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Reminiscences with Dr Haruna Samaila

 Dr. Haruna Samaila became popular when he left the public service in 1990 to set up one of the few private hospitals in northern Nigeria…

 Dr. Haruna Samaila became popular when he left the public service in 1990 to set up one of the few private hospitals in northern Nigeria then, Rimi Clinic. After about 28 years of private practice, he still attends to patients personally. He told us the story behind the hospital, his early life, the challenges of running a private clinic and many other issues.

 

You are 70 years old, but you still come to work and perform your task as a medical doctor, where do you get the energy at this age?

I will be 70 on May 15, this year. Well, I think it has to do with the life one lives. I live a simple life. I try to eat healthy, I also engage in sports. I do a lot of sports, right from secondary school, to the university. I exercise a lot and I try not to indulge in certain things like drinking etc. Another thing is: when you are doing something you enjoy, you can do it for a longer time. A lot of people don’t enjoy what they are doing, so their work becomes tedious to them and weighs down on them. But if you are doing something you like or enjoy, it takes less stress on you.

That means you have passion for medical practice. How did you come about the decision to study Medicine?

The first time I thought of being a doctor was when I was in secondary school. During my time, there were certain professions that people wanted to go into, such as Medicine, Engineering and Law. It is now that you have more fields; but then, every successful student wanted to go into one of those fields. My dad also influenced my decision to do medicine. When I was in secondary school we had a doctor living close to us in Zaria. I saw the work he was doing and wanted to do that. There were other missionary doctors and nurses working in Zaria then and I used to admire them. They were whites who went to the rural areas. I admired their dedication to work and I felt I wanted to be part of something like that. Generally, I like people and relate with them. And because I like people, children especially, my dad said I would become a teacher. I didn’t go into teaching directly, but I was working in the university, so I was teaching.

Were there challenges along the way?

No. During our time we had a lot of things going for us that were helpful. You just had to desire to be somebody and do some things and you would get through. First, my dad was educated, so he gave us all the support to go to school, and so on. And as you know, I am a Christian, so the Christian community helped. We went to mission schools, which were good at that time. It helped us shape our lives. The government was also very helpful. When we went to the university we didn’t pay. In fact, they paid us allowances, so all these helped us. All you needed to do was do your part. We didn’t have challenges as we have now, but obviously, there was the stress of hard work; you had to study very hard. Getting to the university was easy; you just had to apply. Your parents had nothing to do with it and your name would come out in the newspapers; and that’s all. But now, even if you passed you must know somebody. I think our generation was lucky; we had so many things that helped us.

That means you got admission into the university on your first attempt?

Yes, of course. It was not common to try several times. If you had your papers and the requirements and applied, you were taken.

What year did you get admission into the university? 

I got into the Ahmadu Bello University (ABU), Zaria in 1969.

How many of you were in your department? 

I can’t remember exactly, but I know we were not many. I think we used to be about 30. You knew everybody in the class.

How many of you were from the North?

Well, let’s see: I wouldn’t have the exact figure, but I think there were quite appreciable. Probably more than half were from the North, if you take Kwara and Kogi. 

What was your campus experience?

Campus was actually fantastic. We had things that helped us. We had accommodation – two people in a room. In Medicine, from the third year you would be alone in your room. 

Campus was not too large, so we knew everybody; if not by name, it was by department or set. It was a mixed society – we had people from all parts of the country. The university looked after us. We had luxuries. They used to do laundry for us. There was a bag you would put your “kayan wanki” and leave in front of your door. Food was supplied by the university, not hired people. We used to have coffee. You would have options for lunch. You would choose between two types of meal, and it was always associated with fruits or jelly as dessert. Tea was always there that you could take from, and so on. We had fun; social life was good. There were clubs. Sometimes they invited Mamman Shata for an evening or Fela for a weekend, and things like that. It was big fun that time. We enjoyed campus life.

Did your set participate in the National Youth Service Corps (NYSC) programme?

 We participated in the NYSC. If we did a three-year course we would have missed it, but Medicine was a five-year course and you would also do house jobs. 

Where did you serve?

I served in Anambra State. It was not too long after the war, so people wondered how I would go to the South-East. They said I should change it, and so forth. But I said that God would take care of me wherever he took me. I went with my wife, who was my classmate. We served in Awka and had a fantastic time. It was a good thing because we learnt a lot about people. The impression I had about the Igbo while here was totally different when I got there. In fact, I used to say that among the three major tribes, the most accommodating are the Igbo. That is not the impression you have of them outside. There, everybody wants to identify with you. When they had their yam festival they invited you. I used to feel very embarrassed because they made one the centre of attraction. In fact, they would make you sit next to the chief, saying, ‘this is our brother from the North who came to identify with us.’ So it was fantastic; I really enjoyed it. By the time we were rounding off, individual families organised sendoff parties for us. So it was quite good.

Did you serve in a hospital?

Not exactly. During our time, the government wanted corps members to work in rural areas, rather than hospitals. They wanted them to take medicine to rural areas. So the plan was that each corps member who was a doctor would have an ambulance. You would be given drugs, equipment and a driver to see and manage patients.  Unfortunately, they didn’t get the ambulances, so in a lot of the states they reverted to using hospitals. But in my state, they said we had to do what the government said we should do, so they said we had to go to the rural side. Those days we had cars. We were in house jobs, so we went to the NYSC programme with our cars. We used our cars to go to the rural areas to see patients. It would have been good, but there were no drugs. So in most of the places we went to, we would just sit and chat with the people. 

I learnt a lot of Igbo language when I was there because there was nothing much to do. They never posted us to hospitals, so I never worked in a hospital. The interesting thing was that I had plenty of time. Our former vice president, the late Chief Alex Ekwueme was from that state, and his village, Oko, was not far from Awka.  He had built a hospital for his village and I used to go and work there. There was an Indian doctor working there. That was the only hospital work I did during that period.

You mean there was no hostility, even when they knew you were from the North?

That’s what I was saying. I was surprised that they were very friendly. The only thing I remember is that they couldn’t believe that my wife was a doctor. When we told them that my wife was a doctor, they said, “No, you mean she is a nurse?’ When did Hausa women start going to school that they would become doctors?’’ They believed that Hausa people went to school but the best they could be were nurses. But she is a doctor.

Was it immediately after the NYSC programme that you set up your own clinic?

After service I came back to the ABU to work. I worked for about a year and went to England for postgraduate studies. I did a postgraduate programme in Surgery. After that, I came back to the university and worked up till 1990. I worked in England, so I discovered that the standard was quite different from what I found here. At that time, the health system was undergoing a lot of problems, so I was not happy. I got to the hospital early in the morning and saw a patient with hernia who needed surgery, but they didn’t have the things needed to treat that. We had to write things for them to go and buy. So for somebody who might have come from the village, he had to go back home, sell a goat or chicken and buy those drugs. He left at 9.00am, for instance, and before he came back it might be 2am.  It is frustrating when you need certain things in the hospital and they are not available. 

Those days, when you worked for 15 years with the government you could retire, and when you reached the age of pension you were entitled to be paid. So I served a minimum of 15 years and left. I was a consultant surgeon and lecturer in ABU when I left.

What did you intend to achieve by setting up your own clinic?

To do things the way I think they should be done and get satisfaction. That was the main thing. It was in 1990.

After 27 years, would you say you have achieved your aim of setting up the clinic?

Yes, I have enjoyed doing my work in a simple way. I am a simple person. Many people think that as a doctor you should have a big and mighty building, but I have a small setup and I enjoy doing it.

But you set it up in an elitist environment.

No, this is not elitist. In fact, I wanted to have it in a prominent place like Kaduna GRA, but I was having difficulty in getting a place. My dad has this plot, so he asked, “Why looking for a plot when you can start here?’’ So this wasn’t elitist; it was quite like Ungwan Rimi of those days when I started it.  It is now that you will think it is probably in an elitist area, but it is not, it is simple. Lots of our patients are from the middle class.

You didn’t consider setting it up in a rural area?

I never wanted to go into private practice. The way I started was very interesting. When I was in the university, there was an Igbo doctor who came to do NYSC and was posted to my department, Surgery. When he came, he told me he didn’t plan to work in Nigeria – he planned to go to America. When he finished the NYSC programme he didn’t want to work for government, he wanted to work in the private sector. He said he would want me to open a clinic and he would run it for me. I was taken aback. I was a consultant, so I was surprised that he had that audacity. I looked at him and said, ‘Ok we will see about it.’ I forgot about that completely, but when he finished he came and reminded me. I said I was not ready to go into private practice yet. I tried to get him a job in ABU, but he said he didn’t want to work in a government hospital; then I got him a job in a private setup known as Multi Clinic. He told them that he was going to work for them temporarily because Dr. Samaila was going to put up his own clinic and he would go and work there. They said they wanted somebody who was ready to stay, so he came back and told me. De pressurized me, and somehow we started looking for a place. That was how I started private practice. I was still in ABU so it had to be in the city.

You retired from the public sector before setting up your own clinic. Now, there is this practice where doctors in public hospitals also run private clinics. What can you say about that?

When things happen, it is good to find out the causes. In my case, I wasn’t getting satisfaction, so I left. On why people are combining private practice with government jobs, it might be that they are not getting satisfaction where they work, either in terms of equipment or salaries. Are their salaries good enough for them? Instead of stealing they would decide to use their skills. So the important thing should be control. I am sure there are a lot of doctors who do their work well, and when it is their free time they go to their private clinics. I don’t see it as a big problem if the government or whoever is in charge makes sure that they do their work. They do a lot of service outside, and you know that statistics-wise, there is more health care delivery service in private practice than in government. I used to know the percentage in this state. We have rules, like everything else in Nigeria; it is controlled.

How do you feel when you hear that medical doctors are on strike? These are people who are supposed to save lives.

It is not a good idea for doctors to be out of work completely. But even in developed countries, doctors go on strike. However, when they do, there are people who run emergency centres and other highly critical areas. Strikes are not the best; leaving patients to suffer is not the best. During our time, when we were younger doctors, you never had a shutdown of the hospital. 

House officers and corps members cannot go on strike. And usually, consultants do not go on strike. So you still have people who look after emergencies. I think that if there has to be anything like that, there should be an arrangement so that at least you don’t leave the hospital completely shutdown. The government should learn to listen to people and dialogue with them.

People complain of negligence, and that doctors don’t show much compassion as they did in those days; does it bother you?

Is this peculiar to medical people? I don’t think so.  I think the standard of doing anything anywhere has changed. The way my dad worked with the government is not the way it is now. I remember he worked beyond official hours. He would bring files home and work. So this is a general issue in the society. It is a societal thing that is affecting all facets. This needs to be addressed in a more holistic way. Yes, doctors now are not the same as they were, just like teachers. When I was young we never had extra lessons with our teachers. You would go to school and leave at the appropriate time, then come home and play all day. The teaching you got in class was enough for you, but it’s not like that now. Yes, the standard is not the same.

If asked to offer a piece of advice on the practice in which accident or robbery victims are taken to the hospital and doctors insist on police report, what would it be?

I think the primary aim of a doctor is to save lives. Doctors are supposed to give first aid to any person they meet anywhere, not only if they come to your hospital but even if you meet them on the street. As I said, we have to look at things in a holistic way. Many doctors have gone into trouble handling accident or robbery cases. They do it in good faith, but they get into trouble. I have a friend who is a very hardworking doctor. He was trained abroad, so he has ‘Oyinbo’ mentality. He was going to work one day and saw a dead body on Kaduna road.  He went to work, but when he was coming back he still saw that dead body on the road, so he said it was not right. So he went to a police station and reported it; but they locked him up. They said he was the first suspect. Luckily, he knew some big people and he was released. Just because he reported, they put him behind the counter. So when you treat an armed robbery patient you are taken in as an accomplice. Many doctors have gone into trouble that way; that’s why they insist on police report.

How do you handle cases of indigent patients who are not able to settle their bills?

To be honest, when things were good, we had plenty of such patients. Some of them would say they would pay later. And people with good faith would pay. We helped those we really knew could not pay. In cases of emergency we did whatever we could do. If it was something we thought was too expensive as a private hospital, we referred it to ABU. But we helped as much as we could. We operated many people free of charge in those days. But as you can guess, it is more difficult now. It is becoming more difficult every day because you don’t see many patients. And I have members of staff to pay. In medicine you don’t reduce members of staff. If you were an engineer, when there are challenges you scale down your staff, but in medicine you can’t. I must have a doctor, nurse and an attendant all the time, a nurse. 

For such patients, I go out of my way to assist. I will phone a doctor in a public hospital and say, ‘I have a patient who can’t afford the cost, I am sending him to ABU or Barau Dikko.’ I help through that way.

How did you meet your wife?

I met my wife in the medical school. In the medical school they divided us into small groups for different postings. When we were doing a posting in the eye, or radiology, it was not the whole class that would go there. They divided us into small groups in alphabetical order. My surname is Samaila and my wife’s surname is Samande, so I was in the same group with her.  As a result of that we moved together. When we came to Kaduna, we used to go to Dala Orthopedic Hospital. We were always together. 

Parents usually advise that a man should marry somebody at least five years younger, but you married your classmate. From your experience, what is your take on that advice?

It was good and successful; otherwise we wouldn’t have been together.  It has been very alright. During our time, things were different. Now, most people don’t marry early. In those days, when you finished school, the next thing was to get married immediately. Most of us doctors got married during house jobs. In fact, some of our Hausa friends got married even before we started house jobs. These days, for a man to marry he has to graduate and get a job. By the time he is marrying he is over 30. When he comes to marry, his female mates might not be available; they might have gotten married. So, it is likely for him to marry somebody much younger. The situation has changed. Three of us married our classmates in the medical school. My wife’s uncle and Dr Ajakpor in Abuja also married their classmates. It was common among us, and all of us have successful marriages.

How did you come about the name, Rimi Hospital?

I had a friend who was a banker. I wanted to coin a name that would have my name, the name of my wife and two children. In the course of telling him I was trying this combination, he said, “You are on Rimi Drive, why not just put Rimi?’’ So I listened to him and named it Rimi Hospital.  It used to be on Rimi Drive, but some crooks tried to take advantage of that. Some people thought it belonged to the former governor of Kano State, Abubakar Rimi. They would come and say he sent them to collect money or something. You know he looked like me, so they thought I must be his younger brother and he opened a hospital and put me there.

Your two children are in the medical field; did you influence their choice of career?

We didn’t. In fact, my wife tried to convince the younger one, Ibrahim, not to do medicine, but he insisted. She noticed he was not the studious type, so she thought he wouldn’t do well in medicine. When they were filling the Joint Admissions and Matriculation Board (JAMB) form, I wasn’t around; I travelled abroad. He wanted to fill the subjects for Medicine but his mother said no. So he refused to fill and kept it till I came back. When I came back, I said if he wanted to do Medicine, why not? So we didn’t influence them. They might have been influenced by the way they saw the profession. 

Malaria is still an issue in the country despite the number of medical personnel we have; what do you think is responsible for that?

Malaria is not a small thing as you put it. It is one of the largest killer diseases worldwide. Malaria is a difficult thing to control. You know there is something that carries the malaria parasite – the mosquito – so controlling that aspect is one of the most difficult things you can do. It requires a global type of effort to make it work. You can put mosquito nets and other disinfectants in your house, but if your neighbour does not do the same thing, mosquitoes can come into your house.  If Nigeria can spray the whole country with something that can kill mosquitoes, and Ghana and other neighbouring countries do the same, the problem would be tackled. I think these are the things that have made it difficult to eradicate.

How do you react to polio scourge in the North?

It is really hurting, annoying and demoralising. These are factors that play in our society, especially Nigeria. Unfortunately, everything has been politicised. As you know, when appointments are made, the first question is: How many people from the North, the Igbo or Christians are there? So many people have different biases. Unfortunately, they allow these biases to affect their judgements. Sometimes the biases are so much that they believe it is right. It is really sad. 

Many years ago I was involved in this polio thing. I was in Katsina supervising. One day they came to me, saying a lawyer told them that nobody should come out for vaccination. I asked how old the lawyer was and he seemed to be about my age. So I said it was going to be easy to convince him. I went, but he won’t even talk with me. Can you imagine that a lawyer would do that? People with biases affect those who are illiterates. Unfortunately, the biases affect even the educated people; they take sides immediately, they are subjective. But I think it is improving; it is now better.

How did you feel when President Muhammadu Buhari had a medical challenge and was flown out of the country for treatment despite the progress we have made in medical practice?

Yes, medical practice in Nigeria is affected by a lot of things. Facilities and other things are not available. If you go abroad, a lot of specialists that see people are Nigerians. In America and England we have capable people that can do that. But we lack facilities. It is really not the fault of doctors, but the administrators and policy makers. They don’t give us the right environment. These facilities are not available, and life is precious. If you find out where you can go and get treatment, the tendency is to go and get it. The president might not want to go abroad, but the people around him might. They are concerned about the health of the head of state and they think the facilities in the country are not good. 

There’s an influx of technology in private clinics. These facilities are coming in, but as usual, it covers a cost. How many people can afford it? We have doctors that could do almost anything, but the facilities are not available. It’s not nice that we still have to depend on other countries.

What do you do for leisure?

 I used to play tennis and squash, but now I go to gym, then I watch football and tennis. I am a Chelsea fan, so I watch them. I also like travelling. 

At 70, if you were asked to make a wish, what would it be?

I think it should be to have good governance in Nigeria. Up till now, we don’t have the kind of governance we deserve in this country. We need the right changes in education, medicine, everything. My wish is that we have a government that would be able to lead us out of our problems.

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