Thoughts on Visit to Nigeria & AFMED

Thoughts on visit to Nigeria and AFMED
Ray Rogers

People keep asking me about my experience in Nigeria, and, at times, I find it difficult to describe everything I saw, everything I experienced, and everything I sensed while I was there. “Life changing” is certainly a fitting description in that I see our world in a new light. The uncertain imagery that I had in my mind prior to seeing Nigeria was forever replaced with real images of people living in a country where many of the very basic necessities of life are beyond reach.

Clean water, uninterrupted electricity, public sanitation, and quality healthcare – essential provisions that Americans take for granted – seem both possible and impossible at the same time for Nigerians. And yet, the people of Nigeria, at least those we met, are filled with an astounding hope that tomorrow will be a better day, that their standard of living will advance, and that the wealth they possess as a nation could one day find its way to them. In a region with extreme poverty and some of the highest infant and maternal mortality rates in the world, hope may be all that some people have.

With so many unmet needs, it is difficult to imagine where to start: where one’s efforts can impact the lives of a hopeful nation. But the essence of service-to-others lies in knowing that the collective product of many small efforts can be transformational. While disappointment exists in a world fraught with uncertainty, never have I met people with greater hope for what can be done or what might be possible.

I was inspired by the work of team members Dr. George Mulcaire-Jones, a family physician from Butte, Montana, and Dr. Robert Scanlon, an OBGYN from Huntington, New York. Both have dedicated their lives to improving the care of so many people in places that seem so out-of-sight, so out-of-mind. Making sure that a mother is given a better probability of safely delivering a child, of a child surviving those first few critical months, and supporting HIV/AIDS prevention, treatment, and care were all part of the training provided by George and Bob to healthcare providers from throughout Nigeria.

Characteristically, these healthcare workers thirst for better skills, more timely and relevant information, and the dissemination of “best practices” in medical treatment and care. Their desire for knowledge is palpable.

The effort to improve healthcare in Nigeria may at times seem inconsequential in such a vast region with such a large population, but the results can be measured … one healthy mother, one healthy baby at a time. And as these healthcare providers take their new found skills and knowledge to other care providers throughout Nigeria and Africa, the cumulative effect is soon measured in much greater numbers. However, this task must be accomplished correctly; bad training doesn’t help anyone.

Maternal Life and the National Center for Health Care Informatics want to create a multiplier effect – where certified medical training can be propagated to care providers throughout a community, region or nation. From this recent trip, we now know that information technology can play an important role in achieving that desired result. While infrastructure challenges remain an important consideration when attempting to implement any information technology project, we successfully demonstrated that adequate infrastructure indeed is in place.

Using the same video conferencing equipment we use at the National Center for Health Care Informatics, we were able to connect 35 energized healthcare workers in Jos, Nigeria -- many from Our Lady of Apostles (OLA) Hospital where we were conducting medical training -- and 20 IT, healthcare, and faculty representatives at Montana Tech in Butte, Montana. These two groups were in a sustained, high quality, two-way video conference half way around the world with streaming quality nearly equal to that of TV.

When the actual connection between Nigeria and Montana was made, cheers erupted and no one on either side held back their excitement. Spontaneously, several of the health care leaders present in Jos took the occasion to rise and articulate to their new colleagues in Butte the importance of what we had accomplished and the remarkable hope that IT brings to improving healthcare in Nigeria. The opportunity now exists to provide certified, regularly scheduled, on-going video conferencing training sessions to physicians, resident physicians, nurses, and midwifery students at OLA Hospital and elsewhere.

With a better understanding of the myriad healthcare issues and needs of the people in this region of Africa, we collectively believe that we have taken a major step forward in establishing the framework for our African Family Medicine Education and Development Initiative (AFMED). We have envisioned educational training modules that target specific healthcare needs while emphasizing cultural sensitivity and appropriateness to existing healthcare capacity and infrastructure. We also now understand the technological challenges and opportunities of delivering high quality video conferencing/training from locations in the US to locations in Nigeria – connecting healthcare providers.

We recognize that conventional methods of medical training in developing nations are inadequate. Our AFMED initiative fills the gaps and provides a systematic approach to providing continual training that can be easily replicated and highly scalable.

Our next step is to encourage a partnership with funding agencies that align with the goals and expectations of AFMED. Our goal is simple … to improve healthcare by improving the quality of training to healthcare providers. So too are our expectations … to help one mother, one baby, or one malaria, TB, or HIV/AIDS patient at a time. The results will be measurable … in great numbers.