“Professor Alonge is one of the best orthopedic surgeons in the world. He is often called up for complicated orthopedic cases outside Nigeria, God has really helped him”, was the statement a close associate of the outgoing Chief Medical Director (CMD) of the University Teaching Hospital (UCH), Ibadan, Professor Temitayo Alonge, used to describe him, while this writer was researching on the professor of medicine. Professor Alonge, whose tenure started March 1, 2011 and would come to an end on February 28, 2019.
With half of a section of his office decorated with awards of medical feats and various certificates of membership of top Medical Universities across the world, Alonge, is indeed, a force to reckon with in the medical field both inside and outside of the country.
When asked how he felt stepping down from his position as the CMD of UCH, after eight years of meritorious service, Prof. Alonge, calmly seated in his office, decked in a navy blue blazer, a sky blue shirt, gray pant with a flower patterned blue tie to match, described the journey as more of a mixed blessing, as, according to him, many challenges had been thrown up. He explained that his mindset, prior to his assuming office, has been well articulated but pointed out that “there were few things that I would have loved to put in place but couldn’t, but all in all, I think I feel fulfilled.”
When asked about how much he was able to accomplish in that regard, he said he had seen the good, the bad and the ugly sides of the University College Hospital.
How has been your journey so far?
I began my medical career as a student of the University of Ibadan, during the 77/78 session, and moved to the University College Hospital in 1980. Those periods, for me, were the days of excellence in practice, excellence in attitude, and medicine was exciting as a profession. These were the good, while during medical school, I found out that there was a huge defect, things were not how it used to be and when I came back from England, where I went to train as an orthopedic surgeon in 1995, I saw the ugly. My understanding of the founding principles of the University College Hospital was still registered in my mind from my initial technical days in 1980. So, my mindset, when I became the CMD was to bring about changes that would reposition the University College Hospital as a centre of excellence in clinical service delivery, and also as the reference point in healthcare in Nigeria. I adopted a theme called ‘the rebirth of excellence’. The University College Hospital was established on a tripod; training, research and service delivery. On assumption of office on 1st of March, 2011, the deficiencies that I saw in the system, prior to my assumption of office were quite frightening. My mindset was to try and readdress those defects. I set about wanting to know what was wrong, specifically with the training programme. Upon my findings, it was apparent to me that most of the healthcare professionals hardly go for professional course for up to five, ten years. The aftermath of that is that new technologies, new methods of treating patients, new investigations and all of those things were deficient. They were living on past glory. I wanted to build the people up, I got every professional groups in the hospital to be up in their games by engaging them in training of all sorts. I also discovered that majority of the professionals in UCH are top heavy in their calling; be it anesthesia or neurosurgery and they comprised of leaders of various medical associations and unions in the country. I reasoned that if we had a training centre that would allow professional courses be run in the hospital, it would bring the courses home. They would technically be forced to go for the training rather than travel outside of their comfort zone. The first training centre is called ‘The Professor Olowoladebo Continuing Development Centre.’ We established a training centre for every cadre; we have a dry lab, wet lab, lecture theatre, toilet facilities, cooling units and electricity generators so that they can enjoy a conducive atmosphere during lectures. Till date, that training centre has been the bedrock of training centers in the hospital. We reinstituted the cardio-pulmonary course; a mandatory course in any institution outside of the country. So, we taught them the basics and we also began to run the Basic Trauma Course, which is for every newly employed medical doctor; whether as a house officer or as a resident doctor because outside of medical emergencies, the second common emergency in the emergency department is actually trauma related. So, they must know how to handle such cases. The course has become mandatory and is being run every week by various professionals. That was my own way of instituting training and the concepts of training on every mind of every professional. After training, the second step was to invite them to a department that is called ‘Total Quality Management’, which was established primarily as a ‘policeman’ to me and the management. They were to look at issues affecting the hospital, for which there were complaints. They were to address them, offer challenges and solutions for managers to solve. The total quality management, which was the first of its kind in Nigeria, has actually instituted 105 processes. One of which is patient compliance with medications, attendance in clinics, water in clinics, water supply to the clinic, the kind of food patients eats, its quality and taste and so on. All these checklists were meant to ensure that we do the needful and the right things. Today, the total quality management has become the envy of the entire nation. These days, you can’t have to come to UCH at 6 am for an appointment of 2pm. Those days have been phased off and are one of the systems of the total quality management. We have collation of statistics; we have maternity statistics— every death in UCH goes to the mortuary, so that we know the causes of death and we also instituted what we call interventions. In 2012, the commonest cause of death was hypertension related diseases like stroke and other cardio vascular diseases. We created various awareness campaigns about cardio vascular diseases and offered free treatments to diabetes too. As at 2015, the commonest cause of death in UCH was cancer. Interventions may not show up immediately but over a long period of time—although we didn’t treat all of them, we created awareness about it in eleven local government areas of the Ibadan and four in Oyo state. In 2016, the commonest cause of death was infection related, many of which were HIV\AIDS. I must also add that when I resumed as the CMD, there were forests at both sides of the entrance. I witnessed a man parked his car outside, walked inside UCH and into the forest and was defecating there. And when the rain came, heavy trees planted there began to fall. My first point of action in infrastructures was to cut all the trees and plant what we call ‘friendly habitable’ trees. The moment you ask a person to come to UCH, what that readily comes to their mind is that their condition might be bad. My tenure gave UCH a facelift and I thank God for the Ministry Of Works and Housing, who augmented our effort by helping us with the road network, resurfacing some areas and tarring some roads and providing drainages.
How have you been able to surmount the challenge of poor funding in realizing the UCH of your dreams?
When I came on board, I asked for the account of the hospital. There were 123 contractors that were owed money, the total debt that I inherited was 1.4billion naira but of course, you don’t cry wolf when you take up a position, you will have both liabilities and assets. The question then was to address these liabilities and find a way round and making sure that it does not have any negative effect on the running of the hospital. I can say categorically that from 2011 till today, we have not had shortage of water. Prior to this, there were three months in a year when we had constant lack of water that patients had to buy bags of sachet water for bathing, washing and drinking. That was prior to my administration. It was just a simple procedure; distil, have a bigger volume of lake, more water being pumped and therefore, more water to the hospital. I also approached the Ogun-Osun river basin authority, who, after the initial manual distilling, came up with their machines and helped the hospital distill, which have lasted for more than five years. In terms of overcoming poor funding, the issue of capital, personnel and overheard has been in short supply. Prior to my assumption of duty, the overhead of the hospital was about N26 million. As at that time, electricity bill was about N4million. However, these debts didn’t deter me from not executing the big projects that I had set out for the hospital. In terms of personnel, we had some shortfalls but that has been addressed on a yearly basis between the hospital and the ministry of finance. All the short falls have been paid off up till 2016; we still have some residual outstanding like promotion arrears.
Looking back, what would you describe as your most anxious moment as CMD?
It is usually when we have industrial actions and many patients in the ward and at the emergency department would be requiring care. My mindset and one of the guiding principles that made me to apply for this job was to reduce the incidence of preventable deaths. I get very anxious when there is a strike, what that means is that patients would not be looked after and the chances that some of them would die prematurely from issues that are preventable would be high. Those are the only times that I get a little agitated but otherwise, I take this job as personal as I can, anxious moments? Not a lot.
How did your immediate family members receive the news of the end of your tenure as the CMD of UCH?
My wife is ecstatic, she is happy that she is going to have more time with me. I love farming; I usually go to the farm every Saturday, except during Saturdays that I may have an important wedding to attend. I am not a very sociable person; I am family oriented, so, I like to spend time with my nuclear family. My family is happy that the burden of being in the hospital all day and night would end. I only see my wife on Sundays, except when we go to farm together, she also like farming. We usually spend about four hours on Sundays together just talking to each other and playing golf.
You have been with UCH for decades and have reached the pinnacle of your career both in practice and in administration. Are you going back to the classroom or are you stepping out of the hospital system or even, nursing a political ambition?
Laughs… well, politics is not in the making at the moment but the truth of the matter is that I still love research, I will be 60 years of age this year and my retirement as a professor in the university is pegged at 70. So, I still have ten active academic years to run. I have been embarking on a research activity for over twenty years; I have been working on bone infections, which was the topic of my inaugural lecture. I may do more of research on Anti-biotic Career System, not just to treat bone alone but also chronic bone cavities and infected wounds. I hope to be working with my son, who is currently doing his masters in biotechnology and he has produced a particular material that I might work on. He said if I need to be taught, I should come to his lab, so I am looking forward to that. However, if an offer for a job that I believe would impact lives comes up, yes, I will take it but for now, I am more than happy to go back to what makes me tick, which is to teach and to operate on patients. I once had a patient who accosted my secretary and said to her that he had never seen me that happy, that I was smiling and laughing in my scrub because I had just operated on a patient. My secretary told him that the happiest day of Professor Alonge in the week is when he goes to the operating room and comes back. I always focus all my attention into getting somebody better, while aligning the bone and treating the infection. That is what makes me happy. I would resume back at the University of Ibadan on the first of March because I was loaned by the university to the hospital, I took a leave of absence of eight years. I appreciate the Vice-Chancellor for allowing me to serve as the chief executive of UCH and I will be more than happy to teach my students. I have mentee medical students that are attached to me and I still teach the resident doctors too.