Dr Shabihul Hassan, Chief Medical Director: Indian with a Mission to Turn Nigeria to a Medical Mecca…

The Nobel Laureate Albert Einstein whose famous theory of relativity, E=MC2 (energy equals mass multiplied by the speed of light squared), changed the world science and ushered in an entire new generation of scientific applications was a Germany Jew, who migrated to America. Andrew Grove, Time International 1997 Man of the Year, the in-tech impresario was a Hungarian who migrated to America penniless as a refugee, but he went on to make Intel the Silicon Valley powerhouse whose microprocessors run 90% of the world personal computers at the end of the 20th Century.

We can go on and on to show that most great nations are made great by the combinations of factors among which are the contributions of great minds who immigrated to that nation. Or are you not aware that Steve Jobs’ biological parents immigrated to United States from Syria? Among the inventors that the US-based magazine, Popular Science, published about upcoming Class 2014 young inventors in American universities is 18-year-old Chaimaa Makoudi who invented solar panels supercharged with quantum dots. Her family moved to the United States from Morocco in 2004. Another is 18-year-old Nikita Khlystov who invented a magnetic space sail. He is from Germany. Others are Benjamin Song, a 16-year-old who invented urine test for colon cancer, Daniel Wang, 18, who invented energy harvesting wallpaper, and Nolan Kamitaki, 17, who invented computer simulator for flu outbreaks.

They are all from Asia and they are all schooling in America making enormous contributions to that great nation.  So, today, we have the American story in Dr. Shabihul Hassan, an Indian medical practitioner who came to Nigeria in 1972 with his dad when he was just nine. He has resided in this country for 40 years and, today, he is running not only the most modern hospital in the nation, called Dr. Hassan’s Clinic and Diagnostic Centre, Maitama, Abuja, he is about to answer our dream of turning Nigeria into a world destination for medical tourism. In this first interview ever granted any Nigerian newspaper, he told ASPIRE the many life-saving interventions his organization is making, and their plans to even touch lives in many more ways than one. Excerpts:

Do we now call you a Nigerian?

I consider myself a Nigerian, my friends consider me a Nigerian. I still have an Indian passport. So, Nigeria is home; India is also home for me.

Have you procured the necessary documents?

Well, formally, I am still an Indian citizen. I have an Indian passport; but Nigeria is where I have always been. This is where my friends are. For me, this is where home is.

But you married an Indian?

Yes, I married an Indian who was born in Nigeria. My wife’s parents came to Nigeria in the late 1960s and they left a few years ago. She was born here. In fact, she has only been to India only two or three times, since she was born.

That’s incredible! Then, she too is more of a Nigerian?

Yes.

What have you been doing here in Nigeria over the years?

I am a medical doctor; so I practice medicine. I have a hospital here in Maitama District, Abuja. It is a 65-bedroom hospital. We have all the medical departments. We have very good doctors from India, Nigeria and many other countries. It is a blend of different nationalities.

Before you opened this hospital, which other things were you doing? You have been in Nigeria for 40 years?

I was working at the Maiduguri Teaching Hospital. I later left the university to set up this hospital in Abuja in 2005.

How long has your father been in Nigeria?

My father has been here for more than 40 years. He completed his 40-year stay in this country in January this year (2012). In fact, it was on the 26th of January, which coincidentally was the Indian Republic Day. The High Commissioner of India gave him an award for his various contributions. He trained many children all over the country.

Your father?

Yes

He trained many students?

He trained many students starting from 1972, when he came to Nigeria, till 2008 when he retired. His students are in many towns and cities, in many ministries and parastatals are here.

What was your father’s profession?

He was a professor in mathematics, he retired in 2008.

In which university?

University of Maiduguri. I came here as a child with my dad. You know when you stay in a place and spend all your childhood and all your days there, it becomes your home. My friends and every body that I know, every body that I care for, every body that cares for me, are all here. I have been travelling to India every year and I have gone to many other countries in the world, but that basic quality of friendliness and tolerance of the Nigerian people, is something that appeals not just to me only but also to many foreigners.

In fact, we, foreigners, at times joke among ourselves because many of us complain that the Nigerian economy is bad, that there is corruption, this and that; but we refuse to go home. Even those who go home come back or want to come back; be it Indians, Bangladeshi, Pakistanis and others, they love Nigeria and would always want to stay or come back to this country. This is because there is something in the Nigerian people. Nigerians are very friendly people. I am not saying this to your face as eye service. No. But the truth is that I love this country. I grew up here. For me, this place is home. I appreciate that personal touch between the Nigerians of all tribes. Foreigners live in this country as if it is their home. There are countries where foreigners are treated as second-class citizens or where people look up to them as being superior. But here in Nigeria, foreigners don’t feel like foreigners because Nigerian people are very down to earth, friendly tolerant. This is a wonderful quality. This is true because I know those who always want to come back. They love this place.

How often do you travel outside?

I travel outside once in a year, but, sometimes, it could be twice in a year. I do keep in touch with my family in India. It is a huge, big, extended family and we talk to them on the phone often. So, we are very much in touch with my people in India. I grew up all my life here, but I have been very much in touch with my family back home. I respect the extended family.

Let me ask you a personal question. Looking at the huge investment in this hospital, which runs into hundreds of millions of Naira, how did you, as a former lecturer, come up with the funds to set up an investment like this?

You don’t do this kind of investment in one day. I started this clinic in 2005. I started with a small clinic in Wuse, Abuja. At a point, it became essential for me to expand the hospital with the assistance of those who assisted me; the banks for instance. It has been a step-by-step process; it is not a one-day affair. Development in business, as in other life situations, is a step-by-step process, and not a one-day process.

Do you think, with people like you in this country, the issue of medical tourism, which makes people to go abroad, especially India, Britain and America, for medical treatment is still necessary?

Hospital tourism or medical tourism started few years ago; and I realized that many of the people, who were traveling out of this country for treatment, go to India. I am also the panel doctor for the Indian High Commission here. So, I was actually involved right from the beginning. When the government of India facilitated the travel of people, by making visa cheaper and easier, especially the new ambassador has been very helpful, in achieving this. He has gone several steps ahead to see that whoever needs to be treated outside the country, that things are facilitated. As the Panel Doctor to the High Commission for many years, I was involved in the process. We have been seeing people, but only those people who would not be able to get the treatment they are looking for within the country would be given special visas to go to India, to get the required treatment and come back.

But all along, my dream has been to build a hospital here so that people don’t have to travel outside this country for medical treatment. This is one of the main reasons for building this hospital here. This is a 65-bed hospital. It is a big hospital. All the necessary facilities are here. In fact, since we started this hospital, there are so many diseases for which

people used to go outside the country for treatment, especially to India, that we are now effectively treating here. People no longer travel outside for such treatments. Such patients are now referred to us to handle. We are doing things step by step here. There are delicate surgeries that we are now doing here, in this hospital.

We have started doing Laser surgery for hemorrhoids, which even is no done in many places in India. It is a very advanced surgery. We do the surgery here; there will be no bleeding, no pain. In two hours after the surgery, you could go home. This type of surgery used to be one of the messiest surgeries, a surgery that patients were afraid to do. People preferred living with hemorrhoids all their lives, just because there is so much bleeding, so much pain. You stay in the hospital for many days; sometimes weeks. But now we do this surgery here in less than 30 minutes, using laser surgery. After the operation, the patient just stays for two or three hours and goes home; no pain, no bleeding. This is an example.

We are setting up our molecular diagnostic laboratory, which probably will be the first of its kind in Nigeria. We will do advanced DNA testing. We brought in a South African company to organize a seminar about three months ago. Many of the diseases for which people travel outside Nigeria for treatment can be well treated within the country. It is just a question of the people having confidence in the system. I grew up here, I know the people in the medical circle here. Nigerian doctors are very good doctors.

They enjoy very good reputation across the world. You will be quite surprised to hear that there are more than 30,000 Nigerian doctors in the United States alone, and these are not doctors doing small clinics. These are doctors in very good positions; proper specialists in various areas of medicine. They are in the Middle East, U.K., U.S.A.; all over the world, holding respected positions. Specialists of various kinds who are products of Nigerian universities.

Within the country also, there are very good doctors today. Sometimes, they may not have access to as many facilities as they would like to have; but that not withstanding, many of the diseases for which people travel outside Nigeria for treatment, can actually be properly treated within the country. It is just that sometimes, some people don’t have confidence in the system as a whole. But for some of them, because they have the money or can afford it, they prefer going abroad for treatment. I thank God that people have a lot of confidence in me. I get patients from all over the country on daily basis. People come from Port Harcourt, Lagos and other places. They will land at the Abuja airport and I will pick them and treat them. For the outpatients, they will fly back with the evening flights. So, when I tell my patients that their sickness could be handled here, that there is no need for them to go outside the country, they usually agree to be treated here. The whole idea is just to make them have confidence in the system here. So, there are practicing doctors on whom people have confidence.

This thing (pessimism against Nigeria’s health care system) will ultimately thin down. It is just a matter of patience and time, but one cannot predict it. It started at a time when the economy went down.

Things were not as good as they used to be as in the good old days of Nigeria. When I was a child, the Nigerian pound was stronger than the British pounds sterling. That was an era when education was almost free here, when health facilities were far better. So, there was a stage that things went down. But then, the potential is there and the confidence will eventually come back. What I am trying to do here is one by one; we are talking on things for which people go abroad for treatment. We are just doing that gradually. We are also in the process of building a bigger hospital. It is going to be a 300-bed hospital.

Where?

Here in Abuja.

Have you acquired the land?

Everything is on ground. We are working on it now. We are going to call it India-Nigeria Friendship Hospital. We had discussions about this with our embassy that is the Indian embassy; and with the appropriate authorities in the country. By the time the hospital is ready, Nigerians will not have to go outside the country for treatment, as long as it is something do with medial success.

This has been my dream. I love this country and I grew up here. I know that this country has the potentials. Nigeria has huge potentials to become a hospital tourism destination. In New York, in New Delhi, in London, and in many other countries, you meet Nigerians who are holding good positions in those countries, I want to see the day when patients will come from Cameroun, Congo, Gabon, Tripoli and other African countries to Abuja to look for medical treatment, rather than people going from Nigeria to other countries for treatment.

You made me glad with what you have just said about Nigeria becoming a medical tourism destination. But when will the DNA testing be in full swing here?

We are in the process and we are hoping that within 8-12 weeks we will start. Meanwhile we are training our staff. Some of our laboratory scientists have gone to South Africa for further training. In fact one of our female laboratory scientists will also be in South Africa in the next two to three weeks to contribute to the training of our lab scientist there. The head of our laboratory, Dr. E.C. Okala, who is also the President of the National Association of the Laboratory Scientists, is the most experienced lab. scientist in this country. So, we already have a very advanced laboratory.

We do all kinds of tests here. We also get referral tests from other hospitals and clinics from other places within the country, from other towns. But we are taking these things a step further. By the time, we start doing DNA testing at an advanced level, we will be in a position to be able to detect some diseases, long before they manifest. Yes, diseases, such as diabetes are diseases that could be insidious, that is developing silently until they begin to disturb a patient.

You said some diseases could be ever before they manifest…

Yes, you can prevent some diseases at their early sages if detected early. Preventive medicine is the future of medicine. We have already started doing trials in our advanced laboratory. The company that is assisting us set up our laboratory has been here and we have been there. So, we are exchanging training visits with them. Apart from the head of our laboratory that knows these things, we want to make sure that some other staff of our laboratory are well trained in these things. We know that when we start there would be a rush, we will start getting requests from around the country.

So we want to be properly positioned to take the load. We will also have requests from scientific institutions within the country, including the advanced centres in Plateau State, the national agencies that will be cooperating with us. We will all be doing these together. We don’t want this to be done as a laboratory in a private hospital. We want the laboratory to be a reference point; where, ultimately, other lab-scientists from other hospitals will be further educated. We want to be able to disseminate medical information. Medicine is not a monopoly of one person. I don’t want this to be a situation where everybody will be praising my hospital alone.

I strongly believe that the quality of education that has been given to Nigerians in this country should be put in the development of the system. It should be put into education. There are people in this country who have big, strong, potentials. People make efforts on their own all over the country. By the time their efforts come together, there certainly will be a big change.

A lot of people in this country, even in Abuja, don’t know that you exist. So I want you   to tell me, the various departments you have in your hospital and if possible tell me the type of equipments you are using?

The truth is that with the exception of some very advanced surgeries like open heart surgery, kidney transplant, I will tell you that contrary to what people think, all surgeries are done in Nigeria, not just in my own hospital but also at the National Hospital, Abuja, at the various private hospitals, big ones in the country and at the various teaching hospitals around the country. So, if anybody feels I am doing this alone, no. This is not right. This is being done in other private hospitals in the country. There is a wave of people that do go outside the country, but that does not necessarily mean that the facilities are not available here.

But in Abuja, where our hospital is located within the diplomatic enclave in the city, we try to convince people that many of these medical problems could be handled here. For instance, people have been going abroad for things like fibroid. Fibroid operations are done all over the country. We do a lot of fibroid here. But like I told you, the relationship of patient to hospital is a relationship of confidence. We try to convince people that many of the illnesses for which they go out for treatment could be handled here, and most often, they agree with me and have their treatment here. I can tell you that, we get people from all over the country for fibroid operations now. We are also doing prostate operations here; people who have enlarged prostate, we treat them here. For fibroid, we do so many here.

We treat hemorrhoid with the new laser or infrared techniques and which has become so common. People come from all over the country for it. General surgery, we do them a lot. You know that disease patterns is not any different here than in any part of the world. Of course, there are always a few diseases that are specific to some areas. But we have a good team. A very good, very dedicated good team. From day one, as you walk into this hospital, you must have noticed that it does not look like a hospital.

That is true; even the smell of the place, is unlike a hospital…

Yes, it is unlike a hospital, my office does not look like a consulting room.

From day one, my concept of a hospital is that there should be a personal touch. We have reduced administrative bureaucracy to a minimum. When I started this hospital, I was seeing patients, even before their personal folders, are prepared. Now, the place is too big for me to manage it that way. In fact, even now, if a patient comes in and wants to see me, we don’t compel them to open a folder or file before I see them.

I see them, finish everything; paper work can be done after. Personal touch is very import -ant in a hospital. These are the things that make people to have confidence in a hospital. People walk in here; they don’t feel intimidated. We make them comfortable from the beginning. In this hospital you find people of various nationalities working here.

You personalized the relationship between the doctor and the patient?

So often, the doctors and the patient are on phone…

Not just about health issue alone but also to discuss about other personal matters…

Yes. Exactly. They call us. Sometimes, there are days my phone will receive over 500 calls a day. Sometimes, people complain that I don’t pick their calls; sometimes, it is not possible, but we don’t say no. I have trained all our doctors in such a way that people should go the extra mile. It is not a question of patients just coming to get treatment, pay and go. We train our doctors in such a way that there should be a personal touch. You should receive people with a smile. It is not every disease in the world that is 100% treatable, though all diseases have a cure. But there are diseases you know that, okay you have come to a dead end, but the difference is made when you treat the person kindly. You talk to the person; you explain issues to them. This is another thing that we do; to all our patients we explain the medicines we give to them. We train our pharmacists, our nurses on good human relations.

Our patients don’t go to the pharmacy counter to collect drugs or medicines. From the finance and administrative point of view, it is convenient for everybody to go to collect medicines, but I have not allowed that to happen. Every new manager who comes to the hospital asks me why don’t I change this, I have always told them ‘no’.

The medicine is collected from the pharmacy by a nurse, taken to the patient; then the nurse will now explain to the patient how the drugs will be taken. Before then, I had already explained to the patient the kind of drugs that I prescribed for him and the possible side effects of each medicine. These little things are necessary. Medical practice is about communication between the doctor and the patient. The ultimate healing is in the hands of God.

There are no new medicines that are used all over the world; but the idea is that you know that there is a divine hand in the healing of the individuals. So, if you know that God has a hand in the healing process, you have to do what God expects you to do. First of all, you have to be kind to the patient, you have made a diagnosis, you have to explain to the patients that ‘look, this is the diagnosis.’ If it is a bad one, you have to do it in the best possible way, so that the impact is eased. So, we try to go the extra mile, you know, not just practicing medicine the way it is taught in the medical school.

Accepted that you have praised my country, Nigeria, as a wonderful place, but sincerely, are there problems you are encountering, because the authorities are going to read this? We want to make the environment friendlier for men of ideas like you, to come and contribute in uplifting our nation, Nigeria.

Well, I thank God that I have not met any obstacles from the Nigerian authorities or from the ministry or from any quarters at all. Technically, I have not had any obstacles, but I am aware that in the private sector, people do meet obstacles, and I think that either way we see it; people tend to complain about the government. That the government is not doing this or that. But I believe that all the responsibilities should not be shouldered by the government alone. You just mentioned the example of the United States; their system runs on the shoulders of the private sector. The best hospitals in India are owned by the private sector.

All the Nigerian patients who go to India, they don’t go to government hospitals. They go to fantastic private hospitals built by individual efforts. I think that government should encourage individual efforts. I think that the government should encourage the private health sector here, more than it is doing now. The people I met in government are aware of this. In fact, the authorities here are generally 100% on agreement on this: that the private health sector at the state level, at the federal government level, should be strengthened.

But in strengthening it, it should not only be at the level of the big corporations. This should go down to the grassroots. I am talking about fresh medical graduates. By appointing graduates with an MB, BS degree, for example. The fresh graduate does his housemanship, does a bit of practical training for extra 1 to 2 years here. He may then decide to open a hospital in his hometown or village or anywhere.

This is where government should give him financial support. He does not have the collateral to collect money from the bank to buy land or build his hospital. He is a professional; if he builds a hospital in his hometown, he will make money and at the same time help the society. He will do what people expect the government to do. So, such medical graduates should be helped at whatever level, starting from the bottom. When that is done, that is when you will see the health private sector very strong.

My hospital is located in the heart of Maitama. Now this hospital alone cannot serve every body. There are other very good hospitals in Abuja, in Lagos, in other big cities. But if you want the health sector to be really good, there should be good private hospitals, right down to the district and village levels. There are many doctors who would like to do this. Doctors who are from those villages and towns. But you see the struggle for too long. They spend many years before they are able to set up a hospital. By the time they have funds, they don’t want to go back to their villages again. They are already settled somewhere, in another town. These doctors can be given soft loans so that they could acquire a building or land in their own hometowns or in their own villages to set up their private hospitals.

They should be given incentives that will make them settle in rural areas, in fact to the extent that they wouldn’t want to go to any other place. There could be special incentives for such doctors. This will strengthen the private health sector, right at the grassroots. I think there are many more things that can be done, but ultimately, I believe that the future of medicine in this country lies with the private sector. It should be regulated so that there will be no malpractice, but it should be regulated with understanding. Not to regulate to the extent that the individual will get frustrated. Professionals should be encouraged

Could you suggest ideas, on how the health sector could be moved to the next level? I understand that getting loans by doctors is not easy in this country.

I think the system of getting loans is not any different from other countries. I can tell you something; I am closely in touch with the members of the Nigerian Medical Association, the Medical Council. Some of them are my classmates, my friends, you know – they are doing their best. You know, the public see these people from a distance, as if they are not doing anything.

They are doing and making a lot of impact. But, believe me, the future of the health sector of this country is in the hands of individuals. In India, our health sector peaked, it was not the government that did it, it was individuals who did it. As long as the authorities are not creating the enabling environment, the health sector will find it difficult to grow. The government should make the procurement of loans, by the medical professionals easy.

The Nigerian Medical Association is doing a lot. These are educated people; they know what the problems are, as far as the health sector is concerned. The association is governed by very educated, very young, very dedicated people.   The same is applicable to the medical council. There is a limit to what the government can do. It was different in the 1970s when the government was dong everything. But things have changed now that the government is down. It is the individuals that, ultimately, will take the health sector forward.

How many doctors do you have in your hospital, what is your workforce?

We have visiting consultants; we have other doctors who work full time. All in all we have over 150 people working in this hospital.