3 months ago
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Dr Olutoyin Akande-Ajala is a seasoned geriatrician trained in Nigeria and the United Kingdom. She founded JBS Gerontology Centre, Nigeria’s first private geriatric hospital and specialist centre for the elderly. She speaks to VICTORIA EDEME about her life and career journey
You are from a family of professors, how has that shaped your career?
I am the second child and only daughter of my parents, Emeritus Professor Oluwole Akande and Professor Modupe Akande. My father is from Ososo in Edo State. My childhood was great.
For most of my life, I used to think that I had a tough childhood because my mum was a disciplinarian and didn’t let me do all the things I ordinarily would want to, like partying.
My dad, however, was more relaxed but very busy. He is a retired professor of obstetrics and gynaecology, an academic, and an administrator, who became the first provost of the College of Medicine at Ibadan and the first Chief Medical Director of University College Hospital, Ibadan.
Growing up, I was very close to my maternal grandmother, a businesswoman. Most of my fondest childhood memories revolve around my grandmother.
In school, I was very intelligent and always topped my class, though I was also playful and talkative. I grew up with three brothers and this made me a tomboy.
How influential were your parents in your life’s journey?
My parents were extremely influential in charting my life’s course. I was named Olutoyin (God is worthy to be praised) because my dad nearly died two months before I was born.
He had stomach bleeding, and if it wasn’t for someone in the hospital who knew what to do, he would have died.
My life’s journey would have been different if he had died. All my life, I have been known as Professor Akande’s daughter; it became part of my identity. My mum is a role model and has been influential in my life because she brought me up with certain standards and ideals, which still serve me well.
You mostly schooled abroad. Can you take us through your educational journey?
I attended Maryhill Convent School, Ibadan, Oyo State, for my primary education and then went to the International School for my secondary. I then travelled to Canada with my parents and did A-levels at Highland Secondary School in Ontario, Canada.
I returned to Nigeria and got into the College of Medicine, University of Ibadan and graduated in 1991. I had my one-year housemanship at UCH, before moving to the United Kingdom for my residency training in geriatric medicine.
Why geriatric medicine?
I never knew I would major in geriatric medicine when I moved to the UK. When I left Nigeria, there was no such thing as geriatric medicine. I only came across it when I got to the UK.
I knew I wanted to be a physician but did not want to be a surgeon or paediatrician. I wasn’t sure which subspecialty in general internal medicine I wanted to pursue. So when I got to the UK, I decided to begin my career in Wales.
That was when I heard about geriatric medicine. I was curious and applied for the job, which I eventually got.
So my first job in the UK was as a senior house officer in geriatric medicine in Wales. When I was leaving the job after six months, my first consultant, Dr John Morris, told me I was a natural-born geriatrician.
That was the first time someone planted the idea in my mind. After that, I moved on to other specialties in general internal medicine before returning to geriatrics.
It took me two years to finally decide that I truly loved geriatric medicine.
Geriatric patients are like paediatric patients; they don’t fake anything and are just like children. I think being so close to my grandmother also influenced my choice.
She was the closest person to me while growing up and I loved her dearly. The one regret I have as a geriatrician is that I wasn’t able to care for her. I wish she were here now so I could look after her the way I now look after other people’s grandparents and parents.
She was one of the first people I told about my decision, and she was happy. She told me that I would come back and look after her. Sadly, she passed away by the time I finished my training and returned to Nigeria.
How did you move from being a geriatrician to owning Nigeria’s first private geriatric hospital?
This journey started many years ago. During my training in geriatric medicine, I received calls from people I knew whose parents were getting old. They struggled to find people to care for them and manage their illnesses properly.
It was then that the idea of setting up a geriatric healthcare service in Nigeria was planted in my mind.
I started to put pen to paper and made inquiries. This was around 2007, and there was practically nothing in that regard.
Things are much better now. The response at that time was not very positive, and those I believed were meant to support me were not particularly keen on my returning to Nigeria.
So I put it aside until 2017, when a friend reached out to me about her sick mother and asked for my help.
It was then that one of my cousins, Funmi Iyayi, reignited my passion for setting up a geriatric hospital. I asked if she would help me with it, and she agreed.
By 2018, we concluded our research and tried to set things up. Only my cousins, brother, and husband were aware.
I didn’t even tell my parents or anyone else until we were ready. So I launched the service, advertised my services as a consultant geriatrician in Nigeria on social media and sought referrals.
While doing that, I thought I would only get a patient after maybe some months. I remember putting it out on Facebook. I was so scared. That was how I set up JBS Medicare Services.
I thought I knew everything I needed to know about setting up a geriatric health service. It was when I started that I realised I knew nothing. All I knew was how to be a geriatric nurse, but I learned how to run a service on the job.
It wasn’t until 2020 that another relative suggested the idea of owning a hospital. I thought she was kidding because I didn’t know anything about running a hospital. By that time, we were running JBS Medicare Services very successfully and had patients all over Nigeria.
The name of my centre was coined from the names of the three consultants I worked with: Dr John Morris, Professor Robyn Bacon, and Dr Leighton Seal.
How did you run your geriatric services without owning a hospital?
It was a home service. We did patient assessments and managed them at home. I had nurses, physiotherapists, occupational therapists, dieticians, and other specialists I needed to run a complete geriatric healthcare service.
However, if I had a patient who needed to be admitted to a hospital, I would call a friend who owned a hospital. I was able to network with other hospitals to get my patients admitted for treatment.
It wasn’t until 2020 that someone suggested I consider owning a hospital. I wondered if I needed a hospital because I thought the service was doing quite well and making an impact.
Owning a hospital wasn’t something on my radar at that time until something else happened. I had a patient who was very ill in Ikorodu during the COVID-19 lockdown in 2020.
We couldn’t get a car to reach the person. My doctor had to go on a bike to get there. By the time they arrived, the patient was in a very bad state. I think it was clear to most people that he was going to die.
We managed to get an ambulance, but they went from hospital to hospital, and no one would admit him.
I kept thinking that if I had my hospital, I would have admitted him. He did pass away, and that reinforced what I was told about having my facility.
It was at that point I decided to begin the process of establishing a hospital. However, I couldn’t return to Nigeria for over a year. I came back in 2021 and started planning for a hospital.
What were some of the challenges you faced while trying to set up your hospital?
At the time, I wondered where I would get the money to set up a hospital. I thought about looking for a small property to buy, renovate, and convert into a hospital. Then I met someone who advised me to take a long lease on a property and start that way, and that’s what I’ve done.
It does cost an arm and a leg, especially to get the renovation work done. In fact, by the time we finished the renovation, I wondered whether it wouldn’t have been better to just buy a place because the amount of money we spent renovating that property was a lot.
We found the property in October 2021. To complete the renovation and put things in place took almost a year, and it was ready in December 2022.
I called my family and friends for the first tour. It wasn’t a grand opening, just an opportunity for everyone to see what we had done.
However, we couldn’t start operations until February 2023 because the Health Facilities Monitoring and Accreditation Agency had to approve.
There were many regulatory hurdles to cross, but we finally began operations on February 1, 2023.
We also have a foundation that caters to underprivileged elderly people.
How would you describe your experience as the founder of Nigeria’s first private geriatric hospital so far?
First of all, I am so thankful because it’s such a privileged position. It’s a privilege to be able to look after people’s parents. People entrust me with their parents and grandparents, and they continue to refer others to us.
We know we’re making a difference because we’re told that all the time. There was such a huge gap in the system because older people generally get mismanaged. Geriatric medicine, even in the West, is a young specialty.
All the other specialties, like cardiology and gynaecology, have been around for centuries. Geriatric medicine is new. Even if you have all the money, the expertise simply wasn’t available.
Now, we’re able to bring that expertise to Nigeria, put it into practice, and see the results. It has had its challenges, but it has also shown me where my strengths and weaknesses lie.
It has helped me build a team, and I’m so proud to be a geriatrician. I believe so much in living boldly so that you have no regrets in later life. I’m really glad that I’m able to do all of this now because the one thing I wouldn’t want is to get to the age of 90, by God’s grace, and then regret that I never did this.
I’m just thankful that God pushed me back into this path and that we’re able to make such an impact in the world. So, I’m very proud to be in this position.
When did you get married, and what impact has your marriage had on your career?
I got married in 1997. I was 27 and just starting my specialist training in geriatric medicine. I met my husband about four years before then, and he was a wonderful person.
I am blessed to be married to a husband who supports me 100 per cent. He believes in me. When I have doubts, I go to him, and he reminds me of what I’ve achieved. He’s god-sent. We have four daughters together.
As a wife and mother, how do achieve work-life balance?
Thank God my children are older. My eldest is going to be 27 in October. My youngest is heading for 19 later this year. In 2007, when I first came to Nigeria to set up this geriatric healthcare service, I couldn’t do it because I had a young family.
It’s regrettable, but that’s the truth. At that time, I had to prioritise my children’s welfare. I knew it wasn’t something I could do at the time because they were just too young.
I had to put the dream aside until my children were old enough. I thank God I was jolted back into this path. However, one of the reasons I’ve been able to do this is because I have managed to raise very independent children who don’t need me that much. I also have a very understanding husband.
For a long time, I’ve been the sort of person who has always been able to outsource things. You have to be able to delegate if you want to get anything done. You can’t do everything yourself. You can’t be the founder of a geriatric hospital and be a full-time cook in the house and a full-time cleaner.
You have to delegate and surround yourself with a team of capable people.
What are your thoughts on the place of women in the medical sector?
I would say we’re crucial. My grandfather refused to let my mother go to medical school because he believed that once she went, she wouldn’t get married or have a home.
He told me this himself. When I graduated as a doctor, my grandfather told me my mother wanted to be a doctor.
She was accepted into medical school, but he refused to let her venture into the field. She cried so much back then, but he stood his ground.
Now, things have changed. Women are a dynamic force. We bring a difference to the table. It has been proven, beyond doubt that patients do better when they are looked after by women.
So, we are crucial to the health force worldwide. Women tend to be organised. We tend to be able to collaborate and put egos aside. More often than not, women manage teams and people better.
