Seyi Oyesola: A hospital tour in Nigeria

Recorded atJune 06, 2007
EventTEDGlobal 2007
Duration (min:sec)14:05
Video TypeTED Stage Talk
Words per minute192.14 fast
Readability (FK)71.47 very easy
SpeakerSeyi Oyesola
DescriptionNigerian doctor

Official TED page for this talk


Dr. Seyi Oyesola takes a searing look at health care in underdeveloped countries. His photo tour of a Nigerian teaching hospital -- all low-tech hacks and donated supplies -- drives home the challenge of doing basic health care there.

Text Highlight (experimental)
100:18 Just to put everything in context,
200:20 and to kind of give you a background to where I'm coming from,
300:24 so that a lot of the things I'm going to say,
400:26 and the things I'm going to do --
500:29 or things I'm going to tell you I've done --
600:31 you will understand exactly why and how I got motivated to be where I am.
700:38 I graduated high school in Cleveland, Ohio, 1975.
800:42 And just like my parents did when they finished studying abroad, we went back home.
900:48 Finished university education, got a medical degree, 1986.
1000:53 And by the time I was an intern house officer,
1100:57 I could barely afford to maintain my mother's 13-year-old car --
1201:02 and I was a paid doctor.
1301:06 This brings us to why a lot of us, who are professionals,
1401:10 are now, as they say, in diaspora.
1501:14 Now, are we going to make that a permanent thing,
1601:17 where we all get trained, and we leave, and we don't go back?
1701:24 Perhaps not, I should certainly hope not --
1801:27 because that is not my vision.
1901:31 All right, for good measure, that's where Nigeria is on the African map,
2001:37 and just there is the Delta region that I'm sure everybody's heard of.
2101:42 People getting kidnapped, where the oil comes from,
2201:46 the oil that sometimes I think has driven us all crazy in Nigeria.
2301:51 But, critical poverty: this slide is from a presentation I gave
2401:54 not that long ago. tells the story of the gap
2502:00 between Africa and the rest of the world in terms of health care.
2602:04 Very interesting.
2702:07 How many people do you think are on that taxi?
2802:11 And believe it or not, that is a taxi in Nigeria.
2902:14 And the capital -- well, what used to be the capital of Nigeria -- Lagos,
3002:17 that's a taxi, and you have police on them.
3102:20 So, tell me, how many policemen do you think are on this taxi? And now? Three.
3202:28 So, when these kind of people -- and, believe me, it's not just the police
3302:33 that use these taxis in Lagos. We all do. I've been on one of these,
3402:38 and I didn't have a helmet, either.
3502:41 And it just reminds me of the thought of what happens when one of us
3602:49 on a taxi like this falls off, has an accident and needs a hospital.
3702:55 Believe it or not, some of us do survive.
3802:59 Some of us do survive malaria; we do survive AIDS.
3903:03 And like I tell my family, and my wife reminds me every time,
4003:07 "You're risking your life, you know, every time you go to that country."
4103:11 And she's right. Every time you go there,
4203:14 you know that if you actually need critical care --
4303:19 critical care of any sort -- if you have an accident --
4403:22 of which there are many, there are accidents everywhere --
4503:26 where do they go?
4603:29 Where do they go when they need help for this kind of stuff?
4703:34 I'm not saying instead of, I'm saying as well as,
4803:37 AIDS, TB, malaria, typhoid -- the list goes on.
4903:43 I'm saying, where do they go when they're like me?
5003:47 When I go back home -- and I do all kinds of things,
5103:50 I teach, I train -- but I catch one of these things,
5203:54 or I'm chronically ill with one of those, where do they go?
5304:00 What's the economic impact when one of them dies or becomes disabled?
5404:06 I think it's quite significant. This is where they go.
5504:10 These are not old pictures and these are not from some downtrodden --
5604:14 this is a major hospital. In fact, it's from a major teaching hospital in Nigeria.
5704:20 Now that is less than a year old, in an operating room.
5804:25 That's sterilizing equipment in Nigeria.
5904:28 You remember all that oil?
6004:30 Yes, I'm sorry if it upsets some of you, but
6104:34 I think you need to see this. That's the floor, OK?
6204:38 You can say some of this is education.
6304:40 You can say it's hygiene. I'm not pleading poverty.
6404:44 I'm saying we need more than just, you know, vaccination,
6504:50 malaria, AIDS, because I want to be treated
6604:53 in a proper hospital if something happens to me out there.
6704:56 In fact, when I start running around saying,
6804:58 "Hey, boys and girls, you're cardiologists in the U.S.,
6905:01 can you come home with me and do a mission?"
7005:04 I want them to think, "Well there's some hope."
7105:06 Now, have a look at that. That's the anesthesiology machine.
7205:09 And that's my specialty, right?
7305:11 Anesthesiology and critical care -- look at that bag.
7405:15 It's been taped with tape that we even stopped using in the U.K.
7505:19 And believe me, these are current pictures.
7605:22 Now, if something like this, which has happened in the U.K.,
7705:27 that's where they go. This is the intensive care unit in which I work.
7805:32 All right, this is a slide from a talk I gave
7905:37 about intensive care units in Nigeria,
8005:41 and jokingly we refer to it as "Expensive Scare."
8105:46 Because it's scary and it's expensive, but we need to have it, OK?
8205:54 So, these are the problems.
8305:57 There are no prizes for telling us what the problems are, are there?
8406:01 I think we all know. And several speakers before
8506:04 and speakers after me are going to tell us even more problems.
8606:08 These are a few of them. So, what did I do?
8706:12 There we go -- we're going on a mission.
8806:15 We're going to do some open-heart surgery. I was the only Brit,
8906:19 on a team of about nine American cardiac surgeons,
9006:24 cardiac nurse, intensive care nurse.
9106:26 We all went out and did a mission and we've done three of them so far.
9206:31 Just so you know, I do believe in missions, I do believe in aid
9306:35 and I do believe in charity. They have their place,
9406:38 but where do they go for those things we talked about earlier?
9506:43 Because it's not everyone that's going to benefit from a mission.
9606:48 Health is wealth, in the words of Hans Rosling.
9706:51 You get wealthier faster if you are healthy first.
9806:57 So, here we are, mission. Big trouble.
9907:01 Open-heart surgery in Nigeria -- big trouble.
10007:04 That's Mike, Mike comes out from Mississippi.
10107:07 Does he look like he's happy?
10207:09 It took us two days just to organize the place, but hey,
10307:13 you know, we worked on it. Does he look happy?
10407:18 Yes, that's the medical advice the committee chairman says,
10507:20 "Yes, I told you, you weren't going to be able to,
10607:22 you can't do this, I just know it."
10707:24 Look, that's the technician we had. So yes, you go on, all right?
10807:29 (Laughter)
10907:30 I got him to come with me -- anesthesia tech -- come with me from the U.K.
11007:34 Yes, let's just go work this thing out.
11107:38 See, that's one of the problems we have in Nigeria and in Africa generally.
11207:42 We get a lot of donated equipment.
11307:44 Equipment that's obsolete, equipment that doesn't quite work,
11407:47 or it works and you can't fix it. And there's nothing wrong with that,
11507:51 so long as we use it and we move on.
11607:54 But we had problems with it. We had severe problems there.
11707:56 He had to get on the phone. This guy was always on the phone.
11807:59 So what we going to do now?
11908:01 It looks like all these Americans are here and
12008:03 yes, one Brit, and he's not going to do anything --
12108:07 he thinks he's British actually, and he's actually Nigerian,
12208:09 I just thought about that.
12308:11 We eventually got it working, is the truth,
12408:13 but it was one of these. Even older than the one you saw.
12508:17 The reason I have this picture here, this X-ray,
12608:20 it's just to tell you where and how we were viewing X-rays.
12708:26 Do you figure where that is? It was on a window.
12808:29 I mean, what's an X-ray viewing box? Please.
12908:34 Well, nowadays everything's on PAX anyway.
13008:37 You look at your X-rays on a screen and you do stuff with them,
13108:41 you email them. But we were still using X-rays,
13208:43 but we didn't even have a viewing box!
13308:45 And we were doing open-heart surgery.
13408:47 OK, I know it's not AIDS, I know it's not malaria,
13508:49 but we still need this stuff. Oh yeah, echo --
13608:53 this was just to get the children ready and the adults ready.
13708:57 People still believe in Voodoo. Heart disease,
13809:00 VSD, hole in the heart, tetralogies.
13909:04 You still get people who believe in it and they came.
14009:07 At 67 percent oxygen saturation, the normal is about 97.
14109:12 Her condition, open-heart surgery that as she required,
14209:15 would have been treated when she was a child.
14309:18 We had to do these for adults. So, we did succeed and we still do.
14409:22 We've done three. We're planning another one in July
14509:25 in the north of the country. So, we certainly still do open-heart,
14609:29 but you can see the contrast between everything that was shipped in --
14709:34 we ship everything, instruments. We had explosions
14809:38 because the kit was designed and installed by people who weren't used to it.
14909:45 The oxygen tanks didn't quite work right.
15009:47 But how many did we do the first one? 12.
15109:51 We did 12 open-heart surgical patients successfully.
15209:55 Here is our very first patient, out of intensive care,
15309:59 and just watch that chair, all right?
15410:02 This is what I mean about appropriate technology.
15510:06 That's what he was doing, propping up the bed because the bed simply didn't work.
15610:12 Have you seen one of those before?
15710:15 No? Yes? Doesn't matter, it worked.
15810:18 I'm sure you've all seen or heard this before:
15910:20 "We, the willing, have been doing so much with so little for so long --
16010:24 (Applause)
16110:25 -- we are now qualified to do anything with nothing."
16210:29 (Applause)
16310:32 Thank you. Sustainable Solutions -- this was my first company.
16410:37 This one's sole aim is to provide the very things that I think are missing.
16510:42 So, we put my hand in my pocket and say, "Guys, let's just buy stuff.
16610:46 Let's go set up a company that teaches people, educates them,
16710:50 gives them the tools they need to keep going."
16810:53 And that's a perfect example of one.
16910:55 Usually when you buy a ventilator in a hospital,
17010:57 you buy a different one for children,
17111:00 you buy a different one for transport. This one will do everything,
17211:03 and it will do it at half the price and doesn't need compressed air.
17311:05 If you're in America and you don't know about this one, we do,
17411:08 because we make it our duty to find out
17511:11 what's appropriate technology for Africa -- what's appropriately priced,
17611:16 does the job, and we move on. Anesthesia machine:
17711:20 multi-parameter monitor, operating lights, suction.
17811:23 This little unit here -- remember your little 12-volt plug in the car,
17911:27 that charges your, whatever, Game Boy, telephone?
18011:31 That's exactly how the outlets are designed.
18111:34 Yes, it will take a solar panel. Yes a solar panel will charge it.
18211:38 But if you've got mains as well, it will charge the batteries in there.
18311:43 And guess what? We have a little pedal charger too, just in case.
18411:47 And guess what, if it all fails,
18511:49 if you can find a car that's still got a live battery
18611:52 and you stick it in, it will still work. Then you can customize it.
18711:57 Is it dental surgery you want? General surgery you want?
18812:00 Decide which instruments, stock it up with consumables.
18912:06 And currently we're working on oxygen -- oxygen delivery on-site.
19012:15 The technology for oxygen delivery is not new.
19112:24 Oxygen concentrators are very old technology. What is new,
19212:29 and what we will have in a few months, I hope,
19312:31 is that ability to use this same renewable energy system
19412:34 to provide and produce oxygen on site. Zeolite -- it's not new --
19512:41 zeolite removes nitrogen from air and nitrogen is 78 percent of air.
19612:48 If you take nitrogen out, what's left? Oxygen, pretty much.
19712:53 So that's not new. What we're doing is applying this technology to it.
19812:57 These are the basic features of my device, or our device.
19913:01 This is what makes it so special.
20013:03 Apart from the awards it's won,
20113:05 it's portable and it's certified. It's registered, the MHRA --
20213:09 and the CE mark, for those who don't know, for Europe, is the equivalent
20313:12 of the FDA in the U.S.
20413:16 If you compare it with what's on the market, price-wise,
20513:20 size-wise, ease of use, complexity ...
20613:25 This picture was taken last year.
20713:27 These are members of my graduating class, 1986.
20813:31 It was in this gentleman's house in the Potomac,
20913:33 for those of you who are familiar with Maryland.
21013:37 There are too many of us outside and everybody,
21113:41 just to borrow a bit from Hans -- Hans Rosling, he's my guy --
21213:47 if the size of the text represents what gets the most attention,
21313:52 it's the problems. But what we really need are African solutions
21413:57 that are appropriate for Africa -- looking at the culture,
21514:00 looking at the people, looking at how much money they've got.
21614:04 African people, because they will do it with a passion, I hope.
21714:09 And lots and lots of that little bit down there, sacrifice.
21814:13 You have to do it. Africans have to do it,
21914:16 in conjunction with everyone else.
22014:18 Thank you.
22114:20 (Applause)