The leading ladies of Paelon Memorial Hospital
Ngozi Onyia
Ngozi Onyia is the Founding Partner and Managing Director of Paelon Memorial Hospital. A graduate of Medicine and a Fellow of the West African College of Physicians in Paediatrics. She possesses an MBA from the prestigious Lagos Business School and a Certificate of Travel Health from the International Society of Travel Health. She is a Trustee of both Pharmaccess Nigeria and the Society for Quality Health in Nigeria of which she also serves as the Chair of the Program’s committee. She is a past principal officer, (College Treasurer) of the West African College of Physicians. She worked in the public and private sectors culminating in a 10 years stint as the Company Medical Adviser of Nigerian Breweries (CMANB) from 2000-2010 , a senior management position, being the first woman to attain senior management in the then 63 years history of the company. Onyia is a member of the Paediatric Association of Nigeria, International Paediatric Association, International Society of Travel medicine and an associate member of the Society of Occupational Health Physicians of Nigeria. She is married with two grown children and recently became a grandmother.
Paelon
I established Paelon Memorial Clinic in March 2010 shortly after my exit from Nigerian Breweries Plc where I had served as the Medical Adviser from 2000 to 2010. My Dad who was my role model was a doctor who established the first private hospital in Asaba, I wanted to be like him. The experience of mothering my 3rd and last child, Patricia Elozie Onyia in whose memory the hospital is named was another reason, finally, Victor Famuyibo who was my immediate boss as Human Resource Director of NBPlc as he handed me my cheque suggested that if my plan to go to Liberia did not work out, I should use my severance pay to set up a small clinic in VI or Ikoyi. I guess the answer therefore is destiny.
Solution to challenges in healthcare delivery in Nigeria
A. Strengthen our healthcare system to create an enabling environment
B. Healthcare financing including insurance.
C. Adequate reward for healthcare practitioners to stem the renewed tide of brain drain.
It still boils down to the Nigerian problem- infrastructure, rule of law, enabling environment.
Your contribution to the solution
Someone in response to my post on FaceBook said each of us should fix Nigeria’s broken wings one feather at a time in our own spheres. That is exactly what I set out to do in the healthcare industry and with God helping me, I am achieving that.
Partnerships
I believe firmly in the synergy that comes from partnerships. Each partner ought to bring something to the table. A big mistake is to underestimate the contribution of others and conversely over estimate one’s contribution. Not all partnerships will work the prime example being marriage but that does not stop remarriages. From the second year of Paelon, I took on partners. Some have left but most have stayed. Roles have evolved but most have stayed on.
Nnenna Mbonu
Nnenna Mbonu is a Partner and the Quality Assurance Director at Paelon Memorial Hospital. She qualified as a doctor in from the University of Manchester, UK and went on to specialize in Anaesthesia acquiring a Diploma in Anaesthesia from London in 1980. She joined Paelon Memorial Hospital in August 2010 as a general practitioner. She was a Consultant Anaesthetist at Eko Hospital, Ikeja from 1995 to 2005 and then spent 5 years as a Part Time Consultant Anaesthetist at Choithram Hospital, Freetown, Sierra Leone. In 2010, she stopped practicing Anaesthesia and subsequently took up mainly administrative roles in Paelon, finding her niche in January 2015 in Quality Assurance and with guidance from SafeCare helped improve the hospital’s quality of service from Level 2 to an unprecedented Level 5, the highest level achievable on SafeCare’s Quality Assurance accreditation scheme. Mbonu is married with four children and one grandchild. She is an avid sportswoman and ex Nigerian Olympian.
Healthcare delivery in Nigeria
Healthcare delivery in Nigeria is woefully deficient in so many ways. Deficient in manpower, funding, infrastructure and planning. Our universities and nursing schools are producing poor calibre doctors and nurses and the federal and state governments are not placing any priority on the health of the populace. There needs to be a huge injection of funding into the system to address the proper training of all healthcare professionals and the building of tens of thousands of extra clinics and hospitals.
Partnership
Partnerships work if the partners share the same vision and passion. There is the saying ‘two heads are better than one’, which to me sums up the benefit of partnerships. Each partner brings something a little different to the table and the overall effect is an improved product. This is exactly what happened at Paelon Memorial Hospital.
Importance of adequate healthcare
As our clientele, the patients continue to get increasingly well informed about what they should expect from their leaders, doctors and healthcare personnel so the Nigerian environment will continue to improve. The Society for Quality Healthcare in Nigeria is a beacon of hope and is trying to make an impact in the training of personnel, but many more similar organisations are needed for an impact to be felt. I left my speciality of Anaesthesia after 28 years of arduous, often nerve racking practice to focus on Quality Improvement and have not regretted that decision made in 2009.
Life’s lessons
I have learnt over the years to try and maintain a healthy balance between my work and my life. Sometimes though, even if you would like to do this, it may not always be possible due to one’s particular circumstances.
The Paelon effect
In 2010, on my return to Nigeria from Sierra Leone, I decided to join Dr Onyia, who had opened Paelon Memorial Clinic just six months earlier. She was someone I knew quite well when she was the Medical Director of Nigerian Breweries PLC and she was also someone with a drive and passion I admired and envied. It was an easy decision and one I have not regretted.
Nkeiruka Asumah
Nkeiruka Asumah is the Consultant Paediatrician and Partner in charge of the hospital’s medical support services. She graduated from the University of Nigeria Enugu campus. She is a Fellow of the Nigerian Medical College of Paediatrics. She also possesses a Master’s in Public Health from the University of Lagos. She completed her masters in Healthcare Administration from Walden University, Baltimore, USA in November 2016. She was the head of department of Paediatrics at the Federal Medical Centre (FMC), Lagos where she was responsible for teaching paediatric interns and medical officer. During her tenure at the FMC, a fully functional paediatric unit was established including the paediatric intensive care unit. She is a member of the Paediatric Association of Nigeria and also a member of the Nigerian Society of Neonatal Medicine. She joined Paelon Memorial Hospital in August. She has three adult children.
Healthcare delivery in Nigeria
It should be better than it is now as the majority of citizens have poor access to healthcare. Although the Nigerian healthcare system is a three-tiered structure, one finds that delivery at primary care level is so poor that most people access at the secondary and tertiary levels which become overwhelmed. The rich can however access healthcare at the best hospitals available. The parlour structure of the economy is partly responsible for the massive exodus in healthcare personnel to countries with better healthcare infrastructure. The nation is training new doctors who then migrate to other countries offering better facilities and welfare. Thus, newly qualified doctors are like rough diamonds that are acquired by foreign employers and polished in a system with proper healthcare infrastructure. Nigerian doctors face incredible odds and difficult conditions in their practice and as such, have become masters of improvisation.
THE WAY OUT
This requires political will. Nigeria has a central budget for healthcare, so more emphasis should be placed on reaching many poor citizens who dwell in the rural areas. Most people require mainly primary healthcare. Nigerians need to believe in the country, think long term, and be willing to make certain sacrifices. I know this is a difficult thing to achieve, but it must be done. At Paelon we practice safe ethical healthcare. We are continuously striving to provide healthcare that is comparable with the best in the world, despite the obvious constraint in the Nigerian environment. I am proud to admit that Paelon is at the forefront of changing healthcare delivery in Nigeria. I am a paediatrician who has an interest in neonatology. Neonatology is extremely tasking because it capital/technology intensive and requires dedicated health personnel. However, many Nigerians have no choice but to use Nigerian hospitals for the care of their premature infants. Someone has to cater for those needs. The mortality rate for premature infants is high but can be reduced, and one cannot give up. Fortunately, healthcare has become more affordable with the advent of health insurance. Many patients no longer must pay out-of-pocket for healthcare.
The importance of partnership
For any business to remain sustainable, I believe partnership is the way to go. A good business should exist after the life time of the founder(s). However, partners should be chosen based on the value they will bring to the business and on shared visions. The partners in Paelon each bring a unique value to the business. We are all in tune with the long-term vision to change healthcare delivery in Nigeria for the better.
Unoma Grant
Unoma Grant is the Partner in charge of non-medical services and the Chief Operating Officer at Paelon Memoria Hospital, She graduated from the University of Cape Town in South Africa in 2009 with a Bachelor’s of Science in Mechanical Engineering. She attended the Senior Management Program at the Lagos Business School in Nigeria in 2016 and the Health Management Program at the Pan African University’s Enterprise Development Centre. In 2010 she began working with Dr. Onyia to start Paelon and in 2011 left Nextzon and Joined Paelon full time as the Assistant to the Administrative Partner. Since then she has gradually risen to the position of Chief Operating Officer, overseeing all the non-medical operations & staff of the hospital, the hospital’s brand. She is married with one child.
What change will you like to see in the healthcare space?
Despite graduating as a mechanical engineer, I have spent most of my career working in the healthcare space in Nigeria. In this time, I have come to understand the industry’s strengths and see where the gaps are; and right now, the most glaring gap is the lack of healthcare workers in Nigeria. As the nation’s population continues to grow, and our people live longer, the demand for and on health care workers continues to grow. This high demand for healthcare professionals has driven up the cost of providing good quality healthcare, which leaves the poorest amongst us without access to care.
According to a 2015 WHO report, there are 4 doctors to 10,000 patients in Nigeria. As most of these doctors are in Lagos and Abuja, over 70% of our population do not have access to quality healthcare either due to financial limitations or a lack of qualified healthcare professionals I their area. This is made worse by the massive brain drain with over 50% of healthcare professionals trained in the Nigeria working in other countries that are willing and able to pay them more. This has led to our wealthy 1% seeking healthcare in the developed world and spending money that can be used to develop local talent and infrastructure, outside Nigeria. Healthcare is an issue that affects all of us and as a nation, we need to begin to take steps to increase the number of healthcare professionals and administrators produced by our universities and when they graduate we need to be willing to train them and pay them a liveable wage so they don’t feel the need to leave Nigeria for Europe and America and finally we need to invest more in the healthcare space as a whole to ensure that we do not find ourselves in a crisis.
Sylvia Cole
Sylvia Cole is a Consultant Physician Anaesthetist and the Partner in charge of Anaesthesia department and the High Dependency Unit. She qualified as doctor from the College of Medicine, University of Lagos. During her undergraduate years, she pursued electives and observer roles at the National University of Singapore where she focused on tropical medicine. She holds a Diploma in Anaesthesia and trained as a resident in Lagos University Teaching Hospital, then moved to the United Kingdom where she continued training under the Stoke on Trent School of Anaesthesia, covering district and general hospitals in Staffordshire and the West Midlands culminating in the award of the Fellowship of the Royal College of Anaesthetists, in 2009. She is certified in obstetric life support (MOET), trauma life support (ATLS), advanced paediatric life support (APLS), an instructor in Advanced Life Support and attended the Owner Management Program at Lagos Business School. She is married with three children.
Healthcare delivery in Nigeria
The one word I can use to describe Healthcare in Nigeria is ‘FRAGMENTED’. As a doctor who was trained in arguably one of Nigeria’s best Teaching Hospitals situated in what has for a long time been the economic capital of Nigeria, Lagos, then went abroad for further training before coming back to work in the private space, I can only comment on some areas of this very fragmented space. Nigeria doesn’t have a lack of ‘training grounds’ for doctors, real or imagined. There are the government hospitals at Federal (e.g The Teaching Hospitals) and State (e.g The General Hospitals) levels, Private Hospitals and hospitals of major corporations (e.g Mint, Shell, NNPC, Military Hospitals). This is where a lot of the expertise resides. However, many doctors trained in these large institutions end up lost to the diaspora. There are Religious Institutions who have clinics that deliver free healthcare, though I might add that no care is really FREE as someone is paying for it (e.g Government, taxes, HMO’s, NGO’s, private individuals, volunteer doctors, Gift Aid, Aid from other countries and so on). However, some of the clinics only run during large religious programs like conventions or festivals. Then there are the Traditional/Natural healers but for those who end up there, the outcome of their healing all depends on how skilled the person they end up with is. The fragmentation comes from the fact that even though there are seemingly sufficient ‘training’ and ‘operational’ outlets for the provision of health care, there is very little collaboration or linkages between hospitals. It is also a postcode lottery depending on which city one is in. Big cities have a lot of hospitals: government, state and private. While villages are left with small poorly funded and equipped clinics (usually manned by NYSC doctors). You also have poor enlightenment and accountability whereby some people go to Religious Institutions for ‘faith’ healing, totally avoiding the healthcare system in place, however fragmented it is and when they do not receive the healing they sought, come back to the hospitals for treatment by which time it may be too late to save them.
WAY FORWARD:
There should be better locationing, role mapping and integration between Tertiary, Secondary and Primary Healthcare providers nationwide. There should also be a central place for people to go where they can be triaged and transferred to Emergent care, Urgent care and Routine care. This can be a virtual space (e.g call centres) from where they can then be diverted to treatment centres based on need and location.
Observations from you area of specialty
Simply put, it is DIFFICULT. Anaesthesia is my area of specialty. My work over the years has seen me progress into the realm of Intensive Care, which I would describe as a super specialty but where Nigeria still lags behind greatly in terms of fully equipped Intensive Care Units (ICU) and trained personnel to run them. ICU aside, we do not even have enough Specialist Anaesthetists to cover all the various anaesthetic needs of the nation. These needs are at various categories and require Anaesthetists of various specialties, all of which are in short supply.
Partnership
Partnership is like a marriage; you have to take the lovely with the not so lovely. It is critical that you must make up your mind early in the journey that failure (divorce) is not an option and attaining the vision and upholding the ethos of the business is paramount. At Paelon, we all recognize and respect each other’s strengths and leverage on it.
Kemi Ajumobi