Professor Osato Giwa Osagie has been a professor of Obstetrics and Gynaecology for many years. Countless number of babies have been born under his supervision. One notable baby is Halima, daughter of former military president, General Ibrahim Badamasi Babangida. At his Lagos Island clinic, the professor emeritus, who has produced several consultant obstetricians and gynaecologists, spoke with Sunday Sun and shed light on infertility causes, his life as a medical doctor and why he chose to specialize on reproductive health practice.
As a gynaecologist how do you cope with women?
I’ve always got on very well with women. I keep saying that the day a woman is in charge of anything in Nigeria, as president, vice president, governor, minister or permanent secretary, all my problems are solved. With the exception of few recent examples, women tend to be less corrupt than men. And, if a woman tells me, ‘Professor, I will do this for you,’ they always do it.
The man will not give me that commitment because part of his problem is that he starts thinking, ‘if I help this man now, he will be richer or better than me, I can’t talk to him anymore.’ He wants you to stay where he met you so that he will overtake you and so on. It’s unfortunate but that’s how Nigerian men are. That’s why when they are in office you find it difficult to see them or meet them or communicate with them. And that’s why they make mistakes.
For instance, people like me, we want to advise them, we don’t need any money from them, I will advise you, if you take it and you succeed I’m satisfied. But they don’t want to hear that. They don’t want to hear about people who can advise them on how to do things right.
The rate of infertility is high, even virgins before marriage are caught up with infertility. What is the problem?
The causes of infertility in Nigeria or in Africa generally haven’t changed in the last 30 years. The main causes are infections such as sexually transmitted infections and infections during pregnancies. Induced abortion is quite common. It’ßs speculated that over 600,000 abortions are done per year. Remember that we are 160 million people. If you do an abortion, if it is done by somebody who has not been trained to do it, or you do it in an unhygienic environment you are going to get infected and you will have problems with your tubes later on.
If it’s done by a trained person in hygienic environment there will be no complications 90 per cent of the time. Abortion, whether it’s spontaneous or induced, is an important cause of infertility.
Then sexual diseases like gonorrhea, chlamydia infections are very important causes also. Then delivery under unhygienic conditions, where people are left to be in labour for two days or three days, with their waters broken infections may get in; they may deliver the baby okay most of the time but the infection can damage their tubes for other babies. You find out, therefore, that the most common form of infertility is what we call secondary infertility.
That is, the person has been pregnant before then started having problems in getting pregnant again because of these reasons I have given you. Another cause is, scar tissue following surgery or infections.
For instance, ruptured appendix leads to inside the abdomen in addition to scar from this can affect the tubes. Scar tissue following operations on the ovaries, fibroids, or caesarean section…
These are far more important causes of infertility than the hormonal ones (which is failure to release an egg, and things like that). Of course in a man, low sperm count or zero sperm is the number one cause. A man can also have hormonal problems – if he has a high level of prolactin he will be impotent, he won’t have the urge at all to have sex, even if he does, he can’t impregnate anybody. Infertility will appear to be more common now because the women are better educated and, therefore, they ask questions; they just don’t take it that its God’s work. In spite of what I have said, there are still quite a few women who believe that everything is God’s work.
They will be infertile, they won’t do anything scientific for years, and they will just be waiting for God to intervene. As I tell them, if you believe so much in God, why you don’t just sit in your bedroom, don’t go to school and go and sit the exam and see whether the answers will be in the sky for you to copy. Some people have unreasonable expectations of God. You have to do your own part and let your faith do the rest.
Because a pastor tells you that its holy water you have to take, 90 per cent of the time it’s daft. So, we are well aware of infertility, we have tests and gadgets we can use to detect the causes, so it will appear to be more common to say like 30 years ago. A virgin can be infertile for several reasons. It may be hormonal imbalance and the ovaries may not be functioning properly. You can be a virgin and maybe you don’t even have a womb.
Is that possible?
Yes. The person will not menstruate ever. Or they get infected following appendectomy (operation to remove inflamed appendix).
Burst appendix can finish any woman’s tubes. So, there are reasons why a woman who is a virgin can suffer infertility. These are just some of the reasons I have mentioned.
What made you want to become a doctor?
I just like the idea that somebody could be crying at this minute , when a doctor goes to that person, he finds out what the cause is, applies something and the person comes back the next day walking around. It’s almost like magic. That is very important for a young person. I used to like them in their white coat and with the stethoscope. They would be swinging it. Young children are attracted to uniforms. They see a captain in uniform they want to be a soldier, they see a naval officer they want to be naval officers. It’s the same thing, you see a doctor in action, and you want to be a doctor.
What gives you joy as a doctor?
What gives me joy is being able to solve problems. I tell my patients, I’m a gynaecologist and obstetrician, so I deliver babies, look after pregnant women and I look after the business of women like fibroids, infertility, and cancer and so on. Looking after these women and producing positive results is more satisfying than giving me N100 million.
In Nigeria, with our worthy sense of values, it means that you lose out when you are busy looking after these women, including the wives of governors and senators and so on, they are busy sharing land and they don’t remember you. I was in this Lagos when they shared the whole of Victoria Island, the whole of Oniru estate, and I didn’t get one.
That would not have happened in Nigeria of 50 years ago. The perm sec would tell them to go and give Dr. So and So, tell him to fill it and bring. Nobody cares about that in Nigeria. So, sometimes, when you hear that doctors are rude or inhuman to some patients, it’s their reaction to what they have to go through. Nobody does a doctor a favour anymore. If they can take away the little you have from you, they will take it.
Why do doctors often go strike?
It is very sad that doctors should be allowed to go on strike. When I was in England, I went on strike once or twice. As a doctor in England I was working for over 100 hours a week. We were not paid any overtime. It was during my tenure that doctors went on strike there. Then the government started paying doctors overtime. Depending on how busy you are, at times the overtime was equivalent to your full salary, so it was a very welcome thing. We were part of that strike in the UK.
As you know it’s in the news, that they have been having strikes in Britain as well. In Nigeria when I came to the country in 1978, the doctors had some strikes during the military regimes and when I was at Lagos University Teaching Hospital (LUTH) we had one, when we were asking for improved power supply in LUTH. I did caesarian section in LUTH labour ward with torchlight. The National Electric Power Authority (NEPA) had taken power and LUTH had no generator. At some stage the doctors went on strike. I think it was during the administration of Alhaji Shehu Shagari as president.
They went on strike, demanding that there must be power generation and water supply. It had nothing to do with salaries. I remember that strike very well. Another one was during the first coming of President Muhammadu Buhari as a military head of state in 1984.
One of the demands was for better pay and most of those times they went on strike I can assure you don’t know what they are going on strike for because you are just working, and then the activists in your group go for meetings and they tell you we are going on strike from next week.
You go on strike, if you didn’t join the strike, you would find out that you were the only one on duty; so we all went on strike and we were dismissed from our jobs as doctors. Mobile police were sent to evict us from our homes in LUTH compound. So when I support any government and so on, I don’t support them out of ignorance, I know what they have done before as those that come back as head of state.
I know that some of them when they are faced with the fact of the case they bent a bit, they couldn’t be seen to reverse themselves in the military regime. So, I have been through all that. From what I have seen, particularly in the past 25 years, I believe that there are some civil servants who are not doctors, who sit down there in the ministry when these negotiations are going on. And intentionally mislead the government.