British-born Nigerian medical doctor and managing director, Flying Doctors Nigeria, Olamide Orekunrin, in this interview explains to CHRISTIAN ONWUACHUMBA how paucity of funds, shortage of doctors and hospitals made it imperative for the society to give priority to the air ambulance option. Excerpts.
Why did you choose to go into air ambulance operations in Nigeria?
Mine is a textbook story. I started my business about seven years ago. I was born in England, I grew up there as well and my younger sister, who was 12 years old, came back to Nigeria for holidays. At some point, she got very sick and we were trying to fly her to a better hospital because she was too sick to be moved by road. We were looking for an air ambulance, because it is such a common thing in England, we just assumed that it would be available in Nigeria. To our amazement, we found out the closest air ambulance service was in South Africa! My parents were trying to engage the service when she died. That really stuck in my memory even though I hadn’t been to Nigeria in my adult life, it was something I wanted to do, knowing that the tragedy about my sister happened because the service wasn’t available. Most young people I speak to dream of going to England; my dream was to come to Nigeria while growing. I was so eager to see what it would be like to live in this kind of society, which was very different from where I grew up. As soon as I graduated from medical school, I moved here.
What are the prospects and challenges of air ambulance operations in Nigeria?
Air ambulance is an essential tool for medical professionals. It is about getting patients to the right medical facility within the right time frame. For instance, we recently moved a patient to Lagos from Benin. A building fell on her and her hip was so shattered that it could only be done at Igbobi in Lagos and to move her by road, because of the state of the road, it would have been very difficult, as the hip had to stay completely stable. We were able to move her successfully from Benin to Lagos and she had her operation successfully. This service is just about moving people to the place where they can receive treatment in the shortest time possible. One of our most common trips is Maiduguri to Lagos. Before, trying to move complex orthopaedic cases from Maiduguri to Lagos by road could take several days. With our service, it can be done in just one hour. There are other problems of moving patients via road such as the state of the roads and the condition of the patient. If the patient is on oxygen for instance, then imagine, from Maiduguri to Lagos, how many cylinders of oxygen you need to pack inside that ambulance to get the patient to the final destination, since one cylinder lasts for just one hour. You will need two ambulances, one for the cylinders and another for the patient. If the car breaks down in an area where there is no hospital, then there will be a problem. So, the air ambulance provides a way that in just an hour and half a patient can move from remote areas where there might not be all the medical facilities to be found in a large city to that large city for treatment. Occasionally, people need to fly out of the country for treatment and we do that as well. Sometimes a lot of people abroad need to fly back into the country for treatment. A lot of people may have been diagnosed with a terminal cancer and they want to come back to Nigeria. Even for people in the West African region, from Chad to Mali, a lot of them come to seek treatment in Nigeria and we fly them into Nigeria.
What level of acceptability has your service gained in the Nigerian market, and how affordable is your service?
Flying Doctors is the first indigenous air ambulance in Nigeria and West Africa. We have been in operation for about 10 years. Where I was coming from in the United Kingdom, everybody was using private jets and helicopters to transfer patients and I thought this would be the best thing to bring to Nigeria. But after few years I realised that, in this market, expecting a patient to pay up to $10,000 or more for a transfer between cities was not feasible. What we did was to bring down the price. We forged a partnership with a number of commercial airlines we now have a way of placing all the life-support equipment inside a commercial aircraft, thereby reducing the price from $20,000 to as low as N200,000 for air ambulance transfer. It is just a small closed-up cabin, the curtain would be around the patient so nobody knows the patient’s identity, while the rest of the passengers sit in their seats. We are the only air ambulance service that specialised in doing this, and I realised that, in Nigeria and most of West Africa, the affordability is quite low for the private jet model. That is how we designed this to fit into any commercial airline. Maiduguri to Lagos, Benin to Lagos, Kaduna to Abuja are journeys that patients need to make every day for treatment. It has really changed the lives of a lot of people that would have not been able to seek the best care for them without the use of our service.
Why did you decide to bring such a sophisticated service to Nigeria, knowing the challenges?
It is more essential in Nigeria than it is anywhere across the world. In the UK, the country is so small that it can probably fit into two Nigerian states. You can drive across the UK in six hours. It is a really small country. They have bigger budget in terms of health than in Nigeria. The budget in England per person for health is almost $3,000; the budget in Nigeria is about $6 per person. Because of that, the number of very large sophisticated hospitals that we can afford to have here is small compared to what England can afford. In addition to that, their roads are good and they have more doctors. In terms of accessing specialist doctors in Nigeria, we have about four doctors for every 10,000 people. In England, there are 32 doctors for every 10,000 people. So the number of doctors, number of specialist hospitals, the budget and the conditions of the road make air ambulance for Nigeria and West Africa more essential than other countries.
What challenges did you set out to address through your operations?
We really wanted to increase affordability in accessing health care services both in Nigeria and for those travelling outside the country. We also want to help members of other West African countries that need to move between countries in the region.
How many foreign and domestic airlines have you been able to partner with?
We work with most foreign and domestic airlines operating in Nigeria but a lot of our traffic actually comes from domestic airlines.
Have you been able to partner with hospitals across Nigeria?
We are partnering with a lot of hospitals. Usually, the patients have destination hospitals in mind.
What is the nature of the staff you employ?
We have critical care doctors, nurses and paramedic doctors, among others. Some patients that we transfer are unable to breathe on their own so they need to breathe with a ventilation machine and the role of this machine is like taking the place of the lungs, which is like a life-support machine. So, because of that complexity in controlling the machine, how they are breathing, the pressure at which they are breathing, we need critical care specialist. For the regular cases, we use nurses or paramedics.