Pushing frontiers of service delivery at National Eye Centre, Kaduna

By Idibia Gabriel

National Eye Centre Kaduna, under the management team led by Dr. Mahmoud Alhassan, has continuously raised standards for effective medical practice within its catchment areas and beyond, giving hope to Nigerians with sight challenges.

An overview of the past four years of stewardship witnessed great strides and remarkable additions in terms of patient attendance, sub-specialty manpower development, provision of comprehensive investigative and therapeutic ophthalmic equipment.

This also could be seen in the upgrade of the medical laboratory complex, renovation of the hospital building, construction of a sewage treatment plant, provision of renewable power supply, and water supply.

These have led to improved service delivery to Nigerians needing eye care from all strata of life. Within the past 5 years, the hospital has attended to an average of 39,261 patients per year, mainly Nigerians.

This is different from the various community outreach programmes which take the centre’s eye care services to the doorsteps of indigent Nigerians in partnership with non-governmental organisations, local government leaderships and public-spirited individuals.

Most often, these exercises are conducted with little or no cost to the patients. In the area of infrastructural development, the centre has witnessed tremendous improvement over the years from November 2015 till date.

The capital projects undertaken by the current leadership include completion of 50 rooms of patient transit camp, rehabilitation of dilapidated walkways, concrete pavements and roofing.

Others are rehabilitation of abandoned centralized sewage treatment plant, building and structural rehabilitation work at an administrative building (Block A).

This consisted of upgrading of plumbing, sanitary fixtures and the building façade; structural rehabilitation at all specialized clinics (Block B), including upgrading of plumbing, sanitary fixtures and retrofitting of electrical fittings.

Also was the complete rehabilitation of the Primary Care Clinics (PCC), patients’ wards (Block E and C), including upgrade of all sanitary fixtures, plumbing fixtures, and electrical fittings.

There was also a comprehensive rehabilitation work at Block (F) which houses the main theatre (6 independent theatre suites), community ophthalmology, and residency training and refraction units.

The Centre also procured utility vehicles such as Hilux, Hyundai Elentra, and Toyota Corolla for hospital logistics.

Water and electricity for clinical and other uses has improved significantly especially with the drilling of additional boreholes and increased investment in the maintenance of facilities.

The management commenced a phased upgrade of the substations and power control equipment to ensure adequate and uninterrupted power supply to the hospital complex.

In sub-specialty manpower development, the hospital, in the last four years, provided state-of-the art facilities and a convenient work environment to give ophthalmic services to patients in need.

The paucity of such care in the past had led to an exodus of Nigerians to access services in Europe, America and Asia.

Patients had to commit huge resources to travel out to have cornea transplants or vitreo-retinal surgeries which the hospital now offers.

Therefore, it is pertinent to note: “Our effort in human capital development has started yielding results, though complexity in accessing corneal tissue for transplant is still work in progress.

“The knowledge of human development as an instrument for institutional transformation was the major driving force behind our investment in the training of subspecialists in the hospital.

“There is more than 100 percent improvement on sub-specialized manpower. The subspecialists were largely trained in various world-class institutions of India and Bangladesh.

The training was also supported by CommonWealth Eye Health Consortium (CEHC); an intervention programme of Queen Elizabeth Diamond Jubilee Trust Fund.

The overall idea and aspiration of the human capital development is to make our institution a training ground for subspecialists in the country and to also help curb the gale of medical tourism bedeviling our health and economic sector.”

Also, in the area of Electronic Medical Records (EMR), “This Management has also been able to start Electronic Medical Records (EMR) which is the practice globally.

Medical equipment procured within the past four years could be seen in the equipping of sub-specialty clinics, procurement of ALCON Posterior Vitrectomy Machine accessories, purchase of a set of optical machine, computer software acquisitions and procurement of various project vehicles.”

Others include computerization of critical areas in the hospital, construction and establishment of cornea bank, supply of 2 Anaesthesia Machines, construction and equipping of artificial eye production lab, as well as supply of anterior segment /cornea assessment equipment. Furthermore, centre acquired computer software; Medical equipment – OCTA Machine and SL Bio- Microscope Monitors; IRIDEX Micro Pulse LASER Machine, 1 Unit; B-SCAN with UBM option Sonomed USA; accessories for B-SCAN; 14 Ophthalmoscope Keeler UK; 1 Binocular indirect ophthalmoscope (Wireless); 2 Lens+60D, 78D; 2 Cataract set; 1 Diathermy machine; 1 unit Refractor Keratomater; 2 B-Scan Machine probes EZ scan AB 5500 (USA); and 1 Cautery Machine.

Also procured are Index Laser Diode photo coagular system Japan Firbre Optic cable; Anterior vitrectomy Machine (Germany) probe; 1 Ultra low Temperature Chest Freezer; 1 laboratory Refrigerator; Corneal Transplant set; Auto-keratometer; Iridek Micro Pulse Laser Machine; A & B Scan Machine; Scanoptic Microscope eye Piece; Sonomed “A’’ Probe Scan; Topcon A/T Table Plus Top; Topcon OCTA Machine and Slit Lamps Biomicroscope. Semi Automated Chemistry analyser; 10x Adjustable Eye Piece; 1 Inverter 7.5 KVA Pure Sine Waves 200 Ah Batteries; Installation of inverter with 10 Battery Racks; and Cables.

In order to vigorously take eye care to the doorsteps of rural dwellers especially women and children, the hospital sought the collaboration of Kaduna State Government to establish a satellite station in General Hospital Turunku in the Igabi Local Government Area of the state through an initiative called NEC Community Eye Care Programme (NECCEP) where the hospital provides technical and logistic support to allow patients access cheap, yet qualitative eye care.

The programme has since been a success story and many people regained their sight through the initiative. Other community outreach initiatives carried out within the period include: Medical Outreach Services, MOS, in Kaduna Zone one Senatorial District (Makarifi & Giwa), Medical outreach services in Kaduna metropolis, zone two, Kaduna town, Medical outreach services in Kafanchan and medical outreach services in Kagoro Town, all in zone three. On International collaboration and linkages, the hospital had attempted to collaborate with individuals and institutions outside the country for mutual benefit to involved parties.

Consequently, there had been in-house training of clinical staff by foreign mentors who volunteered to come to our institution.

We had Vitreo retinal training by Dr. Ihab Sa’ad Othman, an Egyptian Vitreo retinal surgeon of international repute and another Vitreoretinal surgeon from Ethopia, Dr. Dereje Negussie Woyessa.

The Dr. Mahmood Alhassan-led management will set the ball rolling by reclaiming government land taken up by land grabbers. The need for adequate number of highly skilled Ophthalmologists and Ophthalmic nurses needs not be overemphasized.

The fact that the hospital is the apex training institution for eye care in Nigeria makes the need for a post graduate medical school imperative.

The school will expectedly continue to address the herculean task of continuously training ophthalmologists known in everyday parlance as eye doctors to meet the demand for the rising number of Nigerians who yearn for eye care service.

“The management will institute interventions and programmes to reduce patient waiting time, which is the best indicator of promptness of service delivery, through increased hospital attendance.

This will be achieved while maintaining good quality service delivery to all. We hope to grow the patient attendance by 30% annually in the next 4 years. Implementation of strategies to achieve universal coverage of health will definitely also lead to higher patient load at our facilities.

“In ensuring more community services, with the conclusion of the pilot rural outreach at Igabi LGA, the NEC will seek further collaboration with the Kaduna state government to implement the programme in other LGAs in Kaduna.

All other communitybased service delivery activities will further be strengthened to offer high quality services.

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“In terms of training and retraining of staff, the ongoing training programmes will be expanded while seeking collaboration with many other renowned training centers across the globe.

All the core specialist areas including the paramedics will be properly trained. The National Eye Centre, Kaduna will become the hub for training of all cadres of eye health workers in the country and beyond.

“There will be renewed zeal to update our ophthalmic equipment to meet up international standards. With good planning and proper advocacy, this is achievable.”