This Day (Lagos)
Lanre Alfred
27 June 2009
interview
Lagos — Dr. Tunde Okewale is a leading consultant, gynecologist and fertility expert. He is the medical director of St. Ives IVF and fertility unit and St. Ives Free Health Foundation in Lagos. The hospital celebrated the delivery of its first IVF baby on June 7, 2008, less than one year after opening their IVF unit to the public. Dark and handsome Tunde had his post-graduate training and practiced as a gynecologist and infertility expert at Leeds, Manchester and Oxford Regional health Authorities in the UK.
He is a fellow of the prestigious Royal College of Obstetricians and Gynecologists in the UK. Also a member of faculty of family planning and Reproduction Health Centre in the UK. After practicing in the UK for over 10 years, he came back to set up St. Ives in Nigeria. LANRE ALFRED had an interview with this cerebral young man...
Can you tell us about your IVF unit since inception?
We successfully had our first baby in June 2008 after the programme kicked off in July 2007. Over the last two years since the unit berthed we have successfully delivered 20 babies. The recent one was a set of twins that was delivered by a 45-year old woman who has been infertile for 20 years. The success rate as far as IVF is concerned is mostly dependent on the age of the woman. That is why there is a lot of public education and awareness. Couples who find themselves infertile for a number of years and nothing is happening should resort to Ivf as early as they can because the younger the woman the higher the chances and success of ivf. We've had relative success here.
Are there any risks?
The greatest risk in IVF is failure. Because of the cost of the procedure, failure is taken very badly by the doctors and the patients, as the process is the last resort for many couples. So, when it fails, it gives a psychological blow on the doctors and patients. Aside that, IVF has been around since 1978 when the first baby was born and a lot of research has been done and there have been no side effects towards the babies that were born or parents that delivered them. In fact, the first IVF baby already has her own baby now. So, for 30 years, research has proven that it's safe resorting to IVF as a way out of infertility. IVF babies are just like normal babies, but like I said the greatest risk or effect is the failure when it doesn't work. This hardly happens because the success of any IVF treatment solely depends on the age of the woman and that is why people should be aware of the IVF treatment. It is best done when couples are still young and they have tried other means before they get into their 40s and what have you.
How many babies can IVF produce at a go?
There are a certain number of embryos that can be replaced back into the woman. For us, the maximum replacement of two embryos because research has shown that replacement of two embryos gives higher success than one. And the higher replacement of embryos, the higher the likelihood of success in the pregnancy process. But anything after four doesn't confer any added success but it could confer multiple pregnancies.
Can you share the experience with us when the pregnancy process is successful?
It's a thing of joy you only need to go into the mind of someone who is infertile with the social stigma, all the pressures from the family, especially on the woman. Pressure is on the man to get another wife or children illegitimately or outside wedlock. So, it's a thing of joy when the woman gets pregnant and everyone can see. It's always a joy to the extended families, couple and also the hospital and medical staff, when the process is successful. Usually, there's always an expression of gratitude.
At what age does your clinic deny treatment to a woman?
Generally, I think after 50, patients should be counseled regarding other options such as adoption. Personally, I believe that having a child is a basic human right of every woman, irrespective of age. This view, however, has to be tempered with what is acceptable to society in general. I believe that God has prepared children for every couple. So, we would achieve it naturally. Others through assisted conceptions like IVF and IUI. There are millions of babies worldwide waiting for a family to call their own. Waiting for someone they can call mummy and daddy. They are God's provisions that are being overlooked.
IVF is said to be expensive and out of the reach of many couples, is that true?
Unfortunately, this is true, not only in Nigeria but worldwide. Priorities of couples also differ. The cost of setting up a standard IVF lab and the disposables and consumables are high. The cost of running a lab is even higher in Nigeria where power is a problem. A lab needs 24 hour power. So, apart from generators, labs in Nigeria invest in alternative power supply such as solar, inverters and ups, etc.
We are constantly looking for a way to make the cost more affordable for couples. We are presently running a shared risk scheme for some patients that fulfill our requirements; the scheme is "pay us only after getting pregnant".
As a private medical practitioner with such laudable achievement in the country, how do you feel?
I feel proud especially for all our medical practitioners that have travelled abroad and have come back to transfer the technology and skills that have been learnt abroad in helping our people at home. I think move Nigerian doctors need to come home, they are in various specialties and the people of Nigeria need them more than in the environment where they are working. For example, if I were practicing in the UK, I probably would have been another Nigerian doctor in the IVF unit doing my job but in the Nigerian context, I have set up the clinic, employed people, and I am transferring the skills to the Nigeria - based doctors and this is more laudable and satisfying than just being another doctor in America or UK.
Why did you choose gynecology?
While I was in the UK, had different specialists. And I noticed that there were more Nigerians coming to the UK for this kind of treatment than any other form of medicine I actually went round a lot of clinics in the UK and a lot of Nigerians were coming over for fertility treatments. It is a field of medicine where you could really make a difference. People come to you with fertility problems and if you are lucky you will be able to help. They are people who just cannot get pregnant and we have the technology for intro-fertilisation which works very well. So, you are able to solve these problems. And it is a very good feeling.
What is your dream for the medical profession in Nigeria?
The government needs to provide the necessary infrastructure so that our people need not go abroad for medical check-ups. There is the need to bring in Nigerians who are in the medical profession by providing an enabling environment. Talking of development we are still far behind.
What is your dream for St. Ives Clinic?
To be a reference point in reproduction health in Africa. We want the clients to know that we are here for them, not for ourselves. Providing new equipment that will enhance what we are doing. But, right now we have some of the world's best equipment at St. Ives hospitals.
Why did you come back to Nigeria to practice?
I came back because I felt my services would be better needed here than any other place. If I was in the UK, I would be working within an IVF unit. The other thing is that you will ask me why I didn't go to the public sector. We all know that dreams die quickly in the public sector.
Did your parents push you towards medicine?
My father was not a doctor, he was a broadcaster. He was one of the pioneer broadcasters in the old western Nigerian Television. He was one of those who set up OGBC and OGTV. My sister, Toun Okewale, is a well known broadcaster as well. I come from a family of broadcasters.
Why didn't you go into broadcasting?
I love broadcasting. In fact, I love the entertainment industry, but I just didn't toe the line.
How was growing up like?
Growing up was beautiful. I grew up in a civil service setting, the environment was okay. We were not rich but everything was working. There were no strikes in schools. Everything was normal.
Where did you start your medical training?
I got my first degree in medicine at UCH, Ibadan before I went to the UK for further studies and practice.
How do you unwind?
I have time for relaxation. Once you operate within your area of specialization, you cannot experience stress. There is no emergency you cannot handle because you are tuned to anything. But the moment you go out of area, you are constantly under pressure. You are not sure whether you are doing the right thing for the patient. I believe that any doctor who operates within his area of specialization will make more money. But when you go out, you are likely to be constantly embarrassed and eventually the patient will know that you are applying trial and error method, and you will not have rest of mind.
What is the greatest lesson life has taught you?
There is nothing you cannot achieve in life provided you are committed, devoted, focused and undaunted. The moment you take a pause and pay attention to your detractors, it's finished. And there is no obstacles ahead of you except ones you set for yourself.
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