Reminiscences with Prof Olu Akinyanju

Professor Olu Akinyanju, who hails from Awe in Oyo State, celebrated his 84th birthday in October.

He read Medicine in London and worked for many years in the Lagos University Teaching Hospital (LUTH), in the Department of Medicine and Pathology. He started a sickle cell clinic due to his exposure to many patients. In this interview, he spoke on the state of gadgets like phones and television sets before the advent of technology, how they trekked long distances to access western education, sickle cell anaemia and other issues.

Where were you born and when?

I am the first out of the two children my parents gave birth to. I was born in Victoria, now known as Limbe, in Cameroon. Victoria was part of Nigeria, but it used to be a German colony. My father was transferred there to work. He met my mother there.

I was born in 1936 and my brother in 1938. My recollection of that was very vague. I only knew some years after my brother was given birth to; we left Victoria for Lagos, Nigeria.

What was your relationship with your parents?

It was normal. My father sent us to school. We did well in school; and we were told my father was very clever. I guess that rubbed off on us. My younger brother got first class honours. I also have a child who graduated with first class honours.

I remembered that when I was growing up, my father travelled a lot due to his work. From Cameroon, he was transferred to Lagos, then Port Harcourt. We went by ship to Port Harcourt. My father was transferred because he was promoted to a collector of customs. In Yoruba, that position was called Ipo Oyinbo (British man’s position).

A lot of Nigerians were in junior service and only the Oyinbos (whites) were in senior service. My father went for an examination for all the Nigerians in the service; he came out tops and got promoted. If we stayed in Lagos, we would have stayed in Ikoyi with his position. We stayed in Port Harcourt for two years before he was transferred to Sapele.

After I travelled out of Nigeria and returned years later to Lagos, I remembered that Yaba bus stop was the end of Lagos. There was no Lekki, Ajah, Victoria Island.

What are some childhood memories you cherish till date?

I remembered that I grew up in Lagos, which was not the same as it is now. Many things have changed. At that time, there was no television. I knew when television first came up. At that time, there was also no phone to contact anybody, and when there was eventually a phone, the wire had to go from your phone to the other person’s phone. Things have improved now due to technology.

Now, in Lagos, there are so many cars. Back then, there were very few of them. I used to walk from Olowogbowo, where I grew up, to my school in CMS. We walked all the way through Broad Street without any problem because there were not so many cars. Our parents were not worried. When we saw a car, we usually wondered who it belonged to – Alakija or someone else. At that time, most of the cars were owned by white people.

At that time, Ikoyi was reserved for the whites. They even had a church known as St David’s Church, behind the governor’s house in Broad Street. It is still there, but it is now for Nigerians.

There was also a tennis court for the whites, called Ikoyi Club. No black man or woman dared to play tennis there. After some time, somebody started the Island Club for everybody, including Nigerians.

I was not born in 1926 when the Yoruba Tennis Club was started for Nigerians because they could not play tennis with the whites. It was only a tennis club; it has become a social club. It was on the other side of the road, next to the museum.

My father was a tennis player and I usually went with him to the club to pick the balls. After playing, an iced box would be opened for cold drinks since there was no fridge at the club. The player would have sweated a lot; hence the need to cool down with something cold.

Anybody travelling abroad would go through Apapa, and his friends and family would see him off.

There was no airport or aeroplane at that time, so the only way people travelled was by ship. It took two weeks to get to London from Lagos because the ship would go through Liverpool, stop at Accra to pick up Ghanaians (Ghana was called Gold Coast), then Freetown as well before heading for London. Now, someone can fly to London within six hours.

Can you mention some of the pranks you played in school.

I cannot remember any of them right now.

While in secondary school, what kind of discipline did you receive that assisted you later in life?

I ended up being the head prefect. When I went back for the higher school certificate, I became the head of school, otherwise known as top prefect.

The most common punishment was grass cutting. The school was a huge one, and whoever was caught doing something that should not be done would be asked to cut the grass. This made students to be scared of misbehaving.

We had a cricket field, football field and tennis court in the school.

What kind of sport do you enjoy playing?

I was a cricketer. I also enjoyed playing table and lawn tennis. I played basketball too. I didn’t like playing anything related to football. After secondary school, I continued playing, but because I didn’t have that much time, I dropped them one after another. In London, there was no time for such things.

At what point did you decide to read Medicine?

It was in secondary school that I decided to become a doctor. I developed interest in medicine and there was no particular reason. At Ughelli, I was doing General Science, and if you want to study Medicine, you will need to study Physics, Chemistry and Biology. When the school started the three subjects, I joined them; and the following year, I went to the higher school.

Are there some old schoolmates you still remember or keep in touch with?

Bukola and Jimi Nobel; they live in London. Some of my friends at the Cathedral Church too are still alive. I keep in touch with them. The late Onosode was my senior. There were many of them.

Sam Amuka of Vanguard is one of my oldest surviving friends. We were classmates in Warri, then Ughelli. He was in Daily Times, then went to Punch. He left there to establish his own, which we all know as Vanguard till today. I see him regularly, up until yesterday (a day before this interview was conducted). He still reminds me that I am his junior because he was born a year before me.

Mrs Bolanle Olaniyan, a retired teacher, is also my friend till now. Dr Williams too was my classmate.

Tell us more about your education.

We started school in the CMS Girls’ School, run by European women. It is behind the Cathedral Church of Christ in Marina. The school had only female white teachers. Many parents raised concern about not having a school for their male children and they later allowed boys in the school. In 1942 or thereabouts, I entered the CMS Girls’ School.

After about two to three years, we went to the school opposite, which was CMS Grammar School. I was there for almost two years, preparing to go to Class 1 when my father was transferred from Lagos to Port Harcourt. He was going to leave us in Lagos in the care of one of the Reverends, but he decided to take us with him at the last minute. I attended a school there, but I can’t remember the name or year.

Till 1960, Nigeria was a colony of the British, that is why we speak English and not French.

When we got to Sapele after two years in Port Harcourt, I started going to a school. A man at the place we were living in Sapele, Mr Molokwu, who was an educationist, told my father about Warri College, which was not too far from Sapele. At that time, I was preparing for my secondary education. I was enrolled into Warri College in the late 1940s. I met some good friends there, some of whom are still alive.

After about two years in Warri, the boarding school was moved to Ughelli in Delta. The name was changed from Warri College to Government College, Ughelli. I finished my secondary education there.

After my secondary education at Ughelli, I went back there to do sixth form, which was in the form of a higher school certificate. I needed to do Physics, Chemistry, Biology (Botany and Zoology). After passing it, I was admitted to Medical School in England.

I got a government scholarship to read Medicine in England in 1958.

At that time, going by ship was no longer the only option as there was airplane already and it had started to land in Lagos.

My father took me to the airport in Ikeja, and it took many hours to get to England. The plane had to go from Lagos to Kano to refuel, then another stopover in Algeria or so to refuel again, and somewhere in Europe to refuel before we got to London.

Which school did you attend in London?

I attended the St Mary Medical School, which was part of the University of London. The university had about 10 medical schools.

I met some Nigerians there. One or two were in classes higher than mine. There was a Nigerian from British Cameroon who was some years ahead of us. We were told he was so intelligent that the whites did not look down on blacks.

I entered the school in 1958 and qualified as a doctor in 1963.

I continued studying there because I did not want to come back as a mere medical practitioner. I wanted to be a specialist. I didn’t want to do surgery, neither did I want to be an obstetrician or gynaecologist. I thought, if I returned to Nigeria, I didn’t know if I would be able to go back to London. So I stayed back. I did a house job. I became a member of the College of Physicians of Edinburgh and London.

I came back to Lagos in 1967 and was already a specialist.

When you returned to Nigeria, what did you do?

Because I travelled through a government scholarship, I was expected to work in a government facility. People started calling me, suggesting the University College Hospital (UCH), Ibadan and the Lagos University Teaching Hospital (LUTH), which was new then. I settled for the LUTH. I resumed in the College of Medicine as a senior registrar. Later, I became lecturer, then lecturer grade 2, senior lecturer and later became a professor and consultant all in the LUTH. I became a professor in 1979.

In 1979, I was earning a very good salary. N1,000 was a lot of money. Things have changed and the value is no longer as it was. I bought a brand new Mercedes car at N11,000 when I became a professor, but recently, I bought my car battery at N26,000. That money I used in buying a car can only buy a tyre now.

Did you further your education when you returned from London?

When I got to the LUTH, what I saw was that I needed to specialise in a field. When I got to neurology, I discovered it was filled up. I later settled for haematology.

I travelled to Canada to later study haematology. I spent almost two years in the University of Toronto between 1969 and 1971. I started attending to haematology-related patients, which could sometimes be leukaemia or sickle cell. To further attend to them properly, I advocated a sickle cell clinic in the LUTH, which I started. The clinic is on Mondays and it still runs till date. The late Professor Leshi was running the sickle cell clinic for children and I was known for running the adult clinic. We were able to work together.

When did you marry?

I got married while I was in London in 1966. I knew her in Nigeria and we later met in London. In the few years we spent in Lagos, each time I left home at Olowogbowo to CMS, sometimes I passed in front of her house; but if I didn’t want to, I would go through Broad Street. I got to know her through the school. We also attended the same church, the Christ Cathedral. She went to England before me and was reading Law. When we met, we were all grown and happy to see each other. We got married in England, devoid of all ceremonies and later came to Nigeria together.

I got married to my present wife too without ceremonies. We just went and got married. I have kids from my two marriages but none of them read Medicine. One read Law; and my youngest from my second wife, Morenike, is doing very well working for a bank.

What gave birth to the National Sickle Cell Foundation?

In the LUTH, when I saw sickle cell patients and the way their parents treated them, it made me feel somehow. There is a belief that someone is after the life of that child, that is why he or she has sickle cell. Many parents don’t even know what it meant. To further have a one-stop facility beyond the clinic, I decided to have a sickle cell centre.

At what point did you decide to establish the centre?

It was at the point I felt we needed to focus more on sickle cell so that more lives could be saved. If my focus had been on cancer, a cancer centre would have been established. The truth is, the sickle cell clinic at the hospitals across the nation may not be able to do justice to saving lives.

It was a non-governmental institution, but we wanted the government to be aware that the institution exists to cater for the health needs of the masses. At the time, Muhammadu Buhari, now president, was heading a parastatal, so, he was there to lay the foundation stone in 1998. When we apologised for the inconvenience it caused him from Abuja to Lagos, he told us it was worth it as he had two children with sickle cell disorder. When we finished the building, Obasanjo was the president and we invited him to commission it.

The foundation would have been established in the LUTH because I wanted it there. Fortunately for me, hospital did not have enough space.

How did you get a land at a busy place like Idi Araba?

The land was owned by the LUTH. Since I could not get it established within the hospital, I later got this land to erect the structure. For the sake of sickle cell patients, we could not afford to go far from the hospital.

How many sickle cell patients do you attend to in a month or year?

Very many.

What do you do at the foundation?

The foundation is not a hospital, but there are some things we look after here. People without sickle cell have strokes when they are older. But, people with sickle cell have strokes when they are young, we still don’t know why. They have strokes before the age of 10. From two years, up to the age of 16, we do transcranial doppler when we examine them, to see if they are prone to stroke. We quickly take it up from there, so that the young child won’t end up having stroke.

We also treat leg ulcer, do genetic counselling, automated exchange of blood transfusion and other things related to sickle cell disorder. We also do research and write bulletins and pamphlets every now and then to tell them what to do and not to do. We make booklets to educate health workers in various hospitals across the country so that they can better manage any sickle cell patient they come across.

We cannot say we will look after all the sickle cell patients in Nigeria; it is not possible.

What are some of the publications you have?

In 2006, I wrote a book, How to Live with Sickle Cell Disorder. I am reviewing it and it will be out by the end of 2020. I have written small booklets too, one of which is the National Burden of Sickle Cell Disorder and the Way Forward. Many others have also been written.

How would you describe your working experience with the World Health Organisation?

They invited me. The WHO has many areas they call people to specialise in. Anytime they were having a meeting, they invited me and we discussed. I started going for WHO meetings since the 1970s, but I no longer do.

Between the time you started the foundation and now, what has improved in the treatment and management of sickle cell disorder?

There are some drugs we use today that have been very good. One of them is hydroxyurea. Also, sickle cell patients are given more confidence as they are being continuously told that they can survive it. All they need to do is to prevent malaria and infection.

What has malaria and infection got to do with sickle cell?

Malaria and infection are not something anyone should have, regardless of the condition. It makes it worse. It leads to crisis for the patient. Such a child won’t be able to walk, go to school, play or do anything.

Is there a way to prevent crisis in a sickle cell patient?

To prevent crisis, it is important to prevent infections and malaria. And some drugs should be used, such as hydroxyurea. With it, a patient can go for years without having crisis. Some other drugs are coming in too.

There was a time people tagged sickle cell patients as abiku, ogbanje (one who will die soon). What has changed in this regard?

People now know more about it. Gone are the days when a parent would not even know what was wrong with the child and believe that someone somewhere was after them. And people would give them all sorts of things to use, blindly.

What made me to start the struggle for sickle cell is the attitude of people and poor management. Anyone with a child with sickle cell anaemia has to manage the child well. We organise sensitisation programmes to make people understand, as well as project survivors who lived up to 70 years.

Are there herbs proven to assist in the management or treatment of sickle cell?

No. If there are such herbs, we will test and broadcast it all over the world.

Is it true that Nigeria has the highest burden of sickle cell anaemia in the world?

Nigeria has the highest burden because we have a lot of people here. Ghana is not bigger than Lagos, in terms of population. The Republic of Benin also does not have the kind of population Nigeria has. So, every disease, such as hypertension, diabetes, sickle cell and many others have high burden due to the number of people living in Nigeria.

What is your advice to intending couples who are sceptical of marriage due to genotype issues?

My advice to intending couples is, regardless of your genotype, marry who you love. There was one lady who was very ill and I was invited to treat her. I transferred her to St Nicholas Hospital and treated her. She became better, although she thought she was going to die at one time. When she fully regained her health, she invited me for her marriage. It was then she told me her husband was AS. She thought I would disapprove or discourage her, but she was shocked when I didn’t. She explained to me that she left the man she wanted to marry because he was AS, so she could be with someone who was AA. The relationship did not work and she ended up with the AS man whom she was inviting me for the wedding. They got married and have since been living in America. They have two children. She came to Nigeria in 2018 when her father turned 80 and she brought her children, a boy and girl, to my house. Both children happen to be AS.

There was one year I was invited to Brazil on a sickle cell seminar and the person in charge of the sickle cell club there was SS and his wife was also SS. If they want to give birth, they can. They may decide to adopt a child or not have children at all. It is a decision you take and not let someone influence you to say marry this person or don’t marry that person.

I wonder if people check whether the person they want to marry has hypertension or diabetes in their family.

People should stop worrying about their genotype. It is their decision.