Okaro: Masterclass in Surgery will Reduce Medical Tourism, Obesity

Having led a team of specialist surgeons from West Africa in the first Bariatric Surgery for weight loss and diabetes in Nigeria, Consultant-General and Laparoscopic Surgeon of Euracare Multi-Specialist Hospital, Dr. Abuchi Okaro, in this interview with Rebecca Ejifoma, called for more collaborations in Africa to prevent medical tourism in that field

Tell us about Bariatric Surgery
Bariatric, which is minimally invasive, is a surgery done to adjust mostly the stomach and primarily the small intestines to result in eating of less food and much more control of smaller diet and the ability to eat less like a baby and end up losing weight. Weight loss can be done over one or two years with the support of this kind of monitoring of experts like dietician and nutritionist and of course surgeons.

Can Bariatric Surgery curb medical tourism?
It is always impossible to predict that because at the end of the day, the choices or the reasons people go abroad in medical tourism and which is not restricted to Nigeria by the way, are multiple. One of it is the lack of availability of relevant services and care, so yes in that regard it will. But ultimately the only way you can begin to tackle health tourism in an healthcare system that is not well established is to plug the gaps with services and then see how the public responds. But the primary focus of us setting up the Bariatric services is purely because people deserve to have it close to home.

What is the essence of the masterclass?
I’m excited about this because it took me about two years to organise it. This is not something you can just call people around to say make time. These are all basic surgeons. I cannot just ask them to come to Lagos and spend time with me. They would want to know what it is about and they are going to make the time and it is not something I can do on my own. We needed to have the support of people who have influence like Euracare, which has really been so generous. They supported me. Also, more importantly the company called The Matronic is a large American healthcare manufacturing company. We used their equipment for the surgery. They have actually been the ones that have made it happen.

What are the objectives of the masterclass?
The masterclass is really purposed to bring like-minded surgeons together because we are facing the same challenges in surgery. We try to educate the public and our colleagues – doctors and nurses – to say this procedure are available locally now.
The other thing that is nice to do is when you have a complex set of problems and you bring people of like minds together and when you share your challenges you get solutions and that’s really the main reason for the masterclass.

What about the surgeons?

We have five surgeons from different parts of West Africa – from Ghana, Cameroun, Abuja and Lagos. We were also able to dial into our colleagues in London. We had a video call to London and Texas just now. We have opened up the net to bring in people’s idea and I think that’s very powerful.

What are the expectations?
Because it’s a first of its kind, you know it’s only fair for us to have a debrief before the end of the day. We have got surgery to do shortly that’s where they will have an independent opinion. Now of course I called for the meeting. I organised it. I ran it in combination with others. So, I will leave it up to them to judge whether it will be useful for them to want to have another one or not. But if you ask for my personal recommendation, I will say yes. We can have it say once a year in a large scale, but also to have slightly more smaller video conferencing meetings in smaller scales between ourselves in our different locations.

What is the big picture?
Importantly, the surgery is a very small part of it. The big picture is education of the people about wellness, healthy living and healthy eating. Prevention is key. It is worth adding that for a patient that already has the problem, the dietician and nutritionist and mind-set of a patient is very important; it is not just the surgery. The surgery is a fixed part of a very long process. Having said that, the benefits are clear, there are obviously a lot of hurdles in terms of selection for the surgery, and obviously challenges in terms of recovery and risks which anybody will understand.

Will this be up to international standards?
The purpose of this is to be able to deliver to the standard that is considered internationally. We operate on a strict adherence to guidelines that are internationally laid down and that’s another thing we have touched in the masterclass. I am really encouraged. We have had a lot of informal discussions about how they feel. There have been some kind of benefits particularly in just opening their minds to the fact that others are doing similar things in different parts of the country and we can’t underestimate the importance of that feeling that you are not in isolation particularly in the West African region.

Is obesity a problem?
Obesity is a significant issue and its linked with hypertension, Type 2 diabetes, sleep apnoea, back pain, knee pain, infertility, and certain cancers. These are problems in this part of the world. There is no gender discrimination for obesity and overweight.

How will advance Bariatric surgery in Nigeria and Africa?
The point about this is a multilevel campaign. Two weeks ago, I was in Abuja talking about the impact of Bariatric surgery in the treatment of type 2 diabetes which is a really great opportunity to talk with experts. This masterclass is a great example and I’m sure the media will push it out through their outlets to get the discussion going. Euracare on its own has generated testimonials to enlighten, but there is a huge amount of work to be done.

What is the overall message?
The simple message is that we can solve some of these problems. You don’t have to travel too far; you can have it done locally. We are working hard as a group of specialists to make sure we are adhering to guidelines. We are refining our practices to make sure that they are of the highest quality. We are supporting each other in terms of intellect and expertise. There is a need to focus the mind on the problem at hand. This is a real demonstration. We have the backing of the industry and I think that is a massive endorsement. There is a lot of work to be done.