Monday, 22 June 2020

TET PRESENTS: Dr. Jonah Asiegbu







At the time of me writing this article, lockdown laws enforced by governments all over the world to curb the spread of the the global pandemic caused by the COVID-19 flu are starting to ease down.  In its place is the growing anxiety of the unforeseen consequences it will have on modern society. By and large it has already left its skid marks on the global economy, intensified mental illnesses and challenged personal and professional relationships due to extended periods of quarantining. 

Furthermore, in a world that is increasingly adopting social distancing measures as its new way of life, healthcare professionals now find themselves looking for alternative ways to effectively offer consultation and provide treatments to their patients. 
 

After I spoke to Dr. Jonah Asiegbu, I felt the weighed responsibility to impress upon the world the astronomical lengths that he is taking within the Nigerian health sector in making it more efficient and affordable for patients to receive primary healthcare through his telemedicine start-up, ‘First MedTrade Africa’. 


Focused. Visionary. Perfectionist. Those are the words that bounced around in my head in the hour and a half I had to dissect the brain (and heart) of Asiegbu. With more and more partnerships solidifying the growth of First MedTrade Africa, including German health provider ATOS Group, it was just as well that before he got his hands full propelling his rocket into the stratosphere, he could fit me in for an interview. 


According to Asiegbu, it takes a special type of person – a patriot - to say that they want to practise medicine in Nigeria: “When all of us leave Nigeria who stays back? Somebody has to change the narrative.” 


Despite his opinion, many of his doctor friends have left the country to escape working in a system that is teetering on its edges. Of the 75,000 registered medical practitioners in the country, 40,000 of them are currently practising overseas in places such as Saudi Arabia, Canada and the UK. And can anyone blame them? 


Average salaries for junior doctors in Nigeria currently stand at 200k naira a month (£500) with top medical consultants not even touching the £2000 (less than one million naira) mark at the end of each month. When one compares this with junior doctors in Canada earning on average £30k (₦14,375,475.00) yearly in salary it makes the decision to leave ones country much more easier.


The World Health Organisation suggests nations should have a doctor to every 600 people but in Nigeria there’s one in 4000. The deficit in medical personnel is frankly embarrassing if we are still claiming to be Africa’s Giant. 


Dr. Asiegbu’s journey to assuage the healthcare sector in Nigeria started from an early age. Born in 1985 in the southern state of Cross Rivers, after the death of his father when he was three years old, his widowed mother single-handedly took care of him and his four siblings. Having a mother who so emphatically and practically made sure that Asiegbu was the best he could be, he recognises her as the breeding ground for his success story both as a physician and entrepreneur. Even before he could hang a stethoscope around his neck, she was constantly telling him he was a doctor.


When discussing his academic background he cites his university’s chancellor as one of his earliest inspirations who whilst attending Igbinedion University, would invite the country’s influential figures such as former Head of State Ibrahim Babangida to give speeches to the student body. Seeing the fleet of cars and other symbols of wealth that frequented his campus sparked Asiegbu’s desire to want more for himself and his future. And those boyish ambitions have carved out the man he is today.


After finishing his first degree in 2013 he went on to do his internship at University of Calabar Teaching Hospital. It was during this period of his clinical rotations (including time in the neurosurgery unit) in 2014 that the seeds of First MedTrade Africa started being planted in his head, where he was able to experience first-hand the failings of the health system in Nigeria. Since gaining his full medical licence in 2016, he has worked in hospital wards which has helped him understand further the pain points of patients whilst attempting to receive treatment.                 
      

“It’s really pathetic down here […] We should have a system of schedule. The patient should know the time of his/her appointment. If I have an appointment for ten I should know I have an appointment for ten. […] The patient should not waste the whole day in the hospital. […] The primary health care centres […] is not functional as it’s supposed to be.”


Part of the main problem he believes, “the system that was the teaching hospitals or the tertiary sector that was planned in the sixties shouldn’t be the same manuscript we are using now.”


The WHO advises a health budget allocation between 14%-25% but Nigeria’s own is less than 10%. In a way it sabi that the government no get shame.
 

Rewind back to less than forty years ago and the state of healthcare in Nigeria looked promising. Before Nigeria gained independence in 1960 there had been a ten-year developmental plan drawn up a few years prior detailing objectives the nation intended to achieve in the subsequent years. At first, everything seemed fine. For every Nigerian citizen, medical treatment was free, and the government made it a point to invest in the health sector by awarding students with scholarships to travel abroad and study medicine. Once these students were finished with their studies they would come back to Nigeria and a job would be waiting for them. But the country’s over-dependence on oil precipitated the deterioration of the health sector starting in the 1980s. 




When someone decides to be an entrepreneur it is because they want to solve a problem and see a gap in the market. With Asiegbu he saw it was the bastardization of the health infrastructure, but what he could not foresee is the biggest biological warfare in contemporary times that will redefine doctor-patient relationships and will prove to be a blessing in disguise. “I never envisaged that there will be a pandemic like this. So now I think this is the birth of telemedicine in Nigeria.”


Even though Africa is the least affected continent with COVID-19 it is far from comforting given the still rising numbers and the lower standards of hygiene that is found in our part of the world. In Nigeria alone over 18,000 people have had the coronavirus with over 400 of them succumbing to the flu, including Chief of Staff, Abba Kyari in April. 


Simply put, the primary healthcare needs help. But it takes another type of person to say they want run a business in Nigeria. 


When Asiegbu decided to create his solution in 2016 thankfully he was in the fortunate position to be able to bootstrap the running-costs himself. Speaking of the start-up ecosystem in the country he says, “the bank interest rate is outrageous. There is no funding for start-ups. And that is where the brain drain is. Nigerians are one of the most intelligent people I’ve seen on Earth. When I hear what the young chaps, the ideas they have but there is no place to exhibit them. This is how countries grow […] The government does not provide any start-up funding. […] The major problem in this country is lack of insight and lack of funding.”


It would be a trip to Germany where he pitched his idea to a group of doctors, that would give him the greenlight to go full steam ahead with his project. Even though those close to him saw the potential in his vision as with anything great it always takes longer for the masses to catch up. 


From the price of a few agege breads, patients can receive online consultation with certified doctors from an extensive list of specialties such as dermatology, cosmetics, dentistry and cardiology.  To register, patients fill out a straight-forward registration form and book an appointment with their chosen doctor hassle-free. As well as being a B2C start-up, First MedTrade Africa also works as a B2B alongside hospitals by providing air transfer services for patients. In June, they launched an online medical market to provide hospitals with medical equipment to add on to their services.


Growing an online medical platform is all well and good but when half the population lives in rural areas and many of them do not have stable electricity talk less of a mobile phone with internet data, that can be a cause for concern. Nonetheless, this is a challenge that Asiegbu is ready to conquer too saying, “healthcare in Nigeria is an untapped goldmine.”


Another thing which Asiegbu wants to tackle with First MedTrade Africa is medical tourism. In a recent report Nigerians reportedly spend £970m yearly going overseas namely the UK, Middle East, United States and India to receive treatment.  When even the President has to fly abroad for treatment that is when we should think sometin de deh. “We need to reverse that history. There must be a reason for Nigerians working abroad have to come back home. We have to give them a comfortable environment to work and then we have to make sure they’re safe.”


He classes Donald Duke, Akinwumni Adesina, Sanusi Lamido as his inspirations also Dr Adeyemi Johnson who has been a pioneer in the cardiology field within the country.


It is important as Nigerians that we look up to people within our homes instead of looking at outsiders or we are just going to be forever stuck in this Stockholm syndrome perpetrated from colonialism. “Most of these patients travelling out of the country do not believe that there are physicians in this country that can take care of them. Because there are no data, there are no communities, there are no online platforms [to show this].” 


Even though First MedTrade Africa is an ‘indigenous company from Nigeria’ Asiegbu realises that there is more to be achieved when it is a collaborative effort. “First Med Trade is a bridge to the world meaning that we need those partnerships with international communities […] We have to learn from them, we need those partnerships to strengthen our back end, to be able to strengthen the African market.”   


Any entrepreneur that has ever had to grow a team knows that a company is only as good as the people who work in it. Asiegbu knowing this, he credits his core team Amina Ibrahim (COO), Princess Uzoukwu (CFO), Jude Joshua (ICT Manager) and Mfonobong Etokakpan (CMO) who have worked tirelessly to help breathe life into his vision. 


Now four years in and a soft launch earlier this year in February, he teases how much more is in store for First MedTrade Africa including a mobile application which is currently being developed. 

 

With only 24 hours in a day, Asiegbu makes every second count by starting at 2am in the morning and drinking strong black coffee (no milk, no sugar – just how I like it!).  Whilst he tries to work out how many cups of coffee he drinks in a day I hear Amina, telling him that he probably goes through more than five cups of coffee a day. Given his schedule, I am not surprised. 


And his hard work is paying off. With First MedTrade Africa on Nigeria-based venture capital firm VC4A portfolio, he has been able to gain the attention of investors who are looking to help raise his Series-A funding to support the expansion plans. Added to this, the start-up has also been accepted in Forbes 2020 Startup Digital Accelerator Program.


Whether First MedTrade Africa will stick around does not really matter. (Though I have a strong feeling it will). What matters is that it is becoming a part of an important discourse on how technology and digital platforms can positively contribute to health provision in Nigeria. 


You can find out more about FirstMedTrade Africa on their website.  Follow them on Twitter here.

Friday, 17 April 2020

TET Presents: Lolo Cynthia Ihesie




In a quarter of a century, Lolo Cynthia Ihesie, has become the spokesperson for the voiceless by spearheading change in sex education and consistently challenging beliefs in a nation deeply embedded in its rigid cultures and traditions. Through her community work, online persona and artistic endeavours this Igbo warrior continues, at an effortless pace, to successfully bring to the centre stage social issues affecting millions of Nigerians today, doing it in the most unfiltered, non-bullshit way which has made her Shango to her nay-sayers but a ray of sunshine to the countless of lives she has touched – so either way, her presence cannot be ignored. 

Ihesie’s core desire in all that she is doing is “sexually liberating women and men by providing contraceptives and sex education.” And I get it. With a population of over 200 million, ranking 7th in the world, one would think a country like Nigeria would have a liberal approach in discussing the human anatomy but for some reason talking about segz de be big problem.

The estimated worth of the global sex industry is worth a reported £150bn meaning there is high demand for penetration. In countries like Germany, prostitution is legal and just like any other industry, regulating bodies and trade unions are in place so workers can rightfully have that blanket of protection should anything go awry in their working life. They can also get health checks without fear of judgement and contribute to society by paying their taxes which in turn benefits the country’s economy whilst also reducing the risk of human trafficking. 



Unfortunately, within Africa only Senegal has been able to systemise the sex trade and it certainly begs the question why Nigeria has not jumped on board when the advantages are more apparent. Some might say that the federal government’s hesitancy in legalising sex work is due to its fear of promoting promiscuous behaviour but really and truly it is about protecting the women (and men) who for whatever reason have found themselves in a place where that is their source of income.

Hence why initiatives like Ihesie’s ‘MyBodyIsMine’ which she started in 2018 giving out free condoms and offering free STI health checks to sex workers are invaluable; deploying empathy to this community and not making them feel isolated than they already are. To date she has taught over 2,000 students about their reproductive health and was recently recognised by The Aspen Institute as a New Voices Fellow for her efforts.

Bottomline – Nigerians love sex and we are fertile.

But being a highly religious and spiritual country, it can make one think otherwise. Those of us who grew up in Nigerian households were most likely never talked to about sex and if we were talked to about it, more likely than not it was talked about in a negative light. And when children grow up with the perception of something that is so innately part of their biology being Pandora’s box it leads to the high rate of teenage pregnancy (31%), which  the country currently has. 

It is only natural that from a young age we became curious about different areas of our bodies and when certain body parts started swelling, tingling, smelling, leaking or bleeding we wanted to explore them. But if children are not guided by a trusted adult who makes them understand the beauty of hormones and how to embrace the changes whilst also educating on the emotional, mental, and physical significance of these things it further perpetrates the negative ideals people have of their sexuality and for those young individuals (mostly women) they end up carrying a responsibility before they are mature enough to do so. This problem is intensified when 48% of inhabitants in Nigeria live on less than £2 a day, meaning that children being born out of the horniness of these parents are less likely to have access to education, employment that would take them out of their poverty.

Ihesie handing out free sanitary items to women in the community
These are the kind of issues that resonated with Ihesie whilst she was in South Africa studying Public Health as her undergraduate degree at Monash University a change she made after not going on with her first choice of Medicine. “I was focused on linking the social angle to the health angle, finding out what are the sociological factors that is pushing someone to have a health issue.” Her deep interests led her to pursuing her Masters in HIV/AIDS and Health Management which she completed in 2014 before returning back to Nigeria.

As a UNHCR media ambassador she has produced several documentaries highlighting the refugee crisis in Libya and the Nigerian refugees that return. On her YouTube channel, ‘LoloTalks’, she produces profound social documentaries and interviews which has amassed over 1.5million views. In her masterpiece documentary, ‘Dream – Street Teenagers in Lagos’ she reveals the heart-breaking conditions of children living under the Lagos bridges, which Ihesie confirmed to me were all under the age of 18. Asking her what it felt like to interview these children she said, “we are listening to them, but they are living it”. Going further to explain how deep-rooted the issue is she said, "the trauma really, really dehumanises us in this country that you forget to see people for who they are. They don’t have empathy, and that is the only way you can survive - not having empathy.” 

This is a stark reminder of the poor infrastructure caused by the inadequate school curriculum, lack of health reforms and under skilled workforce.  Many of these children had been forced to resort to petty crimes such as stealing in order to sustain themselves. There were several instances I had to pause the video because I would start tearing up from the pangs of guilt I was feeling of watching it in the comfort of my bed in my heated apartment whilst they were out in the streets their innocence eroding day by day. Scenes from Chris Abani’s post-colonial novel, ‘Graceland’ reappeared in my head of the 16-year old protagonist, Elvis who became a ‘caretaker’ to the kids living under the bridge because many of them were sexually molested and physically assaulted whilst they were out begging. The part that really fucked with my emotions is when Abani describes how many of the children would sleep standing up during rainy nights. And I know it is fiction but much of fiction reflects real life. And therein lies the problem.




Ihesie makes no pretences of the weight all these responsibilities have on her. Speaking on the last year she said: “Last year I think I was burnt out. It gets really overwhelming. I’m actually just coming back for air. It’s a lot.”

Sustainability is a huge factor in all her projects and one of her many frustrations is the perception that sexual education has making attracting funds a challenge. “People see it as a passion they don’t see the fact that it’s a public health issue. It’s something the government should be doing. They see that’s just something you love doing, you like helping people. But it’s a proper job. It’s a real thing.” 

As much as the work she is doing is highly impactful she acknowledges that, “a hundred NGOs cannot replace one functioning government”. This is why one of her long-term goals is to work with the health and education departments to provide female students in primary and secondary schools free sanitary items. She believes this is doable. And Scotland, recently showed that this is something that can be doable as they are now the first country in the world who are close in making sanitary items free for all women.

For a few brief moments we talked about the descent of the new form of slavery which is the ‘economic colonisation’ from places like China in Nigeria and when I voiced my displeasure of what ultimately the leaders of the country were subjecting its citizens to, in a tired tone she replied, “I mean, were we ever free? […] But it’s just because the government is also not ensuring that it’s an enabling environment.” 


In 2019 the activist wetted her toes in the political pool by collaborating with the First Lady of Ondo, Betty Anyanwu-Akeredolu. The collaboration was a chance encounter given that Ihesie had been applying for grants to help finance her reusable pad initiative but all her applications were rejected. It was through the advice of her mentor that she reached out to Akeredolu who also had a campaign of her own that focused on period poverty and held summer camps for school-age girls during which Ihesie was also able to provide training to the girls on how to make their own reusable pad. 

Intrigued by the concept and the potential of profitability I asked her if she had considered coming out with her own line of eco-friendly sanitary products but she’d already beaten me to it as it was something that she was already looking into and going further to explain that she would want the materials to be locally sourced whilst also providing employment to women from the community. As someone who is a great proponent for Nigerians and Africans in general to be producers instead of exporters of goods this was music to my ears that this was somewhere in the timeline for Ihesie to achieve. 

I think it was only natural that a significant portion of our conversation was centred around talking about generational trauma something that sadly seems to be the backbone of Nigerian culture. And sadly it is something that I addressed in my TEDx talk having had to combat personal struggles of my own. So when I came across Ihesie’s interview with psychotherapist Amanda Iheme speaking on these same issues it really felt like our paths were perfectly aligned to meet (albeit, virtually - at least for now).

Somewhere in our childhood a lot of Nigerians have been robbed off their identity as individuals. Many of us grow tied to the expectations that our parents, elders set for us i.e. get a degree, get a job, get married, have children. All these activities of “getting” things exist outside of our beings, exist outside of us being okay with who we are within ourselves.
A lot of us from a religious households would more than likely had their parents throw a Bible verse like this their way “Children obey your parents for this is right” in order to manipulate us into doing what they want but then they forget the following verse that says, “Fathers do not provoke your children to anger by the way you treat them’.

Ihesie teaching at a boys' correction centre
This is why Ihesie being the eldest of six siblings she had the foresight from an early age to create boundaries: “It might seem really tough, really mean in the Nigerian or African context […] But I’m not going to start running around picking up my sisters from school. That is the responsibility of my parents […]  I refuse to engage with activities that will drain me […]You want to take care of everyone but the responsibilities never stop so you have to create boundaries […] And whilst I’m focusing on my dreams my younger sisters are watching me do what I have to do. I don’t tell them I show them.”
In every Lagosian I interact with there is always this bubble of energy that seeps out of them in the way they talk and carry themselves. Their work ethic is incomparable and their love for life amidst struggle is infectious. This was no different to what I felt in Ihesie but as our conversation was winding down, I was interested in finding out about Lolo. The Lolo outside of rehabilitating boys in juvenile centres, the Lolo outside of interviewing keke drivers, the Lolo outside of chasing grants and the Lolo outside of standing up for her autonomy to decide whether to have children or not. 

So when I asked her what she liked doing it was almost not surprising that a lot of the things she enjoyed doing such as going to the cinema, going to the gym, reading African literature were all activities she did alone. A fellow empath, she’s obviously a woman after my own heart. “In as much as I’m giving to people I make sure that I also put back into myself.”

It was just as well that this interview took place on the eve of her 25th birthday which served a perfect time for reflection. “I feel so young. I can’t wait to be older. That’s actually the way I want to live.”

I couldn’t have chosen a more suitable person to interview for this new venture on
The Eféctive Times. The problems of Nigeria are plenty but it is individuals like her that make the future of Africa’s Giant exciting. And I can go on forever talking about why Ihesie is one to watch but for now I will let her actions continue to do the talking. 

You can find Lolo Ihesie on Twitter. Subscribe to her YouTube channel here.