By Enyeribe Ejiogu
Just by the whiskers, Dr Levi Uchechukwu Osuagwu, an optometrist from Imo State, while on a night trip to Lagos from Aba, survived a fatal robbery incident in which several people were shot dead. He was shot in the leg as bullets were pumped into the vehicle. Today he is a Research Fellow in Diabetes and Integrated Care as well as Student Coordinator at the School of Medicine, Western Sydney University, in New South Wales, Australia, where he has been for the past three years. Prior to his current engagement, he obtained postgraduate education from Aston University, Birmingham, United Kingdom (Master of Science, Distinction) and Doctor of Philosophy (PhD) from Queensland University of Technology, Brisbane, Australia. When COVID-19 hit the world in 2020, he coordinated African healthcare specialists in the Diaspora for a major research study on the pandemic.
Before leaving Nigeria, where did you practice your profession and for how long?
I have had the privilege of practicing in various private and public health institutions throughout my career. As an intern optometrist, I worked at Majesty Hospital and Eye Clinic, Uyo Akwa Ibom State, for a little under two years, before proceeding for the National Youth Service Corp (NYSC) Programme at Bali General Hospital, Taraba State, Nigeria, which lasted for another year. While there, I made very notable friends including the then late Senator Danbaba Suntai, who later became the governor of the state. Following NYSC, I worked at Victory Specialist Eye Centre, Ijesha, but left after one year, to fill a position at Choice Surgical Eye Centre, Allen Avenue, Ikeja. I left this position for Saudi Arabia in 2006.
What was the practice experience like?
Nigeria is one of very few places in the world where optometrists have a very wide scope of practice that comprises full formulary licence. Nigerian optometrists just like those in the United States and Canada are able to prescribe all ocular and systemic medications for treatment of eye diseases. This is something that many countries continue to fight for including the United Kingdom and Australia. The knowledge gained through the theoretical rigours of the Nigerian optometry school is often enough for many of us to pass international licensing exams, but we tend to struggle with the practical knowledge due to lack of modern equipment during training. We lack in this key area as Nigerian optometry graduates. Given this lack, there was a burning desire in me for more conducive environment for intellectual and professional development.
At what point did you decide to leave the country?
Although I always had the plan to practice abroad in order to gain more practical experience, that decision gained momentum after I survived the most deadly night robbery attacks at the Naval Barracks on my way back to Lagos from a friend’s wedding in Aba. That single robbery incident which lasted for many hours left a gunshot mark on my leg; several people were killed including drivers and conductors as the robbers shot persistently into the passenger buses. This robbery led to the ban on night travels in the country at the time. I sped up my plan to travel after this attack and had my family join me few months thereafter. You could say that the robbery incident hastened my decision to travel out, to acquire more skills, get foreign work experience and develop professionally. I needed more confidence in my practice and optometry skills. Moreover, I wanted to train young professionals.
Paint a picture of the experience of working in a foreign country.
Working in a foreign country is scary at first considering the challenges of living in a new country. As a foreign-trained professional, you are faced with a cultural shock like many other travellers and you try to navigate your way through understanding the system, practice guidelines, do’s and don’ts’ and how things work. As a Nigerian trained optometrist, you are challenged to prove your skills in the midst of professionals in the host country. For example, in Saudi Arabia where I worked for five years, the expectation from your employers is to get going on the first day, keep up with the speed of consultation and join in the business side of the practice. The fact that the employers are often not aware of how the practice works in Nigeria, the expectation is that the optometrist knows how to sale products, repair frames and have knowledge of all brands of contact lenses. Some employers get disappointed to find out that we practice at a slow pace and often lack in the salesman skill on arrival. This is even more challenging considering the language barrier. However, I find that Nigerian optometrists tend to adapt very quickly after some time.
Not very many people outside Nigeria understand the scope of optometry training. I find that we become the ambassadors of the profession as we continually get to explain how the training works in Nigeria compared with professionals from elsewhere. The Nigerian optometry profession is often judged by the individual performance, knowledge and skills among other foreign-trained practitioners and this becomes the national picture for incoming Nigerians.
In my case, the first cultural shock was coming to realise that majority of those I worked with in Saudi Arabia were not optometrists by training, rather these were opticians or optical technicians, who had been employed in the optometry role. The fact that they were less educated became a confident booster for many of us. Even though we often lack the experience of working in modern practice with state of the art equipment, Nigerians are able to learn new skills very quickly through personal efforts, studying and making sure we keep up the pace with new skills. Another cultural shock was coming to the understanding that you can be sued very easily for wrong practice. In Nigeria, this is still not common practice, even though the laws have made these provisions. Patients in foreign countries are more aware of their rights and are quick to ask for your qualifications and training if they do not feel very comfortable. This makes us keep up our practice skills, and education on new techniques as well as have a better understanding of the laws establishing the profession in the host country.
In my current role, it has been a great experience to lecture undergraduate students from various disciplines including mature students and executives enrolled in postgraduate courses. This is something I looked up to during my training days in Nigeria.
As a Nigerian in Diaspora, what have you done to impact your community and former school?
I took steps to get involved with giving back to my community. For instance, I became the first graduate from Australia to make available my PhD thesis through courier for the Optometry School at Abia State University (ABSU). My thesis contained four of my published peer review articles, and through that students can access the articles without having to subscribe to the individual journals, if they needed to. It was also intended to motivate students to pursue further studies in research. In the past, I have also donated contact lenses and spectacles to the optometry outpatient clinic at ABSU for teaching students. I have also collaborated with some other optometrists back home to offer free annual eye and health screening programmes to communities. For these projects, optometry students were involved. This was part of the ‘give back to community’ project, which my wife and I started in 2017 ‘in collaboration with Lions Club Boondall. I have also engaged some optometrists back home in research projects that resulted in promotions for many and high impact publications. Through our Give Back to Community Project, we have continued to conduct free annual eye and health screening in different states in the South East of Nigeria giving out free spectacles (corrective and sunglasses) at no cost.
As a healthcare research specialist, have you tried to create an intellectual development link with your former Nigerian university as Joseph did in the bible for his brothers in Egypt?
I have tried many times to partner with researchers in Abia State University in various projects, but have been largely unsuccessful. However, I have collaborated with optometrists from other Nigerian universities such as the University of Calabar and University of Benin and together we have built strong research groups and many publications in high impact journals. I have also engaged the Nigerian Optometry Association during COVID-19 to investigate readiness of eye care professionals in the fight against the pandemic. For this first time, the association was visible in a peer review article which is now widely read internationally (see link https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399827/).
In 2019, I introduced the Optical Society of America Student chapter programme to members of the Department of Optometry, Abia State University and other Nigerian universities via a presentation at the annual AGM. The association provides grants for student bodies to conduct community projects and sponsorship for them to attend and present at international meetings. Despite these presentations, no interest was obtained from the various optometry schools in Nigeria.
Are we likely to see you mobilising your fellow Diaspora professionals in healthcare just as you did for COVID-19, to work with your counterparts in Nigerian universities to undertake a major research effort in this regard?
I have been involved with mobilising fellow Diaspora professionals in healthcare to undertake research with partners from Nigerian universities. We did this during COVID-19 lockdown and we have continued to work with individuals and organisations including the Nigerian Optometry Association in other projects of interest. Currently, there are projects on glaucoma and diabetes ongoing in Nigeria and Ghana. Another collaborative project with the University of Jos was funded by Tetfund in 2020 to enable our team assess the physical and emotional impact of COVID-19 on healthcare workers in Nigeria, during the pandemic.
Given that you are far from home (like the character in the American movie, ET, the Extra Terrestrial) what do you miss the most about Nigeria?
I miss the Nigerian palmwine and the social life in Nigeria that allows us to sit out in public places with friends listening to life music and discussing over a bottle of beer after work is rare to find outside the country.
When was the last time you ate original Nigerian soup or drank original palmwine or ate ugba and okporoko?
As if you knew what I was going to say. I have not had original palmwine and ugba in the last five years. Luckily, I am married to a Nigerian woman who knows how to prepare good Nigerian meals and as such we don’t get to miss out on the soups. We have the privilege of enjoying different Nigerian soup (okra, egusi and ogbono) in our home with the kids and okporoko is available in Australia, albeit at a cost.
Finally, how strong is the Nigerian Community Association in Australia?
The Nigerian Association in Queensland Australia, the one I belong to, is a very solid organisation and even more solid is the Igbo Association, Nwannedinmba in Queensland Incorporated, where I served as an executive member in 2019. The Igbo community celebrates New Yam festival biannually and through the Nigerian Association, we often mark the Nigerian Independence day annually as well as other notable events. These communities help us to stay connected and support each other and more especially give the children an identity and a sense of belonging.
