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Open Heart Surgeries successfully being performed by a private Nigerian hospital – Tola Adenle

November 5, 2014

Health, Nigeria

The Biket Medical Center – Biket – at Osogbo in Southwestern Nigeria is a modern 40-bed hospital that would be termed a “general” hospital in Nigeria: it is for a large population and attends to patients with all sorts of ailments. Although the city has a Teaching Hospital, a government-owned General Hospital and many private hospitals among which [the Catholic’s] Jalẹyẹmi stands out as the best and the oldest – Biket is the first choice of city residents for quality care that scores very high in every category.

Unlike most hospitals in Nigeria that are into general practice but run by specialists, Dr. Adebisi Adenle who is a cardiologist and the medical director, has been able to put his specialization into a pre-eminent position in his practice. It is not the oldest or the largest private hospital in Nigeria but Biket has put Osogbo AND Nigeria on the world’s medical map as the first private hospital in West Africa where open heart surgeries have been successfully performed.

Biket has been around at Osogbo since the early 1980s, a venture started by Dr. Adenle in his home town to cater to the [then] growing need for quality health care delivery with the establishment of the [now defunct] Nigerian Steel Rolling Mill and the Nigerian Machine Tools. Adenle had risen to the post of a Consultant in the Department of Cardiology at Nigeria’s premier University of Ibadan Teaching Hospital (UCH) before venturing into private practice.

Even while trying to run a practice that would earn him a living, Dr. Adenle kept his focus firmly on his passion: running a first-class hospital that would eventually have cardiology at its center so that he would be able to put into practice all that he’s learned not only at medical school but during his post-graduate at Minnesota, USA, and at various involvements outside Nigeria, especially India.

It was this goal that made him invest in the area of cooperating with a medical outfit in India to which he has travelled for many years on short trips to enable him participate in open heart surgeries and related cardiac treatments. Dr. Adenle never fails to reminisce how he was struck by the efficiency and lack of – how can I describe it without making it sound irreverent – grandeur that characterize Indian medical practice during his first trip. He was met at the airport and was whisked straight to the hospital where, after the usual preps, he was in an operating theater!

The hospital has now proved itself capable of performing open-heart surgeries successfully but to continue to do so, it needs support which does not necessarily mean being handed oodles of cash to support what is a private initiative, a private enterprise. It is not unprecedented in other countries, though, to have public-spirited individuals contribute to this kind of enterprise just as there are those who now donate buildings, equipment, et cetera to the UCH and other government institutions in Nigeria.

The most urgent needs for Biket right now are patients who will come supported to pay all necessary costs for their treatments because as things stand, the hospital has had to shoulder the burden of paying not only the Nigerian professionals from the Universities of Ife & Ibadan from where it draws the local participants for each Mission but also the costs of flights, hotels and remunerations of professionals from outside Nigeria. I could not believe it when I saw the loan documents to meet the costs of the last Mission that saw ten (10) Nigerians operated on successfully.

Nigeria has all the advantages that India offers to the foreign medical tourism trade most of which originates from the United States: it has well-qualified and competent English-speaking personnel, there are affordable hotels in the major centers and there are direct flights between three major US cities and Lagos: Washington, D.C., Houston and Atlanta. Getting to Nigeria from the United States to Nigeria is definitely cheaper than the other places. And, perhaps above all, the costs should be below India, Thailand and Dubai if emotional and rational pairing down of costs are done.

Of course a lot would have to be done before Nigeria gets to that stage: training of non-professional staff in hospitality, et cetera.

The field of “medical tourism” is fast becoming a very lucrative one not only in India but in Thailand, Dubai and even right near home in South Africa, and Nigeria must endeavor to get on the train – yeah, it is a gravy train for any country but I did not want to add that glib word for such a serious business.

Nigeria has the trained personnel to achieve the level of Indian medical know-how that has continued to enable the sub-continent reap billions of dollars annually not only from “medical tourism” but in the manufacture of drugs, especially generics, through the acquisition of patents that have lapsed. It is through such developments that Nigerians can benefit from the availability of very affordable drugs unlike the present situation that can see a patient die because he cannot afford the high cost of high blood pressure drugs.

Biket will be among the outfits in the vanguard of such medical boom in Nigeria if it can get the necessary support.

In his attempt to pass acquired knowledge and expertise in the field of cardiology, Dr. Adenle was, for some years, involved in teaching at the Ladoke Akintola Teaching Hospital in addition to his heavy work-load, a commitment he finally had to drop. He still takes in from time to time medical students who need the exposure that Biket can afford but that may be lacking in their institutions.

Dr. Adenle is supported in the delivery of services to patients by many medical doctors both in-house and sourced from UI and Ife, technologists, et cetera AND nurses. Mrs. Uche Adenle, a UCH-trained nurse who graduated in the 1970s and who had risen to “Nursing Sister” status before joining her spouse, is Director of Nursing Services.

Biket Medical Center is situated along Ikirun-Ọfa Road at Osogbo, a city that can now boast of one more claim to world fame than the world-renowned annual Ọṣun Festival.

DISCLOSURE
Dr. Adenle is the younger brother of blogger’s significant other, Dr. Depo Adenle.


NEXT is an EXCERPT FROM MAIL CIRCULATED TO MEMBERS OF ‘The Cardiac Society of Nigeria’ after one of the missions.

“Safe conduct of complex open heart surgeries” performed by a private medical center in Nigeria

The Biket medical centre owned by our very senior colleague, Dr Adebisi Adenle successfully performed this feat due to the passion of Dr Adenle and his commitment to cardiology and cardiac surgery in Nigeria thereby making The Biket Medical Centre the very first private hospital in West Africa to successfully perform open heart surgeries. The open heart procedures performed are: Complete repair of a double outlet right ventricle (in a 1-year old boy), 2 total corrections of tetralogy of Fallot, 2 mitral repairs (for severe rheumatic mitral regurgitation) and 2 VSD closures. In addition, there was a diagnostic left and right heart diagnostic catheterization (for a 10-year old with a large VSD) and a therapeutic balloon pulmonary valvotomy ( for a 1 year old with valvular pulmonary stenosis)

Surgeries were conducted by combined cardiac surgical teams from Biket Medical Centre, Obafemi Awolowo University Teaching Hospital, Ile-Ife and the Congenital heart centre of the Sheba Medical Centre, Israel.

I believe this effort by Dr Adenle needs to be publicised and applauded by all because this opens a new vista for the safe conduct of complex open heart surgeries in Nigeria. Kindly find attached some pictures of the outreach.

LAST HERE, BUT BY NO MEANS THE LEAST

[Since the last Mission during which Biket performed ten successful operations, there have been publicity in the media, including television. The following interview by Daniel Anzia of the Guardian is one of such publications. The original of the interview is slightly edited by blogger.]

WHY HEART DEFECTS ARE RISING IN NIGERIA – Dr. Adebisi Adenle, The Guardian – Daniel Anazia

Dr-Adenle-2kk

Dr. Adebisi Adenle, Medical Director, Biket Medical Center, Osogbo, Nigeria.

biket

biket2

The number of young people who have holes in their hearts has been on the rise in Nigeria. Why is this so?

Dr. Adenle

Hole-in-the-heart is common in any population of the world. It’s a structural defect as a result of mal-development of walls that separate the chambers of the heart. We have it in America, in Europe, Asian and in Africa. Unfortunately, it is now that we have the state-of-art equipment to detect these problems and that is why it appears as if it’s becoming a household name. When we discover this problem, the only suggestion for the mothers and relatives of the patient is for them to close it up, otherwise, the muscles of the heart will be overloaded. When the muscles are overloaded, it stretches beyond its elasticity and will malfunction. When one of the hearts is overloaded, especially the right, it pumps more blood in the lungs. The lungs will then be flooded with water or fluid and the resultant effect is that air cannot move freely.

The blood, which should have gone to the body properly, sometimes, from the left side of the heart and to the body, is denied that passage. As a result, the whole body becomes short of nutrients. We have two parts of the heart, the right and the left sides. The right carries all the blood that has gone through tissues of the body. In most cases, good things like oxygen have been taken away from them and it returns to the heart for purification. Carbon-dioxide is taken from the body in an exchange for oxygen and it passes through the left side of the heart to the body. But when there is a hole in the heart, and the left heart is stronger, the blood is shunted from the left to the right and each shunted blood now over-floods the lungs. At this point, an unfortunate child is presented with cough and inability to breathe among others.

Initially, it might be misconstrued to be ordinary cough but when it’s frequent, then try to see a doctor, and through a process of echocardiography, it will be detected. Without treatment, the child cannot survive adulthood. Sometimes, they won’t even survive the first year or even the fifth birthday. Unfortunately, we don’t have enough centres in Nigeria where this could be treated. Most times, we send them to India. And one must actually praise some of these institutions that champion the surgical management of these problems. We have come on board because we do much investigation and management of the heart. Sometimes, when we see this problem, we feel impotent, not being able to offer solution. This is why we have invested in the surgical management of this problem. We invested money in this because to open the heart and close the hole is not an easy task.

For you to do that the heart must not be beating and you must use a heart-lung machine. The exchange of gasses in the body will be taken over by the machine. It’s like you killed the patient, you stop the heart and lungs. Their functions are taken over by a machine and now you are able to close the hole and once that is done, you recharge the heart with blood again, and it begins to pump. All these are simple ways of treating it but a very complex procedure, needing a quite other equipment to support the work of a surgeon. It looks daunting, but with the cooperation of some of our colleagues at the University of Ife and Ibadan, we are able to start.

Have you at any point in time ventured into open heart surgery as a private practitioner?

Of course, we did the first one and at that time, they were eight patients. Some of them have holes in the lower chamber of the heart, while other at the upper chamber. Some were at the level of big vessels, emanating from the heart. Out of eight cases, we lost one of them. The reason was not because the surgery was not done properly but the hole had gone too far. And once it has gone too far, the chances of getting a good result becomes very difficult. This is why we are encouraging people to get this surgery done early enough when it has not affected the walls of the heart badly. Apart from that, the seven others were successful and still alive today. We have been following them up and they are doing fine. We were encouraged by this result and we did another mission, where we have five cases and all the five cases came out fine from the theatre and are still alive today. We are about to do another one this year November, and we are looking at, at least, 15 cases. We are quite optimistic that they will, as usual, be successful. We have been careful in the choice of the patients. Those that have gone too far that are not likely to do well; we have not attempted to put them in the list.

This task is capital intensive and quite challenges. What spurred you into it?

Well, I training in 1979 in Minnesota in USA, and throughout my stay in the school, I found that it was not beyond us. So, it has always been in my mind that I would get to a stage where I could solve such problems. Since 1979, I have been engaged in it although it was only in the last 10 years that we decided to garner resources and make sure that we get the equipment of international standards needed for it.

When the Israelis working alongside our local experts came for one of the missions, they were amazed at what they saw. One of them said our equipment was the same as one available in any centre in Israel. When other people from India came, they expressed the same opinion. It is why we’ve been able to record big success in the practice, and it is the reason they have not denied us audience each time we invite them. If our equipment are substandard, they would not have wanted to continue to partner with us.

Do you have any form of financial assistance except the technical support you got from India and Israel for the mission?

Now, what we have done was borrow money from the bank at very high interest rates to fund the missions, and we are still grappling with the interest on such loans. But as you know, the consumables used in open heart surgery are extremely expensive, but if we are able to remove the cost of transportation for both the child and parents, it would go a long way in reducing the cost of treatment. And we are trying to reduce the cost of treatment so that the surgery becomes possible within the environment of the patients.

If you have to go to America, for instance, you will have to secure visas, transportation and all that. While I’m not saying that some cases will not have to be referred to India and other countries, it would have to be more complex cases.

We have to start somewhere to do the less complex cases so that we would have all the experiences to do more complex ones. We have also partnered with Kims Hospital in India. Apart from the technical help, we are still hoping to get some funds, which have to do with buying of equipment or paying for the consumables.

In the last two missions, there were quite a number of patients that were unable to pay. We have committed ourselves and patients admitted. Some said they were coming with the money but when they got to the hospital, we discovered that they were not able to pay. There was a case of a boy who had only N20, 000, and you know that such is nothing in open heart surgery. Before we knew this, we had taken him to the theatre. We tried to take him back again but the surgeon said he was going to operate on him.

Then we have donations from people around and still couldn’t offset his bill. There are other cases that have not paid anything but we operated upon them because they were already within the hospital. But certainly, we need help from philanthropists, governments, wellwishers, corporate organisations, religious groups, associations, social clubs and politicians among others because this project should mature to a stage where it would create jobs for doctors, nurses and lives are saved.

What kind of help do you intend to get?

Well-wishers could come whenever a mission is on, identify with and donate for the surgery of some of the patients that would otherwise not be able to pay their bills.The Governor of Osun State has done that on a number of cases, paying for three patients out of the cases in our records. And we are grateful to him. We have a number of patients that the government cannot continue to pay for. So, we need help from public-spirited individuals and organizations.

In India, in one of the surgical homes, I was told that banks actually donated money to their organisation to ensure that indigent patients are treated. Banks, churches, politicians can do same here. This will give them their lives back. We have Biket Medical Heart Foundation, wired along this organisation but run on a different account in Oshogbo. We are on internet. Those who wish to assist can come to Oshogbo to see what we are doing. You cannot donate your heart as in the case of kidney but you can donate your heart by paying to relieve an individual that is afflicted!

Based on these staggering challenges, how do you hope to embark on November mission?

Again, we hope our target of at least 15 cases for the next mission is met so that we can come close to breaking even. We are going to be operating three patients per day for five days. And by the grace of God, we hope to to meet this target. Some religious organisations have indicated interest to pay for some patients. Unique FM in Ilesha has alsp taken it as a challenge collecting money to pay for one of their patients. If many people or organisations do this, we will be able to move forward.

Biket Websites:

Messages received after successful open heart surgeries –

https://groups.google.com/forum/#!msg/nigerian-cardiac-society/WOw6G1LlnDg/rNdLs1wLMUwJ

General information
http://www.vconnect.com/biket-medical-centre-osogbo-osun_b51572

WEDNESDAY, NOVEMBER 5, 2014. 11:00 a.m. [GMT]

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11 Comments on “Open Heart Surgeries successfully being performed by a private Nigerian hospital – Tola Adenle”

  1. ADENLE S.A. Says:

    Open Heart Surgery in Nigeria is a testament of True PROGRESSIVENESS AND

    TRANSFORMATION ‘

    We will measure your Sincerity with what you do for
    NOBLE CAUSES !

    It has been said ” ASK NOT WHAT YOUR COUNTRY CAN DO FOR YOU BUT
    WHAT YOU CAN DO FOR YOUR COUNTRY ” ( JFK).
    DR. ADEBISI ADENLE HAS DONE HIS OWN,
    WHAT DO WE EXPECT … OBJ? … GEJ? … PDP? … APC? … NIGERIA?

    Like

    Reply

    • emotanglobal Says:

      Dear Mr. Adenle,

      Your excitement and interest are understandable, and one does hope that those in positions to help bring about Nigeria reaping the benefits possible from Dr. Adenle’s commitments of effort and resources will do so.

      Greetings,
      TOLA.

      Like

      Reply

  2. ADENLE S.A. Says:

    PRIMUS INTER PARES ! THAT IS WHO YOU ARE, DR. BISI ADENLE.
    Oshun State and OSHOGBO know who you are BUT IS NIGERIA AWARE???
    HAHAH! Baba Obasanjo, were you aware of this Genius during you Presidency?

    How very close and How very Far! BISI is more than an Oil block, more than The World Cup! More than winning an election. Some of my friends are still alive today courtesy of BISI and the Grace of God.

    WHAT ARE WE STILL WAITING FOR SINCE NO ONE HAS EVER THOUGHT IT FIT FOR OSHOGBO TO HAVE A MINISTER ???

    We are tired of Eating EKO!!! MANY GENIUSES ARE AMONG US IN NIGERIA.

    JONATHAN … PDP … APC … or whatever, NIGERIA, WHAT CAN YOU DO FOR THIS NOBLE COURSE???
    ITAQUE ORACULLUM CONSULUERUNT” QUO MODO ROGAVERUNT ???

    Like

    Reply

  3. Femi Aborisade Says:

    Aunty Tola, Congratulations to Dr ADEBISI Adenle and your good self on the feat attained by Dr Adenle! Femi ABORISADE, Esq.

    Like

    Reply

    • emotanglobal Says:

      Thanks, Dear Femi but the congrats go to Dr. Bisi for his focus, dedication and readiness to help many indigents at his hospital in his quest to, perhaps, follow his professional oath.

      Remember my disclosure that Dr. Bisi is my brother-in-law, a younger brother to my S.O!

      My regards, as always.
      TOLA.

      Like

      Reply

      • Bamidele Opawoye Says:

        Dr Adebisi Adenle is an international person.

        Besides the surgeries done in Osogbo , Adebisi comes to the USA 2 times in a year to deliver papers about his findings at home. He is actively involved with the India Cardiac Association. A visit to BIKET will show how busy the hospital is.

        I approached him last year to help train our [Osun State of Nigeria] doctors at Asubiaro Hospital which he personally agreed to do. Simple CPRs will save a lot of lives at home.

        Bisi, O ku o ku iṣẹ, o. (Thanks for your contributions). We are proud of you, especially the CHARLEANS. Humilitas

        Bamidele Opawoye MD
        USA

        Like

      • emotanglobal Says:

        Dear Doctor,

        Thanks for this and for the insight to the work of one of your high school classmates on contributing his widow’s mite to health care delivery in your native Osogbo, Nigeria, and for raising the bar for private medical practice in Nigeria.

        Sincere regards,
        TOLA.

        Like

  4. Femi Aborisade Says:

    Congratulations to Dr ADEBISI Adenle and your good self on the feat attained by Dr Adenle!

    Like

    Reply

  5. Oladosu Gidigbi Says:

    Good day Ma
    This is a valuable piece of information for me.

    Like

    Reply

    • emotanglobal Says:

      Dear Mr. G.,

      Great hearing from you, and especially having your reaction to the essay on Biket which is in your neighborhood, so to say!

      Greetings,
      TOLA.

      Like

      Reply

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