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Olutoyin Ajala, spearheading the only Geriatrician-led private health care service in Nigeria

Olutoyin Ajala, spearheading the only Geriatrician-led private health care service in Nigeria

Olutoyin Ajala is a Consultant Geriatrician currently working in the UK’s National Health Service and she has been working at the frontline of the COVID-19 response as a frontline senior Physician since March 2020.

She is also CEO of JBS Medicare Services in Nigeria, a specialist elderly medicine, nursing and therapy service. Currently, it is the only Geriatrician-led private healthcare service in Nigeria.

She is the Chairperson/Chief Executive Officer of JBS Elderly Health & Wellbeing Foundation Africa, an organisation that focuses on enhancing the care and quality of life of the underprivileged older persons in Nigeria/Africa.

The foundation has launched its “Adopt A Gran” programme in Lagos State, Nigeria to help the underprivileged elderly.

She graduated from Medical School in Ibadan, Nigeria in 1991 and did her house jobs at the University College Hospital, Ibadan before moving to the UK to complete her specialist training in Geriatric and General Medicine. She has over the past 20 years acquired a vast amount of experience and expertise in the management of all geriatric medicine conditions including managing dementia, Parkinson’s disease, pressure ulcers, stroke, incontinence, mobility issues, heart disease, falls and diabetes.

She is passionate about mentoring younger medical professionals and has participated in several mentoring schemes. She participates in the supervision and training of junior doctors and medical students in her current role. She is passionate about and noted for delivering excellent medical care. She is a notable speaker on dementia prevention and has featured on several radio and international TV programmes.

In 2017, she was appointed as Visiting Consultant Geriatrician at the CTA Geriatric Centre, UCH, Ibadan by the Honourable Minister of Health of Nigeria. She is a lecturer at the Annual Basic Certificate Course in Geriatric Medicine which is held at the University College Hospital in Ibadan and she is the editor of the “Healthier Aging Digest”, a quarterly e-newsletter on Healthy Aging. She is convener of “The Healthier Aging Conference” which had its first event on the 1st October 2019, in Lagos State.

She is an avid traveller and has numerous posts on travel and lifestyle. She has travelled to all the 7 continents including Antarctica and 58 countries in total. She is married to a Consultant Obstetrician/Gynaecologist and she is a mum of 4.

Early years

I grew up in Ibadan; my dad is an emeritus professor of the University. When I was growing up, I don’t remember not being told I was going to be a doctor. I knew from a very young age that I would become a doctor. I’m the only girl, there are four of us and I have three brothers. I was very close to my grandmother, she was my rock. My mum was very strict, so my maternal grandmother was the one I went to for that motherly cuddling. She was very wise and kind. She had two shops and I loved going to her shops, I was always treated extra there.

So, I grew up in a loving home. My dad was my hero. He was a doctor; he told me I was going to be a doctor, so here I am, a doctor. My grandmother was everything.

Read Also: Nigeria Primary health care centres still in rot, 4 years after Buhari pledge to revitalize

Who is a Geriatrician?

A Geriatrician is a doctor that is specially trained as a physician to manage the healthcare challenges of the older age group. A Geriatrician is related to the management of the older age group, everything. We are what we call the true Physicians because we can manage your heart, lungs, diabetes and many more. Apart from that, I can also manage those peculiar things that elderly people have like dementia, Parkinson’s, stroke and all… we’re specially trained in that. As you get older, the body changes and other Physicians don’t know how to manage that, it’s only a Geriatrician that knows how to and can tie everything together.

Why your choice of area of specialty?

When I left Nigeria in 1992, there was no geriatric medicine as a specialty in Nigeria. The first time I came across it was in the UK. So, my first job was actually as a junior doctor in geriatric medicine. I loved it. I was in Wales, had all these elderly ladies, they just loved me and I loved them. This was the first time I was looking after old people. There are many things that happen to old people and we think it’s just because they are old, but there are specific things that happen to them that others can’t identify that a Geriatrician can, and with a simple twist, we can make them better. Dying is a part of life, in many parts of the world, how old people die is not a nice way. You need people there to make sure that your latter years are comfortable.

Also, sometimes, you are influenced by the doctors you work with. My first consultant in the UK was someone I admired. He said to me, you would make a perfect Geriatrician. You’ve got everything it takes; you’re empathic, compassionate and knowledgeable’.

Why did you set up JBS Medicare Services in Nigeria?

I wanted to set up an elderly healthcare service in Nigeria. The reason at that time was because I was getting lots of calls from people with elderly parents who were struggling in many ways, so I saw that was an area that needed attention, I could fill the gap because I was doing my training in geriatric medicine, I was passionate about it and I really wanted to do it. So, I started writing it out, working on it. My children were very young at that time, and I said once I finish my training, I would move back to Nigeria and set up this health service and help the elderly people. I was the only one that could see the value at the time. My family thought nobody would be interested in it.

Over the years, I put it aside because I just couldn’t see it happening because the people I felt needed to support me wouldn’t, and I had my children to take care of. So, I just focused on my NHS work in the UK until a close friend’s mum became ill in 2017. She reached out to me, she was desperate and we were able to help her sort things out. One of my younger ones said, ‘are you going to die without setting up this centre? You’ve been talking about it for years.’ So I said okay, let’s see if it can be done.

I did a lot of reading and asking of questions. In May 2018, I said we were ready; I put it out there on Facebook. I thought I was ready and knew everything I needed to know to put it up. That’s how we started the elderly healthcare service which just took off. I was amazed because I thought I would just sit there and do nothing for six months, but we hit the ground running.

JBS Elderly Health & Wellbeing Foundation Africa

We have not formally launched the foundation, but we’ve started work. The reason we had to do this is that it is a profit-making venture, all my clients can afford the service, but there are people out there who can’t afford the sort of service we provide but need help. I started getting messages from people to help old people wandering in different places.

Somebody sent me a message saying, ‘Is there any way I can care for old people?’ This was because her mum had passed away and she wanted to pour money on old people. We didn’t have that platform. So, that was how this foundation came about, a charitable, not-for-profit arm of the service. We’ve launched this ‘Adopt A Gran’ programme, getting people to sponsor the underprivileged elderly. We have an African-wide vision. We started screening and enrolling, people have started donating money. We’re going to do our first distribution of provisions, medications this week, starting in Lagos.

Response so far

The response is 100 per cent. The response is really encouraging. Fundraising is not easy, you have to be accountable and make sure that everything is recorded. But we are in a position where we can kick-off with what we have.

We had a virtual conference in 2020 and almost 300 people attended from all over the world. Our presenters were brilliant, all the testimonials and everything coming through, people really enjoyed it. We plan to have one this year in October.

Being the only Geriatrician-led private healthcare service in Nigeria

Geriatric medicine is not a specialty yet. It is now becoming one. I think we now have our first indigenous trained geriatrician in 2020. There are only nine of us in Nigeria. I personally know one other consultant Geriatrician in Abuja. We are very scarce in Nigeria. I have set up a healthcare service, not every doctor wants to set something up, and that’s why I’m the only one doing this in my field in Nigeria. There are other Nigerians who are Geriatricians in the UK and I’m trying to encourage many of them to come on board so that we can do more because there is a lot of work to do.

Managing Covid-19 as a Geriatrician

I must be honest, when this first kicked-off in March 2020, I was petrified. I run a Geriatric ward in the UK, I was called to a meeting and told that my ward is about to become a COVID ward on Monday. I wasn’t sure I wanted to go. I was scared. There was no PPE, we didn’t know much about the disease, it was just scary.

I came home and spoke to my husband and children, so we decided we would go and see, and I made sure I was as protected as I could. It was heart-breaking. My patients were dying. I was scared. I prayed hard because I didn’t want to be sick because people were falling sick. 95 per cent of senior doctors were sick.

Now, I’m no longer scared. We have to look after people. In Nigeria, it really affected my service, and I shut down. We had a meeting and sent a mail to all our clients and patients. A lot of our patients in Nigeria got COVID-19. By the time I came out of lockdown six weeks later, practically everybody in Nigeria was sick, lots of patients were sick and I could not travel and had to run things from here. Lots of people recovered, and I think we did well. We lost a few patients but I think we did well.

As a Geriatrician, I think COVID-19 is heart-breaking. It seems like it just came to deal with the elderly population. If you’re 40 and you get it, you will likely survive it, if you are 90 and get it, you will most likely not survive it.

Keeping your mental health especially in the midst of the pandemic

I think the first thing is that you have to shut down some parts. You can’t keep everything going. In March, I called my team and said I needed to keep myself and my family safe, and told them they just have to manage things, and they did. They shielded me from a lot of things at the time. I just had to cut off from a lot of things. It was easy to cut off things because everything was online and there wasn’t much distraction. I do exercise, keep in touch with my loved ones, I shut down on certain times of the day, I pray, I meditate. I can manage my own company. I’m very good at shutting some parts down.

Your view on getting vaccinated

I believe that all the knowledge we have comes from God. Everything that medicine has developed, when you look at it, you will find that things came from nature, from plants. God put all these there for us and gave us the knowledge to be able to use them as medicines. When you look at this vaccine, initially, I was concerned and had many questions because we don’t know too much about it, but looking at the medical side, my daughter is a Scientist, she showed me how the vaccine was developed so quickly. Basically, technology has changed, so the people asking how it was developed so quickly, it is because technology has changed. There were some things that they did 20 years ago that they don’t have to do now.

Look at your phones, it’s the same with science, it keeps evolving. The science that was needed to develop these vaccines has changed. The technology has changed, they were able to identify things so quickly and government poured in billions. So, has the vaccine been developed to kill black people? Let me tell you how I was reassured that it wasn’t. In the UK, the first people to have the vaccines were the most elderly and healthcare workers. In the UK, we don’t have enough nurses and doctors, so it’s very unlikely that they will kill off their health care workers. That reassured me because they needed to protect the people that they needed alive to help save the lives of the citizenry.

The reason I got vaccinated was that a colleague of mine died, there was so much COVID-19 around. When I was tested for anti-bodies, I had anti-bodies and I hadn’t been sick. I truly believe that all medical knowledge comes from God. So, I went to the science and I don’t know any other way.

It’s a public health pandemic like small-pox was and it was a vaccine that solved that problem. I still have questions on the vaccines because we don’t know how long the immunity from the vaccine is going to last, it doesn’t stop you from having it, but it stops you from being sick with it. That was also my first concern.

What happened when you took the vaccine?

Absolutely nothing. I was well. I’m one of those people who are generally well. So, I’ve not had the second dose yet because they delayed in it the UK. I suspect I will be fine even after the second dose. I was fine, just a bit sore on the arm where the shot was given. My husband was lethargic for a few days after the shot, and then he was ill for a few days after the second dose. The truth is, it varies in different individuals but as for me, I was fine after taking it.

Should everyone go out and take the vaccine once made available?

I’ll tell him or her 100 per cent “Yes”. Not because I know everything about the vaccine but because I honestly believe it can be detrimental if you don’t take it. But if you ask me if it is 100 per cent effective, I don’t know. There’s just nothing else out there. But do I think it would kill you, drive you crazy, or does it have a microchip? My answer to that is “None of that is true”. My main concern initially was how effective it is.

Are medical professionals adequately valued in Nigeria by the government?

As Nigerians, our value system is not as it should be and that is unfortunate. When you are in a system and you have two people who are medical doctors, who have a family and with their salary can’t afford to pay their children’s school fees, they don’t get paid sometimes for months, there is no way they will see an opportunity somewhere else and they won’t embrace it. Other people out there know that Nigerian doctors are brilliant. It’s not easy working here (UK) as a doctor with four children when I could be at home with a better support system. But when you look at the reality of how you’re going to raise those children, not many people can afford it. I know people who left the country because they could not afford to pay their children’s school fees.

So, unless the government sees the value in medical practitioners, they may continue to leave for greener pastures. Maybe because if you have money and connections, you can leave the country for medical treatment elsewhere, perhaps that is why it appears like they are not showing concern enough.

What I would say is that, Nigeria is such a great nation and it’s filled with so many brilliant people and the population deserves the best. The doctors are not being recognised and remunerated for the amount of work they do and the sacrifice for the nation. We appreciate that you’ve trained us, but we need the government to recognise the value of what we do and remunerate us accordingly so that we can afford to live in Nigeria comfortably as medical practitioners, delivering the best care to our patients and bringing the healthcare service in Nigeria to par with the rest of the world.

Being in the UK, regarding the pandemic, what comes to your mind when you look at Nigeria?

At the beginning of the pandemic, for some reason, I believed Nigeria would be okay. I had this intrinsic belief that Nigeria would be fine. Unfortunately, over the November/December period, I saw the number of parties and I was very worried.

Unfortunately, it has become real. I’m worried because I think people still don’t get it. I have nurses who are still going to church regularly, but I still believe that Nigeria wouldn’t be overwhelmed and I see that people are taking it more seriously, and I hope that that would help. Nevertheless, I believe we’ll be okay.