Ige Olugbenga is an Orthopedic and Spine
Surgeon. His current place of work is the yet to be commissioned Ondo
Trauma Centre located along a place called Laje Road on the Ondo-Ore
Road in Ondo Town.
For anybody who has visited the Mother
and Child Hospital, Ondo, the job of locating the Trauma Centre could be
simple. For a first time visitor however, more descriptions are
necessary. Laje Road is the last major turning before the main gate of
Adeyemi College of Education, Ondo if one is coming in from Akure and
the first major turning on the left on the reverse direction.
The road before now was not tarred. Now
it is sparkling clean and glittering with fresh tar. There was also no
Orange-roofed market on that junction until recently. The new market and
the new road point to the direction of the massive work going on
further down Laje road.
The major reason for the establishment
of the Trauma Centre in the words of Dr. Ige is to reduce loss of lives
and disabilities from road traffic accidents. This, one will no doubt
agree, is a noble objective.
In a country where keeping records is
not a national past time, all have but agreed fatality through road
traffic accidents account for more deaths than HIV/AIDS if not malaria.
Many will also agree that less attention has been paid to the issue of
trauma through road traffic accident RTA than all other causative
factors of human fatality in Nigeria.
The story coming out of Ondo is that a process to ensure that those
involved in accident are promptly and appropriately attended to is well
under way.
The Ondo State Governor, Dr Ige said,
has come to accept that the only way to do the above is the way it has
been done in other countries.
Elsewhere, the fact has since sunk in
that to have a good result in caring for those involved in accident, the
need to establish a trauma system arises. More than this, the system
must have pre-hospital, the hospital and post-hospital (the
rehabilitation) components.
The pre-hospital system is the ambulance
service and the call centre which is the central command system of the
pre-hospital unit of the trauma system.
In the words of Dr Ige “The Ondo Trauma
Care System involves advanced life support ambulances on the highways
located in stations specially constructed to allow these ambulances
access to the highways and cover the length of the highways where they
are located, such that when there is an accident, between 10 to 15
minutes when the calls come in, these ambulances are at the accident
scene.”
Obviously, ambulances do not rescue
accident victims! In the Ondo case, the ambulances come with paramedics,
extricators or rescuers who can get to the scene of accident and
professionally rescue victims from the wreckage of accident. The edge
here is that the rescuers have been trained and they work with equipment
that do not aggravate the degree of injury sustained but actually
enhance victim’s chances of survival.
In more concise terms, the Ondo
Ambulance system is to get the right people to transport accident
victims to the right place in a right manner at the right time, Ige
said.
Apart from the ambulances stationed
strategically, there are also toll-free numbers to the call centres
where ambulances get the signal to go to accident sites to pick victims.
To complement the activities of the
paramedics in the ambulances, the Ondo State government has trained
hundreds of ordinary citizens in towns and villages along the major
roads to be first respondents.
The process of recruiting first respondents is an ongoing one as many
more citizens still have to be exposed to assist paramedics in safely
extricating survivors of accidents.
Existing government hospitals are also
not left out of the safe the trauma victim focus of the Mimiko
government. The government has also upgraded the accident and emergency
units of general hospitals in the state, so they can handle to a great
extent some level of injuries.
The upgraded hospitals stand lower on the referral ladder than the Trauma Centre which is the apex of the Trauma care system.
Attending to trauma victims is one
dimension of the Ondo State Trauma care system. It also doubles as a
special surgery centre. It is a level one trauma centre in that it has
all complement of surgical specialties in terms of requisite equipment
and personnel to take on neuro-surgery, pediatric surgery, orthopedic
surgery, facial surgery, ENT, maxillofacial, plastic surgery and
neurology among others. With a well-equipped ICU and general surgery,
accident victims brought to the hospital are promptly and appropriately
attended to and “irrespective of the nature or severity of their
injuries, they are given a genuine chance of survival,” Ige said.
Within the first five months after it
opened its doors to patients to test run the facility, about 400 major
surgical operations across all surgical specialties have been done with
mortality rate of less than 3% recorded! And this is irrespective of the
severity of the injury.
The few who were unable to survive were
those who had severe head injuries. The impact of the accident was seen
to have caused irreversible damage to structures of the brain. In most
other cases, the Trauma Centre has gotten to a point where most patient
brought into it, no matter the severity of the injuries, have been given
a chance to survive, by prompt and appropriate attention to the
injuries. “We’ve been doing very well in keeping people alive after
major accidents,” Ige said.
The modest achievements are not by
accident. They are as a result of deliberate planning and meticulous
execution of the vision of the Dr Olusegun Mimiko, the medical doctor
who sits atop the governance structure in Ondo State, Dayo Adeyanju, the
health commissioner, himself a medical doctor, said.
Speaking further on the facility, Ige
said: “The edifice was constructed to respond quickly to victims when
they are brought here, from the access roads to the space where the
patients are dropped to be received by the hospital personnel, quick and
uncomplicated transfer of patient is ensured and enhanced. We have the
resuscitation room which is also referred to as the crash room, where we
have life support gadgets and the design of the place is such that we
can quickly establish patent airway and ventilate the patient if need
be. We can rapidly infuse fluids into the blood system if need be. We
can also rapidly do imaging studies which includes x-rays and ultrasound
inside that crash room, we have point of care machines that can conduct
different tests inside the crash room and we can also do emergency
surgeries if need be.”
The above, the CMD said is a deviation
from what is obtainable in most hospitals in Nigeria. “Elsewhere, where a
patient is brought into the hospital and there is need for urgent
interventions in terms of investigations and treatments, they will have
to move the patient from one point to another, but here we do everything
in the same room,” Ige added.
Our record system is such that everything that a patient requires in
terms of registration and data collection, the patient does not have to
make any initial payment when it is an emergency, we just go ahead to
treat them and they can pay later, things that we see that may cause
patient being delayed from getting attention, we’ve made plans to avoid
such delays. The time that is spent in trying to get information from a
patient also contributes to increasing mortality, so we reversed that
trend. It’s after you’ve been attended to that the attendants come to
you to get all the necessary information, not that you must get a card
before they attend to you.
So the patient gets everything as soon
as they are brought into the crash room, almost everything required for
treatment to restore the patient back to the path of recovery is
available in the crash room.
But the crash room is but one of the many facilities and departments
already taking care of trauma victims in Ondo State. As is the word
around, a trip to Ondo will do the rest. After all, is there anything
wrong with internal medical tourism?
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