Dr. Damian Avar is the founder and CEO of DoctorsHub Nigeria. Avar who is a General Practitioner from the College of Medicine, University of Lagos (UNILAG), in this interview with CHIOMA UMEHA, laments shortage of medical personnel in the country and the need to address it. Excerpts:
The situation at any of the primary, secondary or tertiary health centres is usually depressing, and many people ask: where are the nurses, doctors, and other health workers? This is because there are always many patients and not enough personnel to address their needs. How do you think this can be tackled?
There is growing need for patient-to-doctor gap to be bridged by ensuring that more doctors are in contact with patients.
Currently, Nigeria has a very dismal statistics when it comes to health. A doctor to patient ratio is about one to 6000 as against the recommended World Health Organisation(WHO) ratio of one to 600.
Recently, Prof. Folashade Ogunsola who is a member of Medical and Dental Council of Nigeria said that Nigeria needs about 13,700 doctors to be able to meet up with the WHO’s benchmark. What it means is that if all the colleges of medicine in Nigeria are producing doctors, and all these doctors are not travelling out of Nigeria, they are staying here within Nigeria and all of them are practicing medicine, and none of them suffered death in the process, it will require Nigeria 100 years to be able to meet with WHO’s target.
So this creates a very huge gap, the deficit of doctors which provide health service is very poor in addition to lack of facilities. The need to leverage on technology to be able to bridge that gap is imminent. That is why DoctorsHub Nigeria was launched on November 20, 2016. It was launched out of a burden to bridge this gap.
I conceived the idea when I was in final year in medical council. Although I didn’t work on it until I graduated.
Research has shown that the health awareness index of Nigerians is very poor. What is the way out?
Yes, we have realised that the health awareness index of Nigerians is very poor. One of our findings about the cause is that majority of doctors who write about health issues often do so to impress their colleagues instead of impressing the masses. So often, they fill their articles with medical jargons. When DoctorsHub came on board, we decided to change that.
So what we do now is to tailor our articles to enable the average man on the street to understand and grab the relevance of the health content. If you look at it, the world is changing as advanced countries are moving towards preventive medicines because curative medicines are not sustainable and that’s what we have been practicing.
We wait until the person has complications before you refer the person to the hospital, that is not sustainable and one way you can facilitate preventive medicine is through education, advocacy. So we are doing that currently.
To create more readerships, we are also translating our articles in local dialect such as Pidgin English, Yoruba, Hausa and Igbo. That’s just one aspect of DoctorsHub health content creation. The other one is consultation, primarily, that’s what DoctorsHub is all about.
Currently we have launched emergency service to cater for people who have symptoms of meningitis, as the disease is currently killing many Nigerians. So we launched that weekend and the response have been quite encouraging.
What other roles does DoctorsHub play?
Basically, DoctorsHub is an online platform that provides Nigerians irrespective of age, sex, creed or social status with the best online medical consultancy free 24/7 from Monday to Sunday.
Initially, we started with open consultation, but some patients were not able to access the information because of language barrier, so we expanded our services to local dialect.
For instance if you wake up 3: am and you probably feel a headache or stomach ache instead of you waiting until 7: am before you rush to the hospital, you can just go online and a doctor will explain your symptoms and advise you accordingly.
What is follow up like?
We do follow up via phone chat. Often, we discover that the patients don’t even know where to go to. So we also refer patients to diagnostic centers and health facilities nearest to them. After the test, they can still come to us or go to their doctors. For those who bring the result of their test to us, we offer them treatment accordingly.
How many doctors are working with you at the moment?
Initially, we started the platform with seven doctors, now we have about 25 doctors who are willing to volunteer and offer their services on the platform.
The doctor can stay in his house or office and offer somebody very valid advice without the person leaving his or her house or booking appointment to see doctor within 10 or 15 minutes.
How are you going to sustain this, are they paying for consultancy?
For now, like I said, most of the doctors on the platform are doing voluntary service so we are not paying them. Apart from this, there are other operating costs, but we are doing out of pocket spending for now. But, we are looking at entering into partnership with some accredited health centers and diagnostic centers to create a working relationship.
How many people have you reached with your services?
We have attended to about 650 people in the four months of operation. We have assisted many people who don’t even know that they are to seek help and where to seek it.
What’s your goal?
Our goal is to decongest hospitals because we realise that a lot of people going to hospital are not supposed to go there. For example, some who has Dysmenorrhea which menstrual pains have no business going to the hospital. All they need to do is get a painkiller.
Does it not have side effect?
Actually all drugs have side effect, there is no drug without side effect but like we used say we weigh the benefit against the side effect and there is nothing else to do for a case like Dysmenorrhea. You get painkiller and be treated.
But, some pains are symptoms of endometriosis.
Endometriosis is different from menstrual pains. In fact, you cannot diagnose endometriosis by interviewing patients online. You have to send the patient to test.
Do you have plans to have a facility in future?
For now, no we don’t. Presently, we are doing this thing because we are passionate about it because we discover that health is a problem. It will shock you that many women, some of them graduates don’t even know how to calculate something as vital as their menstrual cycle. This is something that every woman should be able to do easily. When we meet such women, we assist them. So, what have been pushing us is that we are solving a problem.
We expect, once we have a very large data to approach the government, we will do so and show them what we have done so far and tell them that this is how far we can go and that we will need support.
The core issue is that we want to make many Nigerians get access to quality health.
Where did you get your model from?
It is practiced in India in fact Indian healthcare system is a brilliant one to look at, so it is practice there. You know India has a high population and their doctors are not even sufficient so they leverage on technology. It would also surprise you to know that there are other people who are towing this line here in Nigeria presently.
So what we are looking at is situations where we can leverage on technology to screen off those people who are not suppose to go to the hospital. Doctors can take them on online and allow people who actually need to be in the hospital to be there.
I want to state very clearly that DoctorsHub would not have achieved all it has done so far without the invaluable input of the members of the management team, volunteering medical doctors and the other numerous volunteers working on the platform. These include, Mr. Nwagwu Everest, Mr. Ayopo Onafowokan, Tolu Craig-among others who have been very supportive.