Dr. Benjamin Udoka Nwosu is a Nigerian-born Associate Professor of Pediatrics, Division of Endocrinology, at the University of Massachusetts Medical School, Worcester, Massachusetts, USA.
His latest published work is the first to characterize the vitamin D status of pediatric patients with irritable bowel syndrome. This study also compared the vitamin D status of patients with irritable bowel syndrome to those of patients with other malabsorption syndromes such as inflammatory bowel disease, lactose intolerance, and celiac disease. Dr. Nwosu’s work calls for a monitoring of vitamin D status in patients with irritable bowel syndrome, and the initiation of appropriate vitamin D supplementation in those who are deficient.
Saharareporters got hold of the busy doctor to answer a few vexing questions.
Saharareporters. How did you become interested in medical research? How much of it is going on in Nigerian teaching hospitals and universities?
I have always been intrigued by questions on organized thinking, so while a junior at the College of Medicine, University of Nigeria, I joined a club called the Medical Students’ Research Society and I was struck by how the members gathered data, analyzed them, and presented the data as written reports in the school’s medical journal, MEDIKKA. I later became the secretary of this club in my 5th year of medical school and helped edit that year’s volume. This interest in research blossomed during my fellowship years in Endocrinology at the National Institutes of Health, Bethesda, Maryland, where I studied the dynamics of telomere shortening with aging, and growth hormone physiology. Currently, I and fourteen other alums are giving back to the system by sponsoring research activities at the College of Medicine, University of Nigeria, through the African Research League.
Saharareporters. What is the relationship between the pharmaceutical industries and researchers like you? For example, diabetes management in America is a $250 bn industry. Some cynics wonder why will the pharmaceutical industry be interested in finding a cure?
The Pharmaceutical industries have a strong role to play in promoting research and ensuring that their products are consistently being evaluated and compared to emerging products for efficacy and favorable side-effect profile. Finding a cure for one or several diseases would not necessarily spell the doom for the pharmaceutical industry as they have widely diversified portfolios. Remember, they manufacture vaccines to prevent a wide range of diseases and they are still in business. Because of conflict of interest concerns, the activities of pharmaceutical companies need to be monitored. There was a sad case of a pharmaceutical company that snuck into Nigeria a few years ago and was conducting a trial of oral medications on children with meningitis.
Saharareporters: Not long ago, the president of Nigeria returned from medical treatment abroad. How does that make a Nigerian-born doctor like you practicing in America feel? What are the unseen dangers and unquestioned downside in rushing abroad to treat Nigerian leaders?
The president has every right to seek medical treatment wherever he wishes. The downside is in the message it sends to the world: that Nigerian doctors are either incompetent, or that he is the ruler of a banana republic with no medical facilities. I recall when former President Yeltsin had to invite heart surgeons to Moscow to operate on him in his homeland instead of taking a trip abroad for medical care. Fidel Castro never sought medical care abroad! Nelson Mandela received his medical care from South African physicians! When a leader receives care in his or her own land, it shows a healthy pride in his or her nation and people. There are many home-based physicians, and Nigerian physicians in the diaspora who would give him first-class medical care, but we have to respect his choice to work with the British physicians.
Saharareporters: What will it take to have a hospital, like the National Hospital that can treat any ailment that might afflict Nigerian political leaders?
A strong political will backed by a clear vision to deliver first-class care to Nigerians.
Saharareporters: On social media of Nigerians in America are often numerous announcements of young Nigerian men in America dying at young age. Is something unusual going on amongst that population? What are the typical risk factors Nigerian men face in America and how could they reduce the risk?
The westernized diet has many negative health consequences because of its caloric density and high fat content which can easily lead to metabolic syndrome and cardiovascular diseases. There is also the added burden of caring for people in the home country while trying to make a headway in the West. The combination of the deleterious westernized diet and these other societal stressors could have negative impact on health. The best ways to reduce these risk are to eat moderately, exercise daily, avoid cigarette smoking, and get regular physical examination by a competent physician.
Saharareporters: According to Prof. Folashade Ogunsola, a professor of medicine and chairman of the Association of Colleges of Medicine of Nigeria, Nigeria needs no fewer than 237,000 medical doctors to meet World Health Organisation (WHO) standard of one doctor for every 600 persons.
“We will need about 237, 000 medical doctors and we have about 35,000 working in the country today," she said.
What is the actual situation with our needs for doctors? And how do we meet the need?
I am always disturbed when I hear our professionals talking about WHO standards which are nothing but generic recommendations handed down from Europe to Third World nations. In most cases, these recommendations are made with inadequate research data and fieldwork, but these poor nations are expected to adopt them immediately. We remember how helpless the WHO was in the face of the recent Ebola pandemic. WHO does not have all the answers. Does anyone still remember the endless chant in the 1990s of ‘Health for All by Year 2000?’ That was another failed WHO program. Did WHO not count the doctors in the country then before they went on the campaign to deceive the masses?
The question is what are our own homegrown Nigerian standards? Here in the US, the American standards supersede the WHO standards. That is a sign of a progressive society. Leaders of Nigerian physician bodies must accept that the issue is not primarily that of supply, but an issue of allocation of resources. They should break down the so-called shortage of physicians state by state, and then create attractive packages that would draw physicians from the cities to the underserved areas. That is what is done here in the US to drawn physicians from the cities to the rural population. If you double or triple the salaries of physicians in underserved parts of Nigeria, physicians would begin to gravitate to those underserved areas. It is better to have 37,000 well-trained physicians dispersed across the nation, than 237,000 butchers running around with fake certificates!
The second question is what mechanism have they put in place to attract Nigerian physicians in the diaspora to spend their sabbaticals and vacations in Nigeria delivering care to the underserved areas? Let them publish such a plan if they have it because I know a lot of physicians in the diaspora who would jump at such an opportunity to serve at home.
The final question is what have they done to re-imagine how doctors are trained in Nigeria? The current British model is antiquated and should be replaced with the pragmatic US model that allows for junior doctors to complete their residency training within 4 years in most cases, instead of the indeterminate period of time that it takes to complete residency training in Nigeria under the British model.