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?