Why air ambulance is essential in Nigeria
Olamide Orekunrin, a British-Nigerian medical doctor and the managing director of Flying Doctors, Nigeria talks to Ifeoma Okeke in this interview on how paucity of funds, scarcity of doctors and inadequate amount of hospitals have made it very important for air ambulance to be given the needed attention. Excerpts.
Why did you choose to go into air ambulance operations in Nigeria?
My story is a text book story. I started my business about seven years ago. I was born in England, I grew up there as well and my younger sister who was 12years old came back to Nigeria for holidays. At some point, she got very sick and we were trying to fly her to a better hospital because she was too sick to be moved by road. We were looking for an air ambulance and because it is such a common thing in England, we just assumed that it will be available in Nigeria. So, in the process, we found out that the closest air ambulance service was in South Africa. My parents were trying to engage the service when she died. So, that really stuck in my memory even though I haven’t been to Nigeria in my adult life, it was something that I wanted to do, knowing that this happened to my sister because the service wasn’t available. For the young people I speak to, most of them have dreams of going to England and London but growing up, my dream was to come to Nigeria. As soon as I graduated from medical school, I moved here because I was so eager to see what it will be like to live in this kind of society, which was very different from where I grew up.
What are the prospects and challenges of air ambulance operations in Nigeria?
Air ambulance is an essential tool for medical professionals. It is about getting patients to the right medical facility within the right time frame. This morning for instance, there was a patient that we had that we move to Lagos from Benin. A building fell on her and her hip was so shattered that it could only be done at Igbobi in Lagos and to move her by road because of the state of the road; it would have been very difficult as the hip has to stay completely stable. We were able to move her successfully from Benin to Lagos and she will have her operation tomorrow. This service is just about moving people to the place where they can receive treatment in the shortest amount of time. One of our common trips is Maiduguri to Lagos and before trying to move complex orthopaedic cases from Maiduguri to Lagos by road, the journey can even take several days. With our service, it can be done in just one hour. There are other problems of moving patients via road such as the state of the roads and the condition of the patient. If the patient is on oxygen for instance, then imagine from Maiduguri to Lagos, how many cylinders of oxygen you need to pack inside that ambulance to get the patient to the final destination since one cylinder lasts for just one hour. You will need two ambulances; one for the cylinders and another for the patient. If the car breaks down in an area where there is no hospital, then there will be a problem. So, the air ambulance provides a way that in just an hour and half, a patient can move from remote areas where there might not be all the medical facilities you will find in a large city to that large city for treatment. Occasionally, people need to fly out of the country for treatment and we do that as well. Sometimes a lot of people abroad need to fly back into the country for treatment. A lot of people may have been diagnosed with a terminal cancer and they want to come back to Nigeria. Even for people in the West Africa sub-continent, from Chad, Mali amongst others, a lot of them come to seek treatment in Nigeria and we also fly them into Nigeria.
What is the level of acceptability your services has gained in the Nigerian market and how affordable are they?
Flying Doctors is the first indigenous air ambulance in Nigeria and West Africa, which has been in operation for almost ten years. Where I was coming from in the United Kingdom I was looking around and everybody was using private jets and helicopter to transfer patients and I thought that this will be the best thing to bring to Nigeria. But after few years I realised that in this market, expecting a patient to pay up to $10,000 or more for a transfer between cities was not feasible so what we did was try to investigate and bring down the price. So, we looked into partnering with a number of commercial airlines which we are able to do. We now have a way of placing all the life support equipment inside a commercial aircraft, thereby reducing the price from $20,000 to as low as N200,000 for air ambulance transfer. It is just a small closed up cabin, the curtain will be around the patient, so nobody knows the patient’s identity and the rest of the passengers will sit on their seats. We are the only air ambulance service that specialise in doing this and I realised that in Nigeria and most of West Africa, the affordability is quite low for the private jet model. So, that is how we design this to fit into any commercial airline. Maiduguri to Lagos, Benin to Lagos, Kaduna to Abuja are journeys that patient need to make every day for treatment. It has really changed the lives of a lot of people that would have not been able to seek the best care for them without the use of our service.
Why did you decide to bring such a sophisticated service to Nigeria, knowing the challenges we face as a nation?
It is more essential in Nigeria than it is anywhere across the world. In the United Kingdom, the country is so small that it can probably fit into two Nigerian states. You can drive across to UK in four to six hours. It is a really small country. They have more budget in terms of health than in Nigeria. The budget in England per person for health is almost $3,000 but the budget in Nigeria is about six dollars per person. So because of that, the number of very large sophisticated hospitals that we can afford to have here is small compared to what England can afford. In addition to that, their roads are good and they have more doctors. In terms of accessing specialist doctors in Nigeria, we have about four doctors for every 10,000 people. In England, there are 32 doctors for every 10,000 people. So the number of doctors, number of specialist hospitals, the budget available and the conditions of the road make air ambulance for Nigeria and West Africa more essential than other countries.
What challenges did you have in mind to address through your operations?
We really wanted to increase affordability in accessing health care services both in Nigeria and those travelling outside the country. We also want to help members of other West African countries that need to move either between other West African countries and coming to Nigeria.
How many foreign and domestic airlines have you been able to partner with?
We work with most foreign and domestic airlines operating in Nigeria but a lot of our traffic actually comes from domestic airlines.
Have you been able to partner with hospitals across Nigeria?
We are partnering with a lot of hospitals. Usually the patients have destination hospitals in mind.
What is the nature of the staff you employ?
We have critical care doctors, nurses, parametric doctors amongst others. Some patients that we transfer are unable to breathe on their own so they need to breath with a ventilation machine and the role of this machine is like taking the place of the lungs, which is like a life support machine. So, because of that complexity in controlling the machine, how they are breathing, the pressure to which they are breathing, we need critical care specialist. For the regular cases, we use nurses or parametric.