have really boosted staff morale.

We have done a couple of training. What we are planning to do now is high-level training for high-level staff. The hospital had issues in the past, but since I came onboard, we have tried to resolve if not all, most of the key issues.

It seems your our 100 days in office has recorded some level of development?
When there’s a will, there’s a way. With that short period of time, we’ve been able to do quite some things; we’ve painted some buildings that have not been painted for the past 7 years. We’ve changed our radio-diagnostics equipment from the analog to digital; the secret is prudence and priority. We prioritise whatever we do and also, we try to be prudent in our usage of funds.

We increase revenue by giving better services. We make sure we don’t run out-of-stock both in the pharmacy and other departments. With the things we have put in place, we are sure it will give us more revenue. For example, with the digital x-ray, we can do more x-rays and generate lots of money.

With the effects of the COVID-19 pandemic, how have you been able to manage patients and students, in terms of facilities?
It’s been a lot of challenge. We develop the COVID-19 protocol; we have the NCDC guidelines, which is domesticated. The challenge is, we have peculiar patients who might not be cooperative; that way, we have to do extra. We have a very robust infection control committee headed by a consultant with able and hardworking nurses and doctors. We procure large quantities of protective equipment, for the first time, the government gave us funds and specifically code-named it ‘for protective equipment;’ this we utilised fully. We bought these equipment in large quantities and disbursed them evenly.

Before then, we had lots of cases of the infection coming up, even among our staffs, and some uncooperative patients who obviously, because of their mental state, would not follow the COVID-19 protocols in the community. By God’s grace, for the last few weeks or a month now, we’ve not had a fresh infection; whereas, last year was a worrisome situation. We thank the State Government, under the leadership of Godwin Obaseki, who was very proactive to the setting up of the statewide committee, which he personally chairs. He also gave us support by setting up a testing centre here in the hospital.

Also, though we are a federal hospital, the federal government provided funds for us to begin the building of isolation centres and intensive care unit.