Special Report – UMTH: Professor Ahmed Ahidjo; A historic shift in hospital management

By: James Bwala

The University of Maiduguri Teaching Hospital in Maiduguri, Borno state with 1200 bed capacity is perhaps the largest hospital in Nigeria today. Probably the prime in West Africa. The growth given to man’s imagination would not have come easy without a ‘head’ with such humility to melt a stone. As a man thinks, so is he. Knowledge alone does not make a man but knowledge with humility makes great men. That the Professor of Interventional Radiology has been celebrated for administrative purposes in the last four years since he assumed the administrative leadership of the UMTH shows that leadership is not only about leading the people but also about carrying the cross. It is also about submission and listening to good counsel. It was in this case that this mender of our broken walls as far as hospital management is concerned was born from this corner of the world where no such achievements could have seen the phase of years that he has put forward these revolutionary ideas.

From the hospital administrative blocks to students blocks and practically on the patients blocks Professor Ahmed Ahidjo has demonstrated unique and an equal footprint of humility and strength. Reports about him, from the top management and consultants to the least man at the gate reveals a man dedicated to his works with much love to make the difference. A very good listener, who fine-tunes ideas and builds such dreams into reality. An example of such moments were the huge successes recorded in rising large estate of departments from the expansion of the emergency area of the hospital building to building a magnificent Trauma Centre, Child Institute, Physical Rehabilitation centre, Cancer centre, Neurological centre, the burn centre and the largest

computerized store with Hospital Information System under the Health-in -a-Box project in the hospital to mention a few.

The Ahidjo’s ‘dogma’ they said is about building a management that works. His management team has key into his dream of having the best hospital not only across Nigeria but more largely to ensure that our people no longer go across the sea to seek medical attention. The structures he raised come fully with all the equipment needed for better diagnosis and treatment of both in and out patients. The recruitment of doctors otherwise called Residents Doctors and other workers was tactically a push to have the best on ground. He was also moved to training and retraining of staff in the way they should treat patients and patients relations whenever in the hospital seeking for medication and he goes round day and night to ensure what was agreed upon are taken to the latter. Security officials in the hospital from their testimonies said sometimes he comes around by 2:00 AM to check on patients and doctors on duty. It was on such motivation that the CMD ensured to build the best restrooms and relaxation areas for doctors and staff on night shift so as to reduce the distance between doctors and patients at all times.

One wonders how the CMD got all the experience to venture into making such a footprint. But speaking on his worth makes the difference. “Administratively, I was Head of Radiology Department at the University of Maiduguri and University of Maiduguri Teaching Hospital for almost ten years. I became the pioneer Head of Radiography Department to start training of Radiographers in the 19th Northern states. I also became the Deputy Provost College of Medical Sciences for a period of two years. Thereafter, I became the Provost, College of Medical Sciences University of Maiduguri. I was also the secretary National PostGraduate Medical College of Nigeria in charge of Radiology training in the country for a period of four years in Lagos.  From there I became the Chief Medical Director –UMTH. Within the period I also worked at the World Head Organization’s Headquarters in Geneva in Charge of all the Radiology devices globally with 198 member countries. I was also a Research Scholar at the Uniformed Services University of Health Sciences in Maryland. Since becoming the CMD for over three years now I have been working in the office.” He said.

Electricity, which has been the major crisis in Borno state owing to the ongoing conflict that transverse in the last 13 years has been an issue in the hospital but according to Professor Ahmed Ahidjo there is no work as far as the hospital is concerned with electricity. As such he moved with strategic emotions towards the issue of power supply. He knocks at individuals and corporate organizations to come to the aid of the hospital by contributing to ease the pains of rolling the meager revenue on clashing demands. To run the hospital generators requires over sixty-seven million naira on a monthly basis. The revenue of the hospital stands around forty million naira on monthly accounts. The hospital stationed in Borno state with a high poverty rate and all the conflict going and lack of electricity operates as a non governmental organization. The forty million naira revenue is like a drop in an ocean of needs from both demands on consumables and non-consumables items.

According to Professor Ahidjo, ” Energy remains one of the most challenging things in managing health institutions in Nigeria. This is because of the inadequate quantity that we required and also because of the inadequate quality of energy as required. As long as we are moving in the direction we are now, without changing the system the way it should, it is very unlikely that we will give the optimum healthcare to the society using this energy that we have. Generally, there is a need for the government to look at how to optimally or how best to supply energy in this country, especially the hospitals and health institutions in general. Providing that electricity I think will do well to the whole of the country and not only the healthcare system. Once energy is supplied to the country, the healthcare institutions, it means the services will be there. From the experience I had in the past few years, energy is one of the most difficult things that we are supposed to have in the whole of the management of the hospital system in Nigeria. If the government provides energy to the hospitals, that will ease a lot of things. Many countries do that and this is one of the most needed infrastructures in Nigerian hospitals. If they cannot provide, at least let it be subsidized because it is going to be very difficult looking at the way we charge our patients now. 

To pay for the best electricity supply is what we needed to have the best in the hospitals. But where is the money? For example, the gross IGR of my hospital in April this year was Forty-two million (N42, 000,000.00) and Diesel alone gulps Sixty –Seven million and Five hundred thousand (N67, 500,000.00). This is not practicable. The best way is to look at how to assist these hospitals with energy supply. If the National grid cannot give priority to hospitals, let independent power plants especially now that diesel is very expensive, gas generators be provided to healthcare institutions – the Federal ones and let them buy the gas. That will help a lot because buying gas plants may be too expensive for the federal healthcare institutions for now. If the government can procure these big generators and give it to these federal health institutions and let them use gas to supply the energy that they need, this will really alleviate the system otherwise virtually most of the hospitals in this country have cut the energy supply hours because of the hike in diesel price. There is a need for us to look into energy solutions in our healthcare delivery system. Let the government key into this in an attempt to give the hospital the needed energy so that they can give the needed healthcare in line with the National strategic healthcare plan for Nigeria.”

With such pressures of needs, sitting in the 1,800 seats capacity Zulum auditorium of the hospital, the CMD and his think tanks brainstorm to come up with the idea of sustainable development for all departments. The deliberation had people who helped to refresh the minds of the working management to stem the needs and the pressure through a directive idea that would help each department to come alive on its revenue generation to make meaning in its work and sustainability of actions. From that meeting, it was observed that workers are now on their toes and one of the recent achievements is the “Health-in-a-box” project, which is a new technological idea to check activities in the hospital store through computerisation of items coming in and those going out and to where or to which department such items are going and so on. This idea could help in accountability and the result is already yielding.

The Covid-19 pandemic has pushed the CMD into seeking more help owing to the situation in poverty stricken states, especially in the northeast Nigeria. He did not stop at anything but the best. His fighting spirit gave result as the hospital got the best equipment, the best space and treatment areas for the Covid-19 patient. It was state of the art equipment with each bed carrying all the equipment needed for treatment and recovery of patients. The burn Centre is a special area for the treatment of burns. It was another achievement made through the vigorous strategy the CMD employed to deal with issues of burns following the state of the region and the ongoing trauma of victims of the conflict in northeast Nigeria.

The Child Institute is the biggest centre specifically for the treatment of children. The trauma Centre takes the attention of the first time visitor to the hospital and the Physical Rehabilitation centre has given hope to many who wished to walk again. The Cancer centre with four bunkers to stop radiation and to give the desired treatment for cancer patients is just another story on its own. The two machines cost the hospital over two billion naira. All these according to the CMD comes about through spirited individuals who are contributing to the welfare of the people of Borno state and the hospital. This however, did not come without a deliberate move by the CMD to pursue and lobby individuals and organisations to come and help the health system toward the betterment of the state, the region and Nigeria as a whole.

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The Neurological centre under construction is another giant stride of Professor Ahmed Ahidjo and achievements in the last four years of his administration of the University of Maiduguri Teaching Hospital. Like the Cancer centre, it was said to be a project being handled by certain individuals who are silent achievers that saw the need to key into the Ahidjo’s dream of a good health system. In the centre, there are various sections and units and the admirable thing is that all the equipment for the centre is already on ground waiting for the completion of the project, which stands at 90 percent completion. Going round and explaining about the centre, children of the less privileged and hired security on the project site ran into Ahidjo and were clinging. There is no doubt they have seen him often and made friendships. This also indicated that the CMD is not only resourceful to older generations but also the upcoming ones. No wonder the idea also of the Child Institute in the hospital.

In the last four years of dramatic and strategic revolution, the Chief Medical Director, University of Maiduguri Teaching Hospital, Professor Ahmed Ahidjo has changed the way the medical and surgical wards of the hospital used to be. The changes give both patients and relations an air of enhancement. Some of the wards he turns them into cubicles, the floor leading to wards were now tiles and for the women in labour a new lift as the new labour ward is coming underway while improvement was made in the old labour ward making new mother happier as they go to bring new life with tears of joy and motherhood that counts. 

The stories of Ahidjo’s revolution in hospital administration have just begun with additional four years of hospital management experience. For the first time, a CMD was given another appointment prior to the expiration date of his first appointment as CMD at the University of Maiduguri Teaching Hospital. This alone says well of a man that desires duty and accomplishment of responsibility with a magnitude of a humility that breaks stony heart and brings desire for more accomplishments in the drive to change narratives. The training that makes all these possible are in his words:

” I studied Leadership in health from Washington University. That is the qualification I had in management. That was before I became the CMD and this is one of the most respected managerial courses across the globe in healthcare. However, skills sometimes you learn over a period of time. From the beginning I have been in the leadership position. Since my student days, I was a student’s union leader and at residency I was ARD President. I was also Chairman of the Consultants, so I have been in the union side, in administration and then I started as Head of Department and I moved up to the peak professionally to become the Provost of the College without jumping post. I went step by step and I have taken all the posts I am supposed to take to rise to the top. So, in addition to the qualification, I was actually along the line of practical skill acquisitions in management positions. So that is why sometimes when you are managing a system, you get conversant with those systems.  It became easy to manage them. If you are talking as a Head of Department, I was a Head of Department for ten years and I know what it means to be one. If you are talking as an ordinary doctor in the hospital, I know what it feels to be one. I know what it takes to be one and I know the duties of one. If you are a nurse, I have interacted with one. If you are a Radiographer, I have interacted with them. So, you get all these skills over decades.”

Special Report – UMTH: Professor Ahmed Ahidjo; A historic shift in hospital management