Saturday, 9 January 2010

Health is his breath

BY GREGORY AUSTIN NWAKUNOR
DR. Tunde Okewale is seated in a vast room, which seems a reception, with sunlight streaming through the window. The physician casts a blank look at the object by the window side. He stands up and smiles innocently. He looks through the window to see the other side of the road.
Outside, members of staff are preparing for a party for the less privileged. Everywhere is busy, but the doctor, who is just back from a tour, sits down, waiting patiently for some patrons of the Free Health Foundation he launched in 2008 to come.
You’re the journalist,” the soft-spoken Okewale asks. “Yes,” I nod in response. He looks at his wristwatch, draws a deep breath… “you’re welcome.”
His phone rings. He reaches for it. “Yeah,” he retorts. He calls out one of his office assistants, who brings a bottle of mineral water for his guest.
A breath of fresh air follows.
“Our Free Health Foundation, which the hospital is engaged in, aims to provide free health care for individuals who are not currently covered by any forms of health scheme — government or private,” he says. His tone is very warm.
With a diction that sticks out in rhyming lore, Okewale says, “whatever the reasons, many of such individuals are known to us in our various walks of life. The ailments that usually incapacitates and sometimes kill such individuals are basic healthcare issues, which are easily treatable and preventable if they had access to quality healthcare services.”
He says, “it is painful and unacceptable in this day and age to hear of deaths due to malaria typhoid, bacterial infections, childbirth, ulcers, hypertension, diabetes and other minor diseases that are easily diagnosed, prevented and treatable, just because of lack of finance, unemployment and, or ignorance. St. Ives Free Health Foundation works in partnership with benefactors, which comprises individual philanthropists, other charitable organisations and corporate bodies.”
He adds, “the sponsor (individuals, corporate bodies, other charitable organizations) nominates a minimum of 10 beneficiaries openly or anonymously for the scheme. If the benefactors have one mind, the Foundation helps to nominate beneficiaries on our list. We would furnish the benefactors the details of the sponsored beneficiaries if required. We would give regular feedback on the health of their beneficiaries. The benefactor is expected to pay N1000 per person per month. The Foundation matches and exceeds the amount depending on the health needs of the beneficiaries.”

FOR someone who has had more than half of childhood ambition fulfilled, there is much to be expected. Okewale qualified as a medical doctor at the University of Ibadan. His postgraduate training and practice as an obstetrician and gynaecologist was at the Leeds, Manchester and Oxford regional health authorities respectively within the National Health Services (NHS) UK.
After a practice spanning 10 years in the UK, he came back home to contribute his quota to the development of the healthcare service in Nigeria.
The fellow of the Royal College of Obstetrician and Gynaecologist (UK) is also a member of the Faculty of Family Planning and Reproductive Health Care (UK).

AS we chat, discussion veer into In Vitro Fertilisation (IVF) technology. On June 7, 2008, his hospital’s first test tube baby, a boy, Christian, weighing 3.0 kilogrammes and measuring 50 centimetres in length, was delivered after 37 weeks of pregnancy.
He explains with a deep chuckle, “we offer Gynaecological services including infertility investigations and treatment ranging from ovulation induction, ultrasound follicular tracking to assisted reproductive techniques such as intra uterine insemination, Donor insemination, Gamette intra Fallopian transfer (GIFT) Peritoneal, Oocyte sperm transfer (POST) and IVF-GT, ICSI.”
The youthful doctor says, “we do not waste time, money and effort by concentrating on a long list of fanciful tests. Apart from the basic infertility tests which are necessary in the initial evaluation, extended investigations and tests do not get women pregnant and usually do not help much in deciding the best treatment for couples.”

MARRIED with children, Okewale says: “My last set of twins are special because their mum had them when she was 45. She’s been married for 20 years and you can imagine the agony she and her husband went through before they thought of In Vitro Fertilisation (IVF) technology.”
He asserts, “couples that come to infertility doctors for help want to have babies, not extended investigations and having to wait too long in achieving their objective. It is bad enough being infertile but going through tests that add no value to the outcome of the procedure drains the couples emotionally and financially.”
He draws a deep breath and says, “in Nigeria, about 25 per cent of couples in their fertile age group are the sufferers of infertility. Whilst about 40 per cent of infertile couples will get pregnant by themselves, by changes in their lifestyles and by the standard gynaecological treatments up to 60 per cent will not.”
Okewale says, “our mission is to provide an advanced and competitive IVF and Fertility Services of international standard with a high pregnancy rate and at an affordable cost to couples.”
On IVF treatment, he reflects: “In order for pregnancy to occur, an egg has to be released from the ovary and unite with a sperm. Normally this union called fertilisation occurs within the fallopian tube, which joins the uterus (womb) to the ovary. However, in IVF, the union occurs in a laboratory after eggs and sperm have been collected. Embryos are then transferred to the uterus to continue growth.”
The physician says, “the administration of fertility drugs, monitoring of the circle, collection of eggs, mixing egg and sperm together outside the woman’s body in a culture dish or test tube. Any resulting embryos are left to grow and the best embryos two to three are then transferred into the woman’s womb. Any remaining embryo of good quality may be frozen for future use.”
What does the process involve? “You know the saying? When there’s a will, there’s a way. IVF is a technique in which egg cells are fertilised by sperm outside the woman’s womb, in-vitro. It is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilise them in a fluid medium. The fertilised egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy.”

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